World of Psychology

Is Schizophrenia Really Bipolar Disorder?

By Sandra Kiume
March 6, 2006

2 NAMES, 1 DISEASE: Does schizophrenia=psychotic bipolar disorder? in Current Psychiatry Online suggests that schizophrenia is actually severe bipolar I psychosis and not a separate diagnosis. A comprehensive clinical review references questions going back many years, and argues that incorrect diagnosis has many implications. For the patient they include “less likely to receive a mood stabilizer or antidepressant…symptoms worsen” and “more likely to receive neuroleptics for life, increasing risk for severe and permanent side effects.”

The idea that “symptoms should be treated, not the diagnosis” is inaccurate and provides substandard care. When psychotic symptoms overwhelm and obscure bipolar symptoms, giving only antipsychotics is beyond standard of care.

It’s an interesting perspective and one that could change a lot of things. We’d love to hear your comments.


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20 Comments to
“Is Schizophrenia Really Bipolar Disorder?”

This is a fascinating topic, as the researchers note the astounding similarity between these diagnoses. It’s not a perfect fit, but if it appears maybe more than a few people are being misdiagnosed (and therefore, receiving less-than-optimal treatments), maybe it’s time to take a closer look at this issue.

Maybe if the average clinician can’t make a reliable differential diagnosis between these diagnoses, then it’s time to go back to the drawing board.

My sister was diagnosed as a schizophrenic. She was treated, medically, as such. She later committed suicide. That was 15 years ago. No one else in our family has ever been diagnosed with schizophrenia. A year ago, I was diagnosed as bipolar I. Both my father and my mother’s mother were diagnosed years ago with bipolar disorder. I lucked out and inherited the disease from both sides of the family. I have always wondered if my sister’s true disorder was bipolar, rather than schizophrenia. It is good to hear that someone else has the same question. All the best to you in your inquisitions, since the two different disorders are treated differently with different drugs.

When it gets right down to it, neither Bipolar disorder or Schizophernia exist. They are just attempts to come to terms with people whose neurotransmitters are out of control. If you do the math on the number of different combinations which could fit the DSM-IV-TR guidelines for either diagnosis, there are 100s of ways either could present.

Also note the way that various legal and illegal drugs will mimic the various s/s of either diagnosis, (i.e. LSD, Meth, Cocaine).

We need to come to terms with the fact that it is about neurotransmitters run amuck and deal with the various medicaions which can address the symptoms.

I have had one psychiatrist who has been asking his patients/families, “which came first the lack of sleep or the psychosis?” And he says the lack of sleep always comes first.

It’s the dopamine!!!!

well, saddle-up pilgrims–welcome to earth. i was a productive bipolar, not delusional, not viewing life as an endless nightmare. i’ve seen bipolars that ’see-things’, hear voices—so ‘mis-dxing is understandable, but these are distinct, very different states. the only proof you will find is experience—you would not like that. a brief trial of a neuroleptic ‘launched’ me from bicycling a 40 lb ‘cruiser 20 mile/day, happily social, to ’shuffling’ a block for cheap food. social isolation, sleeping 18 hours/day—all within one week of the drug. in four months i gained 60 lbs, was a total vegetable, and five-years later these extra-pyramidal symptoms persist. i tapered down over a week and straight into a mental state of horror never imagined—i put myself in a hospital. i feel mistaking what may appear as similar symptoms is absurd. if you have seen both, you would know. you don’t have to have any dx—use these drugs for a month, swiftly taper—too late you will see my point.
your critical-to-you limbic/dopaminergic/gaba systems will be dead or severely harmed—usually unto death—try the fate you would place on others, not speculate. i never dreamed a madness so different could share some common symptoms—i found out, the hard way. Erudition is No substitute for experience.

Those who have big “ideas”, do “studies”, or “whatever the case may be” should stop and check themselves to see if what they’re doing is an ego thing, to say look at me, look what “I” have found. You should stop for a time and take a long look at yourself and others and until you really really know that what you’re doing is for the benefit for those suffering, who desperately NEED you, then you shouldn’t even put yourself out there to try to influence those who really do have the wish to make a difference even if all they can do is have compassion. Putting Schizophrenia with bipolar disorder is mean. Either way. Do you think it really makes sense? Don’t think you have the answers, not ever. Know it and remember that medicine isn’t an exact science.

I’m bi-polar but have always wondered if I had schizophrenia. I become so paranoid, fearful no terrified of everything, I see things, and hear voices in my head. I was not able to return to the normal life until I started taking an antipsychotic. The antipsychotic has changed my life and made life manageable. Successful treatment would have been much shorter had this idea been considered. UGH

I have always thought that all these diseases were really a part of the same root. Beginning with ADD, progessing to Bi-Poplar, Schizophrenia and then Borderline, they seem to be each a greater split in personality.

I won’t go back as far as the beginning of this mess. Senseless and tiresome, but in 2002, I began having “major problems” that I can only describe as confusing, emotionally painful, terrifying, etc. I don’t know if I’m bipolar but that’s the diagnosis and they are sticking to it. Well, along with PTSD and GAD. I never knew self-harm existed, but I became aware of it in 2004. Getting tattoos helps also. I don’t know why. I have lost years due to “whatever” is happening and I’m just getting worse. I’ve never missed therapy, a psychiatrist visit, or a pill. I don’t drink, have never done rec. drugs, or smoked a cig. I do however have multiple sclerosis and 3 teens. I have other health problems as well. I’ve only switched psychiatrists once since 2003. I’ve done exactly what they’ve told me to do and I still continue to have long periods of dissociation, depression, suicidal thoughts, a mind that won’t stop, fear of leaving the house, paranoia, bouts of psychosis, unimaginable guilt, memory loss and I still self-harm (although not as much as before) I am fighting a losing battle against my physical and mental health. I need to get better. I don’t expect to be who I was, but I wish I had a semi-normal existence and I do miss “her” from time to time. My children deserve better as well. The pain I have caused my children is always at the forefront of my mind. What is wrong with me?

Hi Stephanie - I’m sorry things have been so hard for you. I wish I could simply tell you to “do X and you’ll feel better” but it’s not that clear cut, and I am not a doctor. The most I can do is suggest looking for a second opinion from a doctor, learn all that you can, and wish you my best. Hang in there. I’m sure your children love you.

The posters are closer to the truth than they recognize.

VisionAndPsychosis.Net a private psychology project on the Internet has gathered information to support the thesis that most mental disorders are a continuum of exposure from Subliminal Distraction.

SD exposure was discovered when it caused mental breaks for office workers. The cubicle solved that problem by 1968. Today SD is treated as a harmless nuisance in the design of crowded offices.

It had not occurred to any one to look for this problem other places. It is a problem of human physiology related to the vision startle reflex not just an office problem.

Can you cite a case of someone ‘blind from birth’ having Panic Attacks, ICU Psychosis, or Schizophrenia? I can’t find any. Volunteers searching the APA database find only cases and studies of the partially sighted. There are none among the fully blind.

If mental illness is brain disease, why are the blind immune?

The reason is that Subliminal Distraction is a vision driven problem requiring competent peripheral vision.

An altered mental state that resembles schizophrenia happens to long term users of Qi Gong and Kundalini Yoga. They begin to believe they have superhuman and supernatural powers. Levitation, dematerialization, invisibility and mental telepathy are some of the bizarre feats they believe they can perform. No one has previously solved the cause of these beliefs. Users ignorantly believe that Chee or Prana, universal life energy, is the source of their abilities.

http://VisionAndPsychosis.Net

Whatever… The real problem is that people who were able to deal with life’s daily troubles and still find happiness suddenly lose the ability to cope, and spiral out of control, leaving their friends and family wondering whether they will ever have their loved one back.

Please take your meds first, then make the important decisions about what to do next.

To say that mental illness does not exist is absurd. My mother-in-law has paranoid schizophrenia and we cant find a doctor that can help her she was on lithium and it didnt do a thing for her, she is currently in the psych ward of the hospital. She has had many episodes of delusion. Is it a crap shoot trying to figure out what drugs to give her? She also had breast cancer 2 years ago could she have a brain tumor, would that cause episodes similar to schizophrenia.

Kim,

WTF does not finding the right doctor have to do with the premise? It’s not to say that mental illness does not exist, I think it is more that these people who do not have control of their lives are being driven by a force that they have given their selves to perhaps out of fear of not being in the ‘flow’ of some life force which may explain the supernatural, theological connotations of some of the delusions. To step out of that ‘flow’, to cut off themselves from this magical journey, would be to cut themselves off from some life force. It is very intoxicating, almost like a drug addiction which can only lead to death if taken to the logical extreme. Were it so likely that a simple drug could alleviate the pain and actually ‘cure’ this dis-ease, then more power to the pharmaceuticals and their merchants, i.e. psychiatrists. In actuality, the drugs are just sedatives to quiet the ramblings in their mind and incapacitate them. I think the research into Subliminal Distraction is promising although I don’t know if there is a way to practically apply the research. We can only hope, that your mother-in-law, when faced with a life or death decision, contemplates the meaning of her existence and realizes she has people that care for her on this planet, within this reality. Whether her legacy be that of a woman lost to a dis-ease she could not control, or a woman of value that overcame the odds to make a stand in a sea of blackness and confusion or as a chronicler of another reality will be in the end for only her to decide. As a voice for this side of reality, it is incumbent upon you to also make a decision as to who she is and how much you are willing to invest in that decision. I really wish you the best. It is not an easy row to hoe. Good Luck.

I can remember when I was 5 years old, I had disturbing paranoia, extreme mood swings, heard people talking when no one was around. I remember that I could not go inside a restaraunt to eat with my family because I knew everyone in the building would be looking at me, mocking me, making plans to hurt me. I have documentation that I started cutting when I was 11 years old. I’ve spent my entire life trying to understand what was wrong with me. I can’t sit on my front porch without thinking I’m about to be the victim of a drive-bye shooting. A year ago, I decided for myself, my daughter, and my fiance that I would seek treatment. I was diagnosed with Rapid cycling Bipolar disorder, Obsessive Compulsive Disorder, and ADHD. Two days ago, my doctor told me to immediately stop all medications. I was becoming semi-alarming to him and my therapist. He hopes everything will calm down and we can try to find out what medication was making me worse. I’m starting to wonder if my treatment wasn’t working because I was misdiagnosed. I don’t know what to do and I don’t want to go back to my doctor in one month to tell him I think he didn’t diagnose me correctly.

And to all of the people who think that mental illness isn’t real, please go get checked out. I think you are the ones who are having delusions. I’ve been this way for 20 years. You have no idea what it’s like to live your whole life without being completely in control.

I suffer from what has been labeled as bipolar 1 with extreme mania leading to distorted reality and psychosis. Personally. The terms bipolar and skitzo…. they just seem like labels to cast negativity on people that are misunderstood…. in my world atleast. Ahh… how the world loves labeling things… especialy in a negitive light.

To Crystal,
I am writing this note, especially after seeing what Crystal wrote. Let me give you a bit of my background viz-a-viz schizophrenia. I am a male, over 60 yrs old, I married and raised a family; however, I have always been bothered by the word schizophrenia. The reason is that I had an older sister (about 13 years older) who was at one stage diagnosed with schizophrenia and then died at a rather early age of 53 ( I was told by my family that she committed suicide by refusing to eat; I had no way to ascertain the real cause of death since I now live in another part of the Globe very far from where she lived). I was very close to my sister, and it hurts me to this day deeply whenever I think of her; mostly, because of the pain that she had to go through in life. Right or wrong, I have a hard time believing that she ever suffered from Schizophrenia. In fact, I have always believed that some of my family members might have got me diagnosed with Schizophrenia or some other disease just because they did not know any better, and they had a natural need to get on with their own lives. I think I survived because I was a male. I used my inner discipline (I had to work really hard to develop it over the years) to get increasingly focussed on what I wanted to do in life to survive my time on the face of planet earth. Oh yes! I had debilitating hallucinations, hearing of voices that had nothing to do with reality ( I still do hear them), I came very close to commit suicide twice when I was very young. My sister was a very intelligent person, she taught me about lot how to deal with some tough mental/physical struggles that I was going through as a teenager, she was an eloquent public speaker, and very bright. I believe there were at least a couple of environmental factors in her life that were very real in her life and I think these had a lot to do with how her mental health was adversely affected. The facts were that we were a highly dysfunctional family, she was a woman living in a highly male dominated society and that too in the 50’s and 60’s; we as a family were isolated from the mainstream society because of our non-mainstream religious beliefs and way of life. These conditions alone , I think would be adequate to drive even a sane person sick; especially, if that person possesses a high degree of intelligence and harbours aspirations in life.

Moving away from my background, see what is happening in the society these days. There are numerous doctors who are saying that ADD is being diagnosed and treated with medications mostly when there is no need for these. The doctors, psychiatrists, etc do a wonderful job in treating patients; however, they are humans too who can make mistakes, or just tow the line in terms of what is popular. Look at how the nutrition advice has changed in the last 20 odd years, from promoting low fat to low carb to Glycemic index?

Crystal, I am not trying to belittle your sufferings; I believe they are genuine, and I believe you when you say you get these symptoms of some illness. All I would request you is to keep your mind open to other possibilities. Maybe, you can develop the inner strength to cope with your problems without using medications or with reduced use of medications.

I wish you all the best. Incidentally, if you write again on this blog, I will read it, and I will respond to you, only if you wish me to do so.

May God bless you,

hi¡
my doctor told me that i’m suffering bipolar disorder.while i thought that i’m schizophrenic i was looking in the internet to invistigate the difference between the tow i don’t know i hear voices i see thingsa that doesn’t exist i hear messages in the tv and the radio i ask for some explanation please

I wish there was a simple explanation, Setphan. I can’t clarify your situation; your doctor and family are better able to help you.

Setphan (Stephan(?)),

It’d called ‘ideas of reference’, look it up.

Stephan, the first thing you should do is get a full physical workup from someone that understands the symptoms you have. There are known problems that will cause bizarre behavior and some of them are potentially fatal if not treated.

While you do that read my site and investigate your daily activities for Subliminal Distraction exposure. This will cost nothing, and won’t interfere with any treatment you now have.

I found a way to investigate SD using the Internet. Although believed to cause only a harmless temporary episode of confusion I found other symptoms.

They are fear, panic attacks, paranoia, depression and thoughts of suicide.

Any psychiatric symptoms that are episodic in nature should be suspect as those of Subliminal Distraction exposure.

My six year project is explained in the first 400 words of introduction at VisionAndPsychosis.Net. Look carefully, some of the sources of movement in peripheral vision can be bizarre.

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    Last reviewed: By John M. Grohol, Psy.D. on 7 Mar 2006

 


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