Can bipolar disorder II cause hallucinations?

Sheri Van Dijk

There are different types of bipolar disorder: Bipolar I is the traditional, most widely recongized form of bipolar disorder, usually involving recurrent episodes of mania and depression (about 10% of people with this diagnosis never suffer major depression). In order to receive a diagnosis of Bipolar I, you must have experienced one or more full-blown manic episodes that cannot be attributed to other medical conditions or the use of drugs or alcohol. It's not uncommon for people with Bipolar I to experience psychotic symptoms.

Bipolar II involves periods of major depression and at least one episode of hypomania - this is what I refer to as a "mini-high", rather than a full-blown manic episode. People with this form of bipolar disorder do not experience psychotic symptoms while in a high state. However, psychosis can occur during depressive episodes as well, whether unipolar or bipolar.

So the bottom line is that, while bipolar II can cause psychotic symptoms such as hallucinations, this doesn't happen while in a hypomanic episode (if psychosis is occurring during a "high", this is by definition no longer a hypomania, but a mania), and is therefore much less common than in individuals with bipolar I.

It's also important to point out that not everyone with bipolar I experiences psychosis.

Ms. Julie A. Fast
Mental Health
Psychosis has two main components:  hallucinations and delusions.
What are Hallucinations? 
Hallucinations involve the senses: a person believes that they see, hear, taste or smell something that isn’t there. These including hearing your name called, seeing animals scurry around a chair or watching your own death like you would watch a movie. Many people with bipolar II don’t have to deal with hallucinations, but many of us do!. It needs to be talked about more.
The Role of Mania in Hallucinations
Bipolar I (one) has full blown mania, which means a person can have full blown psychosis with hallucinations during an episode. (This is true for depression as well, but it’s more common in full blown mania.)
Bipolar II (two) has hypomania and most research shows that hypomania rarely includes hallucinations, but those with bipolar II depression can definitely experience hallucinations.
I have rapid cycling bipolar II and have experienced hallucinations since age 19- I'm now 47. I mostly have hallucinations with a few delusions thrown in!
What Medications are Used to Treat Hallucinations?
Many people with bipolar disorder with strong or persistent hallucinations often need antipsychotics such as Abilify (Aripiprazole), Risperdal (Risperidone), Zyprexa (Olanzapine) and Seroquel (Quetiapine) to help with hallucinations. (These are also used as anti-mania drugs.) People with bipolar II (two) are often on these meds, but more for mood swings than strong psychosis.
It’s important to note that psychosis in bipolar disorder is always attached to a mood swing. (You can have psychosis with mania or psychosis with depression, but not alone. If you have psychosis without a mood swing, this is usually diagnosed at schizo-affective disorder).
Can Mood Stabilizers Help with Hallucinations?
If you treat bipolar disorder with mood stabilizers such as Lithium ( a natural occurring salt), Depakote (divalproex sodium), Tegretol (carbamazepine) and Lamictal (lamotrigine), you may be able to reduce the psychosis without an antipsychotic.
Whew! This is a great topic. People are scared of psychosis. There is no need to be, it’s just like any other symptom of the illness.
My blog answers the question: What are Bipolar Disorder Delusions?

Continue Learning about Bipolar Disorder

Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.