How long can a bipolar psychosis go on for?

@Sofia Hi I am not a career but I have schizoaffective disorder (bipolar type) and as far as length goes it can really depend if it is bipolar disorder then the psychosis should go away when his mood goes back to normal if his mood is normal or not very extreme and he is still psychotic then it may not be bipolar alone.... also mania does have an end point as your body can’t really sustain it for extremely long periods so if it has been a long time like maybe more than 6 months then that would be unusual as well.... I can’t really give advice on how to help but I can share my experience with similar issues if you think it would be helpful. For me though when I think people are trying to harm me that is the hardest one to deal with because anything anyone does just confirms it for me that they are indeed trying to harm me. Any attempt at trying to ‘help’ or get me involved with the mental health system just makes me more scared and defensive and feeds into everything. I am not saying it is easy but just saying he might be more scared by you trying to contact services. The only thing that helped me trust people in those situations was when they just sat with me like they didn’t try and get me to do anything but waited until I was more commfortable and allowed me time to build enough trust for me to start questioning why a person who has been kind to me would be trying to hurt me.

Many thanks @Eden1919 for replying.

it's possible he may have been misdiagnosed. This is the third episode in five years where he has been very stressed and lapsed into psychosis. He's paranoid and delusional. One episode was quite bad where he was listening to voices in his head.

Unfortunaty he was away from home trying to assist our daughter with a mental health crisis and as he became increasingly agitated, refused to talk to me on the phone.

So it sort of snuck up on both of us this time. I tried giving him space as to not antagonise but it's not helped.

When I ran into him at the shops one week ago, he was still saying delusional paranoid things. I think we are heading into week 10 of this now and he's unmedicated or very low and ineffective dose.

@Sofia honestly when i said time (and i dont mean to say this to make you dishartened) but for me it took years like i thought people were trying to hurt me for at least 5 solid years before anyone figured it out and if i am honest i still struggle with this issue especially with profenssionals but try my best to ignore it. i think for me though a lot of that time i was still under 18 so didnt have the legal capacity to do some of the things your husband is doing. i cant really speak about diagnosis but if things havent been working then it never hurts to get a second opinion. i am not really sure how you could help but it can take time and is a difficult thing to deal with. just remember to take care of yourself first, he is an adult and while he is struggling there isnt much you can do legally and you certianly cant do much to help if you are not ok yourself. dont feel guilty for putting your health first and do what you need to stay healthy.

Hi @Sofia and welcome to the forums. @outlander is right, I do have bipolar 1 and have had psychosis in the past, but not for many years now. I had a hypomania for 3 months in 2017 but have been stable since - the longest period since diagnosis. I haven't been hospitalized since 2009. However, I've never been on the other side of this as a carer for someone else who has it. It's lasted for varying lengths of time for me. I also have comorbid complex PTSD that interplays with the bipolar. My worst psychoses were almost always after a really traumatic event and sometimes I would be in and out of psychosis for a long time (anything from a couple of days to fluctuating for a couple of years). I'd love to give you solid hope here but can only speak honestly from my own lived experience. I'm 56 now and was only diagnosed 11 years ago with the bipolar, but can see with hindsight that I had manic and sometimes psychotic episodes periodically since I was in my teens. Every person and every period of psychosis will vary.

For me I've learned self-management skills including keeping daily charts to monitor moods, sleep, meds taken etc and how to recognise when things are changing. I'm also completely compliant with meds prescribed by my psychiatrist and my gp. So you see that in my case the foundation of a recovery path is that I accept the diagnosis and want to be stable. I've found that lots of people with bipolar love the highs (they are so much better in some ways than the lows) and are always taking themselves off meds once they feel a little more stable or when they feel like having another high (e.g. if depressed for a while), not acknowledging that it's at least partly the meds that keep them stable. Unfortunately a lot of the behaviours when on a high (manic and/or psychotic) involve a high degree of risk and awful consequences to be dealt with once the person stabilizes. Delusions (e.g. believing someone is sabotaging you or that conspiracies are real or even that you can save the world in some way - been there), overspending, shooting off on wild adventures, grandiose thinking, hypersexuality, - and more.

You might find some other carers with similar experience in this discussion https://saneforums.org/t5/Special-Events/Topic-Tuesday-Are-you-feeling-alone-Carers-Support-and/m-p/811238 which I think is still open this morning. If not, at least you will see names of people you might want to tag into your thread here.

I strongly recommend that you see a counsellor or psychologist yourself for some support to develop strategies to cope with his behaviours and recognise and meet your own needs e.g. boundaries, safety plan if needed, supports you can reach out to, even your financial and property arrangements. If he has a psychiatrist I'd be communicating with them too.

Feel free to tag me if you want to talk some more.

I know it's really hard to do, but ultimately as he's an adult, unless he is scheduled into hospital (changes a lot of things legally) .. only he can choose to be responsible about managing his diagnosis, taking meds, being fair and responsible about finances etc. Really really hard.

My husband’s psychosis lasted about four months. Various degrees of severity over that time. I feel for you, it is so hard. No judgement, a genuine question: why was your husband coming off his medication? When my husbands condition deteriorated, I contacted his psychiatrist and filled him in. But unfortunately only after I tried our GP with no success and then trying the path of least resistance and just letting him do whatever he wanted. It wasn’t until I spoke to his psychiatrist that we started being able to help him. Having Said that, my husband, although he never believed he was unwell at the time, he was mostly compliant with drs orders. And I understand this isn’t always the case with others. All the best - it is a very hard path.

Thanks @eth for your reply.

Honestly, mentioning years really got me down. I have had people say that you can't be in a pyschosis for that long so I don't know anymore.

I am trying my best to take care of myself while my heart is breaking and I worry about him. It's incredibly hurtful to be treated so badly when I have been his constant support for over 20 years, even through the terrible times. I forgive over and over again and it's honestly so exhausting to be betrayed. I know he doesn't mean it but I still have to cope with the feelings.

Sending warm wishes @Sofia Sorry if my post upset you, but I can only speak from my personal experience. As I said, every psychosis is different for every person, every time. Do take care of you through all of this. Perhaps get some legal advice (legal aid?) about the financial side of things. And talk to your doctor, and his too if it's at all possible. I feel for you but don't know how else to help.

Thanks @CLA for your reply. Much appreciated.

We are up to three months now, so your experience gives me hope it won't be too much longer. I have had advice from counsellors that he won't be able to sustain this state forever and something will give.

He is very good at masking and managing as he uses tools like yoga and meditation and EFT over the years to calm down. It's so complicated. He is managing to go to work in a complex job which requires a lot of brain power!

He was coming off medication under the care of apparently one of the best psychiatrists in our city. We went to him a couple of years ago to help with a bad depressive episode (work was getting stressful and too much for him and he subsequently was getting bullied for his inablity to keep up and his mental health).

The psych said he was over medicated, that medication was a hype and not necessary and you could just take beta blockers if you felt an episode coming on. I spoke up and said I was concerned about this and he told me I was living in fear and needed to think about the future instead of basing things on the past.

So under his care, he has been coming off them very slowly over two years. He was doing really well and adjusting okay. Then as usual, excessive stress (this time in the form of our daughter's miscarriage) set him off into the psychosis.

I have lost all faith in the medical system. I have rung to get help and because he is going to work and 'functioning' nobody gives a damn. There is literally. nothing I can do at all because he refuses any communication with me.

He flat out believes he has never had a mental illness and it has been me all this time convinicing him he has, it was me ringing the mental health unit every day during his two week hospitalisation to tell them he was psychotic so they would keep him there.

What benefit there is for me in making him think he is mentally unwell is beyond comprehension. HIs mental health issues have made my life really difficult. I am left with PTSD, numerous health issues, anxiety and I have lost family members and friends who no longer speak to us after his previous episodes. Now I am left heart broken, our family split up and financial struggles.

This illness is cruel. If he had any other sort of illness at least we could be there for each other to provide love and support through it. 😞