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Dr. G: obsession and mania
monkeybee posted:
Hi Dr. G,

I am wondering how common it is in Bipolar Disorder for obsessions to drive or be resulted from severe manic episodes. For instance: spiritual obsessions that turn into religious delusions, obsessions with being famous or meeting someone famous, etc. Also, is it common for the same delusions to reappear in future episodes (ie: someone who reads the Bible once a day becomes manic and starts reading the Bible six times a day. If they go back to regularly reading the Bible will this behavior likely repeat with future episodes? Or, if someone becomes preoccupied with demons while extremely manic, will those delusions likely reoccur?)?

Joseph F Goldberg, MD responded:
Dear Sarah,

The content of delusions can sometimes take on persistent importance after a manic or depressive episode resolves, and if afrank psychosis persists after mood symptoms have ended, the diagnosis may be reclassified as schizoaffective disorder. True obsessions are irrational thoughts that people themselves recognize as irrational yet they intrude into thinking and despite the person's efforts to try to push them out. When someone does not perceive an irrational obsessive thought as irrational, it could signal the presence of psychosis more than an obsession.

Dr. G.
monkeybee replied to Joseph F Goldberg, MD's response:
Thank you Dr. G. In a manic episode, my spirituality turned into religious delusions that became irrational and even dangerous. Since the episode, I have become very detached from my beliefs because I am afraid they will cause me to become delusional again. Is that warranted?

Also, I am not typically obsessive about things but when I am manic, I tend to become obsessed with things (ie: the example of starting to read the Bible 6 times a day). Is that just part of the delusion? Is it common in Bipolar? I am very afraid that the lifestyle I had before this episode will be a trigger again. Is that likely the case? Thanks again.
Joseph F Goldberg, MD replied to monkeybee's response:
Dear monkeybee, It's common in manias for people to take on new interests that, after the mania resolves, they may quickly drop or otherwise see as peculiar, or no longer an interest (eg: Why in the world did I sign up for flying lessons?). Religious delusions are common in mania. If someone had a prior interest and genuine involvement in organized religion when well, I wouldn't automatically assume that that part of someone's life must become off limits just because it had provided content for a delusion when they were manic. Dr. G.
monkeybee replied to Joseph F Goldberg, MD's response:
Perfect; thank you again!

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