According to most psychiatrists, bipolar disorder, or manic depression, is a brain chemistry disorder. It’s a chronic illness that causes alternating mood episodes. These changes in mood range from depression to mania. They involve both mental and physical symptoms.

Depressive episodes are characterized by feelings of sadness or helplessness. During depressive episodes, you may have no interest in things that usually bring you pleasure. This is known as anhedonia. You may also be more lethargic and want to sleep more than usual. It may be difficult to accomplish everyday tasks.

Manic episodes involve an overly excitable, highly energized state. During manic episodes, you are more likely to engage in frenzied activity. You may talk faster and bounce from idea to idea. It may be difficult to concentrate and you may not get much sleep.

Besides these physical symptoms, people with bipolar disorder may also experience psychotic symptoms, including delusions or hallucinations.

Hallucinations are fictitious stimuli created in your mind. They are not real. There are several types of hallucinations, including:

  • visual: seeing things like lights, objects, or people who aren’t actually there
  • auditory: hearing sounds or voices that nobody else hears
  • tactile: feeling something touch or move on your body, like a hand or something crawling on your skin
  • olfactory: smelling an odor or aroma that doesn’t exist
  • kinesthetic: thinking that your body is moving (flying or floating, for example) when it isn’t

Hallucinations are more likely to be auditory than visual in people with bipolar disorder. You’re more likely to have hallucinations if you experience severe changes in mood. Hallucinations and other psychotic symptoms are also more likely to happen to those with schizophrenia rather than those with bipolar disorder. That’s why people with bipolar disorder who have hallucinations can be incorrectly diagnosed.

If you have bipolar disorder, hallucinations are most likely to happen during an extreme mood phase. Hallucinations tend to reflect the mood and may be accompanied by delusions. Delusions are false beliefs that a person strongly believes. An example of a delusion is believing that you have special godly powers.

During a depressive state, hallucinations and delusions may involve feelings of incompetency or powerlessness. In a manic state, they may make you feel empowered and overconfident, even invincible.

Hallucinations may be temporary or they may recur during depressive or manic episodes.

Hallucinations in bipolar disorder can be managed. As with any physical or mental illness, it’s important to seek the advice of your doctor. Both of you can work together to find the right medication to stabilize your mood, or work to adjust your medication.

Hallucinations may be the result of your bipolar disorder, but it could also be caused by something else. Other causes of hallucinations include:

  • side effects of medications
  • fever
  • drug or alcohol abuse or withdrawal
  • certain eye conditions
  • migraine headaches
  • extreme fatigue or sleep deprivation
  • schizophrenia
  • Alzheimer’s disease

Not everyone knows or recognizes when they’re hallucinating. Knowing you’re hallucinating can cause stress and anxiety. Remember that it’s not your fault. There are a variety of coping strategies that you can learn through counseling. Family-focused therapy can help your loved ones recognize bipolar episodes and hallucinations, and help you through them too.