This post is part three of four about mental illnesses that are often mistaken for bipolar disorder or one another in general: major depressive disorder, borderline personality disorder, schizophrenia and schizoaffective disorder. In this post: Schizophrenia.
So far, I’ve talked about the differences between bipolar disorder, major depressive disorder and borderline personality disorder. This time it’s schizophrenia. Bipolar disorder and schizophrenia are often mentioned together when I do my research. It has been suggested that they are part of a larger spectrum of multiple disorders since they are genetically linked, but more research is needed. As it stands, they are still considered separate disorders. So here is what schizophrenia is and why it is not bipolar disorder.
Schizophrenia is a serious mental illness. Obviously all mental illnesses should be taken seriously, but there is increased risk with schizophrenia to the patient and others if left untreated. Treatment requires life-long, regimented care.
Diagnosing schizophrenia is complicated and is often under-diagnosed or misdiagnosed, typically due to the scope of the illness and the wide range of symptoms experienced by patients. No individual experiences schizophrenia in the same way. Men are typically diagnosed in their early twenties whereas women are diagnosed in their late twenties.
Symptoms are typically divided into three groups, positive, negative and cognitive, based on whether the symptom appears in addition to normal behavior (positive) or lacks something from normal behavior (negative). Cognitive symptoms are more general symptoms commonly found across psychiatric disorders. The most common perception of someone with schizophrenia is that they hear sounds or voices that are not there. This would be a positive symptom since the patient hears something in addition to the sounds going on around them. For negative symptoms, normal behaviors or thoughts are more limited and usually described as a “lack” of a trait. For example, a lack of social skills.
Granted, there are times when my social skills are lacking, but all of this happens on a clinical level. Similarly to the hearing things that aren’t there. We all occasionally think we hear something that turns out to be nothing, but the auditory hallucinations with schizophrenia are on a much higher level.
Here’s something to keep in mind: Those with schizophrenia experience their symptoms as reality. If they are having a hallucination, their brain is not experiencing it differently than if it were actually happening. So, in essence, it is real. Think about living life having to determine which experiences were real or not real.
Here are other examples of positive symptoms (psychosis):
-Delusions: Patients can perceive that they are being persecuted or that references are being made to them when they are not (for example, social media). There can also be delusions of having unique powers or being chosen for a special mission.
-Hallucinations: I touched on this one already, but the hallucinations are more than hearing voices. This symptom can affect most of the senses. Auditory and visual you may already know. Patients can also experience tactile (touch), olfactory (smell) and gustatory (taste) hallucinations. All of these can be serious. The voices can be terrifying and demanding the patient harm themselves or someone else. A tactile hallucination may feel like insects are crawling all over them.
Examples of negative symptoms include:
-Low emotional intelligence. It is more difficult for a patient with schizophrenia to detect what another person is feeling and respond appropriately. Everyone has their own levels of emotional intelligence and just because someone lacks emotional intelligence does not mean they might have schizophrenia.
–Blunted affect. Patients can seem one-dimensional. They lack facial expressions, movements, and do not show signs of being startled.
-Lack of energy or interest in daily life.
Cognitive symptoms are ones that most people feel from time to time at varying degrees. This is also true in schizophrenia. These symptoms are disorganized thinking, poor concentration, memory problems or difficulty expressing one’s thoughts.
As far as treatment, medications are a vital part of treatment and are almost always antipsychotics. Adherence to medication is absolutely vital. In addition to medication, sticking with a daily routine, getting enough sleep and avoiding stress are key. As with everyone, having strong social support is important. Not only is it recommended that patients seek therapy themselves, but their families as well. Schizophrenia can be incredibly hard on relationships and life is easier when everyone involved can accept help.
Differentiating between bipolar disorder and schizophrenia can seem tricky, but there are differences. Firstly, there are distinct brain structure differences between patients with bipolar disorder versus those with schizophrenia. This may not sound like that big of a deal, but even the smallest difference can make an impact. Next, psychosis can be present in bipolar disorder (mostly during a manic phase) but is not required for a diagnosis. In schizophrenia, psychosis is a key diagnosis. Similarly, depression is not necessary for a schizophrenia diagnosis. A final difference is that schizophrenia does not follow a wave pattern. It’s almost always present.
The important thing to take away is that people who suffer from schizophrenia can and do lead normal lives. As normal as anyone’s life can be, anyway.