Affective Psychosis: Managing Mood Swings and Auditory Hallucinations

Affective Psychosis

Hello, doctor.
I have affective psychosis and have been consistently taking medication and receiving treatment.
Emotionally, I have primarily experienced depression, but recently I have shown symptoms that resemble a manic episode, such as feeling well-rested after only one or two hours of sleep, having a lot of energy, experiencing inexplicable confidence, and wanting to do many things.
However, these symptoms only last for about two days before I quickly return to depression.
The key point is that during these suspected manic episodes, I do not feel particularly happy or irritable; I just feel a bit sad and anxious.
Does this still count as a form of "mania"? I'm unsure if what I'm experiencing is indeed mania, and I don't want to overreact.
Secondly, I would like to ask the doctor about my experiences with hearing the voice of God.
When I hear this voice, I find it difficult to focus on my surroundings.
In the past, I have heard the voice while crossing the street, and I stood in the middle of the road while cars honked at me.
Now, I can somewhat divide my attention while walking, but my gaze still fixates on an unspecified point, and I cannot help but speak to God (I lack control).
What can I do to at least refrain from speaking when I hear the voice of God? Is this something I can practice? However, I feel like my efforts may not be effective.

Evonne, 20~29 year old female. Ask Date: 2022/04/08

Dr. Xue Gengming reply Psychiatry

I recommend that you 1.
discuss the above situation further with your attending physician to determine if further examinations are necessary.
2.
consider switching to a medical center or a large hospital's psychiatry outpatient clinic for treatment.
Thank you, and wish you good health!

Reply Date: 2022/04/08

More Info

Understanding affective psychosis, particularly in the context of mood swings and auditory hallucinations, is crucial for effective management and treatment. Affective psychosis, often associated with mood disorders such as bipolar disorder or major depressive disorder with psychotic features, can manifest in various ways, including episodes of mania or hypomania, as well as depressive episodes.
From your description, it appears that you are experiencing a complex interplay of symptoms, including what you suspect to be manic episodes characterized by increased energy, reduced need for sleep, and heightened self-confidence, albeit without the typical euphoria or irritability often associated with mania. This is indeed a valid concern, as mood states can vary significantly among individuals with affective disorders. The presence of anxiety and sadness during these periods may suggest a mixed episode, which is not uncommon in affective disorders. Mixed episodes can be particularly challenging, as they combine features of both mania and depression, leading to increased emotional instability and difficulty in functioning.

It is essential to communicate these experiences with your healthcare provider, as they may indicate the need for a reassessment of your treatment plan. Adjustments in medication or the introduction of mood stabilizers may be necessary to help manage these fluctuations more effectively. Regular monitoring and open dialogue with your psychiatrist can lead to better outcomes and a more tailored approach to your treatment.

Regarding your experience of auditory hallucinations, specifically hearing the voice of God, this symptom can be distressing and may interfere with your daily life, as you noted with the incident of standing in the middle of the road. It is important to recognize that while such experiences can be a part of certain psychiatric conditions, they can also be influenced by your emotional state. The challenge of maintaining focus and control during these episodes is a common concern among individuals experiencing similar symptoms.

To address this, several strategies may be beneficial:
1. Mindfulness and Grounding Techniques: Practicing mindfulness can help you become more aware of your surroundings and less reactive to intrusive thoughts or voices. Grounding exercises, such as focusing on your breath or engaging with your environment (e.g., noticing the colors, sounds, and textures around you), can help anchor you in the present moment.

2. Cognitive Behavioral Therapy (CBT): Engaging in therapy can provide you with tools to manage your thoughts and feelings more effectively. CBT can help you challenge and reframe negative thoughts, reducing the impact of hallucinations on your behavior.

3. Medication Management: As you are already on medication, it is crucial to discuss any changes in your symptoms with your psychiatrist. They may consider adjusting your current regimen or adding medications that specifically target hallucinations or mood stabilization.

4. Practice Response Techniques: You can practice techniques to manage your responses when you hear the voice. For example, you might train yourself to acknowledge the voice without engaging with it, using phrases like "I hear you, but I am focusing on my surroundings right now." This can be practiced in a safe environment where you feel comfortable.

5. Support Systems: Engaging with support groups or therapy can provide a sense of community and understanding. Sharing experiences with others who face similar challenges can be validating and provide additional coping strategies.

In conclusion, your experiences with mood swings and auditory hallucinations are significant and warrant careful attention. By working closely with your healthcare provider, utilizing therapeutic techniques, and exploring medication options, you can develop a comprehensive approach to managing your symptoms. Remember, you are not alone in this journey, and there are resources and strategies available to help you navigate these challenges effectively.

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