Two mental disorders that we hear a lot about today are schizophrenia and bipolar disorder. While a few of the symptoms of these disorders are similar, they’re two distinctly different diagnoses. It’s important to understand and distinguish between schizophrenia vs bipolar because effective treatment for each can vary quite a bit. 

Learn more about the differences between schizophrenia and bipolar disorder here—we’re covering everything you need to know, from symptoms, to how each is diagnosed, to treatment options, and more. 

Symptoms: Schizophrenia vs Bipolar Disorder

People with schizophrenia and with bipolar disorder (referred to as schizoaffective disorder) can sometimes have manic symptoms like intense mood swings. However, the similarities end there  for the most part. Each of these disorders has its own hallmark symptoms. One significant difference between bipolar and schizophrenia is that none of the classic symptoms of schizophrenia need be present for a diagnosis of bipolar disorder.

Symptoms of schizophrenia

Schizophrenia has what is called positive symptoms and negative symptoms. Hallmark positive symptoms of schizophrenia are psychotic symptoms like hallucinations (hearing and seeing things that aren’t there) and delusions (having false beliefs or convictions that often conflict with reality). 

This means people who live with schizophrenia tend to have difficulty telling the difference between what’s real and what’s not. They might hear voices in their heads or see things that aren’t really there. In addition, they also might very strongly believe things that aren’t rooted in fact. For example, someone with schizophrenia might emphatically believe they are the King of England, or they may feel strongly that the government is monitoring their thoughts.

Where schizophrenia overlaps with bipolar disorder is in extreme moods. People with schizophrenia often exhibit depressive symptoms and might withdraw from society, friends, and family. They may also act suddenly silly or inappropriately giddy.

Symptoms of bipolar disorder

Although they can be present, none of the classic symptoms of schizophrenia, like hallucinations or delusions, need to be present for someone to be diagnosed with bipolar mood disorder. 

The single necessary element for a bipolar diagnosis is at least one manic episode. Mania, in the mental health realm, can be defined as someone having very rapid speech, inflated self-esteem, little need for sleep, racing thoughts, or an inability to focus on a single thought or project. In addition to mania, people with bipolar disorder can also have extreme lows when depressive symptoms include severe depression and periods of sadness. 

Diagnosis: Schizophrenia vs Bipolar Disorder

While both schizophrenia and bipolar disorder may appear similar in some people, it’s important to get an accurate diagnosis so you can get the best possible treatment. 

How is schizophrenia diagnosed?

When it comes to diagnosing schizophrenia, someone must have two or more of the five hallmark schizophrenia symptoms. These symptoms include:

  • Hallucinations
  • Delusions
  • Disorganized speech
  • Disjointed or catatonic movements
  • Negative symptoms (like withdrawal and social isolation). 

The strongest of the symptoms must be obvious for at least 1 month, and less-obvious schizophrenia symptoms should be present at least for 6 months. In addition, symptoms adversely affect someone’s social, occupational, or personal functioning.

How is bipolar disorder diagnosed? 

The key determining factor in diagnosing bipolar disorder, as we mentioned above, is having a manic period of at least one week that disrupts the ability to function daily. A doctor or psychiatrist will look for the following bipolar symptoms when making a bipolar disorder diagnosis:

  • Grandiose thoughts, feelings of enormous power
  • Suicidal thoughts
  • Intense feelings of self-hatred
  • Difficulty completing tasks or finding it very hard to concentrate
  • Sudden loss of interest in activities that were once enjoyed

Causes: Schizophrenia vs. Bipolar Disorder

No exact cause of schizophrenia or bipolar disorder is known. However, there are some factors that are suspected of playing a role in the development of these distinct mental health conditions.


Schizophrenia tends to run in families, suggesting a hereditary factor. Other suspected factors for schizophrenia causes include: 

  • Subtle differences in how the brain develops
  • Trauma during birth
  • Complications during a mother’s pregnancy (particularly if there are significant issues with malnutrition) 
  • An imbalance of 2 neurotransmitters — dopamine and serotonin

Bipolar disorder

Like schizophrenia, we don’t have a comprehensive understanding of what causes bipolar disorder, but bipolar disorder seems to have a hereditary factor. It’s more common for someone to develop it if a first-degree relative (like a sibling or parent) also has it. Another potential cause might include a difference in how the brain is wired.  

Treatment: Schizophrenia vs. Bipolar Disorder

When looking at the difference between bipolar and schizophrenia, it’s important to acknowledge one major similarity: people with either disorder are able to live a full and rewarding life with continued treatment. 

Although the treatment for bipolar vs schizophrenia differs somewhat, seeking treatment and staying with it is paramount for anyone diagnosed with either condition.

“One common factor between schizophrenia and bipolar disorder is that they both require a combination of medical and therapeutic interventions for best outcomes.”

Talkspace therapist Ashley Ertel, LCSW, BCD

Treatment for schizophrenia

Schizophrenia treatment involves a combination of therapy for schizophrenia, schizophrenia medication, and lifestyle changes. One medication more often used when treating symptoms of schizophrenia would be antipsychotic drugs. These drugs work by blocking the effects of dopamine on the brain. It can take mental health teams a few tries to find the medication that works best, but be patient.

Treatment for bipolar disorder

When comparing treatment options for bipolar vs schizophrenia, the main difference is in the type of medication recommended. 

People with both disorders are helped by psychotherapy, which teaches them how to cope with their symptoms and lead full, rewarding lives. However, whereas those with schizophrenia are typically prescribed antipsychotic medication, medication to treat bipolar disorder is often a class known as mood stabilizers. Like schizophrenia, though, medication can take a while to get right. 

Finding Support  

“It’s important to note that your diagnosis does not define who you are as a person. If you feel as though your treatment team isn’t providing you with individualized care, advocate for yourself and voice your concerns. You deserve a team of professionals who get to know your unique strengths and can leverage those strengths as part of your treatment plan.”

Talkspace therapist Ashley Ertel, LCSW, BCD

There are many differences between bipolar vs schizophrenia, but remember that one thing these two disorders have in common — the importance of seeking professional help and how essential it is to stick with a treatment plan. It may be tempting to quit your medication when you start feeling better, but you should know that your symptoms are likely to return, and they can often be worse than before. 

Another similarity in bipolar vs schizophrenia is that early treatment of either disorder vastly increases the odds of decreasing symptom severity and frequency and ultimately having a better quality of life. 

To find a therapist with experience in schizophrenia or bipolar disorder, you can start by discussing your symptoms with your primary care physician. They should be able to connect you with a psychiatrist or therapist in your area who can help you either through in-person or online therapy. You don’t have to live with schizophrenia or bipolar disorder. You can find effective treatment and take your life back. The right treatment plan and support can help you figure out how to do that. 

Medically reviewed by: Dr. Karmen Smith, LCSW, DD

Reviewed On: June 29, 2022