Schizophrenia, Bipolar & DID: Differences and Counseling

Distinguishing the Three Mental Illnesses

The challenge of near-similar symptom presentation among schizophrenia, dissociative identity disorder, and bipolar disorder has led to many cases of misdiagnosis. This warrants the need to differentiate the three illnesses as a means of limiting the recurrence of this diagnostic challenge.

Bipolar disorder is a common mental illness characterized by alternating episodes of mood depression and mania lasting several weeks or even months. During manic episodes, individuals exhibit high levels of energy and hyperactivity associated with restlessness (American Psychiatric Association, 2013). Such individuals hold an irrational belief that they can accomplish enormous workloads in a short time, and they commit themselves to multiple projects even though none may be completed. Those around the patient will notice that they are constantly on the move and have a great deal to say. Sleep is also reduced as a result of the depressive and manic moods that leave patients feeling deeply unsettled.

Contrastingly, schizophrenia is a mental illness in which individuals hallucinate and act against logic and reason because of delusions. Schizophrenic individuals encounter significant difficulty carrying out normal life activities because their ability to interact with others in society is impaired. Patients hear voices inside their heads, which makes it very difficult for them to function effectively in normal social settings (American Psychiatric Association, 2013). As a result, schizophrenic individuals often cannot maintain employment, and high levels of depression are commonly experienced.

Dissociative identity disorder (DID) is also a condition in which individuals hear voices. However, the voices in DID arise from the presence of one or more distinct internal identities. The disorder leads patients to believe that all of these identities exist within them, and they relate to these identities through internal conversation. Through these alternate identities, individuals seek ways of coping with different parts of a fragmented life. Consequently, they display unique personalities that are distinctly different from what others know as their original self.

The key difference between DID and schizophrenia relates to the nature of the identities patients experience. Both conditions involve hearing voices, but in schizophrenia those voices are perceived as external intrusions, whereas in DID they are understood as part of the self. Importantly, individuals with DID do not experience hallucinations or delusions, unlike individuals with schizophrenia (American Psychiatric Association, 2013).

Educating the Client

Counselors play a central role in educating clients about their mental health status, although the possibility of resistance cannot be ignored. Nevertheless, patients should be educated about their condition as a way of initiating a treatment plan that will improve their mental health. The counselor can also offer additional medical options to strengthen the therapeutic partnership while ensuring that the path to recovery remains clear.

Counselors can help reduce stigma by identifying the possible side effects of prescriptions and discussing these openly with clients. Clients can also discuss the nature of their disorder with the counselor, giving them a better understanding of what is happening in their lives. Through these discussions, counselors have an excellent platform to share success stories of individuals who experienced mental health difficulties but recovered through medication and treatment obtained from various health facilities. Such conversations help clients normalize the experience of mental illness and embrace their treatment.