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Personality disorder as the mood disorder is schizoaffective?


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My psychiatrist has had me diagnosed as schizoaffective unsepcified type and I finally asked what the mood disorder part was because she said I'm not depressed and I don't have bipolar. I'm a little confused because I don't even know if I believe that I have schizoaffective. I'm on saphrris now and will probably be switched to haldol but since I am still confused about having schizoaffective I don't know how comfortable I am taking this stuff. I feel the same but different on meds but not different enough to feel like its helping? I even had mild hallucination the first few days since switching to saphris which makes me uncomfortable. 

 

When I asked her what my mood disorder is she diagnosed me on the spot with borderline personality disorder and said that it was a personality disorder that caused my mood disorder.

 

I've never heard this before. Has anyone else heaard of something like this? I'm getting nervous, maybe I just have a bad personality disorder and they've misdiagnosed me, or I'm a little nervous that maybe the schizoaffective is a trashcan diagnosis or a placeholder and they don't know what's going on or they're lying to me.

 

I guess in all, is it possible for a personality disorder to be the affective part of schizzoaffective or is this hogwash? anyone else out there with a personality disorder and schizoaffective?   thank you

Edited by kitkatt91
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Im schizoaffective (bipolar type) and have BPD also. I question whether or not my mood disturbance comes from actual mood disorder or from the BPD if im honest. I take no lithium now and im on a very low dose of Lamictal, and my moods are fine. I get a little depressed now and then, but i certainly dont get manic.

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It is perfectly possible to be Schizoaffective & have a personality disorder. Although having the actual personality disorder as the mood component in Schizoaffective disorder is a very odd concept; considering mood symptoms of a personality disorder & mood symptoms of a mood disorder are behaviorally, chemically, neurologically & behaviorally different.

 

Concerning the medications though, if you experience the psychosis part of Schizoaffective (the hallucinations, disorganized thoughts & speech, social withdrawal, etc.) then the Haldol & other antipsychotics will help with those symptoms.

 

ETA considering all of the "praise" for Haldol I figured I would throw in a little food for thought with my experience: it made me suicidal depressed.

Edited by Gibson
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Hey katt,

I've not heard of that but my diagnosis is a bit different and I've not had the affective part, so that might explain it. I just wanted to say I'm reading and thinking about you and wishing you well x oh! And I don't think you're completely just getting some random diagnosis. I don't know if it helps but I'm saying it as a ...like, hoping its a cfort that a lot of your posts are totally relatable to me. I'm not suggesting you have, much less want, my diagnostic label, of course. More just saying I don't think you're entirely out adrift on a raft of one and only one who might never reach land. Best to you, x

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Oh! Also, your medications concern: haldol is great for me. Doesn't do much for the thought disorder disjointed bits, but it usually knocks out my delusions within weeks and visual/auditory hallucinations even quicker. I'm a fan of haldol for the most part and if the fluphenazine shortage ends up affecting me i may well switch to haldol injections. save one horrific time, the ones for acute episodes always worked in the hospital, so I'm pretty confident the long acting would be ok to switch to for maintenance as needed. Saphris gave me a sore on my tongue and not much else. There are others it's fantastic for though.

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I'll throw a praise for Haldol in here...has worked wonderfully for me thus far!

 

I don't see sza as a "trash can" diagnosis...

 

I don't know, I had BPD traits but pdoc said my bipolar was confirmed when I was last hospitalized due to what led up to it. It wasn't until I started having visual hallucinations outside of a mood episode that I was diagnosed with sza.

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I've not had borderline or bipolar be discussed as possible diagnoses or secondary things for me (until the dsm did away with subtypes for schizophrenia i was whats on my profile), but you still don't sound entirely unfamiliar, regardless of diagnosis, and I wish you well with the haldol. Typicals can be much better for some if us and I hope it works well for you. :-)

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I personally think that what your pdoc is saying makes no sense. 

 

Schizoaffective disorder is diagnosed when you have bipolar/MDD + schizophrenia symptoms. If BPD is causing your mood symptoms and you don't have bipolar or MDD, then you technically don't have the "-affective" part of schizoaffective. It's possible to have both schiozoaffective and BPD. But, there is no "schizoaffective BPD type" or anything like that. See what I mean? It sounds like she is hesitant to diagnose you with a mood disorder, which is why she leaves the affective part of your diagnosis blank by saying "unspecified type." 

 

I think your pdoc is stepping out of DSM territory here. My suspicion is that your diagnosis will evolve into something else and be fine tuned over the years. 

 

In the end, the diagnosis is not really what matters, it's how you treat the symptoms. And it sounds like your pdoc is doing her best to treat your symptoms. 

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I think your pdoc is stepping out of DSM territory here.

 

Which is perfectly fine. If you read the DSM you'd have no idea how much argument there's been about what the relationship is between BPD and the mood disorders. Psychiatrists have MDs so they can think for themselves, and if slavishly following the DSM were all there were to psychiatry - any of us could do it.

 

I think it's pretty obvious what kitkatt's pdoc is thinking - she's thinking BPD is basically a mood disorder.

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I think it's pretty obvious what kitkatt's pdoc is thinking - she's thinking BPD is basically a mood disorder.

 

 

I don't think any of us can say what the OPs psychiatrist is thinking. To be honest, the pdoc may not know exactly what the issue is, thus giving multiple diagnosis'. That happens so much in the mental health profession, way too often actually. And when it comes to mental illnesses (and we all can understand & contest to this) is that a lot of crazee symptoms overlap, as well as a lot of the diagnosis. And yes, there is a lot of confusion between BPD & mood disorders; a lot of the time because emotions & mood episodes can look & even feel very similar.

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Psychiatrists have MDs so they can think for themselves, and if slavishly following the DSM were all there were to psychiatry - any of us could do it.

 

Exactly. However they do not get in & go through 7-11 years of medical school just to study a few hundred pages. MDs are taught theory, anatomy, behavioral psychology, sociology, pharmacology & of course many different forms & variants of psychology (not to mention the over 200 other credits). So most of the time, we really have to trust their education & judgment. However we do have the right (most of the time) to change or refuse treatment.

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I think your pdoc is stepping out of DSM territory here.

 

Which is perfectly fine. If you read the DSM you'd have no idea how much argument there's been about what the relationship is between BPD and the mood disorders. Psychiatrists have MDs so they can think for themselves, and if slavishly following the DSM were all there were to psychiatry - any of us could do it.

 

I think it's pretty obvious what kitkatt's pdoc is thinking - she's thinking BPD is basically a mood disorder.

 

 

I never said it was necessarily a bad thing. Confusing, but not wrong. 

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wow thank you so much the input ha been really really helpful...

 

i have seen my pdoc using the ICD a lot, I don't know if that changes it, I have never seen someone using the ICD but that is what she goes on before finding the DSM equivalent. Frankly I don't think I have BPD I think they just don't know any other way to explain my moods.  I have anrexia and self injury history so I understand why someone would think it, though I disagree still because I don't have problems with my relationships or anger or anything. bipolar is ruled out over and over again though and my mood swings (for lack of a better word) feel like I'm being posessed. I have to beg for it to stop. It was terrible on risperdal because I felt so agitated all the time and its that agitation that starts it all, but even then my moods go from silly elation to angry and paranoid in a moment, but the feelings don't feel like they are mine? It feels like I'm sick, like my emotions are a cold that I'm working through. I don't know if maybe the fact that I don't identify with my emotions further complicates it. When its over I feel silly and fine again. for borderline I thought moods were predominately negative rather than allover the place, I would assume you would also understand why your moods change, emotion would have subjective context? but I could also have that wrong, its only my impression.

 

I think my pdoc seems conflicted. She says she's certain there is a biochemical problem in addition to ddisordered personality but I don't think she's clear herself what that problem is. She says its time for me to do community mental health services now and get a case manager though so she's starting to pass me off to other hands already.

 

I'm supposed to enroll in a PHP program soon. I am going to focus my energy on PHP instead or at leastt try, the back and forth and uncertainty haas been stressing me out and I don't think I will come to understand it in the near future anyway. It will probably keep changing for all I know. I am just really scared to keep taking drugs that no one has explained to me why i need them and very confused because I have never heard of a borderline type of schizoaffective. It seems other people haven't either. Maybe it will make more sense in the other programs or someone else can help illucidate this for me ddown the road. I think my pdoc is a little overwhelmed right now :P

 

 Oh well. thnk you all again so much

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