What is the Difference Between Manic Depression and Schizophrenia?

Manic depression and schizophrenia are both lifelong mental health disorders that affect a person’s ability to think and behave normally. The symptoms of manic depression and schizophrenia appear similar at first. In fact, without knowing what to look for, one can easily be mistaken for the other. As with all mental health disorders, a proper diagnosis is critical for early intervention and treatment. Here is an overview of the difference between manic depression and schizophrenia.

Manic depression


Also called bipolar disorder, manic depression is characterized by extreme mood swings with periods of normal energy in between. At times, people with manic depression will feel euphoric and full of energy. These “high” periods affect all areas of a person’s life, including their sleep patterns, behavior, and ability to make decisions and think clearly. These feelings are followed by “lows,” in which a person shifts into a depressive state. The depression period is marked by feelings of sadness, hopelessness, and a loss of interest in hobbies and activities. These mood swings can happen occasionally or many times throughout the year. Manic depression is typically diagnosed in a person’s teens or early 20s, but the condition can appear at any time.

Symptoms of manic depression

The symptoms of manic depression can be broken down into two types: mania and major depression.


When a person with manic depression is having a manic or hypomanic episode, he or she will have problems performing at work, school, and in social situations. Symptoms vary from person to person, but an individual experiencing several of the following may be having a manic episode.

  • High energy levels

  • Decreased need for sleep

  • Racing thoughts

  • Inappropriate social behavior

  • Increased sexual desire

  • Easily distracted

  • Increased activity

  • Unusually upbeat and jumpy

  • Excessive talking speed or volume

  • Increased confidence and sense of wellbeing

  • Unusually irritable

  • Reckless behavior

Major depression
Depressive episodes also cause significant interruptions in a person’s career and relationships. A person is considered to be having a depressive episode when he or she experiences several of the following symptoms.

  • Feeling sad, empty, and hopeless

  • Loss of interest in most activities

  • Significant weight loss, weight gain, or loss of appetite

  • Either difficulty sleeping or excessive sleeping

  • Either restlessness or sluggish behavior

  • Low energy and fatigue

  • Feelings of worthlessness and excessive guilt

  • Difficulty thinking, concentrating, and making decisions

  • Thinking about, planning, or attempting suicide

People with severe manic depression can also suffer from psychotic episodes in which they have hallucinations or delusions. For this reason, people with manic depression often mistake their symptoms for schizophrenia.


Schizophrenia is a serious mental health disorder that affects how a person interprets reality. Roughly 1% of the United States population suffers from schizophrenia and the associated delusions, hallucinations, and disordered thinking that make it challenging to live a normal life. One of the main markers of schizophrenia is that a person can’t tell when certain ideas and perceptions they have are real or not. While there is no cure for schizophrenia, treatment is available. Early intervention can help those affected cope with the symptoms of schizophrenia and improve their long-term outlook.

Symptoms of schizophrenia

The symptoms of schizophrenia can be broken down into three types: positive, negative, and cognitive.

Positive symptoms

The word “positive” refers to the presence of symptoms, as opposed to the absence of symptoms. They may include:

  • Hallucinations (auditory, visual, olfactory, gustatory, and tactile)

  • Delusions

  • Confused thoughts

  • Disorganized speech

  • Trouble concentrating

  • Unpredictable movements

Negative symptoms

The word “negative” refers to a lack of normal mental functioning. Negative symptoms may include:

  • Lack of pleasure

  • Talking with a flat voice

  • Not showing emotion

  • Severe withdrawal

  • Struggling with basic activities

  • Lack of self hygiene

  • Trouble staying on schedule and following through

Cognitive symptoms

The cognitive symptoms of schizophrenia are more subtle and are detected with thorough testing. Cognitive symptoms may include:

  • Poor ability to absorb information and make decisions based on that information

  • Reduced mental speed and reaction time

  • Reduced attention span

  • Problems remembering recently learned information and using it right away

  • Inability to recognize one’s own symptoms

Men often show symptoms of schizophrenia in their late teens and early 20s, while women usually show the first signs in their 20s and early 30s.

How to tell the difference

Manic depression and schizophrenia share many similarities, so a doctor must perform thorough testing and take a detailed medical history to make an accurate diagnosis. Here are a few key differences between the two conditions.

  • A person with manic depression will be more expressive with his or her feelings, while a person with schizophrenia will be unable to show emotion, lack facial expressions, and speak with a flat tone.

  • Psychotic episodes associated with manic depression will usually mirror the person’s moods. Someone experiencing mania will typically have upbeat hallucinations or delusions, while a person in a depressive state will have negative delusions. Because schizophrenia is not a mood disorder, a person with schizophrenia may not necessarily experience hallucinations and delusions that correlate with his or her mood.

  • A person affected by manic depression often functions well at work, school, and in social situations when not experiencing episodes of mania or depression. Those with untreated schizophrenia typically struggle to maintain jobs and relationships and have difficulty functioning day-to-day.

  • A person with manic depression may have a history of mood-related symptoms. Previous medication usage and the diagnosis of another mood disorder can also indicate manic depression, rather than schizophrenia.

Get treatment for manic depression or schizophrenia at Alvarado Parkway Institute

If you or a loved one is struggling with the symptoms of manic depression or schizophrenia, help is available. While there is no cure for either condition, treatment is the key to living a healthy, fulfilling life. At Alvarado Parkway Institute, our inpatient programs include medication, psychotherapy, and education to help you manage your symptoms and live your best life. If you’re ready to learn more or want to begin treatment, please call us at (619) 485-1432.