A manic state doesn't have to include psychosis, although some episodes in some people do. I've been manic without psychosis before, but I've also had episodes in which I was not only psychotic but paranoid. Hence my bipolar 1 diagnosis, which I fought for a long time before finally accepting it about a year ago. I've never stripped off my clothes and walked down the middle of a street or hopped on a plane to China on impulse like some bipolar 1's do, but mania doesn't have to manifest itself in such drastic ways. Sometimes it's just seeing black and grey cats running under the linen carts in the ER, or hearing music that has never been composed playing in your ear, or freaking out because a car has been following you for several miles.