Psychosis, Schizophrenia And Bipolar Disorder: Differences And Similarities

Sometimes, given the variety of terms, it can be difficult to identify and differentiate certain psychological disorders or concepts. Both psychosis, schizophrenia and bipolar disorder have aspects in common. However, they are different terms and, therefore, imply different symptoms as well as consequences.

Enter and discover what differences and similarities there are between these terms and learn the most characteristic symptoms of each of them.

What is psychosis?

Currently, the psychosis It does not refer to any particular disorder but rather is a category that encompasses different disorders that have different aspects in common. In fact, in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), this term is not found but is used psychotic disorders to refer to a set of disorders that are independent of each other but that share a key aspect: contact with reality is lost, in a certain way. This means that the person perceives reality in an altered way, misinterprets external events, etc. Therefore, psychotic disorders are characterized by the presence of hallucinations, delusions, disorganized thoughts and behaviors, etc. that vary depending on the psychotic disorder.

Specifically, the disorders found in this category are:

• delusional disorder
• Brief psychotic disorder
• Schizophreniform disorder
• Schizophrenia
• Schizoaffective disorder (also called affective schizophrenia )
• Psychotic disorder induced by substances/medications or related to a medical condition
• Catatonia

What is schizophrenia?

The schizophrenia as we have already seen, is a type of psychotic disorder, which involves different symptoms that persist for at least six months. When the same symptoms disappear in less than six months, the DSM-5 determines that the diagnosis is schizophreniform disorder. At present, it is unknown cause of schizophrenia But there are different risk factors such as drug use, perinatal complications, etc. that can precipitate the development of this disorder.

Schizophrenia is characterized by a significant alteration in the person’s daily functioning, that is, the symptoms lead to a deterioration in the person’s performance in different areas such as, for example, work, academic, etc. and today there is no treatment that implies a cure but rather they are focused on improving the quality of life and well-being of people.

Symptoms of schizophrenia:

The symptoms of this disorder can be:

1. Delusions: Delusions, unlike hallucinations, are characterized by a failure to interpret a stimulus found in outer space. Some of the examples of delusions that people with schizophrenia may present are, for example, mind reading (or irradiation), where the person firmly believes that others can read their thoughts, delusions of persecution, etc.
2. Hallucinations: Hallucinations involve perceiving stimuli, whether visual, auditory, olfactory, etc. that are not found in the outer space where the person is located. The most common types of hallucinations in schizophrenia are auditory hallucinations, such as hearing voices commenting, visual hallucinations, etc.
3. Negative symptoms: Negative symptoms refer to a set of symptoms that imply that the person loses interest in things, feels emotionally flat, lacks willpower, etc. Although we may think that hallucinations or delusions are the symptoms that cause the most discomfort, the reality is that these types of symptoms are the ones that have the most impact on the person’s daily life.
4. Disorganized speech and behaviors: Due to psychotic symptoms (delusions and hallucinations), people can present behaviors that the rest of us may consider strange or inappropriate according to established social norms. In addition, they may also present alterations in speech and thinking, such as, for example, speech that is incomprehensible to others or that does not present a logical sequence, changing the subject without any sense, etc.

What is bipolar disorder?

He Bipolar disorder (also called previously manic depressive disorder ), unlike schizophrenia, it is not found within psychotic disorders but rather has a unique category where the different types of bipolar disorder are divided. This disorder, regardless of the type, is characterized by a sudden change in mood and although we sometimes use the term bipolarity to refer to a person who rapidly changes their way of being, the reality is that this change in mood is not a one-time event but rather implies an impact on people’s daily lives.

Types of bipolar disorder:

• Bipolar disorder type 1: The person has episodes maniacs for at least a week and may present episodes of major depression although they are not necessary for the diagnosis of this type of bipolar disorder.
• Bipolar disorder type 2: The person has at least one episode of hypomania for at least four days and one episode of major depression for at least two weeks.
• Cyclothymic disorder: Cyclothymic disorder is characterized by the presence of symptoms hypomanic and depressives who do not meet the criteria to be called either hypomanic episodes or major depressive episodes. For the diagnosis of this disorder, symptoms must be present for at least two years (or one year in the case of children and adolescents).
• Bipolar disorder substance/medication induced or related to a medical condition.

Symptoms of bipolar disorder:

As we have already seen, the symptoms of bipolar disorder can vary depending on the type. However, we have commented on a series of characteristic episodes:

1. Manic episodes: Mania is a defined period of time that lasts at least a week in which the person has a mood characterized by being abnormally high, that is, the person appears with a lot of energy, agitation, nervousness, irritability, etc. and cannot be explained by the consumption of any substance. Furthermore, these episodes are accompanied by a decreased need for sleep, feelings of grandeur, participation in activities that could have negative consequences such as binge shopping, etc.
2. Hypomanic episodes: Hypomanic episodes are episodes characterized by the same or similar symptoms as previous episodes. However, they have a shorter duration, at least 4 consecutive days.
3. Episodes of major depression: Episodes of major depression last at least 2 weeks and are characterized by the same symptoms as major depression, decreased interest in activities, feelings of worthlessness or guilt, etc.

Schizophrenia and bipolar disorder: differences and similarities

There are certain aspects between both disorders that are similar and other characteristics that can help us differentiate them.

Similarities:

1. Both disorders have a high risk of suicide.
2. They usually begin in late adolescence, although schizophrenia usually begins later in the case of women.
3. They have a high comorbidity with other disorders, that is, it is common for them to be accompanied by other disorders such as, for example, anxiety and disorders related to substance use.
4. Currently, there is no cure for either. The treatments are aimed at improving the symptoms and, therefore, the well-being of the person.
5. Bipolar disorder can also be accompanied, especially in those manic episodes of delusional ideas and hallucinations although these occur only during episodes of major depression or mania.
6. Both disorders can present depressive symptoms.
7. Both generate a significant deterioration in the person’s functioning, which is why treatment is essential.

Differences:

• Although delusions and hallucinations may occur in manic episodes, psychotic symptoms are usually less complex and of shorter duration than in schizophrenia.
• Bipolar disorder usually has a better prognosis than schizophrenia.
• The main characteristics of schizophrenia are the presence of psychotic symptoms and, on the other hand, bipolar disorder is mainly characterized by a sudden change in mood. Therefore, the onset is different for both, while bipolar disorder usually begins with episodes of major depression or mania/hypomania, the first symptoms of schizophrenia are psychotic symptoms.
• The negative symptoms of schizophrenia usually last over time, however, the symptoms of major depression of bipolar disorder only occur when they are in these episodes.

Remember that for the diagnosis of any psychological disorder it is necessary to go to a mental health professional. If you present any of the symptoms mentioned, you do not have to be ashamed or feel guilty about it, but it is important that you go to a psychologist who can determine what is happening to you and offer you treatment adapted to your case.