Whats the difference between bipolar and severe bipolar depression with psychotic features?

Bipolar. Bipolar disorder has different phases of illness, and different levels of intensity. Bipolar patients may have more depression episodes than mania or hypomania. Also, depressions in bipolar disorder may be without, or with, psychotic features. Psychotic features may include hallucinations & delusions with themes of personal inadequacy, guilt, disease, death, nihilism, or deserving punishment.

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I can't tell the difference between psychosis and bipolar in one relative that suffers severe mood changes depression and too many bad thoughts about others. Which one is he?

Bipolar manifests. in extreme mood fluctuations. Psychosis is being out of touch w/reality. The bad thoughts you mention may fall into this category. Your friend may be experiencing both. Psychiatric help is necessary to manage this. Good life style choices concerning food, exercise, rest, are also helpful. Peace and good health. Read more...
Well . Maybe neither Tell your friend he needs an evaluation by a professional. There are elements that must be net for a mental health diagnosis. So best to see your doctor for evaluation . Read more...