Last reviewed:
Jan 17th 2023
LSW
Schizophrenia is a severe mental illness that belongs to a group of mental health problems known as the psychotic disorders. All the psychotic disorders include psychosis as a key part of the condition.
According to the Diagnostic and Statistical Manual of Mental Disorders [1], used by mental health professionals in the US to diagnose mental health problems, people with schizophrenia will experience two or more of the following symptoms, including at least one of the first three, for at least a month (or less if treatment has begun and has been successful):
In addition, symptoms must have a significant impact on a person’s work, education, relationships or self-care. Overall, for a diagnosis of schizophrenia to be made, the person must have been unwell for at least six months (including a month of the symptoms described above).[1]
Bipolar disorder used to be called manic depression. It is a kind of mental illness known as a mood disorder and is usually characterized by periods of both mania and depression.
A manic episode is a period lasting at least one week during which someone’s mood is significantly elevated. They may be unusually optimistic, energetic or euphoric, perhaps focused on achieving a particular goal. Symptoms include:[1]
A manic episode will have a significant impact on someone’s life and many even require them to be hospitalized for their own safety. Someone may experience psychosis during a manic episode, meaning they may have delusions (beliefs that aren’t real) or hallucinations (seeing or hearing things that aren’t there).[1]
In addition to at least one manic episode, someone with bipolar disorder might experience hypomania. Hypomania is similar to mania but symptoms and impact on functioning are less severe.[1]
A major depressive episode is characterized by a period of at least two weeks where five or more of the following symptoms are experienced, including at least one of the first two:[1]
There are two kinds of bipolar disorder:
Schizophrenia and bipolar disorder are both serious mental illnesses. They share some symptoms in common but are different conditions.
Both conditions can cause psychosis, which is a set of symptoms that indicate someone has experienced a break from reality. The two main symptoms of psychosis are hallucinations and delusions.[2]
Both conditions also involve noticeable changes to speech and behavior, which may look similar to others.[3]
However, there are some key differences. Bipolar disorder is a mood disorder, causing significant shifts in mood from elated and euphoric to depressed. With bipolar disorder, psychotic episodes happen only during a major depressive or manic phase. In schizophrenia, delusions and hallucinations are not linked to mood in the same way.[1]
It is thought that schizophrenia and bipolar disorder might be caused by the same genes, as both conditions are more common in families where there is a family history of either condition.[1]
Studies also suggest that factors relating to pregnancy and birth can increase the risk of schizophrenia. These factors include the age of the father, stress during pregnancy, when in the year a person was born, low blood oxygen levels, and the mother’s health problems.[1]
Both schizophrenia and bipolar disorder can be treated with a combination of medication and psychotherapy.
In schizophrenia, the main medication used in treatment is a class of drugs called antipsychotics, which help to alleviate the symptoms of psychosis.[4]
The main medication for bipolar disorder is mood stabilizers. Some antipsychotics can also be used as mood stabilizers.[5]
Psychotherapy may also help with managing symptoms of both schizophrenia and bipolar disorder.
Cognitive behavioral therapy (CBT) can be used to treat both schizophrenia [7] and bipolar disorder[8].
There is a kind of CBT that has been adapted to help people who have experienced psychosis. CBT helps you understand your emotions and find ways to manage your behavior. CBT for psychosis (CBTp) is specifically designed to help people understand their symptoms and reduce the distress caused by them.[6]
Family therapy may be helpful for both schizophrenia and bipolar disorder. A therapist will work with the person affected as well as their family to help everyone understand mental illness and how the family can support their loved one effectively.[6]
If a person has symptoms of schizophrenia as well as bipolar disorder, they may be diagnosed with schizoaffective disorder, rather than receiving a diagnosis of both schizophrenia and bipolar disorder.
Schizoaffective disorder is essentially the presence of schizophrenia symptoms accompanied by either depression or mania.[1] Schizoaffective disorder is also treated primarily with antipsychotic medication, mood stabilizers and psychotherapy.[9]
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