Reply to ISO info on psychosis in late teens/early 20s.

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[quote=Anonymous][quote=Anonymous][quote=Anonymous]If this came on over the course of weeks definitely needs anti-nmda receptor (and other autoimmune encephalitis) work up. The typical course for schizophrenia is more indolent, though bipolar can certainly present as he emergence of mania seemingly out of the blue. Is there a family history of bipolar or schizophrenia? [/quote]

According to cousin, came on over a weekend with no real indicators. What do you mean by indolent regarding schizophrenia?

Family history of depression, maybe some hypomania, but no meds for that (only for the depression).[/quote]

DP. FWIW, in a person who is bipolar, treatment for general
depression with an antidepressant can trigger or worsen the bipolar.  It is not uncommon that a person who is truly bipolar presents as someone who with (unipolar) depression because the depression is obvious to the patient and family - they are down and withdrawn - whereas the mania feels good, like they are doing well, energized, excited, full of plans, etc.  This is particularly true where the "mania" is not "frank mania" ( the kind of mania where one is clearly disconnected from reality) and is instead "hypomania" which is mot disconnected from reality but nonetheless the person needs less sleep, is more active, a bit grandiose or paranoid, etc. The bipolar with frank mania is "Bipolar I" and bipolar with hypomania is "Bipolar II".

My MIL had Bipolar (not sure of type) and she had psychosis at times - in mania psychosis could appear as paranoia.  In depression she had catatonic psychosis.

My now ex DH had bipolar II with periods of hypomania, misdiagnosed as depression and experienced the worsening  mania exacerbated by mis-prescribed anti-depressant.  This type of anti-depressant triggered many can include psychosis (although it didn't in my ex DH's case).

By contrast, schizophrenia usually has a period where the patient becomes more withdrawn, "flatter" emotionally and only later experiencing psychosis.

NIMH has a website with good descriptions of schizophrenia and bipolar depression. https://www.nimh.nih.gov/health/topics/schizophrenia

Not make it even more confusing but I know people diagnosed as "bipolar with schizoaffective disorder" which broadly speaking is schizophrenia combined with elements of mood disorder. [/quote]

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