Bipolar Disorder And Schizophrenia: How To Tell Them Apart

Medically reviewed by Paige Henry, LMSW, J.D.
Updated September 1, 2023by BetterHelp Editorial Team

Bipolar disorder and schizophrenia are mental illnesses that can significantly impact one's ability to function successfully daily. Depending on the severity of the condition, either disorder can severely interrupt one's ability to work, go to school, have a family, or maintain healthy social relationships. Learning to distinguish between the two can help you determine what type of support to seek and how to interpret your symptoms.

Mental Health Symptoms Of Any Kind May Deserve Attention

What Are Bipolar Disorder And Schizophrenia? 

Some people may believe that bipolar disorder and schizophrenia are the same condition. However, they are different diagnoses and are categorized in different sections of the Diagnostic and Statistical Manual of Mental Disorders (DSM). 

What Is Bipolar Disorder? 

Bipolar disorder is characterized by periods of high and low moods. A person may experience manic episodes, which involve intense feelings of euphoria, followed by depressive episodes. If diagnosed with bipolar II disorder, they may experience hypomania, a lesser form of mania. 

Bipolar I Disorder 

Four primary types of bipolar disorder exist, each characterized by mood swings. The most severe form of bipolar disorder is bipolar I disorder, consisting of at least one manic episode lasting at least two weeks. Some people with bipolar I disorder also experience depressive episodes. Manic episodes may require hospitalization, including paranoia, severe delusions, severe sleep deprivation, and distance from reality. 

Bipolar II Disorder 

Bipolar II disorder is similar to bipolar I disorder. However, depressive symptoms may be more common in this condition and are often more prolonged and severe. In addition, people with bipolar II disorder experience hypomania, similar to mania, but may lack severe delusions or paranoia. Hypomania may not require hospitalization and often lasts for three to five days. 

Cyclothymic Disorder 

Cyclothymic disorder is the third subtype of bipolar disorder. It is considered a less severe form of the condition, featuring rapid cycles of hypomanic and depressive symptoms that last for at least a year or two, depending on the individual's age. 

Unspecified Bipolar Disorder 

Unspecified bipolar disorder is diagnosed when someone experiences repeated episodes of highs and lows but does not fit the qualifications for a diagnosis in one of the other subtypes. 

Causes Of Bipolar Disorder

The causes of bipolar disorder can be complex and challenging to pinpoint. While specific causes may differ between individuals, people with bipolar disorder often have a family history of mood disorders such as bipolar disorder or depression and may experience a hormone or neurotransmitter imbalance. 

Alternatively, an individual may have a genetic predisposition for bipolar disorder that surfaces when aggravated by environmental factors like a traumatic life event or prolonged mental stress. There may be a chemical imbalance in the brain for some people with bipolar disorder.  

Bipolar Disorder Treatment

Because factors contributing to the appearance of bipolar disorder are often genetic and chemical, a combination of medication and psychotherapy may be most effective. Three classes of medication may be prescribed to someone with bipolar disorder, depending on the type and severity of the symptoms. Psychotherapy can also provide relief in managing symptoms and the challenges that they may present. Consult a doctor before starting, changing, or stopping any medication. 

What Is Bipolar Disorder Not? 

While someone living with bipolar disorder may sometimes experience delusions or paranoia, as can occur in schizophrenia, the two are not the same. However, someone can be diagnosed with both bipolar disorder and schizophrenia. Understanding the differences between these conditions can ensure you do not spread unfair or unhealthy stigmas about each condition. 

What Is Schizophrenia?

Schizophrenia is a psychiatric disorder characterized primarily by difficulty connecting with reality. People with schizophrenia may experience delusions or hallucinations, such as hearing voices or seeing situations or people that are not real. They may also be out of touch with reality, believing in ideas that are not accurate or connected to their current experience. 

Other symptoms of schizophrenia may include but are not limited to the following:

  • Difficulty with organization

  • Difficulty expressing oneself

  • Confusion

  • Disorganized thoughts

  • Paranoia

  • Difficult caring for one's hygiene or self-care needs 

Causes Of Schizophrenia

A primary contributor to the presence of schizophrenia is a person's genetic disposition. If you have another mental illness or a history of schizophrenia in your family, your chance of schizophrenia increases. 

Other factors contributing to the disorder are often environmental. Increased stress or traumatic events may incite symptoms. Some experts believe that using certain substances, including hallucinogens, can contribute to developing symptoms. 

If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources.

Schizophrenia Treatment

Because the severity of schizophrenia symptoms varies among those living with the condition, some people may navigate them more successfully than others. With a combination of medical and psychological treatment, some people with schizophrenia learn to manage their symptoms effectively and live productive lives. 

Medical treatments consist of a range of medications that significantly reduce symptoms. However, speak with your doctor about whether medication is right for you. Not everyone with a mental health condition responds well to the same medications. Psychotherapy is often coupled with medication so those living with schizophrenia can learn effective coping mechanisms and anticipate episodes before they occur.

What Schizophrenia Is Not

People with schizophrenia do not experience swings of manic and depressive episodes like those with bipolar disorder. Instead, they may experience active periods of schizophrenia that can come and go or persist. These episodes may involve frequent delusions, hallucinations, and a generalized inability to distinguish between real and unreal. 

Bipolar Disorder Vs. Schizophrenia

Although bipolar disorder and schizophrenia involve different symptoms, it can be essential to understand the differences and similarities. Below are a few to keep in mind. 

Similarities Between Bipolar Disorder And Schizophrenia

Bipolar disorder and schizophrenia can stem from genetic makeup and environmental conditions. They both occur in a smaller percentage of the population. Likewise, each disorder can lead to the development of psychotic symptoms. However, psychosis is more common in schizophrenia than in bipolar disorder. 

Differences Between Bipolar And Schizophrenia

While both disorders can involve delusions, people with schizophrenia often have more significant difficulty distinguishing what is and is not real and may experience more delusional episodes. The extreme swings from mania to depression that bipolar disorder can cause may make it challenging to get in touch with one's reality. Still, the critical difference is that delusions may only occur during a manic episode. Outside of these episodes, people with bipolar disorder may be better connected to a logical mindset. 

If you're experiencing the symptoms of bipolar disorder, schizophrenia, or both, it can be challenging to understand how to proceed. Rather than deciding for yourself which diagnosis is the most accurate, it may be wise to seek out the insight of a mental health professional like a therapist. If you are in crisis, contact a crisis line like the one below. 

The 988 Suicide & Crisis Lifeline can be reached by calling or texting 988 to talk to a crisis provider. They are available 24/7 to offer support. 988 also offers an online chat for those with an internet connection.

Mental Health Symptoms Of Any Kind May Deserve Attention

Support Options 

If you suspect you may be living with bipolar disorder or schizophrenia, talk to a mental health professional to obtain an official diagnosis. Both bipolar disorder and schizophrenia can be treated and managed with the support of a professional. By speaking to a professional, you can examine recurring symptoms and develop an official treatment plan. 

If you struggle to leave home due to your symptoms, you can also try an online therapy platform like BetterHelp. Because you'll only need an internet connection and a private place of your choosing to take advantage of it, online therapy can make connecting with a provider who understands your needs simple and stress-free. 

Regardless of which diagnosis best fits your symptoms, online therapy may be an effective way to learn how to manage your challenges. A recent study examined the benefits of mobile assessment and treatment strategies for managing schizophrenia and found that online intervention methods could be effective options for lessening symptoms, promoting positive attitudes, and improving quality of life. 


Bipolar disorder and schizophrenia can lead to similar symptoms and experiences, but they are separate mental illnesses that require different treatment approaches. Consulting with a professional to obtain a diagnosis and develop a plan of action can be a valuable first step if you believe you may be living with a mental illness. You're not alone, and support is available.

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