Are schizophrenia and bipolar disorder the same?

Schizophrenia and bipolar disorder have similar symptoms, which can make them hard to diagnose. Sometimes people have both disorders, or they have a mix of symptoms from both conditions at the same time or close together, which is called schizoaffective disorder.

Schizophrenia and bipolar disorder have similar symptoms, which can make them hard to diagnose. Sometimes people have both disorders, or they have a mix of symptoms from both conditions at the same time or close together, which is called schizoaffective disorder.

Schizophrenia and bipolar disorder are different conditions. They’re sometimes described as opposite ends of a spectrum, but they’re thought of as different types of mental illness. Where schizophrenia is a psychotic disorder, bipolar is a mood disorder. This means schizophrenia causes unusual thinking and trouble knowing what is real and bipolar disorder affects your emotional state and how you feel.

What are bipolar symptoms?

Bipolar disorder causes intense mood states. People with bipolar disorder have extreme emotional highs called mania, where you are unusually happy or irritable, and extreme lows where you are very depressed. These intense moods last for days or weeks and affect your sleep, judgment, work, and ability to think clearly.

Types of bipolar disorder 

There are 3 main types of bipolar disorder: bipolar 1, bipolar 2, and cyclothymic disorder. These have similar core symptoms, but there are some differences:

• Bipolar 1 is where you have at least one severe manic episode. 
• Bipolar 2 is where you have at least one depressive episode and at least one episode of hypomania, but never a severe manic episode. 
• Cyclothymic disorder is a milder form of bipolar where you have many mood swings from high to low but they’re less intense.

Mania and hypomania

Mania and hypomania episodes are bipolar symptoms. A manic episode is when you are extremely irritable or high-spirited. These are severe symptoms that last one week and most of the day during the week. They disrupt your life and lead to dangerous behavior. Symptoms include:

• Lots of energy
• Less need for sleep
• Talking fast
• Being easily distracted
• Irritability
• Feeling self-important
• Restlessness
• Racing thoughts
• Feeling happy or overjoyed
• Psychosis, or a break from reality where you see or hear things that others don’t
• Doing risky things 

A hypomanic episode is like mania but with less intense symptoms that last at least 4 days, though it can last up to several months. 

Major depression

People with bipolar disorder also have major depressive episodes. These are periods that last 2 weeks. Symptoms include:

What are schizophrenia symptoms?

Schizophrenia is a serious long-term mental illness that causes problems with knowing what’s real. It also causes extremely muddled thinking, withdrawal from the world, poor self-care, and a lack of emotions and interest in activities, which is sometimes called being flat. Most people don’t know they have schizophrenia until a family member or friend gets them help. Schizophrenia symptoms can vary and get worse or better.

Hallucinations

Most people with schizophrenia have hallucinations. These are when you see, hear, or feel things that others don’t. Sometimes people say that you might hear or see things that aren’t there. For people with schizophrenia, these things seem very real and feel like a normal experience.

Delusions

Most people with schizophrenia also have delusions. These are beliefs that aren’t based on reality, so you might think someone on TV is sending you messages or that someone is in love with you when they’re not. These thoughts can sometimes also seem paranoid where you feel you’re being threatened when you’re not. 

You might also have delusions to explain your hallucinations. For example, if you hear voices, you might think someone is spying on you. 

Disorganized behavior and thoughts

Schizophrenia causes unpredictable, bizarre behavior and jumbled thoughts and speech. You might have childlike silliness or sudden agitation or you might be in a daze and barely notice what’s around you. Some people say their thoughts are misty and disappear, or they feel like someone is planting thoughts in their mind.  

Negative symptoms

One key difference between schizophrenia and bipolar disorder is the negative symptoms you experience. Negative symptoms are when you become socially withdrawn and stop taking care of your personal hygiene and appearance. You might not make eye contact with people, might speak in a monotone, and have trouble finding pleasure in activities or people. 

Overlapping schizophrenia and bipolar disorder symptoms

Schizophrenia and bipolar disorder have overlapping symptoms, and both conditions share symptoms with schizoaffective disorder. Shared symptoms include:

• Racing thoughts
• Fast speech
• Risky behavior
• Irritability or agitation
• Seeing or hearing things that aren’t there
• Beliefs that aren’t based on reality

So, are schizophrenia and bipolar disorder actually schizoaffective disorder? 

Schizoaffective disorder is a psychotic mood disorder where you have both schizophrenia and bipolar symptoms. Some people say that it’s in the middle of the spectrum between schizophrenia and bipolar disorder. Others say all of these conditions are versions of the same thing and should be merged into one. 

There’s still a debate about it, but the diagnosis manual for mental illness, called the DSM-5, separates these conditions. This means that you can have both a schizophrenia and a bipolar diagnosis, but it doesn’t mean you have schizoaffective disorder. 

For example, you could have periods of schizophrenia symptoms and other periods of bipolar symptoms. But schizoaffective disorder happens when you have a mix of schizophrenia and bipolar symptoms during the same period or close together. 

The key differences are that:

• Bipolar disorder causes severe mania or severe depressive episodes
• Schizophrenia causes more social problems and problems with self-care
• Schizoaffective disorder causes psychosis and mood symptoms at the same time or within 2 weeks of each other and for longer than a month

How are schizoaffective disorder, schizophrenia, and bipolar disorder treated?

Treatment for these conditions is usually a combination of medication and therapy. Medication is an important part of treatment. Depending on your symptoms, these include:

Your doctor will usually treat schizophrenia with only antipsychotics unless you have other mood symptoms. If you have a period of intense schizophrenia symptoms, you might need to stay in the hospital. Your doctor might also suggest different types of therapy like talk therapy, family therapy, or art therapy.

Outlook

While they are separate conditions, you can have schizophrenia and bipolar disorder. They are both serious and lifelong mental illnesses, but you can have a rewarding life with treatment and help.