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Hi,

I was 7 when my pdoc told me (and my not-so-stunned parents) that I have BP1, like them.

All this time later, after 5 hospitalizations, I have yet another new pdoc. This time, I admitted/expressed the full extent of some of my psychotic features. Sometimes the delusions, hallucinations, and difficulty concentrating and paying attention occur when I am not having a mood episode. Usually they actually occur AFTER a hospitalization. ???!!!

So now I'm on 4mg Risperdal. She's talking about ECT and possibly SSDI.

What the heck? How is this different from BP1? Just that the delusions are more annoying and common? What is the difference between BP1 w/psychosis and Schizoaffective?

-- looniest of loons--

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What is the difference between BP1 w/psychosis and Schizoaffective?

In general, BP1 or depression with psychotic features, the delusional thinking happens along with the mood disorder. In schizoaffective disorder, the psychosis can happen independently of your mood state.

Look it up, though, I'm just an interested bystander, not a pro.

Greeny

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I've looked it up on numerous sites, and it does seem that the difference is that for a mood disorder to be the main DX, your psychosis has to happen cyclically. It isn't clear to me from my research if the cycles must happen with the mood cycles, or if they can have cycles of their own, like my anxiety does.

This disorder is generally considered to be a type of schizophrenia. That's a scary DX to me. It has all sorts of negative connotations, worse than BP. Kind of like BPD, it is hurled as a bad word and used in the vernacular as a slang for being a bit interesting, but in a bad way.

I, as another crazy person, of course have nothing  against schizophrenia, except for what it does to people's lives when uncontrolled.

It is just a harsh DX to swallow. It is even hard for me, after 20 years and losing my Dad, to accept BP.

I think I'm going to just forget the label, forget asking her what she DXes me as. I'll just go with treating the symptoms, since there is no clear-cut answer for the schizoaffective DX anyway. I read thta the DX can even jump between BP and schizoaffective. I'll just let her give me meds and not pay attention to the rest of the crap!

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Heya Loon,

Yeah, I was at a conference this weekend and one of the talks was on BP.

One of the most vexing questions we had for the speaker was what the hell is a mixed episode. 

I couldn't give my "what it is for me" talk that I do on CB, or with my docs, and I could see how hard it is for people to grasp.

The other oft-repeated question was about schizoaffective.  Nobody seems to have a clearcut idea *what* that is, or how to reliably distinguish it from BP mania with psychotic features.

Of course, the treatment is basically aimed at, as you noted, specific symptoms anyway.

So I support wholeheartedly your plan to forget about boxes in DSM and focus on what works to get you better.

--ncc--

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Hell, most of the "professionals" in this town couldn't tell the difference between BP and schizoaffective anyway. My girlfriends son got a SE diagnosis from one doctor, and a BP from the other, with both of them switching meds to fit their individual criteria. Poor kid was messed up for quite some time. Just treat the symptoms and don't worry about the label.

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I agree with that.  Treating the symptoms is the main thing.  Knowing a diagnosis is something of a relief in some ways, I guess, but for me it brought about problems such as denial.  That led me to stop my meds several times over the years with bad results.

At one point long ago I was considered BP I with psychotic features.  Over time they decided I was really experiencing Schizoaffective Disorder.  I guess the two diagnoses are pretty similar, except for the timing of psychosis as it relates to mood.  My meds are pretty much the same... an antidepressant to help with the depression that comes and goes and an atypical antipsychotic to help with those other symptoms.

And yes, it is a harsh Dx to swallow.  For me it was, especially when I denied anything was wrong with me and stopped my meds a few times.  I know that this disorder is related to schizophrenia.  I know what that means, prognosis-wise.  I'd just rather it weren't true.

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  • 2 weeks later...

difference between the two, quoth my tdoc and pdoc bp1 with psychotic symptoms only happen when you are manic or depressive.  with schizophrenia it can happen anytime.

so, do you have delusions, hallucinations, etc. anytime or just when you're up or down?

my doc said she doesn't know which i am (she's only seen me like 5-6 times) but said the treatment is pretty much the same so she's not worried about it. >>

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  • 2 weeks later...

My new pdoc says it is whether you have psychosis that is related to your mood disorder (and whether the mood disorder is your primary symptom) or if you have hallucinations more often and they are independent of your mood disorder. She said that SA is a type of S and is not on the BP spectrum. She is confident, and after her explainations I am confident too, that it is BP1/psychotic symptoms and not SA. Whew!

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Heya Loon,

I'm with you -- for me, although it *is* what works that matters most, it always helps to get a name for my demon.

Good for you!  You have a psychiatrist who named it for you.

Hope things are looking more positive.

--ncc--

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BP and Scza are pretty similar even in medical terms, they both afffect mostly dopamine and serotonin, I think it's just in different parts of the brain, hopefully a trusted minion can come and sort that out a bit- does Erica do this board?

<{POST_SNAPBACK}>

oops! must have been asleep at the keyboard as I only just read this ...

My new pdoc says it is whether you have psychosis that is related to your mood disorder (and whether the mood disorder is your primary symptom) or if you have hallucinations more often and they are independent of your mood disorder. She said that SA is a type of S and is not on the BP spectrum. She is confident, and after her explainations I am confident too, that it is BP1/psychotic symptoms and not SA. Whew!

<{POST_SNAPBACK}>

IMHO, and with my knowledge, Loon has written a very understandable, percise, definition of schizoaffective Dx. Thanks Loon. (Not that I am a MD or would dare say I know as much as one). whether anyone is BP w/ psychotic symptoms or schizoaffective, meds and therapy can help. and  folks here are always around to help each other in any way we can.

Erika, note to self, make sure you're reading all posts

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I was originally diagnosed as BP II with psychotic features.  It wasn't until last summer that the word "schizoaffective" came up.

It took me a while to get comfortable with the idea that I have a form of schizophrenia.  There's such huge stigma attached to the word...  But then I noticed that I was the only person freaking out about the new label.  My family and friends don't care what I have, so long as I'm getting the right treatment.  Which is cool.

I've never been one to tell me right up front about my illness, whatever it's named.  But if it comes up, I've gotten pretty comfortable with saying yes, this is what I have.  I told my psychology class last term that I have a form of schizophrenia because it was relevant to the discussion.  Nobody treated me any differently because of it.  So fuck 'em all.  If I can bust some stereotypes just by being myself, then I will.

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I've never been one to tell me right up front about my illness, whatever it's named.  But if it comes up, I've gotten pretty comfortable with saying yes, this is what I have.  I told my psychology class last term that I have a form of schizophrenia because it was relevant to the discussion.  Nobody treated me any differently because of it.  So fuck 'em all.  If I can bust some stereotypes just by being myself, then I will.

<{POST_SNAPBACK}>

Bust up some stereotypes ... please do! Good to hear you are surrounded by some not so ignorant folks.

Erika

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