August 23rd, 2011
01:29 PM ET

Could my bipolar brother develop schizophrenia?

Every weekday, a CNNHealth expert doctor answers a viewer question. On Tuesdays, it's Dr. Charles Raison, an associate professor of psychiatry and behavioral sciences at Emory University, and an expert in the mind-body connection for health.

Question asked by Benjamin from St. Catharines, Ontario

I was wondering if my brother, who we have been told is bipolar, could develop schizophrenia? My uncle, my mom's brother, was schizophrenic and unfortunately fell victim to the mental illness. We are aware that there have been some mental health issues with males on my mother's side of the family, so could it be possible that he could be schizophrenic as well as bipolar?

Expert answer

Dear Benjamin,

Your question points to a major problem confronting the field of psychiatry, which is the imprecision of our diagnostic categories. The problem has a simple cause but no simple answer.

The cause comes from the fact that all our disease states are based on symptoms and how they are clustered together, rather than on any real biological mechanism.

In this way, our diagnoses are similar to the way most medical illnesses were defined before the 20th century. For example, in the old days people with fluid in the lungs and chest pain were said to have pleurisy - it was defined by its symptoms.

Ask our doctors a question

Nowadays we recognize literally hundreds of different reasons for pleurisy symptoms, many of them with specific treatments that have no effect on other causes for pleurisy.

Diseases such as schizophrenia and bipolar disorder are like pleurisy and not like adenocarcinoma of the lung or pneumococcal pneumonia or an aortic dissection, all of which cause pleurisy, but all of which are disease conditions based on an understanding of physical mechanisms rather than symptoms.

Both schizophrenia and bipolar disorder are better thought of as syndromes rather than specific diseases. As such, someone has schizophrenia if he or she meets symptom criteria for schizophrenia spelled out in the diagnostic manual. The same thing holds for bipolar disorder.

It sounds simple enough, but things immediately get complicated. First, schizophrenia and bipolar disorder share important symptoms; for example, psychotic thought and behavior can be present in both conditions, making the syndromes hard to differentiate.

If a person is heavy on psychosis and relatively light on either depression or mania, he or she looks schizophrenic and is called such. If a person is heavier on depressions and manias and only has psychotic episodes when in a mood state, he or she looks more like someone with bipolar disorder and is called such.

To add to our diagnostic troubles, over time many people's symptom patterns swing from mostly psychotic to mostly mood-related and back again, making them sometimes seem schizophrenic and sometimes bipolar. And other people spend most of their lives in an intermediate state, with lots of psychosis and lots of depression or mania, but not enough to be fully bipolar. These people are called schizoaffective.

By definition, a person can't have bipolar disorder and schizophrenia at the same time. But a person can sure struggle for years with psychosis, odd behavior and mood swings and be hard to classify clearly into one diagnosis or the other, which sounds to be the case with your brother.

In the midst of these complications, there is some good news. More important than his exact diagnosis (which is after all only a description of his symptoms and how they cluster over time) is the fact that both schizophrenia and bipolar disorder respond to similar medications.

The important thing is not his diagnosis, but his need to get into - or remain in - consistent treatment, which offers the best hope of providing a hopeful long-term outcome.

Follow @CNNHealth on Twitter.

soundoff (1,758 Responses)
  1. 32955 Sprinter Repair

    I'm excited to find this page. I need to to thank you for your time for this fantastic read!! I definitely savored every part of it and i also have you bookmarked to see new information in your site.


    June 4, 2021 at 03:57 | Report abuse | Reply
  2. ZisseVed

    cialisprofessional cialis trial cialis pay with paypal

    June 4, 2021 at 06:22 | Report abuse | Reply
  3. truck body shops near me


    June 4, 2021 at 07:03 | Report abuse | Reply
  4. oc trailers

    bookmarked!!, I love your website!


    June 4, 2021 at 09:20 | Report abuse | Reply
  5. 5 below near me

    This is a topic which is close to my heart... Thank you! Exactly where are your contact details though?


    June 4, 2021 at 09:21 | Report abuse | Reply
  6. Ram Van Frame Repair

    Hello! I could have sworn Iíve been to this web site before but after browsing through some of the posts I realized itís new to me. Anyhow, Iím definitely delighted I came across it and Iíll be bookmarking it and checking back regularly!


    June 4, 2021 at 11:10 | Report abuse | Reply
  7. orange county trailers


    June 4, 2021 at 12:48 | Report abuse | Reply
  8. same day results covid testing near me


    June 4, 2021 at 12:52 | Report abuse | Reply
  9. Mercedes Winnebago Sprinter Repair

    Greetings! Very helpful advice in this particular post! It's the little changes that will make the greatest changes. Thanks a lot for sharing!


    June 4, 2021 at 13:10 | Report abuse | Reply
  10. Keystone Sprinter Tank Repair Leaking


    June 4, 2021 at 14:17 | Report abuse | Reply
  11. shop for seats rv


    June 4, 2021 at 14:53 | Report abuse | Reply
  12. EncoxAni

    cheap drugs online pharmacy technician online program Chloromycetin

    June 4, 2021 at 15:38 | Report abuse | Reply
  13. rv appliance repair near me


    June 4, 2021 at 17:13 | Report abuse | Reply
  14. Sherrie Geiger


    June 4, 2021 at 18:35 | Report abuse | Reply
  15. remodel center


    June 4, 2021 at 21:11 | Report abuse | Reply
  16. tacos near me

    Oh my goodness! Amazing article dude! Thank you, However I am going through difficulties with your RSS. I donít understand why I cannot subscribe to it. Is there anybody else having the same RSS problems? Anybody who knows the solution will you kindly respond? Thanx!!


    June 4, 2021 at 21:13 | Report abuse | Reply
  17. EncoxHtf

    canada cialis trial cialis discount program cialis c20

    June 4, 2021 at 21:35 | Report abuse | Reply
  18. 2006 Sprinter 3500 Repair Near Me

    Very good info. Lucky me I discovered your website by chance (stumbleupon). I've saved it for later!


    June 4, 2021 at 21:50 | Report abuse | Reply
  19. Sprinter Vanrooftop A/C Leak Repair


    June 4, 2021 at 21:52 | Report abuse | Reply
  20. cialis without a doctor prescription

    tadalafil sublingual buy cialis usa cialis tadalafil

    June 4, 2021 at 21:55 | Report abuse | Reply
  21. bong ash catcher

    Dabpadz14mm female ash catcher14mm 45 Degree Showerhead Ash Catcher By DiamondThe Medicali Ash Catcher with Showerhead Perc has a colored showerhead percolator and is available to order in a selection of colors. Please select your favorite color from the available option in the drop-down thực đơn when you place your order. Please note that you can select the color of the showerhead percolator, it is not possible to select the color or style of the logo. The logos come in a wide variety of colors and styles, you will receive one at random, depending on availability.


    June 4, 2021 at 22:39 | Report abuse | Reply
  22. nectar collector pen

    Dabpadzwhat is a honey strawDiamond Glass 18mm 45 Degree Showerhead Perc Ash CatcherThe bag is held closed by strong velcro as well as a rubber lined zipper that keeps smells locked inside. The inside has two roomy mesh pockets with enough space for your stash as well as a lighter, a hand pipe, and even a snack. The inside of the pouch also has 100 carbon lining, making the smell-proof security even stronger.


    June 4, 2021 at 22:43 | Report abuse | Reply
  23. oc fleet


    June 4, 2021 at 22:46 | Report abuse | Reply
  24. where to buy a one hitter

    Dabpadzgrinder for sale45 Degree Joint Vs 90 Degree Joint Ash CatcherThe Medicali Ash Catcher with Showerhead Perc has a colored showerhead percolator and is available to order in a selection of colors. Please select your favorite color from the available option in the drop-down thực đơn when you place your order. Please note that you can select the color of the showerhead percolator, it is not possible to select the color or style of the logo. The logos come in a wide variety of colors and styles, you will receive one at random, depending on availability.


    June 4, 2021 at 23:19 | Report abuse | Reply
  25. Social Media Marketing Services

    I would like to thank you for the efforts you've put in penning this website. I am hoping to see the same high-grade content from you in the future as well. In fact, your creative writing abilities has motivated me to get my own, personal website now 😉


    June 5, 2021 at 00:11 | Report abuse | Reply
  26. travel trailer repair near me


    June 5, 2021 at 01:11 | Report abuse | Reply
  27. rv slide out leak repair


    June 5, 2021 at 01:15 | Report abuse | Reply
  28. office depot near me

    Spot on with this write-up, I seriously believe that this amazing site needs much more attention. Iíll probably be returning to see more, thanks for the info!


    June 5, 2021 at 01:19 | Report abuse | Reply
  29. Dodge Sprinter Service Centers

    May I simply say what a relief to find somebody who genuinely knows what they are discussing over the internet. You definitely know how to bring a problem to light and make it important. More people have to read this and understand this side of your story. I was surprised you are not more popular because you surely have the gift.


    June 5, 2021 at 01:30 | Report abuse | Reply
  30. top Eliquid

    You really make it appear so easy with your presentation however I in finding this matter to be really one thing which I believe I might by no
    means understand. It kind of feels too complex and very extensive for me.
    I'm taking a look forward in your next submit, I'll try to get the hang of it!

    June 5, 2021 at 02:22 | Report abuse | Reply
  31. Mercedes Benz Sprinter Service

    Spot on with this write-up, I seriously believe this site needs a lot more attention. Iíll probably be back again to read through more, thanks for the information!


    June 5, 2021 at 02:24 | Report abuse | Reply
  32. Fiberglass Van Roof Repair


    June 5, 2021 at 12:59 | Report abuse | Reply
  33. fiberglass near me

    I was able to find good info from your articles.


    June 5, 2021 at 13:40 | Report abuse | Reply
  34. endocrinologist near me

    This is a topic that's near to my heart... Thank you! Where are your contact details though?


    June 5, 2021 at 14:40 | Report abuse | Reply
  35. where to buy cialis without prescription

    tadalafil tablets 5mg tadalafil goodrx elevex 20mg

    June 5, 2021 at 16:06 | Report abuse | Reply
  36. Sprinter Vanrooftop A/C Leak Repair


    June 5, 2021 at 17:29 | Report abuse | Reply
  37. Mercedes Benz Sprinter Service


    June 5, 2021 at 18:48 | Report abuse | Reply
  38. painting a horse trailer

    Aw, this was an exceptionally nice post. Taking a few minutes and actual effort to make a top notch articleÖ but what can I sayÖ I put things off a whole lot and never seem to get anything done.


    June 5, 2021 at 19:33 | Report abuse | Reply
  39. printing near me


    June 5, 2021 at 21:24 | Report abuse | Reply
  40. aralen chloroquine

    hydroxychloroquine side effect chloroquine malaria where do you get hydroxychloroquine

    June 5, 2021 at 23:33 | Report abuse | Reply
  41. roof repairs orange county ca

    Your style is so unique in comparison to other people I have read stuff from. Thank you for posting when you've got the opportunity, Guess I'll just bookmark this page.


    June 6, 2021 at 01:01 | Report abuse | Reply
  42. Mercedes Benz Sprinter Repair Shop

    An intriguing discussion is worth comment. I believe that you ought to write more about this issue, it might not be a taboo subject but generally people don't speak about such issues. To the next! Kind regards!!


    June 6, 2021 at 01:26 | Report abuse | Reply
  43. Mercedes Sprinter Repair Shops


    June 6, 2021 at 13:31 | Report abuse | Reply
  44. trailer services near me


    June 6, 2021 at 14:16 | Report abuse | Reply
  45. solar panel installation orange county

    A fascinating discussion is definitely worth comment. I do think that you ought to write more about this topic, it might not be a taboo subject but usually people don't talk about such topics. To the next! Cheers!!


    June 6, 2021 at 15:41 | Report abuse | Reply
  46. ikea near me

    Hi! I just would like to offer you a huge thumbs up for your great info you have got right here on this post. I will be returning to your website for more soon.


    June 6, 2021 at 22:17 | Report abuse | Reply
  47. interactions for hydroxychloroquine

    chloroquine antimalarial hydroxychloroquine sulfate tabs chloroquinolone malaria

    June 6, 2021 at 22:40 | Report abuse | Reply
  48. Dodge Sprinter Service


    June 6, 2021 at 23:48 | Report abuse | Reply
  49. Authorized Mercedes Sprinter Service Centers Near Me


    June 6, 2021 at 23:51 | Report abuse | Reply
  50. Sprinter Heater Valve Repair

    Pretty! This has been a really wonderful post. Thank you for supplying this info.


    June 7, 2021 at 07:38 | Report abuse | Reply
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35

Post a comment


CNN welcomes a lively and courteous discussion as long as you follow the Rules of Conduct set forth in our Terms of Service. Comments are not pre-screened before they post. You agree that anything you post may be used, along with your name and profile picture, in accordance with our Privacy Policy and the license you have granted pursuant to our Terms of Service.

About this blog

Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.

August 2011
  • An error has occurred, which probably means the feed is down. Try again later.