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How long does it take do diagnose something like schizo-affective?


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#1 Rose

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Posted 22 March 2012 - 01:44 AM

I went to my psychiatrist yesterday. I asked her what she based her diagnosis on and she said poor judgement, poor decision making and excessive shopping. Surely there is more to it than that. She didn't say you're schizo-affective ( I didn't ask her this time) but she was more or less saying I still have the (hypo)mania. She said I still have these symptoms. She hasn't put me on more meds, I suppose she likes to keep her patients on less meds as possible. I am only on 10mg of Abilify though which is way to low to have any affect on manic symtoms. I asked her to reduce the dose, she said one of her worries was the spending might come back.
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#2 crtclms

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Posted 22 March 2012 - 02:22 AM

I'm not sure what a diagnosis of schizo-affective disorder necessarily has to do with this question in particular? Is that what she said you had, or is that what you think you have?

It can take years and years to get a proper diagnosis. It also can happen relatively quickly. But there isn't a set time limit by which you should have a complete diagnosis.

Plus, MIs can manifest themselves differently over time, so a pdoc will get more information over years, and may change your diagnosis. My GAD diagnosis is relatively new, it took a while for my pdoc to decide my anxiety was separate from my BP. I have had GAD for years and years, but I only know that in retrospect, I had no idea I might even have it until someone on this board mentioned it as a possibility. But he just hasn't known me for years and years, he had to learn about me first. The diagnosis was made about two years ago, and I was diagnosed with BP illness over 25 years ago.

Poor judgement, poor decision making, and overspending can encompass a lot symptoms. She may not have listed everything you have done that makes her think this, and maybe that is what you need to do, ask her for specific examples. But "poor judgement" and "poor decision making" could be a catchall she is using for a lot of behaviors. I could totally understand a diagnosis based on that.

Have you ever checked out the symptoms listed under whatever your diagnosis is the DSM-IV? If not you should, but remember, there are a LOT of unlisted symptoms.

An atypical anti-psychotic such as Abilify really seems like it could be appropriate if you are hypo/manic. If you aren't recovered completely, or even maybe for a while after you are stable, lowering it when you are still symptomatic is a bad idea.

You sound a little disgruntled with this whole process. It can be stressful, especially as you don't feel well to start with.

Dx: Bipolar 1; GAD; Migraine w/ Aura; Migraine w/o Aura; Renal Tubular Acidosis (caused by Zonegran); Status Migrainosus
Rx: Alprazolam; Botox; Buproprion; Dihydroergotomine via IV Infusion; Flexeril; Lamotrigine; Latuda; Lithium; Metoclopramide; Midrin; Migranal; Potassium Citrate; Prilosec; Promethazine; Riboflavin; Tizanidine; Verapamil; Vitamin D3
Currently Shelved: Abilify; Amerge; Anaprox; Atenolol; Buspar; Cafergot; Cymbalta; Depakote; Di-Hydro-ergotamine, injected; Gabapentin; Geodon; Imitrex Tablets; Klonopin; Maxalt; Namenda; Nortriptyline; Norvasc; Propranolol; Prozac; Risperidone; Relpax; Sansert; Sumatriptan injectables; Tegretol; Trazadone; Zoloft; Zolpidem; Zomig; Zonegran


Affectations can be dangerous. -Gertrude Stein

 

I moderate Bipolar, Panic/Anxiety, Dissociative Disorders, Migraine, Seizures, Not Otherwise Specified, Anticonvulsants, Side Effects, Family Feud, and I Still Have Issues. Remember, I am not a medical professional. PM me if you have any questions


#3 InfiniteInsanity

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Posted 22 March 2012 - 08:27 AM

I have schizoaffective, and I have been seeing my pdoc for 2 years now. But, everything started 4 years ago with my first depressive episode. Then, I started getting hypomanic. My psychologist referred me to a pdoc. My first diagnosis was bipolar NOS. Then it was eventually changed to bipolar 2. About 6 months ago, and still today, my pdoc says I still have signs of psychosis. Now she changed it to schizoaffective disorder bipolar type. In order to have this, one must have psychosis without mania or depression for at least a certain amount of time, if I remember correctly. My memory isn't always the best. Remeber, these things take a long time to diagnose. My diagnosis has changed a few times. There is no certain length of time for a diagnosis. It is about the symptoms and duration of the symptoms.

My pdoc always says "Least medication, most effect"

If you think might have schizoaffective, have you ever had psychosis? Is that why they put you on abilify? or is it the mania that got you put on abilify?

Also, remember, I am not a doc! I am just talking from my own experience and from what I have read about.

Diagnoses: Schizoaffective bipolar type, self-harm, OCD, ADHD, PTSD, Possible ED, and possibly a personality disorder
Current Meds: 900mg Lithium, 300mg Seroquel , 100mg Amitriptyline, 40mg Vyvanse , .5mg Xanax as needed, .5mg Cogentin
Meds I took that didn't work:  Abilify, Prozac, Latuda, Saphris, Geodon (too big to swallow), Risperdal, Lamictal, 
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#4 Rose

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Posted 22 March 2012 - 09:26 AM

I'm not sure what a diagnosis of schizo-affective disorder necessarily has to do with this question in particular? Is that what she said you had, or is that what you think you have?

Have you ever checked out the symptoms listed under whatever your diagnosis is the DSM-IV? If not you should, but remember, there are a LOT of unlisted symptoms.

[...]

You sound a little disgruntled with this whole process. It can be stressful, especially as you don't feel well to start with.

I have checked out the DSM-IV yes, but I think my psychiatrist relies on the ICD. I have checked them both and I seem to match the ICD symptoms more. So it's all very confusing. I assumed that if I have hypomania, that automatically means I have schizo-affective. Someone told me (a friend social worker) that you can't have both schizophrenia and mania but you can have schizo-affective which is simular to them both but not quite the same.


If you think might have schizoaffective, have you ever had psychosis? Is that why they put you on abilify? or is it the mania that got you put on abilify?

Also, remember, I am not a doc! I am just talking from my own experience and from what I have read about.


Yes I have had psychosis. That's why I was diagnosed with schizophrenia when it started two years ago. Antidepressants is what sent me (hypo)manic so I assumed I have schizo-affective. Sorry I shouldn't make assumptions without consulting the doctor first.
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#5 apetasticaL

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Posted 22 March 2012 - 10:30 AM

I have checked out the DSM-IV yes, but I think my psychiatrist relies on the ICD. I have checked them both and I seem to match the ICD symptoms more. So it's all very confusing. I assumed that if I have hypomania, that automatically means I have schizo-affective. Someone told me (a friend social worker) that you can't have both schizophrenia and mania but you can have schizo-affective which is simular to them both but not quite the same.

Yes I have had psychosis. That's why I was diagnosed with schizophrenia when it started two years ago. Antidepressants is what sent me (hypo)manic so I assumed I have schizo-affective. Sorry I shouldn't make assumptions without consulting the doctor first.


Has your psychosis occurred only during mood states [depression, hypomania]? Or does your psychosis occur on a regular basis? I think that's the deciding factor between bipolar or depression with psychotic features and schizoaffective disorder.

I am unsure if hypomania can exist in schizophrenic illness.
smiling despair. no solution, but constantly exercising an authority over myself that i know is useless. the essential thing is not to lose oneself, and not to lose that part of oneself that lies sleeping in the world. -albert camus

dx: bipolar disorder NOS, borderline personality disorder, substance abuse
rx: lamotrigine 25 [titrating back to 200], aripiprazole 10, topiramate 50

past rx: lithium carbonate, divalproex sodium, levetiracetam, gabapentin, fluoxetine, paroxetine, doxepin, trazodone, quetiapine, paliperidone, olanzapine, ziprasidone, risperidone, trifluoperazine, methylphenidate, phenobarbital, chlordiazepoxide, diazepam, clonazepam, lorazepam, temazepam, buspirone, hydroxyzine, zolpidem, ramelteon

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Posted 22 March 2012 - 11:50 AM

It took my current pdoc about a year to decide that I was schizoaffective, and before that, it was years before my bipolar mood swings were picked up. Schizoaffective can generally take a while to diagnose because you have to tease out a) the mood[s], and b) when the psychosis occurs. It can be hard to differentiate between schizoaffective and <mood disorder> with psychotic features, because all those conditions involve mood disturbances and psychosis.

The main difference is that schizoaffective features psychosis outside of a mood episode. The current definition says that the psychosis has to last at least two months in the absence of a mood episode - that is, the psychosis isn't solely due to mood.

To compound the problem, schizophrenia features post-psychotic depression, where a person is still largely psychotic and is also experiencing depression.

I'm not entirely sure what the original post is trying to ask, either. No-one on CB can tell you for sure what you might have. Also, medication dosage doesn't necessarily mean a med is, or isn't effective. What matters is whether the dosage is helping your symptoms right now. Everyone has different tolerance for a medication - some people need higher than others. Personally, I can get away with relatively small [compared to others] doses of medication, but it doesn't matter because it helps my symptoms.

I think it's probably more beneficial to focus on your symptoms, rather than your diagnosis. Whatever your label, you're still going to have the same issues caused by your symptoms. Besides, dxs can take a while to change sometimes.

#7 confused

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Posted 22 March 2012 - 01:31 PM

It can take years to get the correct dx. My dx changed from bp to sza after over 2 years, so it can change over time. Why would you want to reduce your dosage if you were just having symptoms? When do you go back? You could ask your dx then.

schizoaffective bipolar type, social anxiety, depersonalization disorder
abilify, lamictal, lexapro, wellbutrin, seroquel

It just may be a lunatic you're looking for

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#8 Rose

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Posted 23 March 2012 - 01:36 AM

That's the thing. I don't know if my psychosis occurs outside a mood episode. But my doctor obviously thinks so cause she diagnosed me with schizophrenia. But she didn't take long making that diagnosis. Within 3 months I was diagnosed. All I needed was delusions and a "flat effect" but that can be caused by the medication itself right? I've never had hallucinations. I always suspected something else was wrong but now I can't seem to accept that there might be something else to it because my psychiatrist always told me it's nothing but schizophrenia at the start
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#9 crtclms

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Posted 23 March 2012 - 02:16 AM

I still am not sure what you are asking. Are you upset that your diagnosis may no longer be Schizophrenia? As people have already pointed out, it is sometimes hard to tease out schizophrenia, from schizo-affective disorder, from bipolar with psychosis.

And since one is detached from reality when psychotic, it might be that you remember hallucinations, or loss of contact with reality, as something real, when it isn't.

It doesn't really make any difference from a treatment standpoint, your pdoc is going to treat your symptoms, not a diagnosis.

There is no medication that will make any of these illnesses go away, so I am not sure why you are trying to create a hierarchy. You just have to keep trying medications until you find something that works. I know, it sucks. But it is what it is.

Dx: Bipolar 1; GAD; Migraine w/ Aura; Migraine w/o Aura; Renal Tubular Acidosis (caused by Zonegran); Status Migrainosus
Rx: Alprazolam; Botox; Buproprion; Dihydroergotomine via IV Infusion; Flexeril; Lamotrigine; Latuda; Lithium; Metoclopramide; Midrin; Migranal; Potassium Citrate; Prilosec; Promethazine; Riboflavin; Tizanidine; Verapamil; Vitamin D3
Currently Shelved: Abilify; Amerge; Anaprox; Atenolol; Buspar; Cafergot; Cymbalta; Depakote; Di-Hydro-ergotamine, injected; Gabapentin; Geodon; Imitrex Tablets; Klonopin; Maxalt; Namenda; Nortriptyline; Norvasc; Propranolol; Prozac; Risperidone; Relpax; Sansert; Sumatriptan injectables; Tegretol; Trazadone; Zoloft; Zolpidem; Zomig; Zonegran


Affectations can be dangerous. -Gertrude Stein

 

I moderate Bipolar, Panic/Anxiety, Dissociative Disorders, Migraine, Seizures, Not Otherwise Specified, Anticonvulsants, Side Effects, Family Feud, and I Still Have Issues. Remember, I am not a medical professional. PM me if you have any questions


#10 San

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Posted 23 March 2012 - 06:43 AM

I don't really get what you're asking... like, do you want a schizoaffective diagnosis? From reading other posts, it kind of seems that way.
I was diagnosed schizoaffective in 2006, but it was changed to bipolar disorder and schizotypal personality disorder in 2008.

Dx: Schizoaffective disorder - bipolar type, ADHD - Inattentive

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Posted 23 March 2012 - 02:12 PM

Oops, I meant two weeks of psychosis without a mood episode, not two months. I had a brain fart.

The more I read this post, the more I'm confused as well. Is getting a schizoaffective dx really important?

#12 crtclms

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Posted 26 March 2012 - 07:46 PM

Confused: My diagnosis is bipolar and I am taking Zyprexa as a mood stabilizer. I just read a book called "Anatomy of an Epidemic" wrote by Robert Whitaker. He wrote about the long term outcomes of medicated bipolars. I think I remember reading that the outcomes of medicated bipolars were as bad as schizophrenic, which caught my attention. He explained that the reason why, was that bipolars and schizophrenics would take the same medications, antipsychotics for example.


Whitaker's work has not been peer reviewed. I generally don't take medical advice from journalists.

Dx: Bipolar 1; GAD; Migraine w/ Aura; Migraine w/o Aura; Renal Tubular Acidosis (caused by Zonegran); Status Migrainosus
Rx: Alprazolam; Botox; Buproprion; Dihydroergotomine via IV Infusion; Flexeril; Lamotrigine; Latuda; Lithium; Metoclopramide; Midrin; Migranal; Potassium Citrate; Prilosec; Promethazine; Riboflavin; Tizanidine; Verapamil; Vitamin D3
Currently Shelved: Abilify; Amerge; Anaprox; Atenolol; Buspar; Cafergot; Cymbalta; Depakote; Di-Hydro-ergotamine, injected; Gabapentin; Geodon; Imitrex Tablets; Klonopin; Maxalt; Namenda; Nortriptyline; Norvasc; Propranolol; Prozac; Risperidone; Relpax; Sansert; Sumatriptan injectables; Tegretol; Trazadone; Zoloft; Zolpidem; Zomig; Zonegran


Affectations can be dangerous. -Gertrude Stein

 

I moderate Bipolar, Panic/Anxiety, Dissociative Disorders, Migraine, Seizures, Not Otherwise Specified, Anticonvulsants, Side Effects, Family Feud, and I Still Have Issues. Remember, I am not a medical professional. PM me if you have any questions


#13 Littleladybug

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Posted 02 April 2012 - 07:46 AM

Lack of insight is a trademark "symptom" if you will in Schizophrenia. Maybe that is what your doctor is seeing.
Current DX: Schizoaffective or Schizophrenia- "unspecified" (whatever that means?), PTSD, Panic Disorder
Current RX: Geodon 140mg, Wellbutrin 150mg, Lamictal 250mg, Cogentin 3mg

Past DX: Bipolar I, Bipolar mixed with psychosis, Bipolar with psychotic features
Past RX: Celexa, Paxil, Lithium, Depakote, Tegretol, Ativan, Risperidal, Invega, Latuda, Fanapt

#14 melissaw72

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Posted 18 April 2012 - 04:57 PM

It took about 8 years for a schizoaffective diagnosis, with PTSD, anxiety disorders, OCD. All this was "untangled" over the 8 years. I started out with depression and ended up over time as things got worse, with schizoaffective, etc.

Current Psychiatric Dxs ... Schizoaffective, bipolar type; Anxiety disorder, PTSD, agoraphobia

Also recovered Anorexic/Bulimic finally after 20 years.

Current meds: Provigil, Klonopin, Xanax, Naltrexone, Wellbutrin, Abilify, Lamictal, Prozac, Lansoprazole, Linzess, QVAR inhaler, Xopenex inhaler, Flonase, Flexeril, Zofran.

Any questions just ask :)

 

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