Psychotic Bipolar is Getting Worse

By Kristina Randle, Ph.D., LCSW

I have Bipolar II with psychotic features, and it is starting to go from bad to worse. I have been extremely depressed lately. So depressed to where I haven’t felt like doing anything at all. I force myself to do all the necessities required for me to do in a day for a full-time college student. Basically, I have lost all trust in my friends. I always suspect they are talking behind my back, and I try to tell myself it’s not happening, but I can’t believe myself anymore. I started cutting again 3 weeks ago. I’ve cutted since I was a Freshman in high school, but quit in my freshman year of college. I have no desire in talking to new people, or even going outside of my dorm. I have been driving my friends away, unwillingly. I have lost so many friends over the past few weeks, and I blame myself for all of it. It seems like my memory is completely deteriorating. I’m starting to forget some pretty simple stuff, like forgetting to go to work. Forgetting what day it is, etc.. I can’t focus at all anymore. I’m just wondering how can I alleviate the bipolar for a while, until I get help? I have no insurance at all, and can’t afford it. Are there any free ways of getting help? Is it also possible this could be a misdiagnosis?

A. Yes, it is possible that you have been misdiagnosed, however, that is difficult to determine from a short letter. My main concern is that you may be experiencing the prodromal phase of psychosis. The prodromal phase can be a one- or two-year period (it varies for each individual) that precedes a full-scale psychotic episode. During this time, an individual begins actively experiencing symptoms, such as difficulty making choices, anxiety, or problems with concentration and memory. Some individuals also become isolative and have problems communicating and interacting with others. During this phase, an individual’s symptoms are noticeable but usually are not severe. Typically the symptoms become increasingly worse over time. It can be difficult for the individual experiencing the prodromal phase to be fully aware of what is occurring.

Yes, there are free ways of accessing mental health treatment, especially in a university or college setting. College counseling centers offer these services to their students. Other ways of accessing free help include: (1) going to a local community mental health center; (2) calling your local health department and asking for a referral for free mental health services; (3) or going to a local psychiatric hospital and inquiring about free or low-cost services in the community. Given your situation, the college counseling center may be your best immediate option. I would specifically recommend seeing a psychiatrist for medication. If you are in the prodromal phase, medication could avert a possible psychotic episode.

I would also recommend contacting your parents. Make them aware of your symptoms. They may be able to help you access treatment. At this time, it would be advantageous to have a trusted friend or loved one assisting and guiding your decisions. Your symptoms may interfere with your ability to think clearly or to make the best choices.

It is imperative that you seek help sooner rather than later. I would advise being less concerned about a specific diagnosis and instead making it your goal to seek immediate treatment. Treatment, specifically antipsychotic medication, may have the power to prevent a psychotic episode. Research consistently shows that with regard to psychotic disorders, the sooner one seeks treatment the better the prognosis. The importance of seeking immediate treatment cannot be underscored. I wish you well. Please take care.

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Last reviewed: By John M. Grohol, Psy.D. on 14 Oct 2010

APA Reference
Randle, K. (2010). Psychotic Bipolar is Getting Worse. Psych Central. Retrieved on September 19, 2014, from http://psychcentral.com/ask-the-therapist/2010/10/14/psychotic-bipolar-is-getting-worse/

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