There are a lot of mental disorders, syndromes, and pathologies. At the same time, they have similar symptoms and signs in which the average person can get confused. Even an experienced doctor may need more than one month of observation of the patient in order to make an accurate diagnosis. In modern psychiatry, there are two main diseases – schizophrenia and bipolar disorder. Both are characterized by a state of psychosis, and sometimes hallucinations. But still, these are different pathologies that require two different approaches to treatment. Let’s find out what is the difference between them.

Bipolar disorder Bipolar affective disorder (BAD), formerly known as manic-depressive psychosis, is an endogenous mental disorder with affective states – manic, depressive, or mixed. It develops in phases that follow one another, as a result of which the patient’s mood changes dramatically.

It should be understood that BAD is a fairly general concept for various disorders. Moreover, they usually develop in parallel with other disorders, such as anxiety. Its symptoms are so extensive that it requires careful diagnosis in each case. However, there are still general patterns. First of all, a phase flow is characteristic of a bipolar. There are two main stages of the disease:

  • Manic;
  • Depressive.

Let’s analyze each in more detail.

Differences Between Schizophrenia and Bipolar Disorder

Manic Phase of Bipolar Disorder

The initial phase is characterized by high spirits. The patient feels a surge of strength, both spiritual and physical. He talks a lot, and very quickly, but gradually the content of the speech becomes more and more meaningless. As a rule, one thought begins to replace another according to the principle of associations. There is hypermnesia, that is, an increased ability to remember details. A person begins to sleep less, but at the same time is quite active and eats a lot.

Further development of the phase leads to an increase in symptoms. The patient jokes and laughs a lot for no reason, but sometimes flares up and gets angry. Speech and motor overexcitation begin to be traced. At such moments, it is impossible to conduct a dialogue with a person, he jumps from one topic to another without discussing anything specific.

People try to communicate less with such a person. He continues to be active, including at work, invests in new projects that everyone considers unpromising, makes bright plans, and fantasizes a lot. Sleep duration is reduced to 3-4 hours a day.

Some episodes that occur to the patient during the manic phase are amnestic.

Then comes the stage of sharp motor excitation. The patient’s actions are erratic, and speech becomes slurred. However, gradually the intensity of the symptoms decreases. First, motor excitation subsides while maintaining the speed of speech. But the latter also fades over time. In a sense, the person returns to normal. Sometimes he is even calmer than he is in ordinary life.


Depressive Phase of Bipolar Disorder

The depressive phase is the opposite of the manic phase and is characterized by a decrease in mood and activity. First, the general mental tone falls. Gradually, anxiety builds up. A person works less because there is not enough physical and mental strength for a long activity. The patient’s speech is slow, and the actions are inhibited.

Further progression of the disorder leads to the development of symptoms of severe depression. Anxiety, melancholy, loss of appetite, silence, and delusional ideas are observed. A person does not answer questions or does it reluctantly and in monosyllables, eats little, and engages in moral self-flagellation and self-abasement.

In this state, the patient often thinks about death and suicide. Moreover, suicidal attempts happen quite often, although they do not always lead to death. Illusions and hallucinations are rare, but some patients complain of voices ordering them to commit suicide.

The exit from the phase is accompanied by speech and motor activity. Gradually, the symptoms weaken and disappear. But it depends on the variant of the development of the depressive stage. It can be hypochondriacal, asthenic, delusional, etc. The name is due to the dominance of one or another feature.


Mixed States of Bipolar Disorder

In mixed states of bipolar disorder, manic and depressive symptoms are observed. They can occur both simultaneously and alternately with a difference of several hours. As a rule, this form of the disease occurs in young patients, especially in patients whose disorder manifested in adolescence.

This type of bipolar disorder is more difficult to diagnose due to the inconsistency of symptoms. A person can be both agitated and anxious-depressive at the same time. The course of the disease is also quite severe. 60% of these patients think about suicide. Moreover, about 50% of patients who committed suicide had precisely a mixed form of bipolar disorder.


Main Symptoms of Bipolar Disorder

So, the main signs of BAD, which are observed in almost all cases, are the following symptoms:

  • Hyperactivity;
  • Increased fatigue;
  • Low concentration of attention;
  • Irritability;
  • Impulsiveness;
  • Lethargy;
  • Sleep problems;
  • Suicidal moods.

All this leads to problems in the family, in relationships, at work, or at school. A person who previously studied well begins to get bad grades, and a responsible employee comes from work with a reprimand, etc. Such manifestations may be the reason for a visit to a psychologist or psychotherapist.

As for delusions and hallucinations, the hallmarks of most forms of schizophrenia, they are extremely rare in bipolar disorder. But the problem is that the presence of these symptoms does not always speak in favor of schizophrenic disorders. It is possible that BAD is still developing.


Main symptoms of schizophrenia

Schizophrenia is a complex and multifaceted disease with many symptoms. They are divided into two groups – positive and negative. The first testify to the activity of the psyche. This includes delusions and hallucinations. The latter is characterized by declines in mental tone. In this case, there are signs that are included in the symptoms of BAD:

  • Apathy and indifference;
  • Increased anxiety;
  • Outbursts of anger;
  • Motor or speech excitement;
  • Insomnia, nightmares;
  • Sudden mood swings.

The intensity of symptoms is determined by the type and form of schizophrenia. So, a sluggish one can develop for years, practically without manifesting itself, and a paranoid one usually has an acute and rapid development.


Risk factors

BAD can be distinguished from schizophrenia through differential diagnosis and long-term observation of symptoms. If we talk about the risk factors and causes of these psychopathologies, then they are largely similar. The fact is that the etiology of both disorders is unknown.

In most cases, we are talking about a genetic predisposition. First of all, doctors find out if there are people with mental disorders in the patient’s family. The closer the degree of relationship, the higher the risk of the disease.


Main Differences Between Schizophrenia and Bipolar Disorder

In bipolar disorder, psychosis leads to overexcitation of the nervous system. This also happens with schizophrenia. Also, a similar similarity is observed with negative symptoms. However, there are three main differences that allow differentiating diagnoses:

  • In bipolar disorder, mania is accompanied by an extreme manifestation of feelings and emotions. However, in general, a person is adequate, and therefore rarely shows aggression. The schizophrenic is not always aware of his actions, therefore he is a danger to himself and others.
  • With the development of BAD, the patient does not lose contact and does not strive for complete loneliness even during a period of apathy. Withdrawal and alienation are the main symptoms of schizophrenia. They are especially noticeable in patients who are sociable in a healthy state.
  • The main difference is in the consequences. Bipolar disorder does not damage the personality, while schizophrenia leaves its mark on the psyche. In a sense, after an attack, a person will never be the same as he was before. In bipolar disorder, even if the psychosis lasts for a long time, personality traits remain the same.

The similarity between bipolar disorder and schizophrenia is that both disorders are chronic. Treatment and prevention will take a lifetime.



An accurate diagnosis of the patient can be made only after a few weeks or months after contacting the doctors. After that, the doctor will draw up a treatment card.

In bipolar disorder, it includes:

  • Psychotherapeutic sessions;
  • Mood stabilizing drugs;
  • Antidepressants;
  • Sleeping pills.

Schizophrenia is treated much more difficult and longer. Sometimes it is necessary to use insulin coma therapy when the patient is artificially injected into a hypoglycemic coma. Antipsychotics and other antipsychotics are also prescribed. Psychotherapeutic methods include several areas – cognitive, behavioral, etc.

BAD cannot go into schizophrenia. These are two different diseases with different prognoses and outcomes.

BAD treatment can be done on an outpatient basis. Attacks in schizophrenia lead to hospitalization. The periods of remission in bipolar disorder are longer. However, serious consequences are possible in both cases. With complications, patients are assigned a disability. Sometimes they are considered insane. And this applies to patients with both bipolar disorder and schizophrenia.


What is more dangerous?

Many people are interested in which is worse – BAD or schizophrenic psychopathology. The question is not very correct, however, in simple terms, bipolar disorder is not so dangerous. It does not lead to the disintegration of the personality. Schizophrenia can completely destroy it, and as a result of which a person will forever remain in his inner world.