What Is Schizoaffective Disorder?

Schizoaffective disorder is often overlooked in the discussion of mental health. Some people might assume that schizoaffective disorder is the same as schizophrenia or bipolar disorder. However, while schizoaffective disorder can show some similarities with schizophrenia, it is an entirely different diagnosis that may come with its own challenges, ideal treatment options, and prognosis.

Below, learn more about schizoaffective disorder, including its subtypes, symptoms, and best treatments. 

What is schizoaffective disorder bipolar type?

The combination of the two types of symptoms means that this disorder can often be misdiagnosed as schizophrenia, depression or bipolar disorder. However, ongoing care and careful observation of symptoms can lead to the correct diagnosis.

Schizoaffective disorder bipolar type can be regarded as a subtype of SD that can include schizophrenia symptoms in addition to episodes of mania—and, in some cases, major depression. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), published by the American Psychiatric Association, outlines the diagnostic criteria for schizoaffective disorder. To be diagnosed with schizoaffective disorder, an individual must experience at least two primary symptoms of schizophrenia—which are delusions, hallucinations, disorganized speech, disorganized behavior, and negative symptoms—and a major mood episode. 

In an individual whose mood episodes are only of major depression, depressive-type schizoaffective disorder may be diagnosed. Someone who experiences bipolar symptoms (mania and, potentially, depression) may be diagnosed with bipolar-type schizoaffective disorder. Because schizoaffective disorder can involve so many symptoms, many of which can be hard to detect by others, this condition can be challenging to diagnose. Not all symptoms may be present simultaneously—so it can be tricky for patients to communicate the full extent of their experiences. Schizoaffective disorder often develops during late adolescence or early adulthood. 

Differences between schizoaffective disorder and other disorders

There has been some debate about the diagnosis of schizoaffective disorder bipolar type in the psychiatric community. However, many experts believe that this diagnosis is valid and distinct from other mental health disorders. Though bipolar disorder can lead to symptoms of psychosis that may mimic schizophrenia, the main difference between the two might stem from the frequency and intensity of these symptoms. 

A person living with schizophrenia may experience delusions, paranoia and hallucinations—possibly to the point of someone losing touch with reality. Someone living with bipolar disorder, on the other hand, may experience these symptoms only during a manic episode. They may be more significantly impacted by symptoms unique to bipolar disorder, such as mood swings between extreme highs and lows that can make it difficult to sustain a job, relationships and a sense of stability. 

A person living with schizoaffective disorder may experience a combination of these predominant symptoms, though they may fluctuate over time. Classifying this disorder as schizophrenia or bipolar disorder alone can be an oversimplification; doing so may ignore the real fact that its symptoms can be uniquely challenging to those who experience them. 

Other schizoaffective disorder types

There are generally two different types of schizoaffective disorder that are currently clinically recognized. Beyond the type mentioned here, the other type is considered to be schizoaffective disorder depressive type. This type can be similar to schizoaffective disorder. Still, rather than experiencing extreme lows and highs, people living with this diagnosis may manage periods of intense depression in addition to schizophrenia symptoms. Both disorders can be frequently treated in many of the same ways.

Diagnosis of schizoaffective disorder bipolar type

Diagnosis of schizoaffective disorder bipolar type can be difficult without ongoing treatment. Often, the doctor must be able to see that a mood disorder coexists with symptoms of schizophrenia for a correct and efficient diagnosis. While there are no laboratory tests that can identify schizoaffective disorder, screenings, medical exams, and other assessments can help a professional rule out other conditions and provide a diagnosis. 

Some key elements generally must be present for a diagnosis of schizoaffective disorder bipolar type. Clinically, diagnosis states that there must, for instance, be a period in which symptoms of mania persist in conjunction with symptoms of schizophrenia. These criteria can establish that a diagnosis of schizophrenia may not be appropriate for a specific patient’s needs. There must also generally be at least two weeks where symptoms of delusions and hallucinations may occur in the absence of mania. 

Another possible criterion for the diagnosis of schizoaffective disorder bipolar type is that there are symptoms of a mood disorder for the majority of the duration of the illness or episode. However, this criterion does not necessarily mean that the patient has mania consistently throughout the illness. There are cycles of mood disorders that can show presence even when a major manic episode may not be occurring.

Finally, it generally must be determined that these symptoms are not due to another explainable cause, like substance use, prescription medication, or the existence of other mental health disorders. 

Prevalence of schizoaffective disorder

Based on current estimates, schizoaffective disorder might only affect about one out of every 200 people in the American population. However, some psychiatrists and researchers believe that the prevalence may be higher. 

Causes of schizoaffective disorder

Little is generally known about what exactly causes schizoaffective disorder. However, like other mental illnesses, experts believe the condition can result from a combination of genetic, biological, and environmental factors. Many believe that genes can play a role in the development of schizoaffective disorders of both types. People who have a history of schizoaffective disorder in their families may be at higher risk of developing the mental health condition themselves. However, exactly what genes are responsible and how that information could be used in treatment or prevention is still generally unknown to most research entities.

Brain function may also be different in people with schizoaffective disorder than in a healthy brain. A chemical imbalance and abnormalities in brain structure are thought to be primary contributors to the condition. However, more studies are generally needed before practitioners can find a clear answer or solution.

Environmental factors can also play a part. For example, people who have a predisposition or risk factors for schizoaffective disorder, such as family history, may start experiencing symptoms after stressful life events. Sometimes, a stressful life event causes onset. Stressful events may include losing a job, experiencing a natural disaster, or living with a serious medical condition. 

However, while that stressful event might seem the immediate cause, it may not be the full picture. Instead, those predisposed to developing the disorder may experience an inciting event that can jumpstart symptoms. This observation may also help explain why some people living with SD can experience an uptick in their symptoms after using substances. Taking mind-altering substances can lead to or exacerbate psychotic symptoms. For example, research suggests there is a connection between synthetic cannabinoids, which are manufactured mind-altering substances, and schizoaffective disorder.

Mood disorder and psychotic symptoms of schizoaffective disorder

While everyone’s experience can be intensely individual, there are certain symptoms to watch for if there is concern about schizoaffective disorder in someone’s life. 

Hallucinations and delusions 

Hallucinations and delusions can be the primary symptoms of schizoaffective disorder. Hallucinations, which are often visual (e.g., seeing objects) and auditory (e.g., hearing voices), involve the perception of stimuli that are not there at the time of symptomatic onset. Conversely, delusions are generally considered to be fixed beliefs that can be proven false but can continue to be held by the individual. 

Disorganized thinking 

Another major symptom of schizoaffective disorder is disorganized thinking. People with this disorder may find it very difficult to concentrate or stay on topic. They may quickly switch from one topic to another during conversations or provide answers that are completely unrelated to the topic at hand.

Mania and depression 

For those living with schizoaffective disorder bipolar type, periods of mania and depression can be more likely to occur than not. During mania, symptoms like racing thoughts, feelings of euphoria, and risky behavior may take precedence. During lows, intense feelings of sadness, disinterest, fatigue, and other symptoms related to depression can become significant. Additionally, suicide attempts and other forms of self-harm are common among people living with schizoaffective disorder. 

Treatment of schizoaffective disorder

Many different treatment options can be available to support those living with schizoaffective disorder, but in most cases, a combination of medications and psychotherapy is generally recommended.

Medications

There are a wide variety of medications that may be helpful in the treatment of schizoaffective disorder. More than one medication might be prescribed to treat all of the symptoms, possibly improving one’s quality of life. As the first-line treatments for schizoaffective disorder, antipsychotics are commonly prescribed to alleviate symptoms of psychosis. Mood stabilizers are often used to manage depressive or manic symptoms of the disorder. A physician can legally assess and prescribe the correct medication per patient to successfully address mental and physical symptoms. 

Psychotherapy

Medication alone might not be enough to fully address the range of symptoms that can be associated with treating schizoaffective disorder. Talk therapy can be a key part of treatment as well. 

Your therapist may utilize many different types of psychotherapy to help you address your symptoms and pursue your goals—with the most common possibly being cognitive-behavioral therapy. Group therapy can be particularly helpful for people with schizoaffective disorder, as social isolation is a common effect of the condition. 

Family Interventions

A family intervention may also be an important part of an individual’s treatment plan. These treatments can help optimize the care provided by family members to the affected person through education, counseling, and stress-management techniques. In one study researchers found that an early intervention involving family members decreased psychotic symptoms and reduced the risk of relapse.  

Self-care

According to the National Institute of Mental Health, psychosis can cause an individual to struggle with self-care. Techniques that allow an individual to tend to their emotional, physical, and cognitive well-being may help alleviate some symptoms of schizoaffective disorder. Self-care can include exercising, practicing relaxation techniques, eating a balanced diet, and engaging in enjoyable activities.

Support groups

Because schizoaffective disorder often leads to withdrawal, the social interaction of a support group can be especially helpful. Support groups allow individuals with schizoaffective disorder to connect with and learn from people who are experiencing similar challenges. 

Alternative support options for schizoaffective disorder 

Whether you’re currently diagnosed with schizoaffective disorder or believe you may fit the diagnostic criteria for it, speaking with a professional about your thoughts can be beneficial. Not only can you find answers to your questions and resources that can help, but you can also receive support and advice that may help you learn to navigate your symptoms in the long run.

Attending therapy sessions through an online platform like BetterHelp may be more accessible, as you can connect with a therapist anywhere you have an internet connection. You may be less limited by the local options when you use online therapy for support. In addition, online therapy may be more cost-effective. 

Research has found statistics that suggest that online therapy isn’t necessarily a less valuable treatment option than traditional counseling. For example, one literature review of several studies analyzing the efficacy of online cognitive-behavioral therapy found research that suggests that it could effectively treat various mental health disorders, including PTSD, anxiety disorders, depression, panic disorder, and others. This finding may be valuable for those living with schizoaffective disorder, as these conditions can co-occur.  

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