Both bipolar disorder and schizophrenia can cause hallucinations and delusions, but symptoms are more severe in schizophrenia. Bipolar disorder involves shifts in energy and mood.
Bipolar disorder and schizophrenia are different chronic (long-term) mental health conditions. But because there’s some overlap in the symptoms, people can sometimes mistake symptoms of bipolar disorder for those of schizophrenia. The two conditions also have similar risk factors and tend to develop at the same stage of life.
Read on to learn how these conditions are alike and how they differ.
The hallmark of bipolar disorder is drastic shifts in energy, mood, and activity level. If you have bipolar disorder, you will experience episodes of extreme mood shifts and may switch between mania (extreme excitement) and depression.
In contrast, the primary feature of schizophrenia is psychosis (a disconnection from or distortion of reality). Psychosis typically shows up as hallucinations or delusions.
Hallucinations involve seeing, hearing, tasting, smelling, or feeling things that aren’t there. Delusions are false, irrational beliefs.
If you have bipolar disorder, you may experience psychosis during episodes, but it’s not a defining feature of the condition. Additionally, psychosis that occurs in bipolar disorder is less severe than psychosis in schizophrenia.
Schizophrenia might also cause disorganized thinking, which may make day-to-day tasks more difficult.
| Bipolar disorder | Schizophrenia | |
|---|---|---|
| Key symptoms | ? episodes of drastic shifts in mood ? psychosis possible during episodes | ? psychosis (hallucinations, delusions) ? disorganized thinking |
| Treatment | ? mood stabilizers ? antipsychotics ? psychotherapy | ? antipsychotics ? psychotherapy |
| Prevalence | ||
| Age of onset | ? ages 15 to 24 in ? second peak at ages 45 to 54 | ? ? |
Are bipolar disorder and schizophrenia related?
Some researchers think that bipolar disorder and schizophrenia are conditions on the same spectrum of psychotic disorders.
They view bipolar disorder as the least severe on this spectrum and schizophrenia as the most severe. Schizoaffective disorder, which has features of both conditions, falls somewhere between the two.
Researchers cite similarities in symptoms, genetic links, and similar patterns in brain changes as reasons for this connection.
Bipolar disorder tends to cause intense mood shifts that occur rapidly or over an extended time. With bipolar disorder, you might experience three types of episodes:
- Manic: During a manic episode, you may feel extremely elated, wired, jumpy, or irritable and be highly energetic and active.
- Hypomanic: When experiencing hypomania, you will have less intense manic symptoms.
- Depressive: During a depressive episode, you may feel sad, hopeless, or anxious and lose interest in activities you used to enjoy. This type of episode mimics the symptoms of major depression.
Doctors determine the type of bipolar disorder you have based on which types of episodes you experience.
Other behavioral changes that may be symptoms of bipolar disorder include:
- restlessness
- hyperactivity
- sleep problems or a reduced need for sleep
- trouble staying focused
- irritability
- extreme self-confidence and impulsivity (during a manic episode)
- suicidal thoughts (during a depressive episode)
With bipolar disorder, you might also experience symptoms of psychosis during a severe manic or depressive episode. These can include hallucinations or delusions. This is one reason people may mistake symptoms of bipolar disorder for those of schizophrenia.
Doctors generally divide schizophrenia symptoms into two categories: positive symptoms and negative symptoms. These terms don’t reflect whether a symptom is good or bad but rather whether the symptom involves adding or removing a behavior.
Positive symptoms might include the introduction of delusions or hallucinations. Negative symptoms might include withdrawing socially or removing yourself from relationships or public events.
The early symptoms of schizophrenia can include:
- social isolation
- a loss of interest in activities
- moodiness
- a lack of feelings
- irrational statements
- surprising or unusual behavior
- changes in sleep schedule, such as sleeping too much or too little
- an inability to express emotions
- laughter in situations where it’s not appropriate
- irritability and agitation
- dangerous or potentially harmful behavior
- hypersensitivity to touch, taste, and sound
- hallucinations (including auditory ones that present as threatening, insulting, or condemning voices)
- delusions
No one knows exactly what causes bipolar disorder or schizophrenia. But genetics is probably a risk factor, as both conditions
This does not mean that you will inherit the disorders if your parent or sibling has them, but the risk is greater if multiple family members have one of these conditions. Just being aware of that risk increases the chances of early detection and treatment.
Environmental factors may also contribute to the risk of these conditions, but this connection isn’t entirely understood.
Experts generally believe that both conditions
Healthcare professionals cannot use blood tests to diagnose bipolar disorder or schizophrenia. Instead, they will usually conduct a physical and psychological exam. They’ll ask about your personal or family history of mental health conditions and about what symptoms you may be experiencing.
On occasion, they may need to order a blood test or an MRI or CT scan of the brain to help rule out other conditions. At times, a drug and alcohol screening may also be necessary.
It may take several visits before a healthcare professional can make an official diagnosis. These visits are necessary to allow them to get a full picture of your symptoms.
Healthcare professionals may also ask you to keep a daily record of your mood and sleep patterns. This will help them spot patterns that may point to manic and depressive episodes.
Treatment for bipolar disorder and schizophrenia can involve both psychotherapy and medication.
The primary medications for treating schizophrenia are antipsychotics.
In most cases, bipolar disorder requires long-term treatment with mood stabilizers, such as
Doctors may prescribe other medications, such as anti-anxiety medications or sleep medications, to help with other symptoms as needed.
For bipolar disorder, psychotherapy may involve:
- learning about changes in mood and how to manage them effectively
- educating your family members about the disorder so they can be supportive and help address episodes
- exploring how to manage your relationships with friends and co-workers
- understanding how to avoid possible triggers, such as stress or a lack of sleep
Psychotherapy for schizophrenia may involve cognitive behavioral therapy.
It’s possible to have an initial episode of schizophrenia and never experience another one. If you’ve experienced just one episode, you may find a coordinated specialty care program called
- psychotherapy
- medication management
- family education and support
- work or educational support
People living with bipolar disorder or schizophrenia have an
It’s essential to continue taking all medications as your doctor prescribes, even if you’re feeling better.
In addition, if you’re living with bipolar disorder or schizophrenia, you might want to consider:
- joining a support group such as NAMI Connection
- avoiding alcohol and substance use
- maintaining a relatively stable lifestyle
- making an effort to get enough sleep
- maintaining a nutritious diet
- using techniques to manage stress
Suicide prevention
If you or someone you know is considering suicide, you’re not alone. Help is available right now:
- Call the 988 Suicide and Crisis Lifeline 24 hours a day at 988.
- Text “HOME” to the Crisis Text Line at 741741.
- Not in the United States? Find a helpline in your country with Befrienders Worldwide.
Can bipolar and schizophrenia occur together?
If a person shows symptoms of both conditions but does not fit either diagnosis, they might have schizoaffective disorder.
How can I help a person with schizophrenia or bipolar disorder?
It can be challenging to watch a friend or loved one who is having difficulty with a mental health condition. A support group may be a good place to find advice on how to cope and how to help. Consider joining the family support group of the National Alliance on Mental Illness or other support groups in your area.
What should I do if I am diagnosed with schizophrenia or bipolar disorder?
You can manage the symptoms of bipolar disorder and schizophrenia with medication and therapy combined with a healthy lifestyle. A support system — involving support groups as well as family, friends, or co-workers — can also be helpful as you undergo treatment.
Bipolar disorder and schizophrenia are distinct chronic mental health conditions, though they have some overlapping symptoms. Bipolar disorder primarily causes extreme mood shifts, whereas schizophrenia causes delusions and hallucinations.
Both conditions can be serious and psychologically debilitating, though bipolar disorder is more common than schizophrenia. Both conditions may be genetic, though environmental factors can also trigger them.
Early diagnosis is critical. Be sure to speak with a healthcare professional if you have any concerns about developing bipolar disorder or schizophrenia.
An appropriate treatment plan can help you manage either of these conditions and help prevent future relapses. You may also find it helpful to avoid any lifestyle or environmental factors that may trigger episodes.