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Schizoaffective disorder or Bipolar II with psychosis?


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Hello everyone,

 

I have been having visual and auditory hallucinations since September of 2014.  My pdoc still hasn't changed my diagnosis at all and I am wondering if I should bring it to her attention at my next appointment.  I have done some research about it and find that with my symptoms I should technically be diagnosed at schizoaffective disorder instead of bipolar II with psychosis.  My visual hallucinations are my dead relatives just standing in front of me (not scary, more protective) and my auditory hallucinations are a group of voices that constantly tell me to kill myself and how worthless/hopeless my life is.  I am scared of the voices because they make me want to act impulsively and just end it.  I am hoping that someone can give me some insight on how their pdoc diagnosed them...

 

Thanks in advance :)

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From what I understand if you're having psychotic symptoms that automatically rules out bipolar 2. Psychosis can and does occur with bipolar 1. And of course Schizoaffective includes mood and psychotic symptoms. If you're having psychotic symptoms when your mood is normal ( not depressed or manic) then it usually points to Schizoaffective. If the psychosis only occurs during mania or depression then it could be bipolar 1.

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Reminder that we are not here to diagnose, we can't since we're not doctors. 

But straight from the DSM-V: 

 

Two specifiers for BPII: 

With mood-congruent psychotic features

With mood-incongruent psychotic features

 

So yes, BPII can have psychotic features. 

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I would definitely bring it up with your pdoc. One important question is how long you've been absent of a mood episode while still experiencing psychotic symptoms. E.g. 3 days max or 2 or 4 weeks, etc. And whether or not your psychotic episodes follow the same pattern as your mood episodes (e.g. when one is bad, the other is bad). Or if they each do their own thing. 

That sort of information will be useful and will aid in making the right diagnosis. 

Edited by iaawal
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My pdoc still hasn't changed my diagnosis at all and I am wondering if I should bring it to her attention at my next appointment.

 

Yes, I would bring it to her attention.  If you have any questions about your diagnosis I think it would be a good idea to get clarification of it.

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