Reviewed by Laura Angers, LPC
Have you ever wondered what the difference is between schizophrenia and bipolar disorder? The symptoms of schizophrenia and bipolar disorder are explained below, along with some information for distinguishing bipolar disorder vs schizophrenia. Because of the intricacies of diagnosing any mental illness, the information provided is for informational purposes only. Please seek the advice of a qualified medical professional if you believe that you or a loved one has schizophrenia or bipolar disorder.
Bipolar vs Schizophrenia
Symptoms of Bipolar vs Schizophrenia
According to the DSM-5, two (or more) of the following symptoms should be present for a significant amount of time during a one-month period in order for an individual to be diagnosed with schizophrenia:
- Delusions: incorrect beliefs about themselves or the world. For example, a person may believe that a rock star’s music is about their own life, even though the person and the celebrity have never met.
- Hallucinations: seeing, hearing, or feeling things that are not really there. For example, a person experiencing hallucinations may hear voices, even when no one else is around. They may also see and hear a person speaking who is not actually communicating with them.
- Disorganized speech: rambling, disconnected ideas, or incoherence in communicating. A person with disorganized speech may jump between unrelated topics, speak in short bursts, or ramble incoherently.
- Grossly disorganized or catatonic behavior: behavior that is either manic or listless in nature. This may also look like either bodily rigidity or flexibility. For example, a person may seem either hyperactive or overly tired. They may exhibit some physical ticks, like constantly rubbing their arms or cracking their fingers.
- Negative symptoms: symptoms that describe something being taken away. These symptoms are not negative in that they are bad, but negative in that they are lacking certain behaviors or qualities present in a person’s usual behavior. For example, a negative symptom of schizophrenia is affective flattening, where a person does not express emotion while they speak.
Schizophrenia is usually marked by the combination of delusions and hallucinations. These symptoms are typically the easiest to pinpoint since they are often the symptoms that distinguish schizophrenia from other diseases, like bipolar disorder.
Symptoms of Bipolar Disorder
While similar to schizophrenia in many ways, bipolar disorder is diagnosed when schizoaffective disorders are ruled out and a person experiences at least one manic episode, which may have been preceded or followed by either a hypomanic or depressive episode.
- Manic episodes: episodes in which a person has increased restlessness and excitement, elevated levels of irritability, a lessened need for sleep, an inflated sense of self-esteem, and marked recklessness. While euphoria is often associated with manic episodes, not all patients will have euphoria during these periods of time. During a manic episode, a person may spend excessively or act impulsively.
- Hypomanic episodes: episodes in which a person may experience some of the symptoms of a manic episode, but to a lesser degree. During a hypomanic episode, a person may find himself or herself to be productive and creative. Because they are not as affected by the negative impact of mania, many with bipolar enjoy elevated levels of achievement during these hypomanic episodes.
- Depressive episodes: episodes marked by a loss of interest in activities, increased fatigue, feelings of hopelessness, and a loss of appetite. During a depressive episode, a person may sleep excessively, miss work, or have feelings of hopelessness or worthlessness.
- Psychotic symptoms: symptoms like hallucinations and delusions may appear during manic episodes. Because hallucinations and delusions are also symptoms of schizophrenia, the appearance of these symptoms in bipolar disorder often makes it harder to distinguish between these two illnesses.
Bipolar disorder is best understood as shifts in the mood and energy levels of a patient. The highs of mania mixed with the lows of depression can create a never-ending rollercoaster of mood swings. The extreme highs of mania only enhance the impact of the potential extreme lows of depression.
What is the difference between bipolar vs schizophrenia?
As you can see, schizophrenia and bipolar disorder can have many of the same symptoms. While schizophrenia is frequently marked by delusions and hallucinations, about half of patients diagnosed with bipolar disorder also suffer from delusions and hallucinations.
So how exactly can you tell schizophrenia and bipolar disorder apart? While psychotic symptoms like delusions and hallucinations may be present in both conditions, bipolar disorder can be distinguished by its extreme variations in mood, energy, and behavior. Meanwhile, schizophrenia can be identified by the severity of the delusions and hallucinations, paired with the disorganized behavior and thinking that come with this mental illness.
Because of the complexities in distinguishing between these two illnesses, it is important to reach out to a qualified medical professional for diagnosis and treatment. This test can help give you an idea of whether or not you’re experiencing symptoms related to schizophrenia.
While this test can help you identify symptoms, it is not meant to replace the diagnosis of a doctor. Your doctor can help you definitively determine whether you have bipolar disorder, schizophrenia, or some other explanation for the symptoms you’re experiencing. Most importantly, your doctor can help you come up with a treatment plan to manage your symptoms.
Bipolar vs Schizophrenia: Can You Have both Schizophrenia and Bipolar Disorder?
Yes. To complicate matters further, there are people who suffer from both bipolar disorder and schizophrenia. While these disorders are not strictly hereditary (meaning we don't entirely know what causes them), those with family members suffering from these illnesses are more likely to develop symptoms than those who have no family history of mental illness.
Research suggests that bipolar disorder tends to develop in the late teenage years and early adulthood, although some people exhibit bipolar symptoms in childhood. The majority of schizophrenia cases are diagnosed between the ages of 12 and 30. It is uncommon, though not impossible, for a person to develop schizophrenia symptoms in early childhood or after they turn thirty. The typical ages of onset of these diseases can help you and your doctor determine whether or not you have these illnesses.
Next Steps: Bipolar vs Schizophrenia
What Should I Do if I Think I Have Schizophrenia or Bipolar Disorder?
An important thing you can do to help to aid a medical doctor in diagnosing a potential mental illness is to keep track of your symptoms. If you suspect you could have bipolar disorder, take a minute each day to write down what your overall mood has been. You can also download a phone app that allows you to track your mood. With an increased public interest in bullet journaling, digital mood tracking services have also become more readily available. Just search "mood tracker" in your device's app store to find dozens of options.
While keeping track of symptoms yourself can be helpful, it can give an incomplete picture. For those suffering from schizophrenia, it may be impossible to distinguish between delusion and reality. Ask a trusted family member or friend (ideally someone who lives or works with you) to write down what they observe in your mood and behavior. This, combined with your own reflections on your symptoms, could help a doctor have the information he or she needs for diagnosing your illness.
If you aren't sure if the symptoms you are experiencing are schizophrenia or bipolar disorder, consider talking to a therapist or counselor either in person or online. If you are worried about the cost of therapy, there are options available, such as the following:
- Sliding scale therapy, which is when a therapist or doctor offers discounted prices depending on your financial situation. For example, they may offer cheaper prices for clients who have a lower income. Ask a few therapists in your area if they offer sliding scale therapy.
- Online therapy, available through platforms such as BetterHelp, is often cheaper and more accessible than traditional therapy. Online therapy may be especially helpful if you are physically confined to one location.
- Support groups, both online and in person. While speaking to a licensed professional will usually cost money, talking to a support group in an online forum either via chat or video call is sometimes free. Reach out to other people like you online and they may be able to offer some guidance and personal advice.
Conclusion: Bipolar vs Schizophrenia
While schizophrenia and bipolar disorder can look similar in many individuals, their symptoms are different. After taking the time to read about bipolar vs schizophrenia, you've likely noticed the ways in which they are similar. Those similarities can make it very difficult to find the difference between bipolar and schizophrenia. However, there are key differences between schizophrenia and bipolar disorder.
Bipolar disorder is best recognized for extreme fluctuations in mood and energy levels. A person suffering from bipolar disorder may have extremely elevated or extremely depressed moods that last for days, weeks, and sometimes months at a time.
Schizophrenia is marked by the delusions and hallucinations experienced by the affected person. They may seem out of touch with reality, unable to tell the difference between what is in their mind and what is happening in the world around them. This test can help give you an idea of whether or not you’re experiencing symptoms related to schizophrenia.
Whether a person is suffering from schizophrenia versus bipolar disorder or both, it is important to get a proper diagnosis and treatment by a qualified medical professional. Bipolar disorder and schizophrenia can both be managed. Those who suffer from these illnesses can go on to live full and fulfilling lives.