Difference in diagnosis

Two people go through similar experiences of psychiatric crisis. One
get's diagnosed with bipolar with paranoid features. The other gets a
diagnosis of schizophrenia. What's the difference?

Differential diagnosis information helps clinicans separate between
different illnesses which may look similar. It's pretty complex for
schizophrenia and bipolar though. There's a debate about whether they're
the same disease or distinct entities though the lay perception is
they're two different things.

The difference in diagnosis can be huge. Schizophrenia invariably ends
up with treatment with antipsychotics. Treatment for bipolar invariably
ends up with mood stabilisers. However lots of medications can be used
together depending on the individual. I was given everything. The
effects of modern antipsychotics are worse than the effects of modern
mood stabiliser medication.

What's really significant for the indivudal may be the stigma. Bipolar
is almost fashionable. Everyone seems to have it nowadays. In fact
schizophrenia may be more common but it's so stigmatised that even in
mental health settings people simply won't disclose. The fear of stigma
can be as hard as the self-stigma and the stigma. Diagnosis can have a
severe negative impact on many people. My own experience was becoming
more bipolar after the diagnosis. I also expierienced high levels of
self-stigma when I was diagnosed with bipolar. But nowadays I think the
stigma wouldn't be so bad. The stigma of schizophrenia is significantly
worse.

Psychiatrists don't seem to be able to use diagnosis reliably in
practice. Mental illnesses are meant to be constant conditions but I'm
hearing more and more people are having their diagnosis changed.
Different psychiatrists often diagnose patients differently. In one
study in America the greatest factor in this variance was where the
psychiatrist learnt psychiatry. The UK public got exposure to this
problem through the documentary "How mad are you?" where the
psychiatrists didn't give the same diagnosis to the same person,
diagnosed mentally ill people as not ill and not ill people as mentally ill.

The impact of this variance in a disease like cancer would cause an
outcry at the science. In psychiatry it seems to be an acceptable
failure. Sadly the impact for patients is as significant as for a
misdiagnosis of cancer. Schizophrenia and bipolar are associated with
very high levels of social disabiltiy. The stigma redoubles the distress
and it's not experienced by cancer patients. The stigma and the
ignorance can block sympathy. Cancer brings a swift end too.
Schizophrenics and manic depressives have to take their own life to get
such relief.