Bipolar disorder and schizophrenia are two different chronic mental health disorders. People can sometimes mistake the symptoms of bipolar disorder for schizophrenia symptoms.

Read on to learn how these conditions are alike and how they differ.

Bipolar disorder and schizophrenia have some aspects in common, but here are the main differences:


Bipolar disorder causes strong shifts in energy, mood, and activity levels. A person with bipolar disorder will switch between extreme excitement or mania and depression.

This may not happen continuously, meaning that you can experience spontaneous periods of a stable mood followed by periods of extreme mood shifts.

When they occur, these shifts can affect their ability to perform daily activities. In some cases, a person with bipolar disorder may also experience hallucinations and delusions (see below).

Schizophreniacauses symptoms that are more severe than the symptoms of bipolar disorder. People with schizophrenia experience hallucinations and delusions.

Hallucinations involve seeing, hearing, tasting, smelling, or feeling things that aren’t there. Delusions are false, irrational beliefs.

People with schizophrenia may also experience disorganized thinking, which can render them unable to care for themselves.

Frequency and ages affected

Bipolar disorder affects approximately 2.8 percent of people in the United States. Typically, it first appears between the late teen years and early adulthood. Children can also show signs of bipolar disorder.

Schizophrenia isn’t as common as bipolar disorder. It’s long been estimated to affect less than 1 percent of the U.S. population, although newer research suggests that it could range up to 1.6 percent or higher. People usually learn they have it between the ages of 16 and 30. Schizophrenia isn’t usually seen in children.

People living with bipolar disorder tend to undergo intense mood shifts that occur rapidly or over an extended time. They can experience three types of episodes:

  • Manic: Those having a manic episode may feel extremely elated, wired, jumpy, or irritable. They are highly energetic and active; their mood is expansive.
  • Hypomanic: People undergoing hypomania will have less intense manic symptoms.
  • Depressive: Those having a depressive episode may feel sad, hopeless, or anxious and lose interest in activities they used to enjoy. This mimics the symptoms of major depression.

People may be diagnosed with bipolar I disorder after having at least one episode of mania. They can be diagnosed with bipolar II disorder after undergoing a major depressive episode and hypomania.

These mood shifts may not occur continuously. Even if you experience periods of stable mood occasionally, you can be diagnosed with bipolar disorder as long as you fit the diagnostic criteria.

Cyclothymia, a less-intense condition, is diagnosed after someone exhibits alternating episodes of low-level depression and hypomania.

Other behavioral changes that may be symptoms of bipolar disorder include:

  • restlessness
  • hyperactivity
  • reduced need for sleep or disordered sleep
  • trouble staying focused
  • irritability
  • extreme self-confidence and impulsivity (manic episode)
  • suicidal thoughts (depressive episode)

People with bipolar disorder may also experience psychotic symptoms during a severe manic or depressive episode. These can include hallucinations or delusions. Because of this, people may mistake symptoms of bipolar disorder for those of schizophrenia.

The symptoms of schizophrenia are divided into two groups, generally referred to as “positive symptoms” and “negative symptoms.” This isn’t based on whether a symptom is good or bad but on whether the symptoms add or remove a behavior.

Positive symptoms might include the introduction of delusions or hallucinations. Negative symptoms might include social withdrawal or removing oneself from relationships or public events.

The early warning signs of schizophrenia can include:

  • social isolation
  • a loss of interest in activities
  • moodiness
  • a lack of any feelings
  • making irrational statements
  • surprising or unusual behavior
  • an altered sleep schedule
  • getting either too much or too little sleep
  • an inability to express emotions
  • inappropriate laughter
  • violent outbursts
  • acts of violence toward oneself
  • hypersensitivity to touch, taste, and sound
  • hallucinations (including auditory ones that appear as threatening, insulting or condemning voices)
  • delusions

No one knows exactly what causes bipolar disorder or schizophrenia. But genetics is probably a risk factor, as both conditions can run in families.

This doesn’t mean someone will inherit the disorders if their parent or sibling has them. The risk increases, however, if multiple family members do. But just being aware of that risk increases the chance of early detection and treatment.

Environmental factors may also contribute to risk, but this connection isn’t entirely understood.

It is generally believed that both conditions occur equally across sex, race, and ethnicity, though historically, African American and Latino American/Hispanic individuals have been diagnosed with schizophrenia more often than other people, while Asian and Latino individuals have been more often diagnosed with bipolar I. Experts think these diagnoses could have been affected by bias or missed symptoms, making them unreliable.

Health professionals cannot use blood tests to diagnose bipolar disorder or schizophrenia. Instead, they will usually conduct a physical and psychological exam. During the exam, they’ll ask about their patient’s personal or family history of mental disorders and inquire into what symptoms they may have been experiencing.

On occasion, a blood test, MRI, or CT scan of the brain will be needed to help rule out other conditions. At times, a drug and alcohol screening may also be necessary.

It may take several visits before the final determination is made. These visits are necessary and allow health professionals to get a full picture of a person’s symptoms. They may also ask patients to keep a daily record of mood and sleep patterns. This will help them spot patterns that point to manic and depressive episodes.

Treatment for bipolar disorder and schizophrenia can involve both therapy and medication.

For bipolar disorder, psychotherapy may include:

  • learning about changes in mood and how to effectively manage them
  • educating family members about the disorder so they can be supportive and help address episodes
  • exploring how to improve relationships with friends and co-workers
  • understanding how to avoid possible triggers, such as stress or a lack of sleep

A healthcare professional may prescribe medication that controls mood and helps with other symptoms. Examples include:

People with bipolar disorder often have trouble sleeping. Sleep medication is sometimes prescribed.

Treatment for schizophrenia includes antipsychotics and psychotherapy. Some of the more common antipsychotics used to treat schizophrenia include:

Psychotherapy approaches may include cognitive behavioral therapy.

It’s possible to have an initial schizophrenic episode and never experience another one. People who have experienced just one episode may find a coordinated specialty care program called Recovery After an Initial Schizophrenia Episode especially helpful. The program offers:

  • psychotherapy
  • medication management
  • family education and support
  • work or education support

People living with bipolar disorder or schizophrenia have an increased risk of suicide. Anyone who has had suicidal thoughts should speak to a healthcare professional about treatment. It is extremely important to continue taking all medications as your doctor prescribes, even if you’re feeling better.

In addition, anyone living with bipolar disorder or schizophrenia may consider:

  • joining a support group such as NAMI Connection
  • Avoiding alcohol and substance use
  • Following a relatively stable lifestyle.
  • Getting an adequate amount of sleep.
  • Maintaining a healthy diet.
  • Using techniques to manage stress.

Bipolar disorder and schizophrenia can be confused, but they are different chronic mental health disorders. Some of the symptoms can overlap. However, bipolar disorder primarily causes extreme mood shifts, whereas schizophrenia causes delusions and hallucinations.

Both disorders can be serious and psychologically debilitating, though bipolar disorder is more common than schizophrenia. Both conditions may also be genetic, though it is thought that environmental factors may also be triggers.

Early diagnosis is critical. Be sure to speak with a healthcare professional if there is any concern about the emergence of bipolar disorder or schizophrenia. A well-thought-out treatment plan can go a long way toward managing these conditions and preventing future relapses. So will avoiding lifestyle and environmental factors that trigger episodes.

Can bipolar and schizophrenia occur together?

There is research indicating that similar genetic factors can predispose a person to develop either of the conditions. But you can be diagnosed with schizophrenia or bipolar disorder based only on criteria from the “Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5).”

This is because one diagnosis will usually exclude the other. But if a person exhibits symptoms of both conditions but does not fit either of these diagnoses, they could have schizoaffective disorder.

How can I help a person with schizophrenia or bipolar disorder?

It is difficult to watch a friend or a loved one with a mental health condition. A good place to find advice on how to cope and how to help can be a support group. Consider joining the family support group of the National Alliance of Mental Illness (NAMI) or other support groups in your area.

What should I do if I am diagnosed with schizophrenia or bipolar disorder?

You can manage the symptoms of bipolar disorder and schizophrenia with medication and therapy combined with a healthy lifestyle. Having a support system through support groups and family, friends, or co-workers can help you as you undergo treatment.