People who experience psychosis and mood disorders might have schizoaffective disorder, a debilitating condition that is less common than schizophrenia and mood disorders, according to Healthline. However, it bears similarities to both of these disorders and can make life difficult for those who have it.
If left untreated, schizoaffective disorder can have adverse effects, making it challenging to hold a job, relate to others, or even take care of oneself. Fortunately, it is treatable.
A Closer Look at Schizoaffective Disorder
The schizophrenia part of the psychiatric condition involves having delusions and hallucinations, which indicate a loss of contact with reality. The mood disorder part of the disorder is characterized by depression or mania, when a person has periods of high energy, arousal, or overactivity.
According to the Mayo Clinic, the two types of schizoaffective disorder both involve some symptoms of schizophrenia. “They are bipolar type, which includes episodes of mania and sometimes major depression [, and] depressive type, which includes only major depressive episodes,” the clinic writes.
According to Healthline, scientists do not fully understand what causes schizoaffective disorder. Theories about the disorder’s causes range from a person’s genetics and environment to an imbalance in the brain chemicals serotonin and dopamine, the health website writes.
It is also thought that having a close blood relative with schizophrenia, bipolar disorder, or schizoaffective disorder can increase someone’s risk of having schizoaffective disorder. Stressful events that could be triggering and using substances when the disorder is present are also thought to be risk factors for it.
How schizoaffective disorder develops and presents itself varies depending on the person who has it. However, people who have it can struggle to function in their daily lives, making it challenging to work, go to school, or navigate social situations.
The Mayo Clinic explains that “defining features include a major mood episode (depressed or manic mood) and at least a two-week period of psychotic symptoms when a major mood episode is not present.”
The clinic writes that treatment can make the condition manageable and help improve people’s lives.
Schizoaffective Disorder Signs, Symptoms
Common symptoms of schizoaffective disorder are:
- Paranoia, paranoid thoughts
- Catatonia (the inability to move around normally)
- Disorganized speech, trouble verbally communicating
- Unorganized behaviors, thoughts
- Difficulty concentrating, focusing
- Appetite changes
- Poor hygiene habits
- Sleeping problems (insomnia)
- Social isolation
- Thoughts of suicide
The Mayo Clinic says that people with schizoaffective disorder are at increased risk of suicide and suicide attempts. They also are at risk of experiencing anxiety disorders, unemployment, substance use disorders, health problems, poverty and homelessness, and conflicts with family members and others.
Diagnosing Schizoaffective Disorder
Schizoaffective disorder is often misdiagnosed as schizophrenia or bipolar disorder. According to the National Alliance on Mental Illness (NAMI), this happens because schizoaffective disorder is not studied as often as the other two disorders. It cites data published in the Archives of General Psychiatry that says the disorder has a lifetime prevalence of only 0.3%, making it rare when compared to other mental illnesses.
According to NAMI, it is also possible for patients with schizoaffective disorder to also have other mental health disorders, including post-traumatic stress disorder (PTSD), attention-deficit hyperactivity disorder (ADHD), anxiety disorders, and dual diagnosis, when substance use disorder and a mental health disorder co-occur.
It is best to receive a diagnosis from a licensed mental health professional to confirm the presence of schizoaffective disorder. A professional can rule out other causes for the symptoms someone is experiencing, such as other mental illnesses, substance use disorders, medication that someone could be taking, or a physical medical condition. Any of these can have effects that mirror those of schizoaffective disorder.
A physical exam can rule out medical conditions, while tests and screenings can look for signs of substance misuse and eliminate conditions with similar symptoms. If a psychiatric evaluation is performed, a physician or mental health professional can ask questions to learn more about a person’s symptoms.
These questions can focus on a person’s mental state and give them more insight into why the individual is experiencing mood changes and psychosis. The person might also be asked about their family history, substance use history, and other relevant information about their personal history.
Once the professional has gathered enough information, they can compare it to the criteria in the Diagnostic and Statistical Manual of Disorders (DSM-V) to determine if schizoaffective disorder is the case.
According to criteria in the manual, published by the American Psychiatric Association, a person diagnosed with schizoaffective disorder must have a continuous period of illness in which a major mood episode happens. This episode can be either depressive or manic.
They also must have at least two of several symptoms occur in that period that characterizes schizophrenia. These symptoms can be:
- Disorganized speech
- Grossly disorganized or catatonic behavior
- Negative symptoms, such as diminished emotional expression or avolition, which is a lack of motivation
Two or more of these must be present for a significant time during a 30-day period. Other criteria include:
- The person has hallucinations and delusions for two or more weeks when a major mood episode does not occur. This major mood episode can be manic or depressive.
- The symptoms that meet the requirements for a major mood episode are present for most of the duration of when the illness occurs.
- The illness is not the result of a substance use disorder or use of medication or another underlying medical condition.
Treatment for Schizoaffective Disorder
People with schizoaffective disorder can benefit from an approach that combines medication, psychotherapy, skills training, and hospital care if needed.
Medications commonly prescribed for people with this condition include antipsychotic medications, mood stabilizers, and antidepressants. The antipsychotic medications can help the person manage disordered thinking as well as delusions and hallucinations. Mood stabilizers address the bipolar type of the disorder, keeping the severe highs and lows of this disorder stable. If depressive symptoms are more present, then antidepressants can help manage feelings of sadness or troubles with focusing.
Psychotherapy often accompanies medication for mental illness because it focuses on treating the person, not just the physical and mental effects of the disorder. Various psychotherapies are used to help patients learn the reasons for their disorder and learn tools and strategies that can help them manage the situations that may arise in daily life.
Cognitive behavioral therapy (CBT) helps people change their behavior by first recognizing and changing disordered thinking, and family therapy can help family members learn how to support their loved ones.
Life Skills Training
Some people with schizoaffective disorder will need guidance in reestablishing order to their lives and preparing themselves for their daily routines. Life skills training will help them learn or relearn social skills, good hygiene habits, and self-care. They can also get help with securing employment and learning other skills to help them manage their finances and home life.
In cases where a patient experiences psychosis and becomes suicidal, they can become a danger to themselves and/or others. Hospitalization may be required to keep them safe. A setting such as this ensures the individual gets the medical attention they need.
Living with Schizoaffective Disorder
The Mayo Clinic says schizoaffective disorder requires ongoing treatment and support. It advises that people with the disorder learn more about it, which can help them stay on course with a treatment plan.
Education can also include learning how to recognize the warning signs and creating a plan to address them when they arise. This plan can include a contact list of doctors and mental health professionals who can offer help. Family, friends, colleagues, and others can also educate themselves about the mental disorder to help the person who has it.
A support group can also make living with schizoaffective disorder manageable for the people who have it and their loved ones. There may be groups in your local area, or you might be able to find one online.