Brief Psychotic Symptoms & Possible Bipolar Disorder
Hello, I am inquiring about the plausible causes of some symptoms that I have experienced. Sometime during my prepubescent years, I believe to have had mild auditory hallucinations. Beginning shortly after laying my head down on a pillow at night, it often sounded like two people were conversing in the distance. It was never coherent, and when I would pick my head up to try and listen, it would abruptly stop. This was a common occurrence for a couple of years, but is rare to happen now. However, I still do experience mild auditory hallucinations from time to time. It seems as if I perceive them as an outside stimulus, rather than hearing it “in my head”. Occasionally I will hear someone calling my name (when no one actually is), doors being opened or closed (even if there is no one else in the house), or the distinct sound of this really noisy fan that has not been in use for quite some time now.
Within the past four months, I have had two instances of very brief visual hallucinations. They were both extremely vivid, and they both disappeared in the blink of an eye. The first was of an elderly man, whom I did not recognize. I looked across the room to see him standing near the corner, and as I blinked, he vanished. In that split second of seeing him, I understood that he could not be real; yet his existence seemed just as palpable as my friend’s, who was sitting beside me. I can recall his exact outfit, hair color, and approximate age and height. Shocked, I told my friend about what I just saw. His response was, “Huh, that’s weird”. I don’t think he believed me, but I know what I saw. The second instance was of my cat, as I entered my house. Upon being let through the front door by my cousin, I noticed one of our cats walking around a rocking chair. I looked up to say something to my cousin, and as I redirected my focus back to the cat, he was gone. I asked my cousin where the cat ran off to, and she said that he was never down there to begin with. This troubled me much more than seeing the man, because I truly believed that the cat was there.
My question is this, what could be causing these hallucinations? I have read through the DSM IV about psychotic disorders, and cannot find diagnostic criteria that matches my experiences.
I have also speculated on the idea of having bipolar disorder, as my father has been diagnosed with bipolar I, with his most recent depressive episode being severe with psychotic features. I have noticed mood and energy abnormalities within myself over the past seven months or so, but I am not sure if it has been prominent enough for diagnosis. I think I experienced a depressive episode for about five months, but I am still debating on whether or not it was actually depression caused by chemical imbalances, or if I was just extremely sad due to the loss of a relationship with a once close friend. I know that I have never had an episode of mania, but I seem to have exhibited hypomanic symptoms, following the end of that depressive state. I woke up one day full of energy, optimism and ambition. It lasted for about a week and a half to two, then I returned to a more normal medium. Since then, I have not experienced any lasting mood differences; but there are many days where irritability or sadness will strike me. What is your take on this?
I do wish to consult a psychiatrist, but at the time, this is not possible for me. I would greatly appreciate a reply, as I am very curious for an assessment. Thank you for your time.
A. With the facts that you have provided, it is difficult to determine what might be wrong. Your experiences and symptoms are noteworthy but may not necessarily be indicative of a psychotic disorder. As you said in the latter half of your letter, you recently experienced a distinct period of depression after ending a relationship with a close friend. It is normal to grieve the loss of a friendship.
You mentioned that your father has bipolar disorder and has experienced psychosis. People who have family members with a mental illness are often concerned that they might also develop a mental illness.
Having said that, I believe that you should be evaluated by a medical professional. It is always prudent to undergo a medical evaluation if psychosis is a possibility. Such an evaluation generally involves ruling out neurological problems.
Having a mental health evaluation is also advised. Even if no definitive mental illness is present, you would likely benefit from psychotherapy to assist with the stress associated with having a mentally ill parent and in managing your emotions. Also consider contacting the National Alliance on Mental Illness (NAMI), an advocacy group that provides free psychosocial support to family members who have a loved one with a mental illness. I think you would greatly benefit from a NAMI support group. Please take care.
Randle, K. (2012). Brief Psychotic Symptoms & Possible Bipolar Disorder. Psych Central. Retrieved on April 28, 2015, from http://psychcentral.com/ask-the-therapist/2012/12/10/brief-psychotic-symptoms-possible-bipolar-disorder/