Psychotic Symptoms in Bipolar Disorder

Regarding the patient who had thoughts that she was responsible for the fall of the Berlin Wall: Why not leave her on "low-dose" antipsychotic treatment full-time? I have Bipolar I Disorder, take an antipsychotic (admittedly not low-dose, though) -- I function much better taking the drug than if I did not or only did so intermittently. Then, the patient would probably seldom if ever have to deal with this symptom. Studies also show that once medication is discontinued that if symptoms are allowed to come back, they are that much harder to bring under control again.
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Brilliantly written.  Thanks for the insight.  Never knew about the dopamine connection.  It now makes sense why Wellbutrin & Effexor had seemed to make me worse.
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 I had an attack on Sunday morning, I dont know how I got to my friends house I dont know, I screamed and went hysterical, all I could see where black crows.  I wanted to harm myself, and I blamed myself and felt ashamed.  The care workers come out every day, Im supposed to be working, but I just want peace and silence this week.  I blank out, and people have to tell me what Ive done, everything runs very fast, it is a blur afterwards.  This peice is a great peice of work, I can relate to it, and will use the tools on the ste to help pre plan an onset.  This wasnt possible at the weekend as I was badly attacked and kept in a room for 2 hours.  I went hysterical, and a doctor had to sedate me, so this was an extreme case.  Anything can set me off however,

 

Kitten

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I have had these delusions and auditory hallucinations; also have had some visuals as well...my delusions consist of believing i am talking to people in other contries because i understand their language and their governments, when, really i can make sense of foreign languages because i am extremely smart; its like understanding the language behind math.  i have this sense of talking to people because i have good advice or good ideas for them. some times i get alittle paranoid thinking that they know what i am thinking and are going to mess with it or don't like me becasue of what i am thinking--like that i am a ***** or am very too critical of them and that they don't like me because of me thining that.
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I suffer from extreme depression and at one point was heavily medicated. Due to financial problems I had to be taken off the medication. I now am noticing different things about my depression that worry me. I will get abnormally upset and angry over things that generally wouldn't phase me. I have thoughts that make no sense, such as your patient did. I think that all of the peoples problems are because of me, and it makes me want to hide in fear of being attacked. I have racing thoughts that seem to make sense in my head but as they are coming out of my mouth don't seem rational. I also do not hallucinate so much so as seeing things, but I do remember things that I know haven't happened. Such as converstations with people who have been long dead, and speaking with them as if they weren't. I do not believe I've done these things or many more like it, but it's getting harder to tell if they are just random psychosomatic thoughts, or if I'm actually losing touch with reality. I sleep only two to three hours every three days, and eat one meal every two days. I've lost twenty pounds in one month due to not eating alone. I cannot focus on everyday tasks, and when I need to get something accomplished I make up foolish and unreasonable excuses as to why it can wait. I am just wondering if maybe I am not depressed but bipolar. My old understanding of bipolarism was changing from one mood to the next, but I'm beginning to see it's not that simple. Although that is a new development as well. I can be completely content one minute, angry at the world for no reason the next, and then after that I feel guilt and remorse. So if I could just be told if this sounds like I need to see a doctor for this disorder, I'd really be appreciative.

Thanks. 

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