Family and Caregiver Schizophrenia Discussion Forum

What exactly is a psychotic / manic / hypomanic episode and the difference between them?

My wife has these following symptoms 24/7 and has done for a few months: she constantly hears voices, sees things, has delusional thinking, thinks I’m not her husband/I’m a partial husband/I’m one of 3 husbands. She’s been like this continually for a couple of months now.

These things don’t change, they are constantly there, but what does drastically change is her behaviour. Sometimes she’s a) very angry and shouts and screams and swears for hours on end at the voices/people/situation b) quiet and calm, but still talks to the voices, but in a much more calm way - “oh, who’s that” she might say for example. c) she’s in incontrolable anguish, she rolls on the floor and weeps and screams but this not not screaming in anger but due to sadness - sadness that her husband isn’t there (even though I’m right next to her), or sadness that I won’t tell here what’s going on and what’s happening (she weeps and pleads with me to tell whats happening but I can’t - she has anosognoisa, and if I even attempt to suggest or allude she might be ill she screams even more as she thinks I’m misleading her).

Is a psychotic episode this entire combined collection of behaviours or a subset of it? If its the entire things then when she’s in a very angry and shouting mood does that have its own specific terminology to describe it?

I don’t have an answer for you but it sounds like she is in constant psychosis which is what I believe my son went through for sometime before medication. I was not his (real) Mom. They say that can happen to people with sz. He thought I was an imposter. I’m sorry you are going through this. It’s not easy and many of us have been in similar situations.

In mania there is a shift in energy. Also sleep is very disrupted, there may be less than 5 hours sleep a night if any. The person may think they have been sent by a higher entity for a special purpose, or that they will one day become great themselves, that they will lead the world to salvation etc. There is euphoric (happy) mania, and mixed/dysphoric mania, were the mania may be of a higher energy but interspersed with negative thoughts and anguish. Mania does not always have psychosis riding along with it. Psychosis occurs when the person is out of touch with reality, there can also be anger and despair and grandiose delusions but if the psychosis occurs without a ramping up of the energy of mania or the slowing down and negativity of depression and stands alone with the energy features being minor to the unrealistic thoughts, then it is more of a psychotic disorder than a mood disorder. Hypomania is a less obvious version of mania, and there is no psychosis attached to it. Schizoaffective disorder is a hybrid of schizophrenia and bipolar disorder. You will need to take your wife to a psychiatrist for a diagnosis, and it is not always obvious which disorder it is.

Have you seen my videos? Mine is the same way or worse… You laugh it off, play along, then promptly forget it ever happened, till next time… You can try to analyze it but you wont get anywhere… mine can fight to be normal for about 30 minutes a day tops. The limited availability of effective meds with genetic manipulation… The vids depict all three phases you are asking about… I call it subdued insanity, crazy, gone…