aura

BP/MDD -> SZA

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For those of you who were originally diagnosed bipolar or major depressive and were re-diagnosed schizoaffective, do you know what caused your doctors to change their mind? I'm currently existing in that nowhere-land between the two diagnoses. I have psychosis outside of mood episodes, but it comes and goes (mainly... I have a constant low level of hallucinations). I know the diagnosis doesn't really matter much because the treatment is so similar, but I ask out of intellectual curiosity. 

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What changed their mind for me was that I was hearing voices and also that I was delusional (it was a very obvious thing for them to see because I was listening to the voices and doing things they said).

FWIW, I am glad I have a diagnosis because when explaining things to others, at least I can explain it in one word.  Giving people all these symptoms, they don't really "get it."

The treatment stayed the same for me when the diagnosis changed, but I was very glad I was finally able to explain what was going on with me in one word.

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A different pdoc.

sza was always there as a rule out. Since I had mostly psychotic symptoms and psychosis without mood episodes a hospital pdoc changed my dx and my regular pdoc changed it then.

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I am in the limbo where my pdoc has not told me a dx, and never has, except that she agrees with the OCD dx given by a previous pdoc, so all I know aside from having a OCD dx is that I have low, high, and mixed mood symptoms, paranoia and hallucinations in any mood, and I have lack of motivation, inappropriate affect, and find myself having trouble understanding people's speech or even entire conversations. As for dxes from past pdocs aside from OCD dx I have been given BP1, BP2, and unable to decide between BP1 and BP2 dxes, and I have also had an SZA dx suggested.

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Posted (edited)

1 hour ago, Closure said:

I am in the limbo where my pdoc has not told me a dx, and never has,

I'm surprised with her knowing all that is going on, that she hasn't diagnosed you with something, even temporarily ... or is trying to rule/out different diagnoses?

Same with OP ...

Quote

I'm currently existing in that nowhere-land between the two diagnoses.

 

 

Edited by melissaw72

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I was bipolar 1 until a few years ago. I just had a lot of psychosis type symptoms outside of mood symptoms. The diagnosis can go from one to the other, but they thought possibly I had been misdiagnosed from the start as my past symptoms fit more a SZA diagnosis than a bipolar one. At least they used to, who knows with this new doctor I have. 

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i was originally diagnosed w major depression but as my disorder began to 'evolve' into voices, paranoia, and delusions, i was diagnosed with paranoid schizophrenia.  i then had a major episode of mania coupled with psychotic symptoms which eventually led to my diagnosis of SZA

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Posted (edited)

I had schizotyap/schizoid traits and have been cyclothymic since being a kid and started to have hallucinations at 11-12. First I was misdiagnosed with high functioning autism/Asperger/PDD-NOS because of negative symptoms when I was 14. Then they realized there was something else going on, I had an hypomanic episode when I took Paxil and they added seroquel and told me I had Bipolar. When I told them about the hallucinations and delusions they said I had psychosis. Later, when I was 17 I was told I probably have schizophrenia/schizoaffective because I was having psychotic symptoms without being depressed/hypomanic/mixed-like.

I stopped seeing pdocs until I was 19 and I was IP, I was diagnosed with PD-NOS Cluster B. After being discharged I saw a pdoc every week and he didn't agree with the personality disorder nos. Then I changed pdoc because he left, my current pdoc diagnosed me first with psychosis nos, then schizotypal disorder (the ICD-10 psychotic disorder, not the DSM-V personality disorder), and then schizophrenia.

I have mood symptoms but they are either not severe enough or don't last enough to be considered a mood episode. Some people with SZ have mood issues that are not severe enough to be diagnosed as SZA, or psychotic symptoms are the first that appears and more prominent and mood symptoms minor.

My mood symptoms look like cyclothymia, but there is not SZA cyclothymia subtype. I guess it's considered mood dysregulation as a symptom of SZ. 

Edited by OliverB

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Interesting, it seems like for the majority of you SZA was a correction of a previous diagnosis of BP or MDD. I, on the other hand, like @strange eyes, think my disorder is evolving into having much more psychosis involved. Prior to this I've had moments of psychosis, but they were always tied to mania. Now it has come untethered and I seem to have episodes where the psychosis aspect is predominant. On top of that I have ongoing hallucinations and frequent moments of delusional thinking. I never used to have this before. My non-expert theory is that my really bad manic episode in Jan/Feb last year altered my brain chemistry and/or created neural pathways that facilitate psychosis.

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Met with tdoc today... she assured me I likely don't have SZA because my hallucinations don't happen every day and seem to be connected to stress/sleep. Not sure why that makes sense, since I'm still dealing with hallucinations outside of a mood episode, but she's the expert, not me.

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I was BP1 and then was re diagnosed as sza.

The thing that got me that dx was because I started to have powerful delusions about my brain rotting away and that the meds had something to do with it. All the while, however, I was not depressed and I was also not manic. Plus I have paranoia outside of a mood state also, and some hallucinations.

 

I hope you're doing well @aura - long time!

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@Hester! Long time no see. Glad to see you around. 

What confuses me is that I do have psychosis outside of mood episodes, it's just not constant enough apparently to warrant a SZA diagnosis. This is even though I had a several week episode of psychosis with very few mood symptoms and pretty frequent hallucinations (about half the week most of the time). Just looking at the psych bible I seem to fit the criteria, but I guess not the clinical presentation (in my docs experience)? Who knows.

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