Difference Between Psychotic Mania and Full-blown Mania

Symptoms of psychotic mania and full-blown mania are similar, but there's one important distinction between the two. Find out what it is.

Psychotic mania and full-blown mania can look so similar. When someone thinks they are such a genius at picking stocks that they open their own firm in a week and bring along a lot of new employees on the adventure until they crash, this is certainly very odd behavior. However, even if the behavior is completely out of character, it's not bizarre. Psychosis is bizarre. Here is how board certified neuropsychologist, John Preston, Psy.D. describes the difference:

"People who are really manic have reckless and very impaired judgment. They will drive at 150 miles an hour and truly believe they are invincible. But when you ask them, hey, so you think that's safe? They may say, "It's probably not safe for others, but it's fine for me! It feels goooooood!" This is dangerous and impulsive, but not bizarre. Now, if that same person believed they were a superhero who could stand in front of a car going 150 miles an hour and not get killed because they are invisible, that is psychosis because it's a bizarre delusion. A person with full-blown mania may think they can fly, but they have a realization that it might kill them. A person with full-blown manic psychosis will falsely believe they can fly and may jump off a building."

Full-blown Mania vs Mania with Psychosis:

Here is an example of the difference between the two:

Full-blown Mania

I thought I was the gift of god. That I could do anything. I could beat anyone at anything. I decided to go from New York to LA and be a movie star. I went to a modeling agency and got a contract and I'm 5'1"! I felt beautiful and people thought I was beautiful. It was like they fed off my energy. I drove around on a little scooter I bought that was too dangerous- but I felt wild and free! I slept with three men... at once. No one could tell this was not the real me. I felt it, so they felt it! I was pretty hot stuff!

Sherri, 45

Mania with Psychosis

In 1997, I received a message from God that said I needed to go to Honduras and feed the poor. I heard His voice. I needed a lot of money. I decided to pray all night every night to get the money. I read the Bible and felt God was giving me clues on every page. It wasn't hard to stay up. I just wasn't tired, but I was very physically uncomfortable. I went outside with a bowl and asked for money. My parents were extremely upset, but I believed in what I was doing. I had this idea that I was going to save orphans just like Mother Theresa. It never entered my mind that I had zero training, no money, didn't speak the language and had never traveled outside of the US. But I kept seeing myself as a savior. I soon stopped eating and wanted to get as thin as possible to show my worthiness. I lost 40 pounds. I heard God all of the time. I was finally committed on a 72-hour hold by my parents.

Mark, 53

Psychotic mania has poor judgment with impaired thought processes. Sherri functioned in society even when she was phenomenally manic and making dangerous decisions. She made plenty of normal decisions such as remembering to eat, drive and participate in normal conversations. Mark could not. His ideas were not only out of character, they were bizarre and divorced from reality.

If a healthcare professional asked Sherri and Mark the same question: "I know you're feeling all of this very strongly and that you're confident about your success and most importantly, you don't worry about risk or failure, but is there a chance this is not the smartest thing for you to do? Is there a chance this won't work out?" Sherri would say, "Well, maybe, but I'm the best and I know I can do it. I just won't let anything stop me!" Mark would said, "God talked to me. He sent me a message and I have to do what he says. The children will die if I don't go."

It's also important to note here that Mark is having psychotic delusions and they are bizarre, but unlike in schizophrenia, his speech and actions are coherent enough to seem real; which is why a psychotic episode can go on quite a while before the person becomes ill enough to need hospitalization. Unfortunately, in a case like Mark's, it's often extremely difficult to get the person into the hospital as they feel their actions are 100% normal.