Psychotic symptoms are hallucinations or delusions. A hallucination or delusion is a cognitive misperception of reality.

Though hallucinations are typically thought of as being visual, hallucinations can also be auditory, olfactory, or tactile. A person having an auditory hallucination may hear voices telling them to do things.

Delusions are thoughts that are not based in reality. The difference between a mere unrealistic thought and a delusion is the degree to which the thought is unconnected to reality. For example, someone may think they want to become a professional football player though they have not played well in high school. Though it may not be realistic, it is probably not a delusion by psychiatric standards. A delusion is more extreme. The person may think they have been chosen by God, are being stalked by the FBI, or have superpowers.

Psychosis is a defining characteristic of a psychiatric disorder called schizophrenia. Psychotic symptoms can also occur due to severe depression or Bipolar Disorder.

There are different types of schizophrenia, largely categorized based on the types of psychotic symptoms the person experiences. For example, paranoid schizophrenia often causes delusions of being watched or monitored. Some psychotic symptoms of schizophrenia can seem random.

Psychotic symptoms of bipolar disorder and depression are related to the mood disturbance. Psychotic symptoms of depression or depressive episodes can be much more severe than suicidal thoughts.

An example of a hallucination due to a depressive episode is hearing voices telling the person to commit suicide. Depression can cause delusions that the earth is a hellish place from which they must save their loved ones by killing them.

The psychotic symptoms of bipolar disorder from mania can be delusions of grandiosity. The person may believe they are immortal, have superpowers, or are chosen by God or somehow more special than humans.

Psychotic symptoms are not common symptoms of bipolar disorder or depression. People may experience psychotic symptoms only during the worst depressive or manic episodes of their lives and will not experience them again.

Medication to treat psychosis, commonly referred to as anti-psychotic drugs, may be used to treat psychotic symptoms of bipolar disorder. Injections of an anti-psychotic medication like Haldol may be necessary if the person is resistent to taking their medication regularly.

The person may no longer experience psychotic symptoms once the bipolar disorder or depression is stabilized. The hallucinations and delusions are the person’s reality at the time the psychotic symptoms are experienced. People experiencing psychotic episodes may become fearful of the psychosis.

Bipolar Spectrum Diagnostic Scale (BSDS) is a diagnostic tool used to determine if someone with mood disorder symptoms has bipolar disorder. The Bipolar Spectrum Diagnostic Scale contains nineteen sentences.

The Bipolar Spectrum Diagnostic Scale was designed by Ronald Pies, M.D. and refined by S. Nassir Ghaemi, M.D., M.P.H. All variations and levels of severity of bipolar disorder can be detected with the Bipolar Spectrum Diagnostic Scale.

After working with a number of people whose “treatment-resistant depression” was later determined to be undiagnosed bipolar spectrum disorder, Pies was motivated to design the diagnostic tool to accurately diagnose bipolar spectrum disorder that may otherwise be missed. Bipolar spectrum disorder is not an official diagnosis in the Diagnostic and Statistical Manual (DSM).

Some mental health professionals use the term bipolar spectrum disorder to include people who have Bipolar Symptoms, but whose symptoms are not severe enough to be diagnosed with bipolar disorder. Bipolar disorder symptoms that are milder than the guidelines of the DSM is sometimes called soft bipolar disorder or soft bipolar spectrum disorder.

There are two sections to the Bipolar Spectrum Diagnostic Scale. The first section consists of nineteen sentences that describe the primary symptoms of bipolar disorder. The first section is completed when the patient has checked the sentences that describe their feelings or behaviors.

The second section is a rating of how the collection of sentences of section one fits their personal experiences. The score of the first section is determined by awarding one point per sentence that the patient checked as matching their personal experiences.

The score of the second section depends on how the nineteen sentence narrative is rated by the patient. Six points are added to the patient’s score if the patient indicated that the story fits them very well or almost perfectly. If the patient says the narrative fits fairly well, four points are added to the patient’s score.

Two points are added if the patient said the story fits to some degree but not in most respects. If the person says the story does not describe them at all, no points are added to their score.

Bipolar disorder is considered highly likely if the patient’s score is nineteen or higher. If the score is eleven to eighteen, there is a moderate probability of bipolar disorder. There is a low probability if the score is six to ten. Bipolar disorder is considered very unlikely if the score is under five or less.