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Schizoaffective Disorder

Schizoaffective disorder is a serious chronic mental health condition that has symptoms of schizophrenia (hallucinations or delusions) and symptoms of a mood disorder (mania and depression).

Schizoaffective disorder is a rare condition. It's often incorrectly diagnosed at first as bipolar disorder. It can take time to tell the difference between schizoaffective disorder and schizophrenia and mood disorders.

Schizoaffective disorder is life-long (chronic). Though it is important to realize that symptoms can lesson with time and treatment. It makes working and living in society difficult. Schizoaffective disorder is a psychotic disorder. Someone with schizoaffective disorder has thoughts and emotions that are a distortion of external reality. They perceive a unique reality from those around them. The difference between reality and what you think become blurred in your mind. The cause of schizoaffective disorder is not yet known. It's believed to be a result of genetic and biological factors such as brain chemistry and structure. Symptoms of schizoaffective disorder include:

  • Seeing or hearing things that are not there (hallucinations). Hearing (auditory) hallucinations are most common.

  • False beliefs (delusions)

  • Disorganized thinking and speech

  • Severe anxiety

  • Feeling unreal

  • Paranoia

  • Insomnia

  • Trouble thinking or concentrating clearly

  • Depression, feeling suicidal

  • Withdrawal from those around you (social withdrawal)

Depression is 1 type of mood disorder that is related to brain chemistry. It is common in people with schizoaffective disorder. You may feel a lack of interest in normal activities. Sometimes there is sadness or guilt without any clear reason. Thinking may become slow and there can be a lack energy or feeling of hopelessness. Some people have thoughts of harming themselves at this stage. Thoughts can even turn to suicide.

Bipolar disorder is the other major mood disorder. It's an illness that causes strong mood swings between depression and mania. In the manic phase you may think fast and do things quickly. It may seem like you are getting a lot done. At first, this may feel very good; but in the extreme this can lead to a lifestyle that is disorganized and chaotic. It can include risky behavior (spending sprees, sexual acting out, or drug use). In later stages, it may affect eating (no interest in food) and sleeping (unable to sleep for days at a time). Speech may speed up and become hard for others to understand. You may appear to others as if you are in your own world.

It is possibly hereditary which means a person is more likely to get this illness if a family member has it. Use of drugs such as marijuana in certain people, amphetamines (speed) and cocaine increase the risk of getting this disorder. People with this illness will generally have to take medicines to treat it long-term.

Home care

  • Ongoing care and support helps people manage this illness. Find a healthcare provider and therapist who meet your needs. Don't be discouraged if you have to visit a number of therapists before you find one that works well with you.

  • Make sure to take your prescribed medicine as advised, even if you think you don’t need it. Don't change the dose or stop the medicine unless you talk with your provider. Don't share your medicines or use another person's medicines.

  • Talk to your provider if you have trouble paying for your medicine. Ask them to help you find resources to help with this.

  • Get the required lab work on schedule to check your overall health and make sure you are getting the right amount of medicine

  • Seek support from trusted friends or family by talking about your feelings and thoughts. Ask them to help you recognize behavior changes early so you can get help. If needed, your healthcare provider can adjust your medicines and stop serious problems from developing.

  • Tell each of your healthcare providers about all of the prescription medicines, over-the-counter medicines, vitamins, and supplements you take. This includes your dentist. Certain supplements interact with medicines and can cause dangerous side effects.  Ask your pharmacist about medicine interactions before taking a new medicine or supplement.

  • If you are having trouble managing workplace issues, or caring for yourself because of this illness, contact your local Americans with Disabilities (ADA) office to see if they can help.  The U.S. Department of Justice operates a toll-free ADA information line at 800-514-0301 (Voice) or 800-514-0383 (TTY).  They can help you find a local office.

  • Don't use alcohol, amphetamines, cocaine, or related street drugs to manage symptoms. These will interact with your medicines and make your condition worse. If your symptoms aren't being controlled, go back to your provider. You may need the dose of your current medicine changed or a different medicine.

Follow-up care

Follow up with your healthcare provider, or as advised.

Call 988

Call or text 988 if you

  • Have thoughts of harming yourself or others. You will be connected to trained crisis counselors.

  • Have trouble breathing

  • Are very confused

  • Are very drowsy or have trouble awakening

  • Faint or lose consciousness

  • Have a rapid heart rate, very low heart rate, or a new irregular heart rate

  • Have a seizure

The 988 counselors will work closely with 911 to get you the care you need.

When to seek medical advice

Call your healthcare provider right away if any of these occur:

  • Feeling like your symptoms are getting worse

  • Family or friends express concern over your behavior and ask you to seek help

  • Feeling out of control or that you are being controlled by others

  • Unmanageable side effects from the prescription medicines. Don't stop or change the way you take your medicines because of the side effects unless you talk with your provider.

  • Feeling like you want to harm yourself or another

  • Unable to care for yourself

  • Worsening hallucinations

  • Worsening delusions or paranoia

  • Worsening depression or anxiety

Online Medical Reviewer: Marianne Fraser MSN RN
Online Medical Reviewer: Rita Sather RN
Online Medical Reviewer: Sabrina Felson MD
Date Last Reviewed: 9/1/2023
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