Is Delusional Bipolar Depression More Common Than We Think?

July 16, 2013 Natasha Tracy

Delusions are false beliefs that are part of psychosis. Are delusions more common in bipolar depression than we think? Breaking Bipolar blog.

Delusions are false beliefs that are held in spite of a lack of evidence or even evidence to the contrary. For example, a delusion might be believing that the FBI is surveilling you every day or that you can predict the future. Delusions are a part of psychosis which can be present in bipolar depression or bipolar mania.

Delusions are easiest to spot when they’re exaggerated, like in the above examples, but I would suggest that delusions are much more common when we give them credit for. I would suggest that delusions are present in most cases of severe bipolar depression.

I’m the Worst Person in the World

People with bipolar depression often believe things that are decidedly untrue. Examples of this are:

  • I’m the worst person in the world.
  • The world would be better off without me.
  • I’m the ugliest person on the planet.
  • Everyone hates me.

These things are clearly untrue but can be staunchly held beliefs anyway. I don’t think these statements would get you diagnosed with psychotic delusions, but I would argue they certainly are. Even when a person can state they know they aren’t true, they will frequently also admit to believing in them anyway. That’s a delusion plain and simple. It doesn’t involve the FBI, but it’s a false belief nonetheless.

Dealing with Psychotic Delusions

In bipolar disorder we fight our brains on what we know to be real in many ways. We fight the hypomania when we know it’s not a good idea to paint our living room purple at 2 o’clock in the morning and we fight the depression when we don’t kill ourselves. Fighting delusions is, in some respects, the same. We have to fight the poor signals coming from our brain with what we know is real. And once we can grasp that our beliefs truly are delusional, this can be easier to do.

Treating Bipolar Depression Delusions

As the name implies, antipsychotics were developed to treat psychosis, traditionally in schizophrenia, but many antipsychotics are now prescribed for bipolar disorder whether recognized psychosis exists or not and they work quite well. And maybe the reason they work in the cases of severe bipolar depression is because what we’re really experiencing is delusions, is psychosis, but is not recognized as such. Maybe the reason why they work is because that end of bipolar disorder is closer to schizophrenia than we think.

(And, by the way, research on the brain supports the link between bipolar disorder and schizophrenia. It’s pretty common to see similar brain deficits between the two disorders only, in the case of schizophrenia, it tends to be more pronounced.)

I could be wrong about this, but I don’t think I am. I think what we’ll find as brain research matures is that the underlying problems in severe depression where these kinds of false beliefs are held are similar to the problems in the brains of people with schizophrenia.

So maybe it’s time for some of us to recognize that what we’re experiencing is delusions and not just garden variety depression. It might help to put things in a new perspective and make those beliefs easier to handle.

You can find Natasha Tracy on Facebook or GooglePlus or @Natasha_Tracy on Twitter or at the Bipolar Burble, her blog.

APA Reference
Tracy, N. (2013, July 16). Is Delusional Bipolar Depression More Common Than We Think?, HealthyPlace. Retrieved on 2024, June 22 from

Author: Natasha Tracy

Natasha Tracy is a renowned speaker, award-winning advocate, and author of Lost Marbles: Insights into My Life with Depression & Bipolar. She's also the host of the podcast Snap Out of It! The Mental Illness in the Workplace Podcast.

Find Natasha Tracy on her blog, Bipolar BurbleTwitter, InstagramFacebook, and YouTube.

July, 16 2013 at 7:40 am

The delusions are the hardest to explain to family and friends- everyone is all like 'just think positive' and 'stop being negative'. I would so love to not have these thoughts. I certainly don't want to think this way. It is no fun. It brings no joy to anyone around me or to me. However, those thoughts are there, and I am learning to address them as just thoughts, not reality...

Kathleen Brannon
July, 16 2013 at 9:23 am

I always describe my severe depression as psychotic depression; it does help me struggle against the delusions. (It also clarifies that I don't just have a "mood disorder." Mood sounds superficial and transient. Bipolar is neither.)
Another delusion: the belief that strangers are thinking or saying bad things about them when they're depressed -- so they stay away from others and public places, isolating themselves at home.
People often hide these thoughts or beliefs from doctors and other people because they kind of know they're delusional even though they believe them -- so they're too embarrassed to mention them.

Victoria Broker
July, 16 2013 at 10:11 am

Once again, You have written another impressive, educational article that helps me and so many others with bipolar. Thanks so much :)

July, 16 2013 at 3:51 pm

Thanks. This was quite helpful. It sounds a lot like me. Especially the description by one of the above - avoiding places because of the delusion that people do not like 'me' or are talking about 'me'. And definitely the one describing everyone being better off without 'me'. Beacause I know these things are not so, but I cannot shake them. Counseling in which we did Cognitive Therapy was really beginning to help. Lost my Social Security tho. So once again, thanks.

July, 16 2013 at 3:55 pm

Four of my five children have bipolar disorder. The one who has Type I (which her father had) is certainly prone to delusions as she reaches the extremes of the spectrum. Verbal (false) accusations and the paranoia that ensue with these states are obviously steeped in delusion.
No, it's not as obvious as imagining the FBI is surveilling but it is definitely delusional thinking.

July, 16 2013 at 6:18 pm

I have never really thought of these super powerful negative thoughts as delusions before.
This makes a lot of sense to me because my delusions, as you suggest them, stopped as soon as I started taking an anti-psychotic (in addition to my other medications). It was like one minute they were there, and the next minute there was silence inside my head.
I recognize that I got really lucky with my medications. I'm so very thankful!

July, 17 2013 at 9:22 pm

I've had these before. These are possibly one of the most dangerous symptoms. This is because if you are mentally ill you need a support network. The illness causes you to become delusional against your friends and family. And so you run away, homeless, perhaps not even accessing government benefits. I was this close. The only thing that saved me was a credit card, at first, and a family friend who somehow managed to convince me to get help.

Bruce Leflar
July, 18 2013 at 1:53 pm

Thank you for this article. I have experience with Bipolar Disorder and I always thought I had Schizoaffective Disorder because I experience Delusions. These delusions come and go and vary in intensity but they end cyclically, therefore I am not consider for the Schizoaffective Disorder. It would be a relief to have that diagnosis but I have also know that delusions occur with Bipolar patients. Suffering is suffering no matter what DSM diagnosis you have. They are all so similar.

Scott Adam Kaveny
July, 18 2013 at 3:07 pm

Bipolar people can be delusional... I was in that boat. I have ADHD and Bipolar and it almost ruined my life. I have struggled in school, went through a divorce, and had trouble with money...I was almost homeless for this reason. But how I overcome both was making a daily list and priorities of what needed to get done, controlled my manic/depressive disorders by medication, and most importantly believing that I can do it. Right now, I have kept a job for over 2 years, never struggled with money because I can buy medication now, and living a stable life starting a wonderful internet business. I think that delusions can be overcome with medication because it is a chemical thing.

July, 19 2013 at 1:58 am

I appreciated this reflection and I too found it very helpful. When I am most depressed I am convinced and truly believe that something horrific will happen to my kids. This often comes with pictures in my mind. These are not hallucinations but the pictures are so real that they seem like hallucinations.

Jet Fontaine
July, 19 2013 at 11:54 am

I'm bipolar 2 and have delusions about people. I often think that people are saying things about me or if they haven't returned my call or email by now they must hate me. I share this with my husband and he often tells me that, that's not true and I'm being paranoid. It helps a little to hear someone say it, but I can't make myself believe it at the time.

July, 24 2013 at 7:05 am

Perfect timing with your article. I went into a depression spiral yesterday (I am usually on the hypo mania side which I miss greatly ). I started in on that I'm the worst mother in the world because I don't make dinners all the time and read with my children. My brain knows I'm a great mom but when you get in a mood it's hard to control mind over emotion. My family tries to roll with it. Of course it circles back to they must think I'm horrible because they have to deal with me. Viscious cycle. Sigh. Thank you for all you do to help those who suffer know these feelings are "normal" even when you take all your medication.

July, 24 2013 at 6:34 pm

Delusions were a big part of my symptoms until I was prescribed anti psychotics, however the long term consequences for me has been that most times I have to question my decisions or how I interpret social interaction. I find I just don't have much confidence in my brain to make these kind of appropriate responses,does anyone else experience this lack of trust?

July, 25 2013 at 10:21 pm

Question: Does a delusion continually exist - even when you are feeling well - like a thought in the back of your mind? Or, does a delusion completely disappear when you are well?

August, 4 2013 at 5:45 pm

Thank you so much, I have been hiding these feelings from my therapist and the Dr. that prescribes my medication. Thank you for giving me the courage to talk to them about it.

September, 11 2013 at 5:57 pm

My husband is going through some serious issues right now with his mental state. He was diagnosed with Bipolar 1 disorder and lately he's been hallucinating. He was a Marine and is constantly thinking that the government is watching him. We live near a military base and when the helicopters fly over, he thinks they're flying over to look at him and take pictures. One time he called me Staff Sergeant and when I said it was me, his wife, he looked at me with a blank look and said, "they said you would say that".... His heart would pound and it would seem like it was going to explode. The major problem is that he doesn't want to seek help because he feels the doctors are in on this all and they're just going to drug him. I've been trying so hard to get him to get help again but it's really hard... I'm not going to give up though. I can't, I love him.

Natasha Tracy
September, 11 2013 at 6:50 pm

Hi Heather,
I'm sorry to hear you and your husband are going through that. Many service people have mental health challenges when they return to civilian life.
I _highly_ recommend you get this book:
It _really_ speaks to warriors about the things they are going through - exactly like you are describing and it deals with the challenges in getting help.
(In case you're wondering, I had a hand in editing the book, but I make no money from it, I just think it's a great resource.)
I hope that helps.
- Natasha

August, 29 2014 at 5:06 pm

Thank you for this article. It is so true. I have been diagnosed with bipolar yet have a very hard time fighting delusions on an almost daily basis.

August, 30 2014 at 4:41 am

Thanks for this article.i have bipolar 1. I was trying to convince myself that those delusions are not real and sometimes i even believe it but those are few and far between. Havent talked to my doctor about them either because i thought that would surely be what slid me into the schizoprenia diagnosis. Recently had some adjustments to my medications so after reading the comments of others and this article i am hopeful. So glad to hear others feel the same way or experience the same things because now i know im not alone. Thanks.

August, 30 2014 at 6:10 pm

I am Bipolar I, and have certain feelings about our government and certain cultures being in each others pocket. I really believe this is true and that things are going to get worse. My boyfriend has schizoprenia, he thinnks I am confused. I admit I am a Jingo and American Patriot. These things are very real to me, and others. Could this be a delusion? I really don't think so.

November, 23 2014 at 6:14 am

Ok,I kinda don't know where to start. My husband (seperated for 4yrs. now because of this) always have had these spouts and through out the years they have gotten worse. He became less and less responsible for his actions (normally violent)putting blame on everyone else, situations and people that had nothing to do with anything, also making statements of being attacked both physically and verbally by household members and strangers on the street. These people didn't exist. He also said that he was being fallowed and attempts had been made on his life. Emails being sent to him with intimate details of personal belongings were in our room, even inside of jewlery box contents..OK now when this was going on I would ask questions and I would never get an answer from him showing that he believed his claims like i asked to see the emails, his response was no and I was given some stupid reson as to why..I did everything to try to figure this out but never got anywhere..He did get a little better for a while showing minute symptoms..after a while things tend to have a snowball effect and spiraled out of control. He holds grugdes and uses those for excuses to be angy did not matter whether those were justified grudges or not. We split up, since then I have watched him deminish literally, physically and mentally. He holds himself to no standerds, he says what he wants when he wants with no reguaurd even with others saying "hey, kids are around watch how you say things" or "hey not so loud its late" he has even stopped wiping his own nose. please please please some help we have a daughter together that is 7yrs old and I dont want to cause any more hurt or more damage if you have any information for me I would be forever greatful

January, 2 2015 at 11:35 am

I have been bipolar for years but didn't even no about it then it got to a point I started thinking the Feds were following are people out watching me I am very hyper but right now I'm very depressed and not feeling my self here lately I hate trying to explain it to people so I try to stay away from them they think bc I'm on medication I'm suppose to be normal all the time and I shouldn't feel this way but I do I've had a really hard life was married for 15 years and it was very abusive then drugs got invoked I lost my children which today I have them back but then I just had a really bad blow my son was sexual abused and my bipolar condition is not helping I'm trying to stay focused but it's so hard and I'm tired of explain to people I love our asking for help bc they think I'm being strange and it hurts I tell my doctor that something's working and she takes me off of it I have very bad anxiety and she took me off of that to I go there bc it's free through the state I feel like there making me go crazy bc they keep switching my meds on me I just want something so I can feel normal.

Dan Santos
May, 27 2016 at 7:41 am

Can these delusions be an unreasonable fear of people we have relationships with. I go to a Therapists and I feel he is making me question what I remember/think about my wife. Like she's abusive, but not I'm any real sense. I've never had any reason to fear her but now I find myself terrified by her. Is false memory apart of delusions?

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