September 18th, 2009 
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Jamie Foxx in The Soloist
What are the differences and similarities in bipolar disorder and schizophrenia? You may be surprised.
I took the time to watch ‘The Soloist’. Jamie Foxx plays a homeless man who had studied at Julliard and played the violin on the streets of Los Angeles. A news reporter was intrigued by him and began writing a series of columns about Nathaniel Anthony Ayers, Jr. in the Los Angeles Times.
While Ayers was not officially diagnosed, it was suggested that he had schizophrenia. I quickly noticed that the symptoms he had were much like psychosis, often experienced by people who have bipolar disorder 1. I decided to compare the two illnesses and I found that they are strikingly similar.
Schizophrenia
- Schizophrenia is less common than bipolar disorder
- Diagnosis is typically in late teens or early to late twenties
- Affects more men than women
- Involves hallucinations and delusions
- Incoherent or disorganized speech
- Catatonic or disorganized behavior
- Lack of emotion
“Hallucinations are seeing or hearing things that aren’t there. Delusions are the belief in something that isn’t true. People who have delusions will continue with their delusions even when shown evidence that contradicts the delusion. That’s because, like hallucinations, delusions are “irrational” – the opposite of logic and reason. Since reason doesn’t apply to someone who has a schizophrenic delusion, arguing with it logically gets a person nowhere.”
Bipolar Disorder
- Characterized by constantly changing moods
- Alternating highs (mania) and lows (depression)
- Periods may range from a few hours to several months
- Recurring illness (more than 90% have future episodes)
During a manic phase, symptoms include:
- heightened sense of self-importance
- exaggerated positive outlook
- significantly decreased need for sleep
- poor appetite and weight loss
- racing speech, flight of ideas, impulsiveness
- ideas that move quickly from one subject to the next
- poor concentration, easy distractibility
- increased activity level
- excessive involvement in pleasurable activities
- poor financial choices, rash spending sprees
- excessive irritability, aggressive behavior
During a depressed phase, symptoms include:
- feelings of sadness or hopelessness
- loss of interest in pleasurable or usual activities
- difficulty sleeping; early-morning awakening
- loss of energy and constant lethargy
- sense of guilt or low self-esteem
- difficulty concentrating
- negative thoughts about the future
- weight gain or weight loss
- talk of suicide or death
Psychosis is a state in which a person is unable to tell the difference from reality and unreality. Psychosis symptoms include hallucinations, false beliefs about having special powers or identity (such as superhuman strength or X-ray vision). Psychotic symptoms indicate a severe mood episode that requires immediate medical attention and treatment.
People experiencing mania might begin several activities at once, never doubting that they can complete all of them. They may have so much energy that they operate on two or three hours of sleep each day. All of this energy can exhaust the family, friends and co-workers of a person with bipolar disorder.
The two illnesses are often confused but there are differences which can be recognized by a mental health professional. Analyzing all the symptoms present, family history and the patient’s history of symptoms is the only way to correctly diagnose bipolar disorder or schizophrenia.
Download and read my complete comparison of schizophrenia and bipolar disorder:
Bipolar Disorder or Schizophrenia?
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