is it normal to hear voices with bipolar type 2?

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hello peeps
i'm in a bit of a confusing situation. i have recently been diagnosed with bipolar type 2, which sounds a lot like me. except for one fact, online it says that bipolar 2 doesn't have hallucinations...? is that because i may have type 1 bipolar?

i have only ever told 2 friends about these voices that i hear inside my head.and both friends of course reacted really badly about them. one stated that ill end up in a mental hospital one day wearing a straight jacket. so of course i never told anyone else, not even my psychiatrist.

i don't usually hear these voices very often. only when my mood is very depressed or extremely elevated. but iv gotten used to the voices now and learnt ways to try ignore them. most of the times the voices are harmless and nice. but recently during one of my elevated moods the voice was saying things that weren't true. like it was telling me i should go jump of the roof of a building and fly, it said i had super powers. half my brain believed the voices but the other half doubted it. so i listened to extremely loud music to drown out the voice.

but the good thing is that it always goes away if you ignore it long enough. which is another reason i don't see the purpose of telling a professional. and another reason is i'm scared the psychiatrist either wont believe me, or will think im crazy and have schizophrenia. WHICH IM NOT!

another thing that i should probably add is that (i know i should have) but i stopped taking my lithium and sleeping pills. only because i had bad side effects. so the lack of lithium and lack of sleep may have been the trigger.

so what are you guys opinions on the matter. can bipolar 2 have hallucination. and should i tell my psychiatrist. and if so how the heck do i explain it to her? and im sorry but im terrible at explaining things.

could it mean that i may have bipolar type 1? as i heard that hallucinations can be present with that?
thanks

Last edited by Gracey on 05 Oct 2014, 2:01 am, edited 3 times in total.

Hearing voices is not a symptom of bipolar type 2.

My uninformed hypothesis is that you have another condition comorbid with bipolar type 2.

could it mean that i may have bipolar type 1? as i heard that hallucinations can be present with that?

No, with bipolar type 1 you can only hear voices when in extreme mania, and this is always accompanied by delusions of grandeur.

i think i was manic the last time i heard them. and online it said you cansometimes hear them during extreme depressions. which is in my case

That's good that you can tell they are outside of your head. It's much harder to deal with when you cannot.

Also, not sure what sleeping pills you are talking about, but benadryl in slightly elevated duces induces voices for me (voices that I can sometimes tell are real, and sometimes not).

A: If you stopped taking meds you need to contact your prescribing doc and discuss other options with them. It is likely that this will cause return of whatever symptoms were bothering you. Keep in mind that often side effects of lithium can be temporary [go away in a few weeks as you adjust to the dosage] or be mitigated by either increasing the dose slower [go up by a smaller amount over a longer period of time- talk about this with your doctor], or increasing your water intake as it is really important to stay hydrated. I have been on lithium several times in the past.

B: If you have stopped the sleeping medication, same deal, you need to discuss other options with your doctor. Also, if you are not getting as much sleep, you need to talk to them about it.

C: there is a HUGE difference in "voices" we might hear. There can be an internal voice that we all hear- that EVERY ONE hears. This can cause greater anxiety if we are under greater stress. There can be internal voices that take on a different character [have different aspects or seem a different type] if we have other things going on like paranoia, extreme social anxiety or some types of OCD or other possible issues. There can be external voices someone might hear which could be hallucinations OR illusions, and neither of them necessarily will indicate a specific diagnosis- it could be that you have an auditory processing disorder or that you get migraines or that you have schizophrenia or something else. Your friends likely can't tell you what these voices you are describing indicate and no one here can either.

Your provider is likely to be much more help- particularly if you are straight up with them about side effects you are experiencing and what side effects you are willing to tolerate, and which ones are going to make you chuck your meds and simply stop taking them. You need to try to start an open dialogue with your doctor about all of these things if you want to sort it out.

That does not mean doing things you are not comfortable with. But it does mean being honest and upfront about what is going on. Otherwise they can't help you.

False.

One can have hallucinations with or without delusions, with or without mood congruency and delusions with or without hallucinations.
One can hear voices when experiencing extreme depression [depression with psychotic features] or when experiencing a manic episode with mixed features in which case all of the above possibilities apply.

Hearing voices is a symptom of temporal lobe epilepsy as well as psychosis

Hearing voices is a form of psychosis, yet it does not necessarily mean schizophrenia. In times of extreme stress some ppl have psychotic reactions. To use Mt situation as an example, i have Short Psychotic Disorder. The disorder can be diagnosed if the person has experienced at least three instances of trauma. It has no symptoms of schizophrenia other than psychos is and dies not resemble bipolar disorder either. There are other conditions that bring about psychosis that are not schizophrenia.

Hearing voices is a form of psychosis, yet it does not necessarily mean schizophrenia. In times of extreme stress some ppl have psychotic reactions. To use Mt situation as an example, i have Short Psychotic Disorder. The disorder can be diagnosed if the person has experienced at least three instances of trauma. It has no symptoms of schizophrenia other than psychos is and dies not resemble bipolar disorder either. There are other conditions that bring about psychosis that are not schizophrenia.

please tell your doc about the voices. meds can help. your friend over-reacted.

We cannot diagnose you here and the stopping of the taking of the medication and the voices are something you need to bring up to your doctor.

I can give one bit of assurance, however: If you are psychotic, which includes hearing voices, only when you're majorly depressed, mixed, or manic, then you cannot be diagnosed with schizophrenia, per the DSM-IV/DSM-5 criteria and at least implied by the ICD-10 criteria.

EDIT: Also, there's no need to disparage people with schizophrenia, some of whom have overcome their disease, like Elyn Saks.

That wouldn't be from the bipolar unless you were very depressed or manic at the times that this has happened. It doesn't necessarily mean schizophrenia. This also can happen to people who were exposed to extremely stressful things which can cause it. I actually get them myself as well sometimes, but it doesn't bother me or anything either. You seem to be dealing with it fine

Psychotic depression can occur with bipolar-II. But, by definition, bipolar-IIs cannot experience psychosis during their "high" periods. This is why bipolar-IIs only experience hypomania, not full-blown mania, which is often a psychotic state. And SignOfLazarus is correct about how psychotic mania need not have delusions of grandeur. While grandiose delusions are extremely common in psychotic mania, any type of psychotic symptom can occur during mania. Psychosis is psychosis. Schizophrenia and bipolar disorder are more alike than they are different. Just look at genetic studies.

Yet, there appears to be one important difference between bipolar disorder and schizophrenia: The aggregation of self-disorders in schizophrenia spectrum disorders and low levels thereof in even psychotic bipolar disorder (even when adjusted for the severity of positive and negative symptoms). Self-disorders, according to the Examination of Anomalous Self-Experience (EASE) which is a semi-structured interview manual published in Psychopathology in 2005 that measures self-disorders both qualitatively and quantitatively, all share in common "a disorder or deficiency in the sense of being a subject, a self-coinciding center of action, thought, and experience" (footnote removed). A link to the manual's full-text can be found here:

http://www.nordlandssykehuset.no/getfil ... r/EASE.pdf

Self-disorders include dissociative-like phenomena, disturbances in the stream of consciousness, transitive phenomena, and changes in basic world experience. Again, studies have shown self-disorders to selectively aggregate in the schizophrenia spectrum:



http://www.ncbi.nlm.nih.gov/pubmed/22759705

This shows that people with schizotypal disorder have similar levels of self-disturbance to non-affective psychosis (mostly schizophrenia patients), showing significant differences from other mental illness (which included patients with bipolar disorder, major depression, OCD, etc.):

http://schizophreniabulletin.oxfordjour ... /1300.long

Another study with the same result (emphasis added):



http://www.ncbi.nlm.nih.gov/pubmed/22759943

Though we don't have the full-text here, another article cites the above article, saying that it shows that when controlling for the "symptomatic PANSS dimensions" self-disorders still aggregated in the schizophrenia spectrum:



http://schizophreniabulletin.oxfordjour ... /1300.full

This shows another look at the unity between schizophrenia and schizotypal disorder in terms of self-disorders, again showing their "selective aggregation" in the schizophrenia spectrum:

http://schizophreniabulletin.oxfordjour ... 2/344.long

This study uses a pre-EASE scale of self-disorders and compares them in "residual schizophrenia and psychotic bipolar illness in remission":



http://onlinelibrary.wiley.com/doi/10.1 ... 56A.f04t02

This look at self-disorders is interesting and can possibly bring about greater insight into the schizophrenia spectrum as a whole, showing where and how it differs from other mental illnesses, like psychotic bipolar disorder and OCD, thus bolstering the Kraepelinian dichotomy. Here is a study that looks at a possible relationship between self-disorders and insight in schizophrenia, and actually gives a very good introduction to self-disorders. For example, it mentions that in all the foundational texts on schizophrenia, self-disorders were seen as important:



This is under the section "The Disordered Self in Schizophrenia," a very interesting read into the core of the schizophrenia spectrum. Here is the link to the full text:

http://schizophreniabulletin.oxfordjour ... 3/542.long

This explores those self-disorders in that section (footnote removed):



Self-disorders seem like they can discriminate between the schizophrenia spectrum and other mental illnesses and seems to show traits present in the schizophrenia spectrum that are typically absent outside of it, even in other psychoses. Even the non-psychotic schizotypal disorder has an aggregation of self-disorders, which suggest that self-disorders are more of a "schizophrenia spectrum thing" than a "psychosis thing."