The Differences Between Bipolar Vs. Schizophrenia

Updated December 28, 2022by BetterHelp Editorial Team

Schizophrenia and bipolar disorder may have some similarities, and there are overlapping symptoms that affect how a person thinks and behaves such as psychosis, anxiety, and depression, but they are completely different conditions nonetheless. This article will show you how these two disorders differ from one another so you can recognize the signs and make the distinction between each of them.

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Schizophrenia And Bipolar Disorder Are Not In The Same Family & Can Be Treated Differently

One of the main ways that these two mental conditions contrast from one another is that they belong to different categories, and therefore, are unrelated.

In the Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5), schizophrenia is appropriately categorized in the Schizophrenia Spectrum and Other Psychotic Disorders, which also include Schizoaffective and Schizophreniform disorders.

On the other hand, bipolar disorder belongs to the Bipolar and Related Disorders class which contains bipolar types 1 and 2, Cyclothymic disorder, and other situational ones such as bipolar caused by substance use and medication or bipolar disorder due to a medical condition.

Currently, this class' chapter sits in between Depressive Disorders and Schizophrenia Spectrum and Other Psychotic Disorders, indicating some similarities between both categories, but still warranting distinction.

These classes make a difference not only in labeling and organizing conditions accordingly, but they can also indicate the proper course of treatment. For example, although antidepressants are used to treat bipolar disorder in some cases, a prophylactic antimanic agent, or mood stabilizer, is essential. However, if a person mistakenly receives a diagnosis of major depression, they might not get the mood-stabilizing drugs that he or she needs. [1]

The same goes with schizophrenia; antipsychotics can be used to treat symptoms in both conditions, like acute mania, but if the bipolar disorder goes unnoticed solely because of psychotic symptoms, he or she will not be receiving proper treatment overall, since antipsychotics are not always primary medication for bipolar disorder. Nonetheless, quetiapine, a type of antipsychotic medication, has seen success in both schizophrenia and bipolar. [2]

 Bipolar Disorder Is Defined By Its Mood Changes, And Schizophrenia Is Not

When a person thinks of bipolar disorder, often the idea of someone's mood shifting from one end to another; a person can seemingly be fine one moment, and this can change in a blink of an eye.

Despite the public tending to think of bipolar disorder as consisting of quick mood swings, this is not usually the case with the condition, and symptoms are episodic and can occur in phases, often lasting for a week or longer.

The term bipolar refers to the two main mood states that a person with the disorder experiences - mania and depressive symptoms. However, there is also hypomania, which is a less severe form of mania and only needs to last for four days. [3]

Manic symptoms can make people have bursts of energy and happiness as well as sometimes feel angry and irritable during episodes. Depressive symptoms can cause people to lose interest in things, feel tired, and guilty, and can even have thoughts of suicide.

In severe cases, symptoms of bipolar disorder can also include delusional thoughts and visual and auditory hallucinations, and these psychotic signs are one way that it has similarities with schizophrenia, and they can make an accurate bipolar diagnosis difficult at times.

Unlike bipolar disorder, psychotic symptoms are a core part of schizophrenia, along with disorganization, and impaired cognition. [4] However, someone with bipolar might have experience with the latter and can have trouble concentrating, especially if they are in a depressive phase.

Bipolar Disorder Has "Types", Schizophrenia Doesn't

When comparing schizophrenia versus bipolar disorder, another way that they differ is that schizophrenia no longer has separate types, whereas bipolar does.

Although it was once previously known as just Schizophrenia and Other Psychotic Disorders in the DSM-4, the changes in the DSM-5, other than renaming the category to Schizophrenia Spectrum and Other Psychotic Disorders, including removing the individual subtypes such as paranoid, disorganized, and catatonic. [5]

Even though adding one new word seems insignificant, it is not, and it does have some new implications. For example, adding spectrum to the new classification better reflects the gradients of psychosis, which means that the severity of it can vary and also change over time. [6]

This is also somewhat similar to what happened with autism in the DSM-5. Autism was previously considered to have subtypes such as Asperger's Syndrome and Pervasive Development Disorder Not Otherwise Specified (PDD-NOS). In the latest edition of the DSM, these conditions were removed and replaced with Autism Spectrum Disorder (ASD).

However, unlike autism and schizophrenia, bipolar disorder retains its types because they are distinct from one another, and there is a clear separation between them. Here are the main types of bipolar disorder: [7]

  • Bipolar I: characterized by manic episodes that at least seven days, along with depressive symptoms that can last for around two weeks. In this subtype, mania and depression can occur at the same time. Alternatively, if seven days have not passed, the symptoms should be severe enough to require hospital care to get diagnosed with Bipolar I.
  • Bipolar II: Primarily defined by depressive symptoms and a lack of manic episodes. If manic episodes occur, it usually is hypomanic, meaning it is less severe and shorter-lasting.
  • Cyclothymic Disorder: requires hypomanic and depressive symptoms to last for more than two years in adults, and one year for children and adolescents. These symptoms also cannot meet the requirements for a hypomanic or depressive episode.
  • Other Specified and Unspecified Bipolar and Related Disorders: characterized by bipolar symptoms that do not match the other three previous conditions.

Therefore, unlike schizophrenia, where symptoms can evolve and blend in with each other, bipolar disorder is much more clear-cut because there are essentially only two primary types of symptoms (hypomania is a less-severe variation of mania), and in Bipolar I, both mania and depression can coexist.

Bipolar And Schizophrenia Have Different Prevalence Rates & Affect Different Demographics

Overall, bipolar disorder has a significantly higher prevalence than schizophrenia. It is estimated that approximately 4.4 percent of all adults in the United States will have experienced bipolar disorder at some point in their lives, and 2.8 of adults have dealt with the condition in the last year. [8]

In comparison, schizophrenia affects a mere 1.1 percent of the United States population, and throughout the world, it is estimated that 23 million people struggle with this mental disorder. [9][10] This means that bipolar disorder affects nearly as many people in the United States as schizophrenia does globally.

Bipolar disorder is also much more diverse in who it affects; kids, adolescents, and adults can all experience the condition in staggering numbers, and males and females are more-or-less equally affected; however, schizophrenia is more particular as to whom it presents itself.

Schizophrenia is typically diagnosed in people who are in their late teens into their early thirties; it is very rare for kids to have this mental disorder, but there are always exceptions to the rule. It can also become apparent in a person's later years. However, it does affect males slightly more often than females. [9][10]

Males also can show signs of schizophrenia at an earlier age than females as well; males often get diagnosed in their late adolescence and early twenties whereas females will typically show symptoms in their early twenties and thirties. [11]

Despite the large discrepancy regarding numbers when examining statistics between schizophrenia vs. bipolar, both should be prioritized in terms of attention and treatment, as both of these mental conditions contribute to high levels of impairment and disability.

Conclusion

Even though bipolar disorder and schizophrenia are both lifelong, incurable mental conditions, they can both be managed through medication and live normal and productive lives by keeping the symptoms under control.

In addition to prescribed medication, people who have either condition have also seen success and improvements in their quality of life by incorporating psychotherapy into their treatment plans.

BetterHelp offers affordable and convenient online therapy sessions by licensed professionals who are experienced in helping others with various mental conditions by giving them the skills and strategies they need to cope and improve their mood.

Learning that a loved one has bipolar or schizophrenia can also be hard to take in as well, and counseling can greatly benefit those who have someone close to them who has been diagnosed with a condition. These sessions can also give you advice on how to be supportive and provide the best care that you possibly can.

Education also helps, and hopefully, by learning the differences between bipolar vs. schizophrenia, you are better equipped to know some of the signs of each one. However, a diagnosis is ultimately up to a doctor or other mental health professional, and this will be required to receive the prescription medication needed to manage both disorders.

References

  1. Severus, E., & Bauer, M. (2013). Diagnosing bipolar disorders in DSM-5. International Journal of Bipolar Disorders,1(1). doi:10.1186/2194-7511-1-14
  1. Geddes, J. R., & Miklowitz, D. J. (2013). Treatment of bipolar disorder. The Lancet, 381(9878), 1672-1682. doi:10.1016/s0140-6736(13)60857-0
  1. American Psychiatric Association. (2017, January). What Are Bipolar Disorders? Retrieved July 1, 2019, from https://www.psychiatry.org/patients-families/bipolar-disorders/what-are-bipolar-disorders
  1. American Psychiatric Association. (2017, July). What Is Schizophrenia? Retrieved July 1, 2019, from https://www.psychiatry.org/patients-families/schizophrenia/what-is-schizophrenia
  1. Substance Abuse and Mental Health Services Administration. Impact of the DSM-IV to DSM-5 Changes on the National Survey on Drug Use and Health [Internet]. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2016 Jun. Table 3.22, DSM-IV to DSM-5 Schizophrenia Comparison. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519704/table/ch3.t22/
  1. Heckers, S., Barch, D. M., Bustillo, J., Gaebel, W., Gur, R., Malaspina, D., . . . Carpenter, W. (2013). Structure of the psychotic disorders classification in DSM‐5. Schizophrenia Research, 150(1), 11-14. doi:10.1016/j.schres.2013.04.039
  1. National Institute of Mental Health. (2016, April). Bipolar Disorder. Retrieved July 1, 2019, from https://www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml
  1. National Institute of Mental Health. (2017, November). Bipolar Disorder (Statistics). Retrieved July 2019, from https://www.nimh.nih.gov/health/statistics/bipolar-disorder.shtml
  1. National Alliance On Mental Illness. (n.d.). Mental Health By The Numbers. Retrieved July 1, 2019, from https://www.nami.org/Learn-More/Mental-Health-By-the-Numbers
  1. World Health Organization. (2018, April 9). Schizophrenia. Retrieved July 1, 2019, from https://www.who.int/news-room/fact-sheets/detail/schizophrenia
  1. National Institute of Mental Health. (2018, May). Schizophrenia. Retrieved July 1, 2019, from https://www.nimh.nih.gov/health/statistics/schizophrenia.shtml

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