Bipolar and schizophrenia symptoms: How to know the difference

Bipolar and schizophrenia symptoms: How to know the difference

Bipolar disorder and schizophrenia are medical disorders which have certain similar symptoms, but which can have significant variations. The bipolar disorder causes mood, energy levels and thinking shifts. Schizophrenia causes an individual to appear to be losing touch with reality.

People with bipolar disorder may experience mania and depression episodes which are often separated by periods of relative stability.

Individuals suffering from schizophrenia undergo psychotic symptoms such as hallucinations or delusions. Some people with bipolar disorder have psychotic symptoms, as well.

Despite of some differences in symptoms it may be difficult to get the correct diagnosis. A person may also have both schizophrenia and bipolar disorder which may make diagnosis more complicated.

Some people have schizoaffective disorder involving a combination of symptoms of schizophrenia and those of a mood disorder.

We are looking into the similarities and differences between bipolar disorder and schizophrenia in this article. We also discuss diagnostic methods and treatment options.

Symptoms of bipolar disorder

A lady having bad mood
People with bipolar disorder experience extreme changes in mood.

Bipolar disorder and schizophrenia signs differ, and can differ in type and severity.

They can get worse, then improve significantly or leave for a while, which some doctors call remission.

Individuals with bipolar disorder undergo mood swings. Doctors may identify “highs” as mania or hypomania while “lows” mean a reduction in mood and sometimes depression.

Individuals experience a less severe form of mania, known as hypomania, in some forms of bipolar disorder. The signs are the same but they ‘re less severe in hypomania. Nevertheless, they do influence the life and relationships of a person.

A manic episode is what it takes to diagnose bipolar I, while hypomania preceding or following a major depressive episode is required to diagnose bipolar II. A person also experiences irregular periods of relative stability.

Symptoms of mania

Mania can involve:

  • anger or irritability
  • difficulty sleeping or less need for sleep
  • excessive energy and restlessness
  • high self-esteem
  • inability to concentrate or make decisions
  • increased engagement in pleasurable activities, such as sexual activity or drug use
  • intense excitement
  • racing thoughts
  • reckless behavior, such as overspending

Depressive symptoms are the same in a person with bipolar disorder as those with the major depressive disorder.

Symptoms of depression
The primary symptom is a negative or helpless feeling that lasts for 2 weeks or longer.

Other symptoms include:

  • changes in appetite
  • changes in sleep habits
  • fatigue and low energy
  • a loss of interest in things once enjoyed
  • low self-esteem
  • physical aches and pains without an apparent cause
  • suicidal thoughts or behaviors

Anxiety and psychotic episodes may also trigger bipolar disorder, during which a person loses contact with reality.

Nearly half of all diagnosed with a bipolar disorder experiences psychotic hallucinations or delusions.

Doctors may be uncertain if people show psychotic symptoms whether they have bipolar disorder or schizophrenia.

Symptoms of schizophrenia

Symptoms of schizophrenia influence the feelings, emotions and behaviors of an individual. They cover:


These are false assumptions, which are encountered by most people with schizophrenia.

Of example, people might believe they are popular or different in some way, they ‘re being threatened or stalked, or something bad is about to happen.


People see, hear, or smell objects that aren’t there, during a hallucination. The most common form includes listening voices.

Disorganized thinking and speech

When talking with others people can not make sense. They may offer irrelevant answers to questions or the people around them may find their sentences meaningless.

Abnormal behavior

For example, people with schizophrenia can exhibit erratic behaviour by making childlike acts, odd postures or repetitive movements.

Inability to function regularly

Schizophrenia can impair a person’s ability to take care of his or her personal health, participate in socially appropriate ways with others, or conduct everyday activities.

Overlapping symptoms

A bipolar disorder or schizophrenia can show the following symptoms:

Psychotic episodes

Such hallucinations or delusions occur for certain people with bipolar disorder during serious periods of mania or depression.

Disorganized thinking

This is typical in people with schizophrenia but during mania episodes people with bipolar disorder can tend to have disorganized thoughts. They can struggle to concentrate on one idea or task at a time.

Symptoms of depression

Individuals with either disorder may be experiencing a lack of interest in activities they once enjoyed during times of depression. Many people do not feel at ease or have trouble focusing or making decisions

Drug usage problems

For people with schizophrenia , bipolar disorder, or depression, some studies record high levels of drug and alcohol abuse.

When an individual has substantial overlap of symptoms, they can be diagnosed with schizoaffective disorder, which is a related but different mental health condition.


A woman thinking about her health condcondition
Around 4.4 percent of American adults experience bipolar disorder at some point in their lives.

Bipolar disorder is frequenter than schizophrenia.

Approximately 2.8 percent of people in the United States develop bipolar disorder in a given year, and 4.4 percent develop it at some stage in their lives, according to the National Institute of Mental Health.

82.9 percent of them have extreme disability due to their symptoms and 17.1 percent have mild disability.

The disease begins on average at age 25, and occurs in males and females at an equal pace.

0.3–0.7 percent of people worldwide have schizophrenia, making it the most common psychiatric disorder, according to a report in American Family Physician.

That’s also slightly more common in males, and between late adolescence and a person’s mid-30s symptoms begin to occur first.


Diagnosis of the two disorders involves the same procedures. A physician or mental health professional would typically do the following:

A physical examination

It helps to decide whether the psychological effects cause medical problems. Even a doctor can ask for different tests, such as:

  • blood tests
  • MRI or CT scans of the brain
  • drug and alcohol screenings

A psychological evaluation

A doctor, most likely a psychiatrist, will examine the signs and symptoms of an individual, including those influencing feelings , emotions and behaviours.

They will also inquire about family and personal mental health background, and may have a psychological self-assessment form completed for the individual.

The doctor will also observe the behavior and conduct of the individual during this examination and check for symptoms of schizophrenia and bipolar disorder.

They will also equate the person’s symptoms with the guidelines set out in the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association, often referred to as the DSM-5.

Diary of symptoms and moods

Maintaining a regular diary of thoughts, moods, and sleep patterns can help. The doctor can look at this to identify behavior patterns and other hints that may inform diagnosis and treatment.


Both conditions require lifelong treatment to manage symptoms.

Treatment for bipolar disorder

A child talking to her doctor
Attending psychotherapy sessions can help a person manage their bipolar disorder.

Most people suffering from bipolar disorder require medication to regulate their mood.

These may include:

  • lithium, a mood stabilizer that may significantly help prevent relapse in the long term
  • antipsychotic drugs
  • antidepressants
  • anti-anxiety medications
  • sleeping pills

Psychotherapy is an important part of bipolar disorder management. It may take place individually or with a group or the person’s family.

Therapy can help people manage their thoughts and emotions, establish a routine, and identify triggers.

Those who do not respond to medications or psychotherapy may benefit from electroconvulsive therapy (ECT). The goal is to alter the brain’s chemistry by sending electrical currents through the brain, causing a seizure.

Other strategies that can help people with bipolar disorder include:

  • avoiding alcohol and drugs
  • eating a balanced diet
  • establishing a daily routine
  • exercising regularly
  • getting enough sleep
  • identifying triggers and taking steps to prevent or lessen manic or depressive episodes
  • managing stress
  • seeking help and support from family, friends, and others

Treatment for schizophrenia

In certain people with schizophrenia, antipsychotic drugs are a critical part of treatment. Doctors believe they change the chemistry of the brain and lessen symptoms such as hallucinations and delusions.

Some people may need other prescription medications, such as antidepressants or anti-anxiety drugs. A doctor can prescribe ECT for people who don’t respond to medicine, which may improve psychotic symptoms.

People with schizophrenia usually benefit from psychiatric and social therapies when the symptoms of psychosis are under control. These may include:

  • psychotherapy, both in individual and family settings
  • social skills training, to improve interactions with others
  • employment support, to help a person secure or perform a job more easily
  • daily living support, to help people find housing and manage daily responsibilities

Other coping strategies include:

  • avoiding alcohol and drug use
  • joining a support group
  • learning about schizophrenia
  • making certain healthful lifestyle choices, such as eating a balanced diet, exercising, and maintaining a sleep schedule
  • managing stress through meditation, exercise, and yoga
  • seeking help from family and friends


While there are similarities between bipolar disorder and schizophrenia, there are also major differences, particularly about severity of symptoms and treatment.

Individuals with bipolar disorder usually vary between low and high mood cycles while those with schizophrenia normally lose contact with reality when they experience hallucinations and delusions.

An individual who has either condition can control their symptoms with medication and that the effect it has on their lives.

Usually, bipolar disorder becomes more manageable if a person is given adequate treatment. Schizophrenia is more difficult to manage and it appears to require more support from those who do.