Delusions in bipolar disorder are common. It depends on where you draw the line as to how many people actually get them. What I can say for sure is that the majority of people with bipolar disorder do experience psychosis, and delusions are commonly (although not necessarily) a part of that. Here is what we know about delusions in bipolar disorder.

What Are Delusions in Bipolar Disorder?

The concept of a delusion is a simple one: a delusion is a strongly-held false belief kept in spite of contrary evidence. For example, if I strongly believe that I am 10 feet tall, and I insist on keeping that belief even after you measure me and show me that I’m not, that is an example of a delusion.

Delusions are part of psychosis in bipolar disorder. Psychosis is defined as the presence of delusions and/or hallucinations. (Hallucinations being a topic for another day.) In other words, if you’re suffering from delusions in bipolar disorder, you are exhibiting psychosis.

Who Gets Delusions in Bipolar Disorder?

If really depends on who you ask as to how many people with bipolar disorder experience delusions.

As stated, delusions are part of psychosis. By definition, psychosis does not exist in bipolar disorder hypomania. Psychosis can exist in bipolar mania, depression or mixed moods, however. Bipolar mania is when delusions are most commonly experienced so delusions are more common in bipolar disorder type I.

(It was previously thought that psychosis couldn’t exist in bipolar disorder type II at all, but this is no longer thought to be true. Those with bipolar II can still experience psychosis, just not as a part of hypomania. This is clearly recognized by the latest Diagnostic and Statistical Manual of Mental Disorders wherein they note that the specifier “with psychotic symptoms” can be applied to moods regardless of diagnosis.)

In a decent-sized study in 2019, 73.8% of people with bipolar disorder type I had experienced psychosis in general over the course of their illness and 68.9% of people with bipolar disorder type I had experienced delusions specifically. As these numbers suggest, delusions are the more common symptoms of psychosis in bipolar disorder.

In short, if you’ve experienced delusions as a part of your bipolar disorder, you are not alone.

Bipolar delusions are more common than you think. Delusions in bipolar disorder have multiple types and are often very serious. Learn more at Bipolar Burble.

What Are Delusions in Bipolar Disorder Like?

There are parts of delusions in bipolar disorder that are a bit understudied and this is one of them. First-person accounts of bipolar delusions aren’t common in the literature. That said, delusions in bipolar tend to surround (source one, source two):

  • Persecutory themes (thinking that harm is being done to the person or that harm will be done to the person and that there is someone intent on causing harm) E.g., My wife is trying to kill me by poisoning my food.
  • Grandiose themes (also known as delusions of grandeur; beliefs that one is incredibly famous, omnipotent, a deity, etc.) — E.g., I am the returning savior and I can walk on water.
  • Referential themes (thoughts that normal, everyday events and behavior have hidden meanings and relate to the person) — E.g., The billboards on the side of the road have hidden messages for me.
  • Religious themes (obsession with religious subject incongruent with the person and mood) E.g., I am going to reconstruct the psyche of Christ based on every religious text.
  • Paranoia (thoughts of persecution, threat or conspiracy; involves intense thoughts of suspicion which may bring on fear, anger and betrayal) E.g., The FBI is reading my thoughts.

While I know that each example of a delusion may seem unbelievable, what you have to understand is that when your brain is sick, the unbelievable becomes real. As real as I am sitting on my couch right now, a reader of mine believed she could talk to the wind. She believed this so strongly, that when she was speeding down the highway, she opened her window, stuck out her arm, closed her eyes and waited for the wind to tell her when to turn.

This person is okay now, but that illustrates how serious these beliefs are. Bipolar delusions don’t go away through logic or contrary information. That is why they are a symptom of a mental illness. They are very sticky and debilitating, indeed.

If you are suffering from bipolar delusions or you know someone who is, it is generally considered a psychiatric emergency and you should seek help as soon as possible. Remember, a person can die if they believe they can fly. A person can harm others if they believe those others are there to hurt them. Delusions in bipolar are not things to be taken lightly.

Banner image by Todd Huffman from Phoenix, AZ [CC BY 2.0], via Wikimedia Commons.

Image by Flickr user photographymontreal.