Before I get into it I would strongly encourage you to speak with a mental health professional as soon as you can. If you're currently experiencing the paranoia and delusions you described most major hospitals have an emergency mental health department and those things definitely qualify as an emergency.

What you're describing sound a lot like manic episodes. Disorganized thinking, paranoia, and delusions are all strong indicators you might be having a manic episode. Other things to watch out for are impulsivity and a reduced need for sleep.

If you are imagining the people around you turning on you or being replaced by aliens or that you have traveled to another dimension those can be strong indicators your manic episode is severe enough to require medical intervention.

If you've already got a bipolar diagnosis the psychosis is explained as that is one of the halmark features of a severe manic episode. You didn't mention if you are taking medication for the bipolar, but you should strongly consider adjusting your meds or starting some. I speak from personal experience as someone else with bipolar, the meds help tremendously.

You 100% should go to a professional. The thing about mental health is it comes down to if its effecting your life and it very much sounds like it is. The average person has fleeting thoughts but they are usually fleeting. Maybe a bit of depression or even self evaluation will have them linger on them but usually that means they recognized the thoughts as bad or abnormal. Not everyone is logical so simply saying illogical thoughts is a bit tough to say. Its hard for me to describe fleeting thoughts as anything but crazy despite the negative conotations with the word. Its something that should last no more than seconds and at most minutes in a bad spot. If its lasting more you really should seek professional help. I don't know what bipolar is like though so don't know how much this might be a part of it.

It's perhaps worth to trying to work with whatever you have going on at whatever time instead of trying to first categorize an issue into adhd-bpd-mania-physchotic-anxiety kinda boxes. A problem halved is not always a problem solved, sometimes you've just lost half the puzzle.

Not to diminish the issue but more to consider you as a person and less of a collection of often rather weirdly defined medical conditions in constant flux.

I'm more interested in what exactly you were motivated to do when you could have been Indiana Jones. Are we talking just a cool hat, or flying around the world to melt nazi's with the power of god?

That mostly matches the manic and depressive phases of bipolar disorder, but the different dimensions and people being replaced sounds like there may be something else complicating things. Do you know if you were prescribed any medication when you were diagnosed?

If you do seek emergency mental health help, don't use an emergency department as your FIRST choice. Try crisis stabilization or other emergency mental health service first, ED second if you can't find one or they won't take you. If you can find a psych-specific ED that's also a good option but the keyword there is psych specific. Try to avoid a general ED if you can. Some good search terms (for anglophones anyway) are:

• crisis stabilization
• crisis services
• mental health
• behavioral health
• psych / psychiatric
• crisis hotline

You might also pair those search terms with emergency / unit.

A non-psych ED is limited in what services they can offer you. ED staff are not good at much more than rapid stabilization and often have poor psych-specific training. The main psych skill they're trained / equipped for is rapidly medicating, which could be necessary, but might also be an overreaction in your case. It may also take a while to do a bed search for an appropriate psych bed and an ED is a very overstimulating environment for a person who is manic. If you wind up needing that it is what it is, but you'll probably get better care if you try to find a psych specific emergency service in your community if at all possible.

Also try to make and take a Safety Plan with you. It will help them make sure you don't wind up at a more intensive / intrusive level of care than you really need to be at.

The one thing I'll say is, don't go to a doctor and start ticking all the boxes for them, knowing what those boxes are. Don't diagnose yourself.

Don't come up with fantasy ideas of "it felt like my friends were replaced by aliens", unless you actually believed they were or might have been. Be clear about what you actual believe, not what you just think is weird about thoughts you've had.

There's a fuck load of mental things and spectrums that can make people "weird". And the diagnoses for these sorts of things are often arbitrary. They don't always just say oh you got A, B, and C, classic bipolar disorder with mania, take this.

You could get told you're schizophrenic, schizo affective, bipolar, whatever. It doesn't matter. They often will treat the symptoms.

They don't have a pill to magically treat bipolar disorder. They have pills that will numb the fuck out of you to end psychotic behavior, pills with very strong side effects sometimes potentially permanent. They are extreme medications for extreme symptoms.

they have pills for depression, anxiety, anti psychotics. They will determine what symptoms are worse for you and need treatment then treat them.

So don't go in there like "hey I had the idea what if my friends were replaced by aliens", like just the intrusive thought is psychotic on its own. Be very clear about how much you believed these things and how they affect your life, and what is negatively affecting your life.

It might sound like people with X just go take pill Y and get cured but it's not like that. It's often that people have a set of symptoms, they treat the worst of it, they deal with side effects due to those medications, and chip away at their liver for the rest of their life to live a somewhat normal life, but not necessarily normal. Pretty much no one is getting cured witht these daily pills. They're getting serious treatments that sometimes have serious side effects.