There are many mental disorders, syndromes, and pathologies. At the same time, they have similar symptoms and signs that can confuse the average person. Even an experienced physician may need more than one month of patient observation to diagnose accurately. In modern psychiatry, two major diseases are schizophrenia and bipolar disorder. Both are characterized by a state of psychosis and sometimes hallucinations. Still, they are different pathologies that require two different approaches to treatment. Let’s find out what the difference between them is.
Bipolar affective disorder (BAD), formerly manic-depressive psychosis, is an endogenous mental disorder with affective states – manic, depressive, or mixed. It develops in phases that replace one another, changing the patient’s mood dramatically.
It is worth understanding that BAR is a rather general concept for various disorders. Moreover, they usually develop in parallel with other disorders, such as anxiety. Its symptomatology is so extensive that it requires careful diagnosis in each case. However, there are still general patterns. First of all, bipolar is characterized by a phase course. There are two main stages of the disease:
Let’s discuss each in more detail.
Manic BAR Stage
High spirits characterize the initial stage. The patient feels a burst of energy, both spiritual and physical. He speaks a lot, very quickly at that, 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. Hypermnesia, that is, an increased ability to remember details, is observed. The person begins to sleep less but is active and eats a lot.
Further development of the stage leads to an increase in symptoms. The patient jokes and laughs for no reason but sometimes flares up and gets angry. Speech and motor overexcitement begin to emerge. At such moments, it is impossible to have a dialogue with the 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 at work, investing in new projects everyone considers unpromising, making rosy plans, and fantasizing a lot. The duration of sleep is reduced to 3-4 hours a day.
Some episodes that occur to the patient during the manic stage are amnesiac.
Then a stage of abrupt motor agitation sets in. The patient’s actions are disorderly, and their speech becomes slurred. Gradually, however, the intensity of the signs decreases. At first, motor agitation subsides while speech retains acceleration. But the latter also eventually subsides. In a sense, the person returns to normal. Sometimes he is even more relaxed than he would be in his ordinary life.
Depressive Stage of BAR
The depressive stage is the opposite of the manic stage and is characterized by decreased mood and activity. At first, the general mental tone drops. Anxiety gradually builds up. The person works less, as there is not enough physical and mental strength for a long activity. The patient’s speech is slow, and his actions sluggish.
Further progression of the disorder leads to the development of symptoms of severe depression. Anxiety, melancholy, decreased appetite, taciturnity, and delusions are observed. The person does not answer questions or does it grudgingly and unilaterally, eats little, and is engaged in moral self-deprecation and self-deprecation.
In this condition, the patient often thinks about death and suicide. And suicide attempts occur quite often, though they do not always lead to a lethal outcome. Illusions and hallucinations are rare, but some patients complain of voices telling them to commit suicide.
Exiting the phase is accompanied by speech and motor activity. Gradually the symptoms subside and disappear. But it depends on the variant of development of the depressive stage. It can be hypochondriac, asthenic, delusional, etc. The name is determined by the predominance of one or another sign.
Mixed Conditions of Bipolar Disorder
In mixed conditions of bipolar disorder, manic and depressive symptoms are observed. They may occur either simultaneously or alternately with a difference of several hours. As a rule, this illness occurs in young patients, especially those with disorders manifested in adolescence.
This type of BAR is more difficult to diagnose because of the inconsistency of the 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 such patients think about suicide. Moreover, about 50% of patients who committed suicide had a mixed form of bipolar disorder.
Common symptoms of Bipolar Disorder
So, the main symptoms of BAR, which are observed in almost all cases, are the following:
- Increased fatigue;
- Low concentration of attention;
- Sleep problems;
- Suicidal tendencies.
All this leads to family, relationships, work, or studies problems. A person previously a good student begins to get bad grades, and a responsible employee comes home from work with a reprimand, etc. Such symptoms may be a reason for a visit to a psychologist or psychotherapist.
As for delusions and hallucinations, the hallmarks of most types 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. BAD may occur.
Common symptoms of schizophrenia
Schizophrenia is a complex and multifaceted illness with many symptoms. They are divided into two groups – positive and negative. The first ones are indicative of mental activity. These include delirium and hallucinations. Declines in mental tone characterize the latter. In this case, some signs are also included in the symptoms of BAR:
- Apathy and indifference;
- Increased anxiety;
- Outbursts of anger;
- Motor or speech agitation;
- Insomnia, nightmares;
- Mood swings.
The type and form of schizophrenia determine the intensity of symptoms. For example, the low-grade can develop over the years, with little or no symptoms, while the paranoid usually has an acute and rapid development.
Can find differences between BAR and schizophrenia through differential diagnosis and long-term observation of symptoms. If we talk about the risk factors and causes of these psychopathologies, they are similar in many respects. The fact is that the etiology of the two disorders is unknown.
In most cases, it is a genetic predisposition. First, doctors find out whether the patient has a family history of people with mental disorders—the closer the degree of relationship, the greater the risk of the disease.
Main Differences Between Schizophrenia and Bipolar Disorder
In bipolar disorder, psychosis leads to nervous system overstimulation. It happens in schizophrenia as well. A similar similarity is also observed with negative symptoms. However, three main differences allow differentiating the diagnoses:
- In bipolar disorder, mania is accompanied by an extreme display of feelings and emotions. However, in general, the person is adequate and rarely shows aggression. The person with schizophrenia is not always aware of his actions, so he is a danger to himself and others.
- In the development of BAR, the patient does not lose contact and does not seek complete loneliness even during periods of apathy. Closeness and aloofness 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 affects the psyche. In a sense, the person will never be the same after a seizure as they were before. With bipolar disorder, personality traits remain the same even if the psychosis lasts a long time.
The similarity between BAR and schizophrenia is that both disorders are chronic. You will need treatment and prevention for the rest of your life.
The patient may not receive an accurate diagnosis until several weeks or months after seeing the doctors. After that, the doctor will draw up a treatment chart.
In the case of bipolar disorder, it includes:
- Psychotherapy sessions;
- Medications to stabilize mood;
- Sleeping pills.
Schizophrenia is much harder and longer to treat. Sometimes it is necessary to use insulin-comatose therapy when the patient is artificially put into a hypoglycemic coma. Neuroleptics and other antipsychotic medications are also prescribed. Psychotherapeutic methods include several strands – cognitive, behavioral, and others.
BAR can’t turn into schizophrenia. They are two different diseases with different prognoses and outcomes.
Treatment for BAR can be done as an outpatient. Schizophrenia seizures lead to hospitalization. Periods of remission in bipolar disorder are longer. However, severe consequences are possible in both cases. With complications, patients are assigned a disability. Sometimes, they are recognized as insane. It applies to patients with both BAR and schizophrenia.