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Bipolar Disorder, Schizophrenia-Related Psychosis and Long-Term Disability

By Matt Lalande in Long-Term Disability on March 01, 2021

Bipolar Disorder, Schizophrenia-Related Psychosis and Long-Term Disability

As a part of our long-term disability practice we see many individuals who suffer from bi-polar disorder, schizophrenia and other related mental health issues which can cause major functional impairment and totally disrupt a person’s ability to work.

There’s no doubt that individuals who suffer from bipolar disorder or schizophrenia or psychosis often face many hurdles in their lives that can lead to high healthcare and medication costs, decreased quality of life and severe psychological suffering. 

It is also difficult for individuals with schizophrenia or bipolar-related psychosis to receive proper treatment because the delusions and hallucinations they experience don’t seem out of the ordinary to them. As the psychosis is within their brain structure, many individuals are conditioned to believe that what they are seeing and hearing is real. This can make it difficult for family members, loved ones, and caregivers to convince the individual that they require treatment, or for the individual to recognize that they require treatment.

Psychosis patients who do not receive proper treatment options have difficulty maintaining various aspects of “normal” life, including working, social interaction, and interpersonal relationships. Further, treatment is not a cure and is not always permanent, creating difficulty for individuals who do receive it. 

What is Psychosis?

Psychosis is a mental illness classified as the loss of connection or contact with reality. Most people with psychosis have difficulty differentiating between what is real and what is not real, and have disturbed or warped perceptions of the world around them. 

While there are a range of symptoms associated with psychosis, there are typically six major symptoms of psychosis that are common in almost every individual:

  • Hallucinations: An individual may see, hear, smell, or feel things that are not real or that do not exist, such as voices in their head or visions that only they can see.
  • Delusions: The individual begins to believe things that are either not real or not true. In many cases, delusions lead to paranoia, fear, or unfounded suspicions. Delusions may also include the belief that the individual has a strong authority or special power that gives them a sense of grandeur.
  • Psychomotor agitation: When an individual experiences psychomotor agitation, they begin to experience anxious restlessness that causes unintentional movements the individual does not mean to perform or is unaware they are performing. For example, the individual may begin fidgeting, moving objects around, tapping things, pacing, or removing clothing.
  • Disorganized Speech and Thought Patterns: The individual may begin to exhibit abnormal patterns or behaviours in speech or thought that do not make sense to those around them. For example, they may jump quickly between topics that are not related, or make an illogical connection between two topics that are unrelated.
  • Catatonia: Catatonia is an umbrella term for a collection of symptoms that cause an individual to become withdrawn, uncommunicative, unresponsive, or unable to move.
  • Interrupted sleep patterns: It is common for individuals with psychosis to experience periods of insomnia, restless sleep, or prolonged sleep.

Other minor symptoms that may appear as a result of psychosis or as early onset symptoms include changes in mood or personality, lack of self-care or proper hygiene, social isolation, severe anxiety or depression, and sudden changes to energy levels or communication.

Occasionally, delusions and hallucinations from psychosis can cause an individual to harm themselves or others. Hallucinations, especially those that present as voices in an individual’s head, can be incredibly frightening and confusing. The individual may believe that someone intends to harm them and retaliate, or that they are in trouble, and become disoriented by their confusion. Psychomotor agitation may also cause an individual to unintentionally harm themselves as they may begin to perform actions such as biting their lip or picking at their skin without intention.

Common Causes of Psychosis

The exact cause of psychosis is not well known in the medical field. Research has provided some indication that certain conditions and mental illnesses lead to psychosis symptoms, but this research is ongoing and new information continues to provide insight on the condition.

There are many reasons an individual may suffer from psychosis, but the most common known causes of the condition are bipolar disorder and schizophrenia. Both bipolar disorder and schizophrenia are caused by alterations or changes in an individual’s brain structure, as well as alterations in dopamine neurotransmission.

Other less common causes of psychosis may include:

  • Brain changes, such as damage sustained after a traumatic brain injury
  • Major hormonal changes such as pregnancy and giving birth (postpartum psychosis)
  • Genetics 
  • Lack of sleep or sleep deprivation (sleep psychosis) 
  • Substance abuse 
  • Illnesses or diseases such as dementia, malaria, syphilis, or stroke 
  • Recent studies have also shown that there may be a connection between some developmental disorders.(such as autism) and psychosis 

In some cases, such as postpartum psychosis or sleep psychosis, the symptoms may be temporary when the underlying issue is solved. 

Schizophrenia and Bipolar Disorder: What’s The Difference?

The two leading causes of permanent or long-term psychosis are bipolar disorder and schizophrenia. While psychosis is a recognized overlapping symptom of both conditions, the two illnesses have many key differences.

Schizophrenia is the most common illness that produces psychosis, as psychosis is one of the major symptoms of this disorder. Typically, individuals with schizophrenia will begin to notice symptoms anywhere between their late teenage years and their mid-30s – it is rare that a diagnosis will occur in a child or a middle-aged adult. 

Symptoms of schizophrenia fall into two categories: positive and negative symptoms. Positive symptoms are those that are present or add something to the individual’s behaviour, such as hallucinations or delusions. Negative symptoms are those that remove aspects of an individual’s behaviour, such as a lack of hygiene or lack of cognitive function.

Bipolar disorder is a mood disorder that is characterized by sudden, drastic, or extreme changes in mood, energy levels, or activities known as manic episodes and depressive episodes. During manic episodes, the individual may experience a period of inflated excitement, happiness, energy, or hyperactivity. Manic depression causes the individual to undergo periods of severe sadness, hopelessness, low energy levels, or lack of motivation.

There are four types of bipolar disorder based on the level of severity and prominence of the patient’s system. These include bipolar I, bipolar II, cyclothymic disorder, and bipolar-related disorder. Bipolar I is the most severe type of bipolar disorder.

Schizophrenia is classified as a psychotic illness, while bipolar disorder is generally classified as a mood or affective disorder. Psychosis is almost always present in individuals with schizophrenia, while it may not appear in those who suffer from bipolar disorder. Further, psychosis symptoms may present differently in individuals with bipolar disorder and schizophrenia. It is more common for auditory and visual hallucinations and paranoid delusions to appear in those with schizophrenia, while bipolar disorder patients are more likely to experience delusions of grandeur or higher levels of excitement.

Receiving a Diagnosis For Bipolar Disorder and Schizophrenia-Related Psychosis 

Sometimes it can be difficult to diagnose a patient for psychosis because it is often experienced as a symptom of mental illness rather than a mental illness in and of itself, especially in cases of bipolar disorder and schizophrenia.

The first thing most physicians or psychologists will do to diagnose a psychosis patient is rule out other potential conditions or factors that could be causing their behaviour. They will likely check for patterns or history of substance abuse or nicotine addiction, as some symptoms such as psychomotor agitation are linked to alcohol, drug, or nicotine use. Physicians will also rule out other potential factors such as traumatic brain injury or medical conditions.

While there is no specific test to diagnose psychosis, there are various options to determine the underlying cause of the condition. Physicians and psychologists may perform a series of test to determine a proper diagnosis, such as:

  • Urine tests 
  • Blood tests 
  • Brain scans such as electroencephalograms (EEGs)
  • Assessment of personal history
  • Physical examinations

Treatment and Recovery For Psychosis Patients 

Treatment options vary depending on an individual’s condition, but almost all psychosis patients require a multi-faceted approach. This approach may include, but is not limited to, pharmaceuticals, hospitalization, and psychotherapy.

One of the most commonly used methods to treat psychosis is pharmaceutical medication. Individuals with psychosis may be prescribed antipsychotics to alleviate their delusions and hallucinations, as the antipsychotics work to block dopamine transmitters in the brain that cause the hallucinations. However, the antipsychotics do not remedy an individual’s cognitive impairment or psychomotor agitation. Further, antipsychotics do not cure psychosis or treat the illness, and once the individual stops using them the symptoms will usually return.

In some cases, hospitalization may be required for psychosis patients in the acute phase of their condition or if they begin to exhibit extreme behaviours that put themselves or others at risk. Under the Ontario Mental Health Act, an individual may be placed in an involuntary 72-hour hold in a psychiatric facility if the individual exhibits extreme behaviour that poses an immediate threat of danger to themselves or others.

Can I Claim Long-Term Disability Benefits For Psychosis?

There are quite a few psychotropic medications which are used to treat schizophrenia bi-polar and many who suffer from the condition are able to lead relatively normal lives while undergoing treatment. However, many people do not always respond well to medical treatment which can in turn, interrupt their ability to work. 

Individuals with psychosis from bipolar disorder or schizophrenia often have significant difficulty holding a job and performing the tasks of their job safely and effectively. Treatments for psychosis do not cure the condition; they work to alleviate some of the most pressing symptoms and assist the individual in living as “normal” a life as they can. 

However, individuals with psychosis have difficulty functioning within society and performing tasks such as driving, problem solving, using proper judgement, maintaining proper hygiene, communicating, and so on. For these reasons, job loss is a common factor many individuals with psychosis face.

If an individual begins showing symptoms of psychosis in their mid 30s, they will likely miss out on many of their prime working years that are vital for setting up their financial future. Therefore, an individual with psychosis may be considered totally disabled if their condition prevents them from being able to work. 

In order to make a successful claim for disability benefits for a mental illness, you will need to prove that you are totally disabled to perform the duties of your own occupation. After two years, most insurance policies will undergo a change of definition, wherein you must be able to prove that your disability prevents you from performing the duties of any occupation for which you are qualified (through education, training, or experience). 

Speaking to a Hamilton disability lawyer will help you determine if you are qualified or eligible to apply for long-term disability benefits, or if you are able to appeal a disability benefits claim that has been denied or cut off by your insurance carrier. We will review the details of your situation and provide you with a structured solution that allows you to continue your journey to recovery.

If you have been denied long-term disability due to a mental health disorder we can help. 

If your long-term disability claim has been denied or unreasonably cut off while you are still unable to work due to psychosis, you have options and you do not have to settle for the financial stress of treatment and recovery. Our Disability lawyers work with individuals across Ontario who have been denied or cut off from their long-term disability benefits, and have recovered millions of dollars in wrongfully denied payments since 2003. 

Our firm of Hamilton disability lawyers understand how difficult it can be to navigate through the day with a disabling mental illness, as well as the financial burden that comes with it. For this reason, we work on a contingency basis, and do not charge any upfront fees or request any payment until your case is closed. If you do not win your case, we don’t charge.

Book a free consultation to go over the details of your case with us, and we’ll provide you with in-depth knowledge, advice, and inform you of your options. All consultations are free, with no up front fees and no pressure to retain our services after we meet. You can book your consultation using our online contact form, calling us province-wide at 1-844-LALANDE (525-2633), or calling us locally at 905-333-8888.

1 King Street East, Suite 1705

Hamilton, On L8P 1A4

*The above information was approved by Matt Lalande or another lawyer at Lalande Personal Injury Lawyers. The information comes from legal experience, trial experience, extensive medical research and discussion with medical professionals, medical journal review and updates and/or consultations with fellow friends and colleagues in the legal and medical field.



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