Living With Schizoaffective Disorder

Living with schizoaffective disorder is complicated by the fact that it is so difficult to diagnose. Consequently, it can take some time before the presence of the disorder is detected and its symptoms accurately interpreted. Schizoaffective disorder is a life-altering condition that requires an intensive commitment to manage, but with proper treatment and good family support recovery is possible.

Schizoaffective Disorder


From a poorly understood location on the mental illness spectrum, schizoaffective disorder has touched the lives of millions of people, many of whom had no idea what was happening when they started to experience perplexing schizoaffective disorder symptoms. About one in 200 Americans will suffer from the disorder in any given year, which is usually diagnosed sometime during young adulthood.

Most mental health disorders have a clear identity that sets them apart from other disorders, but schizoaffective disorder is unique in this regard. It is a hybrid disorder that includes elements from two separate classifications of mental illness, yet maintains an identity as a singular type of disorder.

For those who are diagnosed (or suffer in silence without an accurate diagnosis), living with schizoaffective disorder can be confusing, discouraging, exhausting, and endlessly challenging—and that’s just on one typical day.

What is Schizoaffective Disorder?


Combining aspects of bipolar disorder, major depression, and schizophrenia, schizoaffective disorder is a multidimensional condition that bombards sufferers with an avalanche of troubling symptoms.

Overall, there are five types of schizoaffective disorder (as classified by the (ICD)):

  1. Schizoaffective disorder, bipolar type
  2. Schizoaffective disorder, depressive type
  3. Schizoaffective disorder, mixed type
  4. Other schizoaffective disorders
  5. Schizoaffective disorder, unspecified

Despite these listings, the first two types—bipolar schizoaffective disorder and depressive schizoaffective disorder—comprise the vast majority of cases. The other three categories are reserved for rare examples of the disorder that don’t fit comfortably in the bipolar/depressive box.

But regardless of the specific subtype they have, those diagnosed with schizoaffective disorder will experience a dense tangle of symptoms that mimic the manic and depressive states of bipolar disorder, plus the positive (or psychotic) symptoms of schizophrenia.

The Bipolar Symptoms of Schizoaffective Disorder


With bipolar schizoaffective disorder, mania and depression are usually experienced in cycles, although one state may appear more frequently and/or for longer periods of time.

The symptoms of mania associated with bipolar schizoaffective disorder include:

  • Boundless energy and a flurry of activity
  • An inability to slow down or rest, even after long hours in action
  • Disrupted sleeping patterns or chronic insomnia
  • Delusions of grandeur or feelings of invulnerability
  • Rapid speech and thought, which often makes little logical sense
  • Reduced ability to focus or concentrate
  • Agitation and irritability
  • Dangerous, risky behaviors with no apparent concern for the consequences

Meanwhile, depressed states associated with schizoaffective disorder (either bipolar type or depressive type) can be recognized through the appearance of the following symptoms:

  • A loss of motivation for even the simplest daily tasks
  • Weight fluctuations and unhealthy changes in eating habits
  • Sleeping at odd or unusual hours, and to excess
  • Low energy, lethargy, and apathy
  • Inability to enjoy previously pleasurable activities
  • Poor grooming habits, lack of concern over appearance
  • Defeatist attitudes and poor self-esteem
  • Social isolation and withdrawal

Schizoaffective disorder, bipolar type causes sufferers to experience both highs and lows, often in a cyclical manner but without any expectation that alternating periods of mania and the depression will be of equal intensity or length. Depressive schizoaffective disorder does not include periods of mania; however, that doesn’t mean the sufferer is depressed all the time. With each form of the illness, sufferers may go through periods where their moods are stable and there is no sign of either mania or depression.

Mood stabilizers and antidepressant drugs used in treatment can help schizoaffective disorder sufferers restore their emotional equilibrium, partially or completely. This is why psychiatrists almost always prescribe these medicines to schizoaffective disorder sufferers who seek treatment for their symptoms.

The Schizophrenia Symptoms of Schizoaffective Disorder


People with schizoaffective disorder suffer from disruptions in mood quite frequently, while their schizophrenia-type symptoms tend to manifest only occasionally in an episodic format. This pattern has some variation, but a person cannot actually be diagnosed with schizoaffective disorder unless their mood disorders are in evidence most of the time, and more so than their symptoms of schizophrenia.

There are three categories of symptoms experienced by schizophrenia sufferers: positive, negative, and cognitive. While symptoms from the last two categories may develop in schizoaffective disorder sufferers, the positive symptoms of schizophrenia are far more common, and it is these that link schizoaffective disorder and schizophrenia and identify them as similar conditions.

In the schizophrenia category, the schizoaffective disorder symptoms frequently experienced by sufferers include:

  • Hallucinations. Auditory hallucinations in the form of voices predominate, but hallucinations of sight, touch, taste, and smell are also experienced.
  • Delusions. These false beliefs about reality and the world tend to be exotic, paranoid, non-productive and occasionally destructive.
  • Movement disorders. Excessive agitation expressed in meaningless repetitive motion is common, but some schizoaffective disorder sufferers go the opposite way and slip into catatonia.
  • Disorganized thinking, speech, and behavior. Logic, meaning, and cohesion become elusive, as the individual seems to pick up or drop new ideas at random.

With respect to the complexity of symptoms, patterns of manifestation vary from person to person. Some schizoaffective disorder sufferers experience alternating periods of mood disorder symptoms and schizophrenia symptoms. But others experience manias and depression interspersed with schizophrenic episodes, the latter functioning as an added complication to a primarily mood-based condition.    

Schizoaffective Disorder Diagnosis: Before and After


Because it includes symptoms from varying disorders, which often manifest in a jumbled order, schizoaffective disorder is an incredibly difficult condition to diagnose. For a long time, there was controversy in the medical profession about whether schizoaffective disorder even existed, which is a testament to the disorder’s elusiveness.

Since the mania, depression, and psychotic episodes associated with the disorder can all be frightening and disabling, people who experience even one attack often seek help immediately, and are thus diagnosed based on a limited profile of symptoms. This leads to mistaken diagnoses of bipolar disorder, depression, or schizophrenia, and it is not until other types of symptoms occur that a more accurate diagnosis can be made.

The uncertainties of schizoaffective disorder make it a stressful condition for sufferers, especially in its early stages when they don’t know what’s happening. They may go from doctor to doctor looking for answers, trying several different medications that may reduce some symptoms but leave others largely untouched. This naturally creates a high level of anxiety, in addition to the mood- and mind-altering effects of the disorder itself.

Putting a name to the disorder usually brings great relief to sufferers, who finally understand the nature of the challenges they face. Medical intervention at that point becomes more carefully targeted, giving the individual with schizoaffective disorder a much better chance of successfully managing, and recovering from, their symptoms.

But schizoaffective disorder, bipolar type and schizoaffective disorder, depressive type are comprehensive in their life-altering capacities. Even with treatment those who suffer from them must work diligently to develop sustainable, all-purpose coping skills. Schizoaffective disorder affects thought, speech, behavior, motivation, and personal effectiveness; its echoes are felt in relationships, in the workplace, in school, in money management practices, and in a person’s ability to stay committed to their rehabilitation program.

Because the requirements of recovery can be so exhausting and difficult to maintain, people with schizoaffective disorder benefit enormously from having a strong, family-based support structure available that can help them adjust to their illness and the diligence it demands.

Fluctuating moods and disruptive or psychotic schizophrenia symptoms can interfere with their ability to manage their daily affairs and maintain their commitment to a healthy lifestyle, and that is where loved ones can make a positive impact.

People suffering from mental illness do need their space, and they should always be treated with dignity and respect. But having family members close by, ready to offer caregiving services and practical assistance as needed, is an essential part of their recovery program, and those who don’t have that support system may have a harder time getting better.

Knowing how to deal with schizoaffective disorder is a skill that must be learned, in therapy and during life skills training but also, to some extent, through trial-and-error. This is a reality for sufferers and their loved ones alike. But if everyone acts in partnership and in close coordination with responsible medical professionals, the individual with schizoaffective disorder can preserve much of their independence while enjoying a good quality of life.     

Getting Help for Schizoaffective Disorder


Once a correct diagnosis has been made (assuming it is eventually made, which may not always be the case), life can and will get easier for schizoaffective disorder sufferers after treatment begins.

Schizoaffective disorder treatment is multifaceted and designed to address the full range of symptoms people with the condition experience. Medication and specialized life skills training, backed by individual, group and family therapy, form the core of a good treatment program, and many sufferers choose to add mind-body therapies that promote overall health as well.

While it may take some time to find the right combination of medicines (antipsychotics for the schizophrenia, mood stabilizers and/or antidepressants for the mania and depression), these drugs do have a good record of success when used by people with schizoaffective disorder.

Assuming the patient remains dedicated to following all treatment recommendations, the strength and frequency of their disabling symptoms should decrease significantly over time.