Table of ContentsView AllTable of ContentsPsychosis in BDMood-CongruenceMood-IncongruenceSchizophreniaMood ManagementHow to Help
Table of ContentsView All
View All
Table of Contents
Psychosis in BD
Mood-Congruence
Mood-Incongruence
Schizophrenia
Mood Management
How to Help
People withbipolar disordermay experience mood-congruent or mood-incongruent symptoms of psychosis. Mood-congruent means that symptoms such as hallucinations are aligned with a person’s mood state (manic or depressive). Mood-incongruent means symptoms and mood state are not aligned.
Symptoms that are mood-congruent or mood-incongruent can impact how a person manages their bipolar disorder
Read more to learn about psychosis in bipolar disorder, including mood-congruent and incongruent features.
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Psychosis in Bipolar Disorder
Individuals with bipolar disorder can have psychotic symptoms such ashallucinations,delusions, or disorganized thoughts and speech during a bout of mania (a heightened, elevated mood) or depression.
Symptoms associated with psychosis in bipolar disorder include:
Difficulty functioning at work, school, and home is a qualifier for whether the other symptoms meet the criteria for a disorder.
Mood-Congruent vs. Mood-Incongruent
Symptoms of mania include periods of elevated mood, an inflated sense of self, and grandiose thoughts. Depression can consist of prolonged sadness, withdrawal, or lack of pleasure in activities. Mood-congruent psychotic symptoms are delusions or hallucinations that are in alignment with the person’s mood.
Mood-congruence and incongruence are associated with learning, memory, and the speed of information processing.
Research indicates that people with bipolar disorder (during a depressive or manic episode) have a bias in their attention based on their mood. In other words, a person who is manic is more likely to pay attention to a face with a euphoric expression than one with a sad demeanor.
There is also research supporting individuals processing content more quickly and prioritizing content that aligns with their mood state.
Mood-Congruent Examples
When psychotic symptoms are mood-congruent, the content of a person’s delusions or hallucinations aligns with the person’s mood state.
There is often a grandiose or inflated sense of self-esteem with mania, while depressive episodes can involve sadness, powerlessness, guilt, shame, and other difficult emotions.
During a manic episode, examples of mood-congruent psychotic features could include a person believing they have superpowers or are best friends with a celebrity. Conversely, beliefs of having committed some unforgivable crime or hearing voices criticizing them can present during depression.
Mood-Incongruent Examples
Withmood-incongruent symptoms, the content of a person’s delusions or hallucinations does not match their mood. For instance, a person may believe they are being targeted, persecuted, or controlled during a depressive episode.
Mood-incongruent features may be associated with a poorer prognosis and response to treatment, so it’s essential to monitor symptoms and share information with medical and mental health providers to support the best outcomes for stabilization and treatment.
Differences in Schizophrenia
Psychotic symptoms can occur with bipolar disorder and schizophrenia. However, one of the differences between these conditions is that bipolar disorder is a mood disorder andschizophreniais a psychotic disorder.
Research indicates psychotic symptoms in bipolar disorder as being more typically mood-congruent and lasting for shorter periods when compared to presentation in individuals with schizophrenia.
Managing Mood Instability in Bipolar Disorder
Medication is always recommended for treating bipolar disorder, and therapy may also be recommended. Treatment can help people manage shifts in mood or psychotic symptoms that can accompany bipolar disorder.
Key goals in treatment may vary from patient to patient but often include psychoeducation, stabilization of mood, reduction in psychotic symptoms (if present), safety planning, and developing coping skills.
Medication
Mood stabilizers and antipsychotics may be prescribed to treat bipolar disorder symptoms.
Adherence to medication can help get symptoms to a manageable level for patients and aid in periods of recovery.
Therapy
Talk therapy (as an addition to medication, not in place of medication) can be effective in treating people with bipolar disorder. Therapy creates an opportunity for patients to:
Forms of therapy utilized in the treatment of bipolar disorder may include cognitive behavior therapy, family-focused therapy, interpersonal and social rhythm therapy, and techniques from dialectical behavior therapy.
Advice for Loved Ones
Witnessing a loved one’s struggle with symptoms of bipolar disorder can be challenging and worrisome, but there are things you can do to be there for them:
Help Is AvailableIf you or someone you know are having suicidal thoughts, dial988to contact the988 Suicide & Crisis Lifelineand connect with a trained counselor. If you or a loved one is in immediate danger, call911.
Help Is Available
If you or someone you know are having suicidal thoughts, dial988to contact the988 Suicide & Crisis Lifelineand connect with a trained counselor. If you or a loved one is in immediate danger, call911.
Summary
Mood-congruence or incongruence relates to symptoms of psychosis that either align or conflict with a person’s mood. Psychotic symptoms can influence a person’s ability to function in daily life.
Treatment including talk therapy and medication is available to help people with bipolar disorder manage these symptoms.
7 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Burton CZ, Ryan KA, Kamali M, et al.Psychosis in bipolar disorder: Does it represent a more “severe” illness?Bipolar Disord. 2018;20(1):18-26. doi:10.1111/bdi.12527Gago B, Perea M, Livianos L, Sierra P, Garcia-Blanco A.Attentional processing of threat in bipolar disorder: Going beyond mood-congruency.J Psychopathol Behav Assess. 2022:1-9. doi:10.1007/s10862-021-09905-zFaul L, LaBar KS.Mood-congruent memory revisited.Psychol Rev. 2023;130(6):1421-1456. doi:10.1037/rev0000394Elowe J, Vallat J, Castelao E, et al.Psychotic features, particularly mood incongruence, as a hallmark of severity of bipolar I disorder.Int J Bipolar Disord. 2022;10(1):31. doi:10.1186/s40345-022-00280-6Burton CZ, Ryan KA, Kamali M, et al.Psychosis in bipolar disorder: does it represent a more “severe” illness?Bipolar Disord. 2018;20(1):18-26. doi:10.1111/bdi.12527Simonetti A, Koukopoulos AE, Kotzalidis GD, et al.Stabilization beyond mood: stabilizing patients with bipolar disorder in the various phases of life.Front Psychiatry. 2020;11:247. doi:10.3389/fpsyt.2020.00247Eisner L, Eddie D, Harley R, Jacobo M, Nierenberg AA, Deckersbach T.Dialectical behavior therapy group skills training for bipolar disorder.Behav Ther. 2017;48(4):557-566. doi:10.1016/j.beth.2016.12.006
7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Burton CZ, Ryan KA, Kamali M, et al.Psychosis in bipolar disorder: Does it represent a more “severe” illness?Bipolar Disord. 2018;20(1):18-26. doi:10.1111/bdi.12527Gago B, Perea M, Livianos L, Sierra P, Garcia-Blanco A.Attentional processing of threat in bipolar disorder: Going beyond mood-congruency.J Psychopathol Behav Assess. 2022:1-9. doi:10.1007/s10862-021-09905-zFaul L, LaBar KS.Mood-congruent memory revisited.Psychol Rev. 2023;130(6):1421-1456. doi:10.1037/rev0000394Elowe J, Vallat J, Castelao E, et al.Psychotic features, particularly mood incongruence, as a hallmark of severity of bipolar I disorder.Int J Bipolar Disord. 2022;10(1):31. doi:10.1186/s40345-022-00280-6Burton CZ, Ryan KA, Kamali M, et al.Psychosis in bipolar disorder: does it represent a more “severe” illness?Bipolar Disord. 2018;20(1):18-26. doi:10.1111/bdi.12527Simonetti A, Koukopoulos AE, Kotzalidis GD, et al.Stabilization beyond mood: stabilizing patients with bipolar disorder in the various phases of life.Front Psychiatry. 2020;11:247. doi:10.3389/fpsyt.2020.00247Eisner L, Eddie D, Harley R, Jacobo M, Nierenberg AA, Deckersbach T.Dialectical behavior therapy group skills training for bipolar disorder.Behav Ther. 2017;48(4):557-566. doi:10.1016/j.beth.2016.12.006
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Burton CZ, Ryan KA, Kamali M, et al.Psychosis in bipolar disorder: Does it represent a more “severe” illness?Bipolar Disord. 2018;20(1):18-26. doi:10.1111/bdi.12527Gago B, Perea M, Livianos L, Sierra P, Garcia-Blanco A.Attentional processing of threat in bipolar disorder: Going beyond mood-congruency.J Psychopathol Behav Assess. 2022:1-9. doi:10.1007/s10862-021-09905-zFaul L, LaBar KS.Mood-congruent memory revisited.Psychol Rev. 2023;130(6):1421-1456. doi:10.1037/rev0000394Elowe J, Vallat J, Castelao E, et al.Psychotic features, particularly mood incongruence, as a hallmark of severity of bipolar I disorder.Int J Bipolar Disord. 2022;10(1):31. doi:10.1186/s40345-022-00280-6Burton CZ, Ryan KA, Kamali M, et al.Psychosis in bipolar disorder: does it represent a more “severe” illness?Bipolar Disord. 2018;20(1):18-26. doi:10.1111/bdi.12527Simonetti A, Koukopoulos AE, Kotzalidis GD, et al.Stabilization beyond mood: stabilizing patients with bipolar disorder in the various phases of life.Front Psychiatry. 2020;11:247. doi:10.3389/fpsyt.2020.00247Eisner L, Eddie D, Harley R, Jacobo M, Nierenberg AA, Deckersbach T.Dialectical behavior therapy group skills training for bipolar disorder.Behav Ther. 2017;48(4):557-566. doi:10.1016/j.beth.2016.12.006
Burton CZ, Ryan KA, Kamali M, et al.Psychosis in bipolar disorder: Does it represent a more “severe” illness?Bipolar Disord. 2018;20(1):18-26. doi:10.1111/bdi.12527
Gago B, Perea M, Livianos L, Sierra P, Garcia-Blanco A.Attentional processing of threat in bipolar disorder: Going beyond mood-congruency.J Psychopathol Behav Assess. 2022:1-9. doi:10.1007/s10862-021-09905-z
Faul L, LaBar KS.Mood-congruent memory revisited.Psychol Rev. 2023;130(6):1421-1456. doi:10.1037/rev0000394
Elowe J, Vallat J, Castelao E, et al.Psychotic features, particularly mood incongruence, as a hallmark of severity of bipolar I disorder.Int J Bipolar Disord. 2022;10(1):31. doi:10.1186/s40345-022-00280-6
Burton CZ, Ryan KA, Kamali M, et al.Psychosis in bipolar disorder: does it represent a more “severe” illness?Bipolar Disord. 2018;20(1):18-26. doi:10.1111/bdi.12527
Simonetti A, Koukopoulos AE, Kotzalidis GD, et al.Stabilization beyond mood: stabilizing patients with bipolar disorder in the various phases of life.Front Psychiatry. 2020;11:247. doi:10.3389/fpsyt.2020.00247
Eisner L, Eddie D, Harley R, Jacobo M, Nierenberg AA, Deckersbach T.Dialectical behavior therapy group skills training for bipolar disorder.Behav Ther. 2017;48(4):557-566. doi:10.1016/j.beth.2016.12.006
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