Bipolar Support Group

I am new to the diagnosis of bipolar. I have had "psychotic features" where paranoia is the main issue. The world outside can get so scary that all I am able to do is hide under my blankets. I think "voices" may have been present but, I am still trying to figure out the definition of what that is. The easiest way to describe it is that I feel like I am arguing with my self. Not in the way of dueling personalities but in the way that I am trying to convince my self that my fears truly are paranoia. I will go back and forth between reality and my delusions. I talk to my self in my head as I try to sort it out, an open monologue of sorts.

My fathers sister is full blown Schizophrenic and his mother, although never diagnosed with anything specific, became a recluse with extreme paranoia. So, I am wondering how many of you have family members who have Schizophrenia.

Both of these diagnoses are a relative [no pun intended] mystery to me. Any insight into a possible connection would be appreciated.

Hi, The short answer is that bipolar disorder and schizophrenia are not at all closely related.

The long answer goes like this:

When you are diagnosed with Bipolar disorder, different descriptions or "specifiers" are added to your diagnosis to make it convey as much information as possible to other clinicians. (In fact, these specifiers go in a specific order and are assigned numbers in your diagnostic code that are part of an international diagnostic coding system, which is used to bill your insurance.)

Among the specifiers used are "XXX with psychotic features." The actual specifiers could be "depressed with psychotic features," "manic with psychotic features," or "mixed with psychotic features."

All the words "with psychotic features" means is that you had either hallucinations and/or delusions. Hallucinations can be auditory or visual or both. (You either hear or see things that are not really there or both.) Delusions are false beliefs maintained in spite of evidence to the contrary. Delusional content is almost always religious or paranoid.

Now, in contrast to Bipolar, which is a mood disorder, Schizophrenia is a thought disorder. Schizophrenia has a completely different etiology (development), course of illness, and prognosis. We know the two disorders to have genetic causes, but there are different genes involved.

Furthermore, schizophrenia does not just have psychotic "features," it has psychosis itself. In other words, in addition to the psychotic symptoms of hallucinations and delusions, schizophrenics have an underlying psychotic process, which bipolars don't.

As far as I can tell from the DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision), there is no familial connection between bipolar and schizophrenia. Except, however, for the fact that they are both major mental illnesses and when you find one major mental illness in a family, you are more likely to find another.

I hope this has been of some help.

Post edited by: sarahtroy, at: 08/21/2011 10:52 PM

Wow, yes! That was really interesting. Thanks for the run down on the differences. Like I said, I am new so, that really is interesting to me.

So there is no close relation other than they are major mental illnesses. My next thought then is that you cant progress from bipolar to schizophrenia. Yes, this makes sense to me. Hmmm, interesting in deed. I wish I had a better family history of the mental illnesses family members had.

Very informative Sarahtroy. Thank you.

When i had my first initial psychotic breakdown a long time ago i was 18 back in 1982, i was diagnosed in the psych. hospital with being paronoid scitzophrenia. I was in the hospital for 9 wks. They kept that diagnosis on me for 3 yrs, the psychosis went away after i got out from hospital and never had it since. Three yrs later i saw a new pdoc and he said i was not scitzohrenic and that i had depression anxiety. So i think a lot of people suffering with bipolar are often misdiagnoised with having scitzophrenia, well back in 1982 they did not know what they know now. Being psychotic i had symptoms that scitzophrenics have, but we all know when we are in full blown mania that turns into a psychosis the symptoms are similar. I was fortunate in that i never got full blown mania again, its been 28 yrs now, ive had some episodes where meds needed dosage upping due to hypomania or having lows weeking for numerous yrs in my 30s, but overall my meds work very well.

I wish you all the best, any symptoms you are having tell your pdoc meds are what help control these, and if they don't keep telling your pdoc there's got to be a med cocktail out there that will work.

Great post sarah troy!

My understanding was that schizophrenia is a disease sui genesis as well - though it seems that you can have a 'bit of both' in the form of schizo-affective disorder.

It seems in mental illnesses like bp and schizophrenia we have a better grasp of symptomology than underlying processes...even then one could wonder if, actually, so-called 'symptoms' for example irritability are more the compounds of the reflexive interaction between self and environment (when a person is ill) than an elementary symptom in themselves. What's an indication and what's a symptom?

...and then you might ask why our starting point is some 'pristine' self which is then conditioned by environment rather than inseparable from it on that elementary level? and then you wonder if you've lost the thread of the thread! And you shut up

Haha Benny! Actually I like your questions.

Here's one case: My mother has schizoaffective disorder and both my sister and I have bipolar. Assuming all the diagnoses are correct, it makes you wonder about the connection, At least I do.

Here's what I read (trying to paraphrase): Schizophrenia and Bipolar affect many genes; they apparently intersect on one chromosome. Don't know or understand the details. I have a schizophrenic uncle, and his genetics made it a little more to moderately more likely for me to have Bipolar. How likely I don't know. The article was from 10 years ago; don't know how accurate it is nowadays.

Zadie

Post edited by: ZadieBlue, at: 08/22/2011 06:48 AM

Sometimes I am confused about my own diagnoses. I was first dx with schizophrenia, then when they noticed the moods it was changed to schizoaffective. Then another doctor thought I was just "an extreme case" of bipolar 1 with psychotic features. Then my dx was changed again to schizoaffective bipolar type. I just don't know anymore...

As long as you're feeling comfortable with your meds, wyndrake, it doesn't so much matter, right? But it must have felt confusing getting all these different diagnoses.