Is Paranoia A Symptom Of Bipolar Disorder?

Bipolar disorder can cause a wide range of symptoms, depending on the type. The loved ones of those with bipolar disorder often understand mania and depression but may find themselves asking, “Is paranoia a symptom of bipolar disorder?” People who experience paranoia as a result of bipolar disorder can face many challenges in their daily functioning, and it can make treatment challenging. Below, we’ll look at paranoia in bipolar disorder, how it can affect treatment, and how to get help.

What is bipolar disorder?

Bipolar disorder is a mental illness that can cause mood shifts of mania and depression or extreme highs and lows. What people with bipolar disorder experience is much different from the typical ups and downs of life. 

Scientists have not determined the cause of bipolar disorder, but they believe that many factors can contribute to it, including genetics, brain structure and functioning, and stress. If left untreated, bipolar disorder can worsen, but with an appropriate treatment plan, many people with this condition can improve their mental well-being and lead fulfilling lives.

Symptoms of bipolar disorder

The symptoms that someone with this condition experiences typically depend on the type of bipolar disorder they have. Not everyone may experience the shifts from mania to depression. 

Types of bipolar disorder

There are three types of bipolar disorder. Each one involves mood changes, but the intensity of these changes varies from one type to another. 

• Bipolar I disorder: People with bipolar I disorder have manic episodes lasting nearly every day, most of the day, for at least a week, or they have manic symptoms severe enough that they require emergency medical care. People with bipolar I also usually have depressive episodes lasting at least two weeks. Mixed episodes are also a possibility and occur when episodes have features of both mania and depression.
• Bipolar II disorder: In bipolar II disorder, people typically experience hypomanic episodes and depressive episodes. Hypomanic episodes are less severe than manic episodes, but bipolar II is not a milder form of bipolar I. While people with bipolar II don’t experience full manic episodes, their depressive episodes can last for much longer than two weeks and lead to significant problems with functioning in their daily lives.
• Cyclothymic disorder: In this type, people experience hypomanic and depressive symptoms that are either not intense enough or do not last long enough to be considered mania or depression. It can be seen as a milder form of bipolar disorder.

Manic symptoms

During manic episodes, someone with bipolar I may feel extremely up or irritable or have more energy than usual. They may experience racing thoughts, faster speech, restlessness, and a decreased need for sleep, and they may engage in increased risky behavior. When mania is severe, people can also experience psychotic features, including paranoia. 

People with bipolar II and cyclothymic disorder experience less severe manic episodes that can last as long as only four days instead of a week. Because these episodes are not as severe, they may be unlikely to cause other psychotic symptoms like paranoia. Hypomanic symptoms also do not cause the same type of disruptions as manic episodes.

Depressive symptoms 

People with bipolar I and II can experience major depressive episodes with symptoms that are severe enough to affect how they function in their daily lives. These episodes can have a variety of symptoms, including feeling sad or hopeless, being unable to experience pleasure, experiencing significant changes in appetite or weight, sleeping too much or not sleeping enough, and having a reduced ability to concentrate or think.

People with cyclothymia also experience depressive symptoms, but they are typically .

Paranoia in bipolar disorder

Research shows that over half of patients with bipolar disorder develop psychosis symptoms, generally delusions, hallucinations, or both. Studies have also found that psychotic symptoms, like bipolar disorder paranoia, are also more frequent during manic mood episodes. 

When psychotic symptoms occur in people with bipolar disorder, they can be similar to symptoms of delusional disorder. Visual hallucinations, auditory hallucinations, and delusions are the most common, including paranoid thoughts or persecutory delusions.

What can trigger paranoia symptoms in people with bipolar disorder?

Paranoia is most common during periods of mania in bipolar disorder. Triggers for manic episodes can vary from person to person, but they can include overstimulation, major life changes, inadequate sleep, or substance use.

Common symptoms of paranoia

While everyone is different, people with paranoia can exhibit a range of symptoms, including the following: 

• Having a hard time trusting other people
• Holding grudges
• Being suspicious of others
• Having difficulty coping with criticism
• Assigning negative meanings to neutral actions or remarks
• Being defensive
• Believing in conspiracy theories

The spectrum of paranoia symptoms 

Generally, there are many types of paranoia. For example, some people who are experiencing paranoia may have a deep mistrust of others or believe that random, neutral events are directed at them. They may be constantly on the lookout for perceived threats. Healthcare providers consider persecutory paranoia a type of delusion.

How to help someone with bipolar disorder

Helping a loved one with bipolar disorder can be challenging, but there are some strategies you can use to help. 

• Educate yourself about bipolar disorder. Knowing the symptoms of bipolar disorder can help you understand more about what your loved one is experiencing. Aim to find reliable sources, like the National Institute of Mental Health, the National Alliance on Mental Illness, or the American Psychological Association (APA).
• Show compassion. It may be difficult for people with bipolar disorder to open up about what they’re experiencing. This can be even more difficult if they are experiencing paranoid symptoms. It may help to check in with them regularly, practice active listening, demonstrate patience, and show empathy when they are experiencing mood swings. 
• Learn their triggers. Everyone with bipolar disorder can experience different triggers. Learning what affects the person in your life can help you support them with managing their triggers or figuring out ways to help avoid them.

Treatment for people with bipolar disorder

Bipolar disorder is a lifelong mental illness. While there is no cure, treatment can be effective at managing symptoms and often includes medications and psychotherapy.

If you are diagnosed with bipolar disorder, a doctor may first prescribe medications to help you balance your mood. Mood stabilizers, antidepressants, and antipsychotic medications are used to treat bipolar disorder. 

Always consult with a medical professional before starting, stopping or changing any medications. 

Multiple types of psychotherapy can help people with bipolar disorder, including interpersonal and social rhythm therapy (IPSRT), cognitive behavioral therapy (CBT), and family-focused therapy.

Challenges of treating this mental health condition

Research published in the journal Bipolar Disorders shows that there are many challenges in treating bipolar disorder, including poorly controlled mood swings, diminished quality of life, and social dysfunction. This research also states that patients with bipolar disorder have symptoms that “are broader than a range of symptoms targeted by available pharmacologic and psychosocial treatments,” meaning that they may be difficult to treat. For people who experience paranoia with bipolar disorder, treatment can also be more challenging because they may find it difficult to trust their doctors and therapists.

Get help from a mental health professional

If you are experiencing symptoms of bipolar disorder, talking to a mental health professional can help. Medication may be needed to manage this condition, so seeing a psychiatrist or other health professional who can accurately diagnose you and prescribe medication can be a good place to start. 

If psychotherapy is recommended as a part of treatment but you don’t feel comfortable with traditional in-office therapy, you might consider online therapy. When you sign up for an online therapy platform, you can work with a licensed mental health professional from the comfort of your home at a time that suits your schedule. With online therapy at BetterHelp, you can change therapists at any time until you find one you feel comfortable working with. 

Research has found online therapy to be an effective treatment for bipolar disorder. One review of more than 370 studies concluded that online cognitive behavioral therapy was effective at treating a variety of mental disorders, including depression, panic disorder, and bipolar disorder.

Takeaway

Symptoms of bipolar disorder can vary from one person to another. Some people may experience bipolar paranoia, particularly during manic episodes of bipolar I disorder. If you think you are experiencing bipolar symptoms, it may help to talk to a psychiatrist to get a definitive diagnosis and treatment plan tailored to your needs. Talking to an online therapist may also help you get the support you need as you navigate treatment. Take the first step toward getting support with paranoia and/or bipolar disorder and reach out to BetterHelp today.