Bipolar, Schizophrenia, and the Fine Line between the Two
Though schizophrenia is a psychotic disorder and bipolar a mood disorder, the overlap between symptoms makes it hard to distinguish between the two – especially in the early stages.
Bipolar disorder is characterized by alternating episodes of highs and lows, known as periods of mania and depression.
During a manic episode, bipolar patients may experience delusions or hallucinations; they may believe they are invincible or see or hear things that aren’t really there.
Schizophrenic patients also experience hallucinations and delusions, and can display depressive symptoms such as disinterest in interacting with others or periods of a “flat” unexpressive mood.
Is there even a difference between the two?
One of the main differences between these two disorders is that bipolar depression is interspersed with periods of mania, while schizophrenic depression is constant. Bipolar depression symptoms are very similar to schizophrenia depression symptoms, both involving hopelessness, feelings of self-loathing, suicidal thoughts, and lethargy. Because of the extreme similarity between the two, the length of depressive symptoms should be recorded in order to distinguish one mental illness from the other.
Schizophrenia is most commonly recognized by the presence of hallucinations, though these can also be present in patients suffering from the intense manic phase of bipolar I disorder. In some ways, however, these hallucinatory experiences can be differentiated from each other.
Patients who are bipolar are typically more expressive when it comes to periods of delusions and hallucinations. Because they occur in the manic phase, bipolar patients are full of energy and restlessness, stumbling over their words and having racing thoughts.
Schizophrenia patients, on the other hand, tend to experience hallucinations and delusions in a more monotonous manner, since they don’t possess the hyperactivity that is commonly caused by mania.
As far as neurotransmitters are concerned, the same neurotransmitters are involved in the highs and lows of both illnesses. The manic phase of bipolar and the positive symptoms of schizophrenia (delusions of grandeur, hallucinations, disorganized thoughts, etc) are associated with the amount of serotonin in the brain.
Likewise, the depressive phase of bipolar and the negative symptoms of schizophrenia (low energy, social isolation, and emotional withdrawal) are associated with the amount of dopamine in the brain.
The initial symptoms of each disorder can be a good way to distinguish between the two. Most bipolar patients report feelings of depression at the onset of their symptoms, and very few report episodes of psychosis. On the other hand, those suffering from schizophrenia tend to report strange delusions as the beginning of their symptoms.
Since bipolar symptoms tend to fluctuate between mania, depression, and normalcy, those suffering from bipolar disease can maintain a healthy, functioning lifestyle at least part of the time.
Unfortunately, those suffering from schizophrenia have a constant sense of detachment from the world. They have a more difficult time living normal lifestyles, and are more likely to be hospitalized for longer periods of time.
To sum it up:
Bipolar disorder affects extreme highs and lows in people’s moods and influences the way they feel about themselves. Schizophrenia also has an effect on people’s moods, though in such a way that they end up separated from reality. The way they hear and perceive others is more negatively affected than the way they perceive themselves. Hallucinations and delusions only occur during the manic phase of bipolar, while they can occur at any time with schizophrenia.
Many symptoms of the two mental illnesses are so similar that telling them apart can continue to be difficult even if a professional has been following the patient for quite some time. Diagnosis of a disease is determined by the amount of symptoms that a patient possesses, and in many cases people can have symptoms of a multitude of different diseases. It is important to note that some bipolar medications do not work on those with schizophrenia and vice versa. Because of this, sometimes people diagnosed with one do not realize they have the other until they have tried a handful of medications with no result.
Though the similarities are there, careful monitoring of any patient with a mental illness is beneficial in determining exactly which disorder they possess. Trial and error in combination with frequent therapist appointments is important in determining whether the illness is bipolar or schizophrenia; accurate diagnosis is the only route to accurate treatment.
From our hearts to yours,
