Bipolar disorder and schizophrenia are mental health conditions that have some common traits and some key differences. Differences include the symptoms a person experiences.
Bipolar disorder causes shifts in mood, energy level, and thinking. Schizophrenia causes a person to appear to lose touch with reality.
People with bipolar disorder may experience episodes of mania and depression, often with periods of relative stability occurring in between.
Individuals with schizophrenia experience symptoms of psychosis, such as hallucinations or delusions. Some people with bipolar disorder also experience symptoms of psychosis.
Some people have schizoaffective disorder, which involves a combination of schizophrenia symptoms and mood disorder symptoms.
In this article, we look at the similarities and differences between bipolar disorder and schizophrenia. We also discuss methods of diagnosis and options for treatment.
People with bipolar disorder frequently experience extremes in mood. Healthcare professionals may classify “highs” as mania or, in less severe cases, hypomania. “Lows” involve a decrease in mood and, often, depression.
There are three main types of bipolar disorder, although some people have a different arrangement of symptoms:
- Bipolar I: The most intense type. It features episodes of mania and depression that can last at least 1 or 2 weeks at a time. In some cases, a person can experience both states simultaneously.
- Bipolar II: This slightly less intense form involves major depression that can last for weeks, as well as bouts of hypomania that may last several days or more. The two may alternate rapidly or have stretches of time in between them.
- Cyclothymia: This features alternating periods of lower grade depression and hypomania that can last weeks. It may also involve emotional dysregulation and anxious, impulsive, reactive behavior, according to a
2023 study. Mood changes are less dramatic but are never stable for more than 2 months.
All three conditions may include periods of stability.
These are false beliefs, and most people with schizophrenia experience them.
For example, people may think that they are famous or special in a certain way, that they are being harassed or stalked, or that something terrible is about to happen.
During a hallucination, people see, hear, feel, taste, or smell things that are not there. The most common type of hallucination involves hearing voices.
Disorganized thinking and speech
People exhibiting these symptoms may not make sense when communicating with others. They may give unrelated answers to questions, or their sentences may seem meaningless to the people around them.
People with schizophrenia can demonstrate unpredictable behavior. For example, they may act childlike, assume strange postures, or move constantly.
Inability to function as usual
Schizophrenia can affect a person’s ability to take care of their personal hygiene, engage with others in socially acceptable ways, or perform everyday activities.
Episodes of psychosis
For some people with bipolar disorder, an episode of mania or depression can give rise to hallucinations or delusions.
This is common among people living with schizophrenia, but people with bipolar disorder may also seem to have disorganized thoughts. During episodes of mania, a person may have difficulty concentrating on a single idea or task.
Symptoms of depression
During periods of depression, people with either condition may demonstrate a loss of interest in things they once enjoyed. Some people may feel like they cannot experience pleasure or may have trouble concentrating or making decisions.
Some researchers report high rates of drug and alcohol misuse among people with schizophrenia, bipolar disorder, or depression.
Bipolar disorder is more common than schizophrenia.
Bipolar disorder affected about
Statistics from the
Symptoms of bipolar disorder usually start to appear around
The NIMH notes that it is difficult to know precisely how many people live with schizophrenia because the diagnosis is complex and symptoms overlap with those of other conditions. In addition, diagnostic criteria vary. Some figures suggest that schizophrenia affects
Symptoms typically appear between the ages of
The experience and likelihood of having bipolar disorder or schizophrenia can vary depending on factors such as a person’s family history and race or ethnicity.
Having a family member with bipolar disorder or schizophrenia does not mean that someone will definitely have the same diagnosis.
Experts do not know precisely what causes these conditions, but researchers have pinpointed a number of genetic variants in people with these diagnoses. The odds of having either condition increase when a parent or sibling has it.
Race and ethnicity
Researchers are not exactly sure why this occurs, but some have suggested that trauma, stress, or marginalization may contribute to the emergence of such conditions.
However, other experts say that there is no difference in the prevalence of bipolar disorder and schizophrenia among those of different racial or ethnic backgrounds. Instead, people may receive a
For example, a Black American may receive a diagnosis of schizophrenia when their symptoms more closely represent major depression or the mania associated with bipolar I disorder. Healthcare disparities among People of Color can amplify these issues and lead to insufficient
Following strict diagnostic criteria can help health professionals determine whether a person has a particular condition. Broader clinical training can
A mental status and physical examination
A psychiatric evaluation
Healthcare professionals — usually psychiatrists — look for signs and symptoms of bipolar disorder and schizophrenia, examining anything that affects a person’s thoughts, emotions, and behaviors.
They may ask a person about their personal and family mental health history and have them complete a psychological self-assessment form.
During this evaluation, healthcare professionals will closely observe the person’s appearance and actions.
They will then compare the person’s symptoms with the criteria in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR).
Diary of symptoms and moods
People who may be experiencing schizophrenia or bipolar disorder may wish to keep a daily diary of their thoughts, moods, and sleep habits. Healthcare professionals can use this to identify patterns in their behavior and to spot other clues that inform diagnosis and treatment.
What are the criteria?
Here are some features that can help distinguish the different
- Bipolar I: at least one episode of mania
- Bipolar II: hypomania with a major depressive episode
- Cyclothymia: episodes of low level depression and hypomania that occur at least half the time over 2 years or longer
The criteria for schizophrenia vary, but according to the DSM-5-TR, a person may receive a diagnosis of schizophrenia if they have
- disorganized speech
- grossly disorganized or catatonic behavior
- negative symptoms, such as reduced speech or lack of motivation
- social or occupational dysfunction lasting at least 6 months, including at least 1 month of symptoms
A doctor also needs to ensure that a person’s symptoms are not due to any other condition.
Both conditions require lifelong treatment.
Treatment for bipolar disorder
Many people with bipolar disorder require medication to stabilize their moods.
- lithium, a mood stabilizer that may
help preventrelapse and manage symptoms
- atypical antipsychotics
Psychotherapy is an important part of bipolar disorder management. It may take place individually or in a group or family setting.
Therapy can help people manage their thoughts and emotions, establish routines, and identify triggers.
Those whose condition does not respond to medications or psychotherapy
Other strategies that can help people with bipolar disorder
- avoiding alcohol and drugs
- eating a balanced diet
- exercising regularly
- getting enough sleep
- managing stress
- seeking help and support from family, friends, and others
Bipolar disorder can vary widely, and the symptoms can change over time. A doctor will tailor treatment to suit the individual and may change the approach over time.
Treatment for schizophrenia
Antipsychotic medications are a vital part of treatment for most people with schizophrenia. Healthcare professionals believe that these medications change the brain’s chemistry and reduce symptoms such as hallucinations and delusions.
- psychotherapy in both individual and family settings
- social or behavioral skills training to improve interactions with others
- employment support to help them secure or perform a job more easily
- daily living support to help them find housing and manage daily responsibilities
Other coping strategies include:
- avoiding alcohol and drug use
- joining a support group
- learning about schizophrenia
- maintaining certain lifestyle habits, such as eating a balanced diet, exercising, and following a sleep schedule
- managing stress through strategies such as meditation, exercise, and yoga
- seeking help from family and friends
Mental health resources
Visit our dedicated hub for more research-backed information and resources on mental health and well-being.
Below are some commonly asked questions about bipolar and schizophrenia.
What is the main difference between bipolar and schizophrenia?
Symptoms of bipolar disorder and schizophrenia can overlap. However, the main difference between the two is that bipolar disorder primarily causes extreme mood shifts, whereas schizophrenia causes delusions and hallucinations.
Can bipolar turn into schizophrenia?
Bipolar disorder and schizophrenia are distinct mental health conditions. While bipolar disorder cannot develop into schizophrenia, it’s possible to experience symptoms of both. Schizoaffective disorder is an example of this.
Is bipolar confused with schizophrenia?
Bipolar disorder and schizophrenia can be confused as they share similar symptoms. However, they are distinct mental health conditions.
Although bipolar disorder and schizophrenia have similarities, they also have key differences, especially when it comes to symptom severity and treatment.
People with bipolar disorder generally alternate between periods of high and low moods, while people with schizophrenia typically lose touch with reality as they experience hallucinations and delusions.
With treatment, a person who has either condition can manage their symptoms and reduce the condition’s impact on their life.
Bipolar disorder is typically more manageable after a person receives appropriate treatment. Schizophrenia is more challenging to treat, and people who have it tend to need greater support.