What Is Schizoaffective Disorder and How to Cope With It
What Is Schizoaffective Disorder and How Prevalent Is It?
Schizoaffective disorder (SZA) is believed to affect between 0.5% - 0.8% of the population, which means anywhere between 1.6 - 2.5 million people in the United States have been afflicted with it. The main characteristics of a person with SZA are that they have a combination of a mood disorder, such as depression or bipolar disorder, along with psychotic symptoms usually seen with schizophrenia.
How Is Schizoaffective Disorder Diagnosed?
Diagnosing schizoaffective disorder can be tricky because the DSM-5 (2013) definition of the disease requires that a person exhibit at least two active symptoms of schizophrenia, and during the majority of that time, a mood disorder must also be present. To be diagnosed with SZA under the DSM-5 (2013) guidelines, the psychotic portion of the illness must be present for at least two weeks without accompanying mood symptoms, but then mood disorders show up and persist during most of the remainder of the psychotic episode. Other possible causes for the symptoms need to be ruled out, as well, such as the effects of alcohol or drug abuse or some other medical condition.
Schizophrenic symptoms include:
- Severely disorganized behaviors
- Catatonic behaviors
- Disorganized speech (not being able to talk coherently or continuously going off-topic)
- Diminished emotional expression
- Decreased movement
The tricky part is determining the duration of the illness with and without an accompanying mood disorder. If psychotic symptoms occur only during a mood episode, then schizoaffective disorder is not the diagnosis. Instead, the person would be diagnosed with a mood disorder with accompanying psychotic features. However, when there are at least two weeks of schizophrenic symptoms by themselves without an accompanying mood disorder, then SZA is the preferred diagnosis, assuming that a mood disorder is present for much of the rest of the duration of the episode.
Do You Know the Difference?
Two Subtypes of Schizoaffective Disorder
There are two sub-types of schizoaffective disorder which are based on the accompanying mood disorder. The bipolar type is diagnosed when the accompanying mood disorder consists of periods of severe depression alternating with periods of manic activity. The depressive type is when the accompanying mood disorder is depression, without periods of mania.
What Is It Like Living With Schizoaffective Disorder?
Schizoaffective disorder affects people differently. Some people have frequent, recurring, and severe episodes while others may have episodes that occur more infrequently. Functioning properly while experiencing psychotic symptoms can be pretty difficult. Some people hear voices or see things that are not there which inhibits the ability to properly care for yourself or others. They may become very paranoid and think that people are out to get them. This causes people to hide in their house or lash out at the things or people they believe are out to harm them or exhibit other behavior that people around them deem as strange.
The mood disorders that accompany SZA can be just as disabling, if not more so. A person afflicted with severe depression may not get up to shower or eat or take care of his daily needs. The emotional turmoil can be extremely painful and debilitating. About 10% of SZA patients attempt suicide at some point.
In addition to the symptoms that accompany the disorder, such as paranoia, fear, depression, etc., untreated SZA patients also frequently suffer from:
- Lack of motivation
- Inability to function well in society
- Inability to create and maintain relationships
- Inability to get or keep a job
- Getting in trouble with the law
A Journey With Schizoaffective Disorder
There Are Effective Treatments
The good news is that there are effective treatments for SZA. Treatment usually consists of antipsychotic medications, mood-stabilizing medications, and psychotherapy. Many people who are treated successfully regain their ability to function pretty well in life. They are able to create and maintain relationships, and they may be able to find and maintain employment.
Finding the right medications, however, can take a lot of trial and error. It usually takes time to find the combination that works well for any one person. Sometimes, it can take years. The treatment outcome for SZA patients is generally better than for schizophrenic patients, meaning a greater percentage can recover enough to become fully functional and lead rewarding lives.
Coping When a Loved One Has Schizoaffective Disorder
Living with other people can be hard in itself, but living with someone who has SZA can present special challenges. Everyone is different and has different personalities, so it's difficult to pinpoint certain behaviors that SZA patients exhibit. In my experience, it's difficult dealing with a person who is hallucinating or who is having delusional thoughts. Dealing with paranoia and anger are also challenging.
The best thing you can do is to make sure you take care of yourself. It's easy to get so involved in the situation and trying to take care of the other person that you forget that you matter, too. Take time to focus on what's important to you. Take a night to pamper yourself and be completely selfish. Don't let the challenges before you overcome you or cause you to become depressed or incapacitated. Make time to care for yourself and your needs.
Another thing that really helps is to interact with others who are also dealing with a similar situation. NAMI and local hospitals often offer support groups for family members of people dealing with a mental illness. Instead of going out to a support group, however, there are a lot of online forums specifically for family members where you can vent, get suggestions, or just feel connected. One such forum is at psychforums, but if you do a search for forums: schizoaffective disorder, you'll likely find one that's right for you.
Things Not to Say to Someone With SZA
Just get over it
Why can't you be like...?
You're so selfish
You're just crazy
It could be worse
Just snap out of it
It's your own fault
We all have problems
How to Live a Full Life With SZA
Living with schizoaffective disorder doesn't have to prevent people from living full and rewarding lives. It's just an illness, and you work around the illness and create a life worth living, even when you deal with symptoms of SZA. People with all kinds of illnesses and disabilities don't let their illness define their life—they make the best of things the best way they can. So the most important thing to keep a hold of when living with SZA is hope. Maybe today is bad, but that doesn't mean tomorrow can't be better.
Life does get better, however, when symptoms are managed. I know several people who have SZA who choose not to go to doctors or stay on medication which would make life a lot easier to manage. It's not fun going to doctors, especially when you've had bad experiences in the past. And it takes a long time, usually, to find the right combination of medications that do make a difference. Don't give up. Keep trying. It's worth it in the end.
Reaching out to others is important, too. Connect with others who are dealing with SZA. Share your feelings, get support when you're down, and lift others up when they're down. It really does help. The Internet has some great groups where you can connect with others living lives that are similar to yours. If you don't want to reach out, at the very least, you can simply browse the various forums if only to remind yourself that you're really not alone.