Your ability to communicate with somebody who is manic and possibly psychotic as well greatly depends on their present state. If somebody is manic and grandiose, you will have to struggle to get a word in, often having to talk over her. It’s important to keep anger out of your voice, and if the person has a sense of humor, and many people who are manic can have wicked senses of humor, a light tone and smile may work: “Excuse me, can I please speak?”
People who are psychotic will often want to know that you believe them, after all, they are really hearing that voice, or are firmly convinced that the FBI has hundreds of invisible agents following them. It’s a fine line between validating the reality of the person’s experience and not wanting to feed into the psychotic experience. If the person has become fixed on a particular delusional theme, you might be able to get them off of it by distracting her or changing the subject. When people are manic, distraction can work quite well: “Let’s go see what mom is up to?” “What are the chances of the Red Sox winning the pennant this year?”
With delusions, fixed false beliefs, it’s a bit trickier and more often than not you have to sidestep and not directly confront or challenge the delusion, especially if someone is in an irritable mixed or manic state. It’s a good idea to keep your voice pitched low and to try not to let your emotions take over: The calmer the better.
As relationships get stronger, people will be more willing to allow you to gently confront their psychotic beliefs.