Living With Schizoaffective Disorder

Schizoaffective disorder is one of the rarest of all mental health conditions. The lives of people with schizoaffective disorder are marked by uncertainty, unpredictability, and stress, and the longer they go without receiving medical assistance the more likely they are to experience significant personal, professional, and health-related hardships.

Schizoaffective disorder has been little studied and remains poorly understood, yet healing and recovery require an accurate diagnosis and a properly targeted approach during treatment.

Less than one percent of the adult population will experience the confusing symptoms of schizoaffective disorder over the course of a lifetime, and because the condition is so unusual it has not been widely studied in the field or in controlled laboratory settings.

Many people with schizoaffective disorder are originally diagnosed with bipolar disorder or major depression, based on the pervasive presence of symptoms consistent with those conditions. Men and women with schizoaffective disorder may go through long periods of depression, or they may cycle between manic and depressive states, identical to those experienced by those with true bipolar disorder.

But at various points throughout their lives, people with schizoaffective disorder will suddenly experience frightening breaks with reality, experiencing symptoms of psychosis that are most often associated with schizophrenia. They may hear voices or see things that aren’t really there (hallucinations), develop strange or eccentric beliefs about themselves, the world, or other people (delusions), or be plagued by unspecified fears or be convinced they’re being followed or persecuted by others (paranoia).

In general, people with schizoaffective disorder function better than those who are diagnosed with conventional schizophrenia. Nevertheless, their dizzying passage through alternating periods of mania, depression, and psychosis leave them feeling constantly perched on the edge of disaster, with little or no control over their own fates.

Encounters with schizoaffective psychosis may occur randomly or in response to stress or crisis. Either way, psychotic symptoms will disrupt daily functioning and can cause a medical crisis if they become too extreme.

Untreated schizoaffective disorder touches every area of a person’s life. It causes intense emotional and psychological turmoil, and those who have it will struggle to retain a sense of normalcy in the midst of the chaos.

Some of the negative life consequences people with schizoaffective disorder often experience include:

• Relationship problems. Loved ones will try to comprehend and empathize with the behavior of a person with schizoaffective disorder, but the condition is so confusing and poorly understood that conflicts and misunderstandings are all but inevitable. Social isolation is, unfortunately, a common circumstance for people with schizoaffective disorder, and the absence of loving care and social support will only reinforce their sense of separation from the world.
• Unemployment and financial difficulties. Unpredictable behavior is anathema to most employers, and people with schizoaffective symptoms often have spotty employment histories because of their inability to perform consistently and reliably. Schizoaffective disorder is a risk factor for poverty and homelessness, and while the latter is a worst-case scenario it is often the final destination for those who don’t get the treatment they need.
• Physical health problems (illnesses and injuries). Self-care skills are usually lacking among people with schizoaffective disorder, who may fail to maintain good health habits or react appropriately to illness or pain when they occur. They also tend to engage in risky or impulsive behaviors, especially during manic episodes or when experiencing delusions or hallucinations, putting them at high risk for serious physical injury.
• Encounters with substance abuse. Large-scale studies reveal substance use disorder rates of up to 60 percent in men and women with bipolar disorder and 50 percent in those with schizophrenia. Schizoaffective disorder specifically remains lightly studied, but similar levels of substance abuse have been observed in clinical settings.
• Self-harming behavior. A 2012 study referenced in the Archives of Suicide Research uncovered self-harm rates of 49 percent among people with schizophrenia and related disorders. Another study from 2004 found that 34 percent of participants with schizophrenia or schizoaffective disorder had a history of suicide attempts, but this naturally underestimates the likelihood of suicidal behavior since the study only included men and women who failed in their efforts.

Happiness, stability, and security often prove elusive for people with schizoaffective disorder. But with the assistance of family and friends and access to professional treatment services, recovery from the most disabling effects of the disorder is possible.

Men and women with schizoaffective disorder need understanding and support, not just from loved ones or employers but from trained medical professionals who are knowledgeable about the various facets of this condition. This is even more vital if a co-occurring substance use disorder is present, since treatment must address drug and alcohol abuse if the healing process is to progress.

Getting a proper diagnosis is the first step, and mental health professionals must rely on thorough symptomatic reporting from patients and their family members, to avoid diagnosing bipolar disorder, depression, or schizophrenia instead of schizoaffective disorder. An initial misdiagnosis may eventually be corrected, but the effectiveness of treatment will be limited if only some of the symptoms present are recognized.

Once the correct condition has been identified, however, recovery can begin in earnest. Inpatient and outpatient programs for schizoaffective disorder will incorporate a multitude of evidence-based treatment services, including therapy (individual, group, and family), medication (likely a combination of mood stabilizers, antidepressants, and antipsychotics), complementary mind-body therapies (yoga, meditation, massage therapy, nutritional therapy, Tai Chi, acupuncture, etc.), and lectures or classes that teach valuable coping skills for various life situations.

Residential recovery programs are likely to last from one-to-three months, but aftercare services will be offered indefinitely, to help the person with schizoaffective disorder manage any enduring or returning symptoms.

Without treatment, men and women with schizoaffective disorder may suffer for years, their lives filled with uncertainty, confusion, and daily struggles against a flood of debilitating symptoms. But with customized treatment and a firm commitment to wellness, a steady and gradual recovery will remain a realistic goal.