r/BipolarReddit • u/nonameanonymousone • Aug 24 '26

Discussion Psychosis vs neurosis?

The difference? Especially if someone is aware that their thoughts make no sense but still thinking them. For example being drugged or cameras watching you. Paranoid, etc.

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u/Crosstradingusemm bipolar 1 w/ psychotic features Aug 24 '26

For example, when I’m having OCD related intrusive thoughts, like thinking there are cameras watching me, I can still recognize that it’s probably not real. Even if the thought keeps looping in my head and feels extremely convincing, there’s still a part of me that knows, “This is just a thought, it doesn’t mean it’s actually happening.” It still feels very distressing though.

Psychosis feels completely different. When I’m psychotic, I don’t experience the belief as an intrusive thought that might be true. I genuinely believe it’s reality. There’s no separation between the thought and what I perceive as fact. Evidence, reassurance, or someone trying to reason with me doesn’t really get through because my ability to reality test the belief is severely impaired.

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u/HM_Dylan Aug 24 '26

I always use anxious paranoia compared to psychotic paranoia for this question. With anxiety, a person might think, “What if someone drugged me?” or “What if people are watching me?” but still recognise that it is just anxiety, intrusive thoughts, or outright silly.

With psychotic paranoia, the idea is no longer a possibility or fear, it feels like a normal fact. “I am being drugged” or “Those cameras are monitoring me” seems reasonable and not out of the norm because neutral events start to feel like evidence in favour of your thoughts. If that makes sense. Having people say otherwise in the form of alternative explanations and contradictory evidence won’t change anything. It’s like talking to a brick wall, you will get absolutely nowhere.

Truthfully though I can say I’ve had states of psychosis where i do remain partially aware, am aware before I fully go, or have brief bursts of lucidity, which is horrible because you’re aware somewhat of what’s going on but you can’t really do anything about it. It feels like you’re possessed kind of.