What's the Difference Between Bipolar Disorder and Schizophrenia?

Bipolar disorder and schizophrenia are both mental health conditions that significantly affect a person’s life and relationships. Bipolar disorder is a mood disorder that causes mood cycles of manic highs, depressive lows, and stable periods. Schizophrenia is a personality disorder that causes a person to lose touch with reality through psychosis, hallucinations, and delusions. 

Both bipolar disorder and schizophrenia affect how a person feels, acts, and perceives the world. However, treatment options and the overall outlook for each condition differ. 

Symptoms of Bipolar Disorder vs. Schizophrenia 

Bipolar disorder and schizophrenia share some similar symptoms, as they both affect how a person thinks, feels, and behaves. Here's a breakdown of each condition's symptoms:

As you may have noticed in the chart above, many of the symptoms of bipolar disorder and schizophrenia are similar.

However, schizophrenia causes a person to lose touch with reality and experience hallucinations or delusions: 

• Hallucinations are false experiences that may cause you to see, hear, feel, taste, or smell things that are not there. A common example of a schizophrenia hallucination is hearing voices.
• Delusions are false beliefs that cause a person to believe things that are not true. Common delusions include believing oneself is famous, being harassed, or being stalked.

People with bipolar disorder, on the other hand, experience severe mood changes from mania to depression. A person with bipolar disorder cycles through episodes of mania, depression, and stable moods: 

• Manic episodes make you feel elated, restless, wired, and irritable.
• Depressive episodes cause you to feel sad, hopeless, and anxious.
  

Differences

Bipolar disorder and schizophrenia are different conditions. While they share some common symptoms, these conditions have differences in prevalence rates, treatments, and outlooks. 

Bipolar Disorder Is More Common

Bipolar disorder is more common than schizophrenia. In 2019, 40 million people were living with bipolar disorder worldwide. In the same year, there were 24 million living with schizophrenia. 

The National Institute of Mental Health estimates that 4.4% of adults in the United States experience bipolar disorder at some point in their lives. It is more difficult to identify how many people in the United States experience schizophrenia because the symptoms often overlap with other mental health conditions. 

Different Treatment Options

Both bipolar disorder and schizophrenia require lifelong treatment. There is no cure for either condition at this time. However, the treatment options for both conditions are different. 

Mental health professionals (such as psychiatrists, prescribing psychologists, and psychiatric nurse practitioners) often recommend mood-stabilizing medications for bipolar disorder. Medications like lithium can help to reduce the number and severity of mood episodes. A person with bipolar disorder also benefits from regular psychotherapy.

However, a psychiatrist will likely recommend several types of medications for schizophrenia. These include:

• Antipsychotic medications to treat hallucinations and delusions
• Antidepressants to stabilize moods
• Anti-anxiety medications to reduce anxiety and paranoia 

In addition to medication therapy, someone with schizophrenia may benefit from psychotherapy, social skills training, employment help, and daily support. 

Different Prognosis

Bipolar disorder and schizophrenia are serious mental health conditions that require lifelong treatment. While both conditions can significantly affect your life, you can typically manage symptoms of bipolar disorder with medications and therapy. 

However, the outlook for schizophrenia isn't always as promising. Some people with schizophrenia may experience difficulty taking care of themselves on their own. They may require help with personal hygiene, finding housing, daily activities, and employment. Schizophrenia causes you to act in unpredictable ways, and this can be distressing to those around them.

It is critical for people with schizophrenia to work with their psychiatrist, rely on a good group of loved ones, and adhere to treatment to manage the condition well. 

Similarities

Bipolar disorder and schizophrenia share common symptoms, but that's not their only similarity. Both conditions also see a similar diagnostic process, have common ages of onset, and are caused by similar factors.

Similar Diagnostic Process

If you or a loved one may have symptoms of a mental health condition, seeking support can be worrisome or anxiety-inducing—but it's important. Knowing what to expect can help, and fortunately, the diagnostic process for most mental health conditions looks similar. For these conditions specifically, the diagnostic process may involve a:

• Physical exam: Blood tests, brain scans, drug and alcohol screenings
• Psychiatric exam: Questions about family history, lifestyle habits, and symptoms and close observation or clinical interview
• Symptoms diary: Tracks your symptom frequency and severity 

To be diagnosed with bipolar disorder, you must experience at least one manic or hypomanic episode and one major depressive episode.

To be diagnosed with schizophrenia, you must experience two of the following symptoms (delusions, hallucinations, disorganized speech, catatonic behavior, and avolition) for at least one month. 

Similar Age of Diagnosis

Young adults are most likely to be diagnosed with both bipolar disorder and schizophrenia. The average age of diagnosis with bipolar disorder is 25. This is the age when bipolar symptoms are most likely to occur. Schizophrenia symptoms usually develop between the ages of 13 and 29.

While these conditions are lifelong, many people might experience fewer symptoms as they age. 

Bipolar Disorder and Schizophrenia Have Similar Causes

Both bipolar disorder and schizophrenia have complex causes and risk factors that involve genetics and environmental factors. Both conditions also tend to run in families. In fact, research suggests that a person with an identical twin with bipolar disorder or schizophrenia is more likely to develop the condition, too. 

However, your genetics don't always tell the whole story. Your environment also plays a role. While environmental factors alone do not cause mental health conditions, they can affect symptom severity. For example, people who have experienced substance use disorder (SUD) or excessive stress and trauma may be more likely to develop symptoms of bipolar disorder or schizophrenia. 

Can You Have Both?

It is possible to experience both bipolar disorder and schizophrenia at the same time.

People who have symptoms of both conditions may be diagnosed with schizoaffective disorder, which causes a combination of schizophrenia and mood disorder symptoms. Someone living with schizoaffective disorder may experience both psychosis and extreme mood changes. 

Medications and treatment can help keep symptoms at bay. 

When To Seek Care and Who to Contact

Bipolar disorder and schizophrenia are serious mental health conditions that require lifelong treatment. It is important to seek help as soon as you (or someone you love) develop symptoms of either condition.

If you are concerned about your mood fluctuations or believe that you are experiencing hallucinations or delusions, reach out to your primary healthcare provider. This provider will then refer you to a mental health professional for diagnosis and treatment.

If you do not currently have a regular healthcare provider, contact your insurance company or local health department for recommendations. Sometimes, mental health conditions can raise your risk of suicidal thoughts.

A Quick Review 

Bipolar disorder and schizophrenia are serious mental health conditions that affect how a person thinks, feels, and behaves. Bipolar disorder causes significant mood changes, including mania and depression, while schizophrenia causes a person to lose touch with reality through hallucinations and delusions. 

While researchers are still working to find a cure, treatment options like medications, therapy, and social support can help you manage either condition well.