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How would you describe schizoaffective disorder?

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Is it a mixture of schizophrenia and depression/mania? Is it a combination of schizophrenia and a mood disorder? Is it mainly psychotic depression/mania but with psychosis for a period of time before and/or after episodes? Is it mainly schizophrenia but with an occasional mood component?

I've read whatever I can find about the disorder, but most of it is really vague. I'm just curious about how people here conceptualize and describe their experience of schizoaffective disorder. 

Edited by aura

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Yeah, I also did some research on this and there were opposing viewpoints and a whole lot of ambiguity, which drives me nuts as I like to have a concrete and scientifically accepted understanding of my health. When working on the DSM 5, early working groups floated the idea of getting rid of the diagnosis entirely (https://en.wikipedia.org/wiki/Schizoaffective_disorder#DSM-5_criteria). I'm curious what will happen in the future with both the DSM and ICD.

In the absence of certainty, I personally view my course of this illness as Schizophrenia + a mood disorder. I do have a mood disorder, but the manifestation of my psychosis is almost incongruent with that. The major depressive episodes I had in my teens had no psychosis. The psychosis I've been dealing with recently has no mood component. When I relapsed in 2012 I did experience both psychosis and depression, but the psychosis manifested itself 2 months before the depression did. And there was no mood component in the 10 or so months I was psychotic in 2009/2010.

Edited by Swamp56
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I am not a typical anything. Late onset, 39, primarily psychotic and depressive symptoms but I have been manic. i would say I have responded more completely to medications than my sz friends. They are still distracted by voices, my meds took the voices, messages, delusions, visions away. i get mild depressions. 

I think sza has a flavor of it's own. I would say I am closer to bp with psychotic features than sz because of the  mania and my progression.

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2 hours ago, aura said:

Is it a mixture of schizophrenia and depression/mania? Is it a combination of schizophrenia and a mood disorder? Is it mainly psychotic depression/mania but with psychosis for a period of time before and/or after episodes? Is it mainly schizophrenia but with an occasional mood component?

I've read whatever I can find about the disorder, but most of it is really vague. I'm just curious about how people here conceptualize and describe their experience of schizoaffective disorder. 

I think it is a mix of SZ and a mood disorder.  From what I know, there is SZA bipolar type and depressive type, and according to my pdoc he says I have SZ-type because I am more at the SZ end than the mood component end.

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The thing about treating SZA as simply a combination of SZ and a mood disorder is that does SZA not tend to be less severe and have better outcomes than SZ, implying that it is not merely SZ superimposed with a separate mood disorder?

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1 hour ago, Closure said:

The thing about treating SZA as simply a combination of SZ and a mood disorder is that does SZA not tend to be less severe and have better outcomes than SZ, implying that it is not merely SZ superimposed with a separate mood disorder?

The prognosis for both is on a spectrum that does overlap; there are people with severe treatment-resistant psychosis that have Sza, and very high functioning people that have Sz.

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I would describe it as a psychotic disorder more so than a mood disorder. Its basically psychosis with mood congruent/mood incongruent symptoms. Your mood may sometimes be hypomanic/manic, dysthymic/depressed, but your primary feature is psychosis that is NOT dependent on mood. You may still be psychotic while in a mood, but the defining feature for SZA is having psychosis WITHOUT mood symptoms. Prognosis IMO is based off of the progression of ones psychotic symptoms. 

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sorry, wrong topic.

Edited by melissaw72

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This is all really interesting. Personally, I feel like I have three kinds of episodes... manic w/ psychosis, depressed w/psychosis, and euthymic w/ psychosis. So psychosis is very prominent, but it's episodic rather than continuous (maybe I can thank meds for this?). I go through long periods of time with mild psychosis symptoms, but I also have acute, life-threatening episodes. So I guess it makes sense to think of schizoaffective as bipolar (for me) plus aspects of schizophrenia (but not the whole thing... I don't tend to have thought disorder or negative symptoms).

According to inpatient pdoc, the prognosis is better for SZA than SZ because affect is preserved in SZA. This strikes me as a huge generalization that might not hold true for everyone on the SZA spectrum, but it also makes some sense.

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40 minutes ago, aura said:

According to inpatient pdoc, the prognosis is better for SZA than SZ because affect is preserved in SZA. This strikes me as a huge generalization that might not hold true for everyone on the SZA spectrum, but it also makes some sense.

I agree ... it kind of makes sense (although I can't put words as to why) and it does sound like a generalization; I don't think it is true for everyone either.

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I like to think about it like this. SZ and a mood disorder had a baby. The baby (SZA) has inherited both of its parents' qualities. Sometimes it acts like both of its parents, sometimes one or the other. Sometimes kids are more like 1 parent even though it inherits qualities of both. So kid might be more psychotic because it's like its dad. 

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2 hours ago, dazed and confused said:

Does anyone know why you can't have both bipolar and schizophrenia? Why does one cancel out the other?

I didn't know they cancelled each other out. 

My interpretation of bipolar and SZ is that bipolar is more a mood thing ... hypo/mania/depressed AND SZ, which would to me, be SZA. 

SZA has mood components while SZ does not.

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24 minutes ago, melissaw72 said:

I didn't know they cancelled each other out. 

My interpretation of bipolar and SZ is that bipolar is more a mood thing ... hypo/mania/depressed AND SZ, which would to me, be SZA. 

SZA has mood components while SZ does not.

I'm curious what the appropriate diagnosis would be if one's psychosis and mood issues are in complete isolation from each other with no overlap. And how does that differ physiologically when psychosis and mood intersect for periods of time. The ambiguity between the two disorders and how they mix, in conjunction with an individual's course of the illness, is both fascinating and frustrating at the same time.

Edited by Swamp56
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21 minutes ago, Swamp56 said:

I'm curious what the appropriate diagnosis would be if one's psychosis and mood issues are in complete isolation from each other with no overlap. And how does that differ physiologically when psychosis and mood intersect for periods of time. The ambiguity between the two disorders and how they mix, in conjunction with an individual's course of the illness, is both fascinating and frustrating at the same time.

I asked because I've heard from various sources that you can't have both. The closest to having both is schizoaffective but it means you have only some of the features of each disorder not all of them and therefore don't meet the criteria for the full disorders. That's what I've heard anyway...

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1 hour ago, Swamp56 said:

I'm curious what the appropriate diagnosis would be if one's psychosis and mood issues are in complete isolation from each other with no overlap. And how does that differ physiologically when psychosis and mood intersect for periods of time. The ambiguity between the two disorders and how they mix, in conjunction with an individual's course of the illness, is both fascinating and frustrating at the same time.

Idk what the diagnosis would be.  Good question.

Does this help?

https://psychcentral.com/disorders/schizoaffective-disorder-symptoms/

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I am diagnosed with SZ but I have a mood component, it just don't last enough or isn't severe enough or it is caused by the psychosis so it is not considered a mood episode. Like being hilarious and pseudomanic because demons have sent me that emotion. It just lasts until the demons stop sending me stuff (minutes to hours).

Normally I am a bit low, something along with dysthimia but it is normal considered my situation and my CPTSD.

I have had around two depressive episodes in the last three years but I got out of them without meds (both times I tried to kill myself) and they lasted less than a month. 

It is possible to have SZ and a depressive episode without being SZA if they are not recurrent enough to the point they are not relevant for treatment or if they were post psychotic depressive episodes (likely my case) or if it is depression as a symptom that don't fit the criteria for a depressive episode. Not all depressions are depressive episodes (clinical depression seen in MDD, bipolar and SZA), depressive episodes include more symptoms and more severe ones. Depression without being a depressive episode is common in many mental illness like PTSD, social phobia, schizophrenia, ... As well as dissociation (and it is not necessary a dissociative disorder).

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This is a good question. According to the doctors I am SZA bipolar type. I have acute symptoms or so that is what they say. My depression is the main monster I battle, but I do experience up swings and hypo mania. The psychosis is around all the time, does not matter my mood.

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Just got diagnosed with schizoaffective, I always tought i had bipolar 2 but recently i had my first episode of psychosis and it wasnt mood congruent, everything was going well and then psychosis came out of nowhere. I would describe it as having mood swings hypomania and depression and psychosis without any of them.

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For me its delusions plus depression! Its a combo... its pretty shit... I guess everyone here can feel that! lol

On 25/03/2017 at 4:57 PM, iaawal said:

I like to think about it like this. SZ and a mood disorder had a baby. The baby (SZA) has inherited both of its parents' qualities. Sometimes it acts like both of its parents, sometimes one or the other. Sometimes kids are more like 1 parent even though it inherits qualities of both. So kid might be more psychotic because it's like its dad. 

I agree with this novel and interesting explanation... yes I do! x (missed you iaawal)

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I had a bad mixed episode and now I am SZA... so from SZ with mood alterations that are not enough to diagnose a bipolar episode to having a mixed episode and therfore SZA.

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On 4/28/2017 at 3:39 AM, Chickenlips said:

For me its delusions plus depression! Its a combo... its pretty shit... I guess everyone here can feel that! lol

I agree with this novel and interesting explanation... yes I do! x (missed you iaawal)

Thanks Chicken! Missed you too. I tend to disappear for short periods of time. 

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I am not diagnosed with SZA but I have the thing where my psychosis exists relatively independent of my mood; I have had hallucinations since November, and have been in all of normal, high, low, and mixed moods during that time, and I have had delusions likewise in pretty much all moods except that they are diminished in severe depression.

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