Schizophrenia vs. Bipolar Disorder

By Katharine Paljug  @YourCareE
July 25, 2023
Schizophrenia vs. Bipolar Disorder

The differences in symptoms and treatment between schizophrenia and bipolar disorder are often misunderstood. Learn more about schizophrenia vs. bipolar disorder.

Bipolar disorder, formerly known as manic-depressive disorder, is a chronic mental illness with symptoms such as extreme shifts in mood and behavior. The National Alliance on Mental Illness reports that bipolar disorder is most often diagnosed in early adulthood, although it can develop at any point from childhood through old age. About 2.8 percent of people in the United States have some form of bipolar disorder. It is equally common in both men and women. 


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Schizophrenia, by contrast, is a psychotic disorder that affects a person’s perceptions, thought processes, and emotional responsiveness. The National Institutes of Health categorizes schizophrenia as chronic, severe, and disabling. Symptoms include hearing and seeing things that aren’t there, known as hallucinations, and false beliefs, known as delusions. 

Schizophrenia affects approximately 1 in 100 people in the United States. According to the American Psychiatric Association, schizophrenia affects men and women equally, but men tend to have their first episode at a younger age. 

Both disorders have a genetic component and are likely to run in families. They may also be related to environmental and developmental factors, such as exposure to chemicals or malnutrition before birth.

Signs of bipolar disorder

Unlike schizophrenia, bipolar disorder is characterized by elated mood and overly energized behavior offset by periods of depressed emotions and low physical energy, known as manic and depressive episodes. Hypomania, or less frenzied manic episodes, is also common.

Unlike the typical emotional highs and lows that most people experience, the emotional shifts associated with bipolar disorder are extreme and uncontrollable, often resulting in destructive and impulsive decisions. Episodes can happen simultaneously or in rapid succession, or they may be absent altogether for a period of time and return without warning.

During a depressive episode, a person with bipolar disorder has extremely low energy. He or she may sleep too much or feel exhausted but unable to sleep. Symptoms of depressive episodes include:

  • Feelings of worthlessness and sadness
  • Trouble concentrating
  • Eating too much or too little
  • A feeling of being physically slowed down

A person in the middle of a manic episode is the exact opposite: excited and elated, with high levels of physical energy. They may have increased activity levels or feel jumpy and irritable. Manic episodes often include impulsive decisions about money, safety, or personal relationships, as well as an inability to sleep or relax. 


YOU MIGHT ALSO LIKE: Our Schizophrenia Section


Signs of schizophrenia

Symptoms of schizophrenia, which usually start between the ages of 16 and 30, fall into three categories: positive, negative, and cognitive.

Positive (meaning, the symptoms are present) schizophrenic symptoms are psychotic traits that don’t generally occur in healthy people. They may include visual and auditory hallucinations, dysfunctional ways of thinking, delusions, or uncontrolled body movements.

Negative symptoms are a lack of the healthy behaviors. They can include:

  • Difficulty completing activities
  • Reduced speaking
  • Lack of pleasure in everyday life
  • An inability to express emotions, often displayed as a flat affect or emotionless voice

Cognitive symptoms are a disruption in mental processes. They include an inability to process information or use it to make decisions, trouble focusing, or poor working memory. Such symptoms can be subtle and difficult to spot, or they may be extreme and obvious to outside observers. 

A person with schizophrenia is often unable to see the difference between what they feel and believe and the reality that other people around them see. That problem can cause paranoia, confusion, or damage to personal relationships.

Treating schizophrenia and bipolar disorder

Like most mental illness, schizophrenia and bipolar disorder are the result of chemical imbalances in the brain that affect how information is processed and used. Although it is impossible to know the exact causes of the imbalances in every case of schizophrenia or bipolar disorder, drugs and therapies are available to help correct them.

Depending on the severity of symptoms and the needs of the patient, antipsychotic drugs can treat both disorders, but a physician or psychiatrist must carefully prescribe and monitor them due to the side effects the drugs can cause. Bipolar patients may also need mood stabilizers or antidepressants.

Once symptoms are under control, psychotherapy is helpful for both disorders. Treatment may include cognitive behavioral therapy, which helps a patient develop coping mechanisms for symptoms that medication doesn’t control, as well as learning to respond to normal social cues and maintain interpersonal relationships.

For both disorders, it is important to seek professional, medical help. If you think that you or a loved one may have either bipolar disorder or schizophrenia, talk to a doctor as soon as possible.


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July 25, 2023

Reviewed By:  

Christopher Nystuen, MD, MBA