Understanding the similarities and differences between bipolar disorder and schizophrenia to determine a correct diagnosis

Pini, Queiroz, DellOsso, et al., (2004), states that, there are three types of psychological disorders that are commonly confused by people. These include the most common one the bipolar disorder, also referred to as manic depression, schizophrenia and multiple personality disorder. The general use of these terms, by media as well as by people referring to anyone who have a mental problem, has resulted to the confusion revolving around them.  These disorders however, do not have much in common except for the fact that those who have them are severely stigmatized by the society.

Similarities and differences between bipolar disorder and schizophrenia to determine a correct diagnosis
Bipolar disorder and schizophrenia are both over-diagnosed and misdiagnosed. Both are disorders affecting the thought process of an individual. These disorders have characteristics that are so similar that non-medical personnel cannot differentiate. In comparison to schizophrenia, bipolar is a very common disorder. It is well comprehended and treated through a combination of various drugs as well as psychotherapy. The major characteristic signs and symptoms of bipolar are, changing moods of mania and depression which can last for weeks or even months. Bipolar though treatable can pose a very great challenge in the course of treatment, because those who are on antidepressants during depression phase are more likely to abandon them during a manic episode. Very few people maintain treatment during the manic phase of the disorder. A number of people however manage to cope with their mood alteration and live a normal live in the society without using medications
Schizophrenia on the other hand is less common. It is usually detected during late teenage. Men are the ones who are mostly affected by this disease as compared to women. The major characteristic signs and symptoms of the disease are delusions and hallucinations. People with delusions normally perceive things that are false in normal live as true and real. They usually hold on to their beliefs even after being shown evidence that contradicts their beliefs. Just like bipolar, as noted by Pini, Queiroz, DellOsso, et al., (2004), schizophrenia is also not easy to treat. People with schizophrenia do not function normally in societal functions and have problems in following their prescriptions. Treatment for people with this disorder usually involves drugs as well as psychotherapy.  Day programs can also be included in the treatment for people who have severe cases of this disease and those who are resistant to medication. The social life of those who have this disorder is severely affected. These people also cannot conduct normal lives such as holding a job.

There are various types of schizophrenia which cannot be mistaken for bipolar because the patient is more withdrawn, but still someone could have bipolar with psychosis thereby looking as if it is undifferentiated schizophrenia or have bipolar that does not display psychosis. The major cause of misdiagnosis is the hasty behavior of psychiatrists, who do not inquire extensively concerning the precipitating factors or may be too impatient to make any sort of diagnosis. The other thing that may lead to misdiagnosis is that, there are people who live with suppressing feelings for a very long time or have feelings that go unrecognized that finally result to manic behavior or a behavior that is just unusual that can be diagnosed as psychosis easily.  If mood disorders are allowed to go for a long time without consulting a therapist they may appear as psychosis (Torrey, Bowler, Taylor, et al., 1995).

People with schizophrenia do not lead a normal life in the society.  They often experience difficulties in sticking to a particular medication.  The social life of people with schizophrenia is adversely affected and they face the worst form of stigmatization in the society. They are totally withdrawn and do not participate at all in social functions. Schizophrenia mostly affects all people at any age. Sufferers of schizophrenia usually experience hallucinations, delusions and thought disorders. The behavior of sufferers of schizophrenia changes from normal to abnormal during the course of the disease.

According to Bhosale (2004) these people experience things that are not real, and which they cannot explain with normal words. They tend to believe that strange things are happening around them. The person may experience happy moments that are not in line with the normal surroundings. People who suffer from schizophrenia experience intense hallucinations. They hear strange voices of people calling out their names and see visions of things happening in front of them and in a fraction of a second these things are gone and the patient acts as if nothing was happening. People who suffer form schizophrenia have a totally different perception of reality as seen by normal people. They act as if they are in a world of their own. Their life is totally distorted by delusions and hallucinations making them live in fear and confusion. They have no emotions and tend to lose hope in life.

These people experience compulsion from an external force. They display no behavioral pattern they may be laughing and instantly they start crying. They laugh and cry for no obvious reasons. Their emotions rise and fall suddenly. These people also show no response to specific emotional situations. The cognitive capability of a person suffering from schizophrenia is highly affected. The normal pattern of life for a person with schizophrenia is totally distracted. They do not participate actively in social matters. They also loose motivation and do not have a sense of belief. They experience difficulties in locating a coherent sense of self. They cannot integrate personality in a usual manner (Grohol, 2010).

Schizophrenia may be caused by heredity. Children, whose one or both parents have the disease, are more likely to have it. Viral infections during early stages of pregnancy and complications during birth are risk factors to development of schizophrenia. Brain abnormalities are also other factors that may lead to development of the disease. Sufferers of schizophrenia have a specific family history of the disease. Genes are particularly associated with the cause of the disease.

As indicated by Chandler (2005), there are various types of schizophrenias each with its characteristic symptoms. Catatonic schizophrenia is one of them. In catatonic schizophrenia patients may either experience extensive loss of motor skills or elevated motor activity. These patients also tend to repeat phrases that do not make sense and imitate sounds made by other people or objects. These people are also socially isolated and perform poorly in normal life activities. They have no emotions and are easily angered. The other type of schizophrenia is the disorganized schizophrenia. Disorganized schizophrenia is highly delusional. Patients suffering from it have no emotional feelings and are very suicidal. They tend to walk in an aimless manner and do not respond appropriately to emotional situations. These people also display unmotivated behavior. The other type of schizophrenia is paranoid schizophrenia. This type of schizophrenia is dominated by delusions and auditory hallucinations. Residual schizophrenia is another type of schizophrenia. This type of schizophrenia is displayed by those who have been diagnosed with schizophrenia in the past but do not experience psychotic problems, only that there are some remaining symptoms of the disease such as irrational thoughts, emotional blunting, social withdrawal and unusual behavior. The last type of schizophrenia is the undifferentiated type. This is the type in which patients who fails to display the symptoms of all other subtypes but have mental disorders are classified.

Bipolar disorder is the other psychological disorder. The major symptoms of bipolar disorder are the extreme shifts in an individuals mood as well as temperament. An individual experiences episodes of intense mania followed by spells of severe depression often with phases of normalcy in between. This disease is characterized by alternation of mood between two different extremities. A person may experience extreme sadness for a moment and immediately shift to euphoric happiness. Bipolar spectrum disorder or the entire range of disorder levels can be defined as a single, mild, or multiple adverse clinical mood swings (Grohol, 2010). Depression and manic, though are often separated by periods of normalcy may at times alternate rapidly, a phenomenon referred to as rapid cycling.

There are two different types of bipolar bipolar I and bipolar II. Bipolar I involve spells of severe mood swings. Women are the ones who are mostly diagnosed with bipolar I. sufferers of bipolar I experience adverse spells of depression as well as hypomania. Bipolar disorder type II is a more mild type of disorder as compared to type I. As stated by Jirage (2008), the exact causes of bipolar disorder are not known. However, genetic, biochemical and environmental factors are attributed to the cause of bipolar. Patients suffering from bipolar, display physical as well as chemical changes in their brain. Neurotransmitter imbalance is a biochemical factor that contributes to the development of bipolar. Hormonal imbalance may also be a factor leading to the development of this disease. Bipolar disorders do not have a specific time when they develop, but usually occur in the late teenage.
Manic episodes of bipolar disorder are marked by an increase in energy, aggressiveness, irritability, euphoria, sleeplessness, illogical thoughts, and lack of concentration. Other symptoms of manic phase of bipolar disorder are high self esteem, risky behavior, increased physical activity, loss of concentration, increased sexual desire, rapid speech, drug abuse, easy distraction, euphoria, agitation and extreme optimism (Amadan, 2006).

The depression phase of bipolar disorder on the other hand is marked by increased feeling of sadness, guilt, helplessness, agitation, distrust, loss of weight, irregular sleep patterns, and loss of interest in life as well as hope.  A depressed person may also have suicidal thoughts. Other symptoms of depressive phase of bipolar disorder include increased anxiety, aggressiveness, loss of appetite, fatigue, loss of concentration, and persistent pain due to unknown reasons. People with bipolar often lead a normal life. These people are very social especially when depressed.  They do not experience delusions like those with schizophrenia. However, episodes of depression and mania occur throughout the life of a patient. At certain times patients of bipolar may feel that, they are not worth being alive, helpless, very sad, and hopeless and at other time they may feel very excited thinking they are at the peak of the world (Maier, Zobel, and Wagner 2006).

The nature of the condition of bipolar disorder in many patients is the cause for misdiagnosis and therefore it is very important for the symptoms to be clearly understood. It is also very important to understand the symptoms of schizophrenia to minimize chances of over diagnosis.

Conclusions
Schizophrenia and bipolar disorders are psychological disorders that affect people of all age and gender. Though they have some differences, the symptoms of bipolar disorder and schizophrenia are very similar. In order to differentiate these symptoms, one has to critically analyze the psychotic and specific mood disorder symptoms. If the symptoms that are detected involve elevated mood, lack of sleep, loss of appetite, irritability, and then psychosis, they qualify as bipolar disorder. Schizophrenia on the other hand is characterized by development of paranoia, disorganized thinking, hearing voices and delusions followed by loss of appetite, lack of sleep, and grandiosity. Whereas schizophrenia occurs for a lifetime, episodes of mania and depression in bipolar disorder are separated by spells of normalcy.

 In schizophrenia, though a person may act as if normal during psychotic phases, there are some residual symptoms characterized by low energy, loss of motivation, and social withdrawal. That may not be a clear cut difference between bipolar disorder and schizophrenia because, a person may rapidly move from a manic to a depression phase displaying low energy, lack of motivation, and social withdrawal. Patents with bipolar disorder are usually social especially when depressed, than those suffering from schizophrenia that are socially withdrawn and have no reasonable behavior. To correctly diagnose schizophrenia and bipolar a physician should gather accurate information by extensively inquiring for the history of the patient form the family members as well as close friends.

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