What is Schizoaffective Disorder?

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I had heard of bipolar disorder and schizophrenia, but when the doctor mentioned the possibility of our daughter having schizoaffective disorder, I had to find out more information. Just what is it, how does it manifest iteself, and what can be done about it?

Schizoaffective disorder is difficult to diagnose because the symptoms manifest themselves differently in each person. The primary defining characteristics, however, mimic those of bipolar disorder (manic and depressive mood swings) and schizophrenia (hallucinations, delusions, and loss of contact with reality, or psychosis).

A diagnosis of schizoaffective disorder usually does not take place until other possibilities have been ruled out. The presenting symptoms include (PubMed Health website):

  • Changes in appetite and energy
  • Disorganized speech that is not logical
  • False beliefs (delusions), such as thinking someone is trying to harm you (paranoia) or thinking that special messages are hidden in common places (delusions of reference)
  • Lack of concern with hygiene or grooming
  • Mood that is either too good, or depressed or irritable
  • Problems sleeping
  • Problems with concentration
  • Sadness or hopelessness
  • Seeing or hearing things that aren't there (hallucinations)
  • Social isolation
  • Speaking so quickly that others cannot interrupt you

Source

For our daughter, the first manifesting symptom was a heightened sense of well-being and power. She became more talkative, wanting to visit at every available moment, yet did not engage in reciprocal conversation. She began reporting contact from an individual with which we knew that she was acquainted and liked, but also knew that he had not contacted her in the past. We questioned the contacts, and she could show no evidence that they actually occurred. She said that he had called a friend's home while she was there, and the friend said that there was no such phone call. She said that he had called her place of employment, but the workplace reported that there were no contacts.

When she reported that she had been fired from work and that the boy was coming to get her, we realized that she was delusional. A phone call to her work indicated that they were expecting her to come to work, and that she was not fired. She was already being treated by mental health professionals for disorders she had from childhood, including separation anxiety disorder, obsessive compulsive disorder, oppositional defiant disorder, social anxiety, and most recently, Asperger's. They told us to bring her to the emergency room of the hospital.

While in the emergency room, our daughter's story changed several times during the course of her being questioned by nurses and doctors. Each time, they would look at me as I shook my head that what she was saying was not true. She was admitted to the mental health unit, and began to lash out in anger. Within twenty-four hours, she was in full-blown mania, dancing and singing, talking about the boy as if he were her husband, saying that she was expecting a baby, and that they had been commissioned by heavenly beings to help populate the earth.

Treatment Options

Because each one of the symptoms of schizoaffective disorder can be caused by a variety of physical ailments such as hormonal imbalance, thyroid problems, seizure disorders, drug use, and other mental health issues, a diagnosis of schizoaffective disorder is not usually made until other things have been ruled out.

Our daughter has a history of thyroid and hormonal problems. Blood tests were ordered to check for her level of TSH (thyroid stimulating hormone), and her female hormone levels. One of the medications she had been on recently caused her menstrual periods to become irregular and frequent. She had already been checked for pituitary issues with an MRI (magnetic resonance imaging) of her brain, and for abnormalities in her organs with an ultrasound. Once it was determined that no additional physical problems were manifesting themselves, they concentrated on therapy and a medication regimin.

She vasilated between mania and depression during the next week, ranging from dancing and singing in the hallways to laying in her bed and crying uncontrollably. Her speech was often rapid and mumbled, and she would mix the names of real people with religious events and characters, as well as familiar television and movie themes. She frequently hallucinated the boy she spoke of. She would talk to him, dance with him, introduce others to him, sit next to him, even lay with him on her bed. When others said that they did not see him, she responded in anger, saying that they were of the devil and had evil spirits she needed to get out of them.

The first medication trial with risperdone appeared to be unsuccessful, even though it had worked for her in the past. While on the risperdone, lithium was added to stabilize her moods. One and one half weeks into her treatment, she claimed that the doctors were trying to poison her, and she refused to eat the food or take the medication. She was sleeping very little at the time and refused to have any contact with the doctors.

Recommendations were made that she be given electro-convulsive therapy. Since my husband and I had durable power of attorney, and she was considered to be mentally incompetent to provide informed consent, we were contacted. We came to the hospital and spent the afternoon learning about the treatment and consulting with the doctors. With her refusing to take the medication, the options for her recovery were narrowing. Electro-convulsive therapy would require that she be sedated, and electrodes placed on her head. A shock would be sent into her brain to mimic an epileptic seizure, however, her body would have minimal movement due to the administration of anesthetic and muscle relaxants prior to the procedure. The therapy would be repeated 2-3 times per week over a three to four week period.

After viewing a video similar to the one shown here and consulting with the doctors, we felt that the therapy would be too invasive for our daughter. She is a very sensitive girl, and although an adult at the age of 24, has always been imature. We felt that it was too early in her treatment to use such drastic measures, and that there was more that could be done to help her in the recovery process. We offered to come to the hospital daily and spend time with her in an effort to get her to eat her food and take her medications.

While we were at the hospital, she had a depressive episode. We could hear her yelling and crying from her room down the hallway. When we came to her room, she was laying on her bed in a fetal position, crying loudly. We held her physically in an effort to comfort her, reassuring her that the doctors were there to help her and that she needed to take the medications to help her get better. That evening she was able to take her medications and eat some food when offered by the staff.

After just one day of being on a new medication, the hallucinations decreased significantly, and she seemed to be less manic. She was still out of touch with reality the majority of the time, but seemed to come around on occasion sufficiently to allow reciprocal conversation. When her sister visisted her from out of state, she actually asked questions about her family. We were greatly encouraged that she was on the mend.

Future Prospects

Schizoaffective disorder becomes evident during young adulthood, between the ages of 16 and 25, and the symptoms manifest themselves for a period of two weeks to a month. The person usually returns to normal functioning, however, the chances of recurrance are high, and medication is needed to manage the illness. Hospitalization may be necessary during psychosis if the symptoms are sufficiently severe.

The experiences of others have been vastly different from those of our daughter, however. Her delusions and hallucinations were of a positive nature. The video clip shows the story of a young man who experienced the depressive part of the disease so pronounced, that he attempted suicide, and was hospitalized as a result. His journey with schizoaffective disorder is one of darkness, fear, and terror. He tells about the various medications he was on, and therapies experienced. With us so new in our journey, we are just becoming acquainted with the different options available for our family.

We were encouraged by the medical professionals to obtain guardianship over our daughter. This would allow us to get medical treatment for her even if she should refuse it. Since one of the issues with schizoaffective disorder is lack of insight, the person may not feel the need for treatment when they are feeling well, and may stop taking the medication. This leaves them vulnerable to the cyclical affects of the disease. Although medication can help prevent future psychotic episodes, there is no guarantee they will not happen.

Other things that exacerbate the condition are stress, trauma, lack of sleep, and inadequate nutrition. Life circumstances happen, and an event can be triggered unexpectedly at any time. It is necessary to be vigilant, and adhere to treatment protocol in an effort to curb the possibility of future occurances. As a family, we can be proactive and protective, but we cannot stop these things from happening. The best thing to do is be prepared for the worst and hope for the best.

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Comments 11 comments

TeachableMoments profile image

TeachableMoments 4 years ago from California

Denise, your story touched me. Your daughter is blessed to come from such a loving home, a home where she can always find love and support. Many people who suffer from mental disorders are often left to struggle alone. Your family is strong, I sense that in your writing, and your love for your daughter is obviously unconditional. She will always have that secure base and it will always bring her back. I've known many people who suffer from depression and acute anxieties, me being one of them, and the strongest medicine, the thing that makes all the difference, is a family's love. It guided me back from great despair. My prayers of hope go out to your family. Voted up, straight across.


denise.w.anderson profile image

denise.w.anderson 4 years ago from Bismarck, North Dakota Author

Thank you, TeachableMoments. Our family is important to us. Having a child with this type of difficulty has been a struggle , but it has also brought us a greater understanding of the needs of others beyond our family circle. It is amazing what happens when you have to reach out to others for help only to find that so many of them have pains and difficulties of their own! We never knew how many friends we had! It has indeed been a learning experience!


Rfordin profile image

Rfordin 4 years ago from Florida

Schizoaffective disorder has always been a diganosis I am interested in simply because it is a combination of schizophrenia and a mood disorder. Lots of good information you have here, although I must admit I'm glad you chose against electro therpy for your daughter (the idea just scares me soooo much). Best wishes moving forward for you and yours...

~Becky


Rfordin profile image

Rfordin 4 years ago from Florida

Opps I forgot to ask (and just tell me I'm being to nosey if need be)...you mentioned you have 7 children. The child that suffers from schizoaffective disorder...where does she "lie" in the birth order? I'm really just curious......but feel free to tell me to bug off.

~Becky


denise.w.anderson profile image

denise.w.anderson 4 years ago from Bismarck, North Dakota Author

Thanks for commenting Rfordin. Our daughter with schizoaffective disorder is our fifth child. She seems to have inherited an interesting genetic mix. After her diagnosis, we found out that there are a couple of people in my husband's ancestry who spent their lives in the state mental institution. I, myself, have emotional issues for which I have been treated, as well as my husband. Several of our children have dealt with depression and anxiety as well. She was born with emotional issues and has been on medication since she was 10 years old. At one point, she was diagnosed with Aspergers. It may be that she had autistic traits then that have been with her all of her life.


Rfordin profile image

Rfordin 4 years ago from Florida

Hey Denise,

Thanks for taking time to reposnd to me. I tend to be very inquesitive(sp) when it comes to mental health and mental health issues. My whole family (both bio AND adoptive) are affected by mental illness in one way or another. That's prob where my decision to go to school for psychology came from my fascination with genetics and the mind....anyhoo

Thanks again for your reposnse it was very interesting

~Becky


denise.w.anderson profile image

denise.w.anderson 4 years ago from Bismarck, North Dakota Author

You are welcome. It is interesting that your family situation is what lead you to study Psychology. My daughter's disability lead me to graduate work as a School Psychologist. I know of many who have had similar experiences.


Sue Bailey profile image

Sue Bailey 3 years ago from South Yorkshire, UK

I found this very interesting but I must try not to diagnose my family members illness myself. It's a trap I tend to fall into when I read or write about mental illness. Voted up and interesting.


denise.w.anderson profile image

denise.w.anderson 3 years ago from Bismarck, North Dakota Author

I think that we all do that, Sue. When I was taking courses in Psychology in college, each time we talked about a new disorder, I thought that I had it! There are many common symptoms among the various mental illnesses, to the point that even Psychologists and Psychiatrists will change their diagnostic impressions over time. Diagnoses depend largely on the presenting symptoms and how they relate to the history of the individual. I wrote this hub after my daughter was diagnosed with the disorder. It helped me to further understand what she was experiencing.


janesix profile image

janesix 2 years ago

I am schizoaffective too. I know how she feels.


denise.w.anderson profile image

denise.w.anderson 2 years ago from Bismarck, North Dakota Author

Schizoaffective Disorder is a very difficult illness to treat, janesix. The medications are so powerful that they frequently cause side affects. It took us over a year after my daughter was diagnosed to find medications that worked for her, only to find out that they caused issues with her female hormones. Additional medications were needed to deal with those affects. We are still in the process of trying to get that matter dealt with in the "least harmful" way.

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