Family and Caregiver Schizophrenia Discussion Forum

Differences between bi-polar and sch?

Since my wife started getting ill some months ago I’ve been reading more and more of this forum and was surprised to find out (not just here but also a patient in Dr Amador’s book) that people with bi polar disorder have some similar symptoms to schiziphrenia.
In particular it seems auditory and visual hallucinations and delusions etc. are common between the two.
Are they actually different illnesses with different treatments and different prognosis, or just different shades of basically the same thing?

There is also schizoaffective. sz with another mood disorder like depression. Julie Fast has and is an advocate for bipolar. Here is her site, you may find it helpful. She also has a program she developed with cards. The ill person can give cards to people telling them what they need at the moment - ie. when I am manic - don’t give me a hug, I am better off not being touched. I got them - didn’t work for us. She also, btw, offers a free 30 minute call with people to see if you would be a fit for her coaching. I sincerely do not think she’s out for money - just to help people. Look it over maybe this could help?

I think the doctors even have a hard time deciding between BP1, SZ & SZA when there’s both a mood component and psychosis involved.

I try to focus on the symptoms, because those are easier to label.

Most of the drugs are the same anyway. You just have to find out what works.
My son has a paranoid schizophrenic diagnosis, but he definitely has manic episodes where he can’t sleep and other mood issues. And his best drug cocktail includes a mood stabilizer and an anti-psychotic.

I think the biggest difference is that unmedicated/undermedicated symptoms wax & wane more often with classic bipolar and they’re more consistent day-to-day for schizophrenia? Just an opinion and what I’ve observed.

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Both are SMIs with overlapping symptoms but as mentioned, the bipolar has the stronger mood component. In my experience, both can easily run in families (lucky us) and often do but every single person has a slightly different treatment and prognosis.

I think you will get some interesting feedback from some folks on here with a lot of knowledge and experience. I’ll be following myself :slight_smile:

Good luck.

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Bipolar is a mood disorder that can have psychotic features, but not always. The poles range from manic to depressed. If someone has bipolar with psychotic features, they are manic or depressed with the extra symptoms on top. Not everybody with bipolar will have psychotic features. In theory, if you treat the mood component, the psychotic features will go away. People with this illness will usually benefit from a mood stabilizer and an antipsychotic.

Schizophrenia is a thought disorder which can have hallucinations, delusions, paranoia, but they don’t have the mood component. The psychotic symptoms exist on their own, and while its common people with sz have poor sleep and have negative symptoms that look like depression, its not considered a mood disorder. These people will only really benefit from antipsychotics.

Schizoaffective is a mood disorder + a thought disorder. It has the manic/depressed phases of bipolar but the thought process disturbance of schizophrenia. The mood component and the psychotic symptoms need to be treated separately. Some psychiatrists actually give the label of schizoaffective because the stigma of schizophrenia is so severe, people become depressed after they are diagnosed with it. These people will benefit from both types of meds.

There are bipolar types 1 and 2.

Bipolar 1 has a manic phase and a depressed phase. Mania is like somebody swallowed a gallon of gasoline. High, high energy, euphoria, no judgement which can be like hypersexuality or excessive spending. Increased irritability, laughing one minute to crying the next to singing and dancing. Going days without sleeping. Thinking they are God, Jesus, or going to become rich, really grandiose. Even their speech changes and becomes rapid and almost like the words cant wait to get out of their mouths. Their minds race constantly and they have no appetite. This can go on for a year or even two then they crash and become very depressed.

Bipolar 2 never reaches full mania, which is where hypomania comes in. Hypomania is like the diet coke of manic. It doesn’t reach the same capacity. It sometimes only lasts days, but the mood will come right back down into depression.

Psychosis is a thought disorder, but shorter than sz. Schizophrenia will be diagnosed if symptoms persist for over 6 months. Psychosis is the paranoia, the hallucinations/delusions, and things like thought insertion, thought withdrawal, thought broadcasting and ideas of reference.


Thanks for this summary.

I’ve always wondered why symptoms need to persist for over 6 months before Schizophrenia can be diagnosed - because are there ever any occurances where people (who don’t have Bipoloar) have symptoms that last for less than 6 months then go away? My understanding is symptoms only ever get worse without treatment, therefore I don’t understand the need for 6 months. If somebody has had symptoms for 2 months for example, and doesn’t have treatment, won’t they just always inevitably continue past 6 months anyway?

25% of people who have an episode of psychosis experience full remission within two years, according to Dr. Torrey’s book “Surviving Schizophrenia.”

"25% of people who have an episode of psychosis experience full remission within two years, according to Dr. Torrey’s book “Surviving Schizophrenia.”

Is that only if they take medication?

There are differences in the DNA damage in these disorders. What I understood from reading papers that the biggest DNA damage is in sz, less damage in bp and sza.
DNA damage is caused by imbalance of oxidants and antioxidants in the cells. High oxidants levels are found in sz. The body cannot repair all the damage at the rate at which oxidants are produced. Anyway, practical use of this info is to increase antioxidants in their diets, put more fruit and veggies. Also give them multivitamins. I know that vitamin c is a good antioxidant and can be taken orally up to 5 g a day. The paper says This study also provides evidence of high oxidative stress statuses and inadequate DNA repair capacities in patients with schizophrenia. Moreover, psychotropic drugs did not induce any DNA damage to the lymphocytes according to in vitro analyses. The use of clozapine and adequate repair processes of the patients were the decisive factors in the prevention of DNA damage.

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Thank you very much for this
I have a strong feeling someone I care for very much was mis diagnosed

Yes! There is also a disorder call Schizophreniform! That is the presence of symptoms for >1 month and < 6. I work in mental health and I have seen people with schizophreniform who completely heal from it and resume normal life. It is totally amazing! I have also seen people develop schizophreniform during times of stress and are later diagnosed with scz. I don’t know if there is a bipolar equivalent but I don’t think so.

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I had not heard of this one. Thanks!

My son has been diagnosed schizoaffective , has all the common symptoms of schizophrenia and all the common symptoms of bi polar , so I wouldn’t say it’s a mood disorder x