Schizophrenia and bipolar disorder are two very significant mental health conditions that many people often confuse. Sometimes the terms are used inter-changeably in the media or everyday conversation. And many people know very little about the actual symptoms and nature of the two. In reality, bipolar disorder and schizophrenia are two different illnesses though both can be very serious problems for sufferers and their loved ones and cause very similar problems.
Both bipolar disorder and schizophrenia affect a person’s attitude, actions, and state of mind. People with either condition may exhibit extremely odd or irrational behavior, and may go so far as to be a danger to themselves or others. Both are serious medical conditions that require the treatment and ongoing attention of medical professionals, and may sometimes result in outpatient, inpatient, or long-term hospitalization and medical care. They both tend to manifest in a person’s 20s, affect both men and women, and are often treated with a combination of pharmaceutical, psychological, and lifestyle treatments.
As more and more research is done on the two conditions, more physical and psychological characteristics that link the two conditions arise, according to Dr. Charles Raison, a mental health consultant for CNN.com. He states that it can be incredibly difficult even for trained psychologists to differentiate a bipolar disordered manic episode from a schizophrenic psychosis. So confusion in the general public about the difference between bipolar and schizophrenia aren’t at all surprising.
There are several big differences between bipolar disorder and schizophrenia, however. For one, bipolar disorder is much more common. According to the National Institute of Mental Health (NIMH) more than twice as many Americans suffer from bipolar disorder, 2.6% of American adults in 2008 compared to 1.1% for schizophrenia.
An easy and simple way to think about the difference between bipolar disorder and schizophrenia is this:
Bipolar disorder involves dramatic shifts in mood, whereas schizophrenia involves shifts in reality.
Bipolar is much more closely related to major depressive disorder, as bipolar disorder often involves periods of deep and sometimes debilitating depression alternating with periods of mania. Mania may be as simple as excess happiness and energy, or may also manifest as anger, anxiety, or other elevated moods or combinations thereof. Someone experiencing mania may make rash, unexpected, irrational decisions, such as suddenly deciding to buy a house, or throw out all the food in their kitchen, which may resemble the behaviors of someone with schizophrenia who has lost touch with reality.
This is a great example of how someone with either affliction may behave in ways that seem incredibly similar, and the consequences of their illness on those around them can be nearly identical, but it’s important to remember the underlying causes and actual symptoms people with these diseases experience can be quite different.
This is especially vital because people with schizophrenia require much different levels of care and supervision than those with bipolar disorder. Also, those with schizophrenia tend to decline further and further into their psychosis as time goes on, some even becoming completely enveloped by their condition and unable to function. Those with bipolar disorder on the other hand will continue to cycle in and out of their disorder, and the condition can both improve and/or decline with age. Finally, pharmaceutical treatment for the two conditions can be very different. Today there are newer medications that can be effective for both bipolar disorder and schizophrenia, however more traditional medications such as lithium that are effective for bipolar disorder, are generally useless for those suffering from schizophrenia. This suggests a real physiological difference between the two conditions.
Those with bipolar disorder can be very highly functional, and can often hold jobs, have relationships and maintain a normal social life. Not always, but very often. They are also far more likely to stick to a treatment regimen and keep symptoms that would otherwise dominate their lives in check. Because people suffering from schizophrenia lose touch with reality, they often don’t function well in society and may even require institutionalization in severe cases. The NIMH describes schizophrenia as “chronic, severe, and disabling”. Voices often tell them to stop taking medications, or do illegal, immoral, harmful, or socially unacceptable things that can make everyday life impossible.
Someone with schizophrenia can easily be perfectly normal one moment, and then explaining to you why the angels want them to always wear the same T-shirt the next. Someone with bipolar disorder, on the other hand, can be giddily shopping for clothes with wild abandon only to be so depressed that they are contemplating suicide later the same day.
NIMH – The Numbers Count: Mental Disorders in America, National Institute of Mental Health
Mental Health Q&A from CNN Health, Dr. Charles Raison
The Differences Between Bipolar Disorder, Schizophrenia, and Dissociative Personality Disorder , Dr. John M. Grohol, Psy. D.