The difference is hard to tell

Bipolar disorder and schizophrenia are distinct yet overlapping mental health conditions that present unique challenges in diagnosis and treatment.

Bipolar disorder is characterized by significant shifts in mood, energy levels, and cognition. Individuals with bipolar disorder may cycle between periods of elevated mood (mania), where they experience heightened energy and activity, and periods of low mood (depression), marked by sadness and disinterest in activities they once enjoyed. These mood episodes are interspersed with periods of relative stability.

On the other hand, schizophrenia typically involves symptoms of psychosis, such as hallucinations (perceiving things that aren’t real) and delusions (believing things that are not true). People with schizophrenia may also experience disorganised thinking and impaired cognitive functioning. Unlike bipolar disorder, schizophrenia tends to be a chronic condition with persistent symptoms that require ongoing management.

However, the distinction can become blurred in cases of schizoaffective disorder, where individuals experience a combination of mood symptoms characteristic of bipolar disorder and psychotic symptoms akin to schizophrenia. This dual diagnosis can complicate treatment and necessitates a thorough evaluation by mental health professionals to accurately differentiate between these conditions.

Navigating the complexities of bipolar disorder, schizophrenia, and schizoaffective disorder underscores the importance of early intervention, comprehensive assessment, and personalised treatment plans. By raising awareness and promoting understanding, we can support individuals in accessing appropriate care and fostering a compassionate community for those affected by these challenging mental health conditions.

Bipolar disorder and schizophrenia can be dangerous

So be aware

It’s crucial to recognise that mental health conditions like bipolar disorder and schizophrenia can have profound impacts on individuals and those around them.

Often beyond what many perceive from media portrayals. When these conditions are not properly managed or when medications are discontinued, the consequences can be severe, including potential brain damage and significant disruptions to personal lives.

Currently, two friends of mine are experiencing firsthand the repercussions of assisting someone with bipolar disorder or schizophrenia. This experience has turned their world upside down, challenging their beliefs and causing considerable turmoil.

In my own experience, my ex-partner even managed to sway the opinions of nearly an entire town, manipulating perceptions and causing widespread misunderstanding.

Sadly, my friends are now facing a similar situation where the individual’s actions and narratives are influencing other’s perceptions, despite the reality of the situation and the evidence from psychiatrists and psychologists.

Individuals affected by bipolar disorder, schizophrenia, and similar conditions can exhibit remarkable persuasive abilities, akin to a magician. They may inadvertently or intentionally influence even the most discerning individuals, leading them to believe falsehoods or misconceptions.

It’s essential for society to cultivate greater awareness and understanding of these mental health conditions.

This includes recognising the complexities involved, supporting those affected, and promoting education to prevent misinformation and stigma. By fostering empathy and knowledge, we can better support individuals and communities impacted by these challenging conditions.

What is Schizophrenia?

Firstly Schizophrenia and bipolar disorder (BD) share many of the same symptoms. So it can be hard to distinguish the difference.

Schizophrenia is a chronic brain disorder that affects approximately 24 million people or 1 in 300 people (0.32%) worldwide, according to the WHO.

When schizophrenia is active, symptoms can include delusions, hallucinations, disorganised speech, trouble with thinking and lack of motivation.

But with treatment, most symptoms of schizophrenia will improve greatly.

Sadly, there is no cure for schizophrenia and the complexity of schizophrenia leads to many misconceptions about the disease.

Schizophrenia does not mean the person has a split personality or even multiple personalities. Most people with schizophrenia are no more dangerous or violent than the general population.

However, some people with schizophrenia are significantly more likely to be violent than other members of the general population. Like in the case of David Berkowitz, better known as the “Son of Sam.” Who killed six people in the 1970s claiming that his neighbour’s dog had told him to do it. He was later diagnosed with paranoid schizophrenia. 

What are the signs and symptoms of schizophrenia?

Schizophrenia symptoms can differ from person to person, but they generally fall into three main categories: psychotic, negative, and cognitive.

They are hard to work out yourself so as soon as you think something is not right contact the appropriate person.

Starting treatment as soon as the first episode of psychosis happens is very important. As this will help recovery.

However, research shows that gradual changes in thinking, mood, and social functioning often appear before the first episode of psychosis. So many times it is difficult to know the first episode.

Psychotic symptoms

These are changes in the way a person thinks, acts, and experiences the world.

People with psychotic symptoms often lose their sense of reality and experience the world in a distorted way.

For some people, these symptoms come and go. For others, the symptoms become stable over time. Psychotic symptoms include:

• Hallucinations: When a person sees, hears, smells, tastes, or feels things that are not there. Hearing voices is common for people with schizophrenia. People who hear voices may hear them for a long time before family or friends notice there is a problem.

 

• Delusions: When a person has strong beliefs that are not true and may seem irrational to others. For example, individuals experiencing delusions may believe that people on the radio and television are sending special messages that require a certain response, or they may believe that they are in danger or that others are trying to hurt them.

 

• Thought disorder: When a person has ways of thinking that are unusual or illogical. People with thought disorders may have trouble organizing their thoughts and speech. Sometimes a person will stop talking in the middle of a thought, jump from topic to topic, or make up words that have no meaning.

 

• Movement disorder: When a person exhibits abnormal body movements. People with movement disorder may repeat certain motions over and over.

Negative symptoms

These include a loss of motivation, loss of interest or enjoyment in daily activities, withdrawal from social life, difficulty showing emotions, and difficulty functioning normally.

 

• Having trouble planning and sticking with activities, such as food shopping

 

• Having trouble anticipating and feeling pleasure in everyday life

 

• Talking in a dull voice and showing limited facial expression

 

• Avoiding social interaction or interacting in socially awkward ways

 

• Having very low energy and spending a lot of time in passive activities. In extreme cases, a person might stop moving or talking for a while, which is a rare condition called catatonia.

 

These symptoms are sometimes mistaken for symptoms of depression or other mental illnesses.

Cognitive symptoms

These include problems in attention, concentration, and memory. These symptoms can make it hard to follow a conversation, learn new things, or remember appointments.

A person’s level of cognitive functioning is one of the best predictors of their day-to-day functioning. Healthcare providers evaluate cognitive functioning using specific tests. Cognitive symptoms include –

 

• Having trouble processing information to make decisions

 

• Having trouble using information immediately after learning it

 

• Having trouble focusing or paying attention

Childhood schizophrenia

Schizophrenia is commonly diagnosed in people in their teens and early 20s. Schizophrenia can begin earlier, but Schizophrenia is rare in younger children.

When symptoms occur before the age of 13, the condition is sometimes called early-onset or childhood schizophrenia.

Diagnosing this condition is difficult, as children’s behaviours are always changing as they develop into teens.

Some of the most common symptoms of this mental health disorder can show up in other conditions like

Symptoms of childhood schizophrenia include:

 

• Unusual fears or anxieties (paranoia)

 

• Sleep problems

 

• Emotional swings

 

• Hearing voices or seeing things (hallucinations)

 

• Decreased attention to self-care

 

• Sudden changes in behaviour

 

• Deterioration in academic performance

 

• Odd beliefs or thinking

 

• Sexual attraction to their carers or even siblings

 

It’s important to understand and see the differences that occur in growing children and teenagers. Thus not to mistake them.

If you are concerned that your child has acquired some new, worrying behaviours. It is important to talk to a mental health professional as soon as you can.

No matter what the issue is, a professional can support you especially if your child is becoming dangerous.

Risk of violence

Most people with schizophrenia are not violent. However, for people with schizophrenia, the risk of self-harm and violence towards others is greatest when the illness is untreated.

It is important to help people who are showing symptoms to get treatment as soon as possible.

It is also very important to not stop the treatment. As once the treatment or medication is stopped then you risk them becoming more dangerous.

Bipolar disorder

Bipolar disorder, previously known as manic depression, is a condition that affects your moods.

Bipolar is a severe mental illness characterised by extreme mood swings and changes in energy levels.

Someone with bipolar can have long or short periods of stability but can then go into deep depression or experience hypomania, mania or psychosis.

Bipolar mood swings go far beyond most people’s everyday experiences of feeling a bit down or a bit unhappy.

To help explain the extremes of mood, Bipolar UK uses a Mood Scale where 0 is low and 10 is high.

People without bipolar have moods that sit in the middle of the scale. On their worst days when they feel down, they rank 4. On their best days when they feel happy, they rank 6.

People with bipolar experience a much wider range of moods — from 0 (deep depression with recurring suicidal thoughts) to 10 (an extreme manic high with psychosis and hallucinations).

They can also experience a mixed state where symptoms of depression and mania occur at the same time.

Hallucinations and delusions can also be experienced as a result of

 

• A brain tumour or cyst

 

• Dementia, including Alzheimer’s disease

 

• Neurological conditions such as epilepsy, Parkinson’s disease, and Huntington’s disease

 

• HIV and other sexually transmitted infections that affect the brain

 

• Malaria

 

• Multiple sclerosis (MS)

 

• A stroke

 

Who gets affected by bipolar?

Bipolar affects people of all ages and from all backgrounds. Bipolar disorder’s causes are hugely unknown.

Like many mental health conditions, bipolar symptoms are usually first noticeable in teenagers and young adults. Research has found that almost 50% of people get symptoms before the age of 21.

In one study, more young people screened positive for bipolar than older people

• 3.4% of people aged 16 to 24 had bipolar

 

• 0.4% of people aged 65 to 74 had bipolar

 

The reason for this big variation is unknown, although limitations in the screening tools used, lower life expectancy and increased cases among young people are all potential factors. bipolar disorder causes

Symptoms of bipolar

These are the most common symptoms of bipolar

 

• Mania

 

• Hypomania

 

• Depression

 

• Psychosis

 

• Suicidal thinking

 

People can go into a mixed state too. Which involves symptoms of depression and hypomania or mania occurring all at the same time. People can also experience psychosis.

There is no typical pattern of symptoms. Some people with bipolar experience more highs, while others experience more lows.

A small number of people with bipolar experience ‘rapid cycling’ or ‘ultra-rapid cycling’, where their emotions change in quick succession.

Some people with bipolar can live a ‘normal’ life with a relatively stable mood for weeks, months or even years at a time.

But both a manic high and a depressive low mood can be incredibly destructive.

Mania

Mania is officially described as an elevated, expansive and irritable mood with changes in energy and activity levels.

 

You may feel 

 

• Euphoric

 

• Very excited

 

• Extremely confident and/or superior to others

 

• More sexually aroused than usual

 

• Irritable

 

• As though your thoughts are speeded up

 

You may

 

• Talk a lot, probably very quickly

 

• Make impulsive decisions

 

• Spend recklessly or gamble

 

• Say inappropriate or rude things You more than likely won’t have any idea how this affects other people

 

• Take risks

 

• Sleep very little

 

Someone experiencing a manic episode usually has no insight into their condition. This means they have no idea how difficult their behaviour can be for their family and friends.

Hypomania

Described as a distinct period of abnormally and persistently elevated mood. Hypomania is the stage between a balanced, happy mood and mania.

 

You may feel

 

• Energetic, as though you have an ongoing adrenaline rush

 

• Happy, with a strong sense of wellbeing

 

• Confident

 

• Creative

 

• Irritable and distracted

 

You may

 

• Talk a lot

 

• Be very friendly

 

• Not sleep much

 

• Become very creative and productive (the reason bipolar is sometimes linked with genius and talent)

 

Hypomania can sometimes feel very pleasurable but, if it’s left untreated, it can tip into mania. It is very scary to be around a person when they are in this state.

Spotting and managing a hypomanic state before it becomes mania is one of the main challenges for people living with bipolar. It is also especially hard for those living with the person, like when I had my “accident.”

Depression

Depression affects everybody with bipolar differently but typical symptoms include feeling sad, hopeless or tearful most of the time.

Symptoms can range from mild to severe, and these periods may be very debilitating.

You may feel

 

• Hopeless, sad and tearful

 

• Tired

 

• Worthless and lacking confidence

 

• Uninterested in everything

 

• Agitated

 

• Experiencing aches and pains

 

You may

 

• Avoid things you usually enjoy

 

• Sleep a lot, or having trouble sleeping

 

• Eat too little or too much

 

• Misuse alcohol or other substances

 

• Avoid social situations and sex

 

• Focus on difficult or upsetting things

 

You may struggle with basic self-care and doing your usual activities, such as working and socialising, for a long time.

Severe depression can lead to suicidal thinking and, very sadly, if your depression is left untreated, it can sometimes lead to suicide.

Psychosis

At either end of the mood scale, both extreme mania and deep depression can develop into psychosis. Where you lose touch with reality and may experience hallucinations, extreme paranoia and delusions. If this happens, you will likely be sectioned to keep you safe.

This is usually when the lies start to happen and they do not stop.

If you think someone is going through this it is important to speak to many different people that have been around the person with psychosis to work out the truth. So you are then aware that this state is occurring.

Bipolar psychosis symptoms

Symptoms of psychosis in bipolar disorder may include

 

• Hallucinations

 

• Delusions

 

• Incoherent or irrational thoughts and speech

 

• Lack of awareness

Hallucinations and delusions

When people hallucinate, they experience things that aren’t real to anyone but themselves. They may hear voices, see things that aren’t there or have unexplained sensations.

Hallucinations can encompass all the senses.

Delusions are an unshakable belief in something that isn’t real, true, or likely to happen.

People may have grandiose delusions. This means they believe they’re invincible or have special powers or talents. In bipolar disorder, delusions of grandeur are common during episodes of mania.

If a person with bipolar disorder experiences depressive episodes, they may experience paranoid delusions. They might believe someone is out to get them, take something from them or their property.

People with psychosis often experience irrational thoughts. Their speech may be fast, rambling, or hard to follow. They may move from subject to subject, losing track of their train of thought.

Lack of awareness

Many people experiencing psychosis may not be aware that their behaviour is not consistent with what’s happening. They may not recognise that their hallucinations or delusions are not real.

Experiencing psychosis along with mood shifts can make completing everyday tasks harder.

Likewise, people with schizophrenia may experience hallucinations or delusions, but they’re also very likely to experience disorganised thinking and speech. Unlike someone with bipolar disorder in the manic phase, the symptoms of psychosis are not accompanied by mania.

Takeaway

Sadly, no medical test can determine which condition you have. Instead, your doctor may refer you to a mental health professional. They will perform a comprehensive psychiatric evaluation and order some tests to help rule out possible medical causes. These tests could include blood tests, imaging tests, and drug screening tests. Please make sure you go to the right mental health professional. An unqualified mental health professional can do more damage than good.

Today in the UK almost a quarter of a million people are being treated for schizophrenia. It affects men and women alike and cuts across all social classes and ethnic backgrounds. Helping someone who has Schizophrenia in Cambodia can be a huge problem. Due to many mental illnesses not being recognised. Also, a lack of professional mental health practitioners.

Schizophrenia is one of the major public health challenges facing us today. But sadly its true impact is very poorly understood by the general public in all countries. The high death toll from suicide and the higher vulnerability to physical ailments means that people living with schizophrenia often will die 10 to 20 years earlier than average.

 Books to help you cope with Bipolar or Schizophrenia

 

• A book about surviving Bipolar: The Bipolar Disorder Survival Guide: What You and Your Family

 

• A book about loving someone with Bipolar: Loving Someone with Bipolar Disorder: Understanding and Helping Your Partner 

 

• A guide to dealing with Bipolar for yourself or a loved one: Bipolar Disorder: A Guide for You and Your Loved Ones

 

• A book about Jake’s world and Schizophrenia: The Cliffs of Schizophrenia: A Mother and Son Perspective

 

• A book about the advances of psychotherapy of Schizophrenia: The Schizophrenia Spectrum

 

• A book about the nature, causes, symptoms, and treatment, of Schizophrenia: Surviving Schizophrenia