Some people have suggested that schizoaffective disorder sits in the middle of a spectrum, with schizophrenia at one end and bipolar disorder at the other. This is because these diagnoses share many similar symptoms. But schizoaffective disorder is recognised as a separate diagnosis.
You might have times when you struggle to look after yourself. Or when your doctors feel that you lack insight into your behaviour and how you’re feeling.
Symptoms can begin at any age, but usually start when you’re a young adult. Some people only experience symptoms of schizoaffective disorder once in their life.
Schizoaffective disorder and stigma
Some people may not understand or have heard of schizoaffective disorder. They may have misconceptions about you. Or a negative or inaccurate image of schizoaffective disorder.
This can feel very upsetting. Especially if the person who thinks this way is a friend, colleague, family member or healthcare professional.
Schizoaffective disorder is less well known than some other mental health problems. This may make it harder to find information or support. Or to connect with others who have similar experiences. This may feel frustrating and lonely at times.
You might want to think about the following options:
Show people this information – it might help them understand what your diagnosis means
Get more involved in your treatment – you can make your voice heard. You can also take steps if you’re not happy with your care. For guidance, see these pages on seeking help for a mental health problem
Know your rights – the law can help you in certain situations. For more information, see Mind’s pages on legal rights
Take action with Mind – for details of ways you can get involved in helping challenge stigma, see Mind’s page on campaigning
What are the symptoms of schizoaffective disorder?
This page covers:
Symptoms of psychosis
Mood symptoms
Types of schizoaffective disorder
Diagnosing schizoaffective disorder
Symptoms of psychosis
These symptoms are similar to those experienced in schizophrenia, including:
Hallucinations – where you may experience things that others around you don’t. For example hearing voices, seeing visual hallucinations and other unexplained sensations
Delusions – where you might hold strong beliefs that nobody else shares. For example, a fear that everyone can hear your thoughts or that you can control the weather
You may also experience:
Your thoughts becoming very disorientated
Feeling confused or frightened
Feeling disconnected from your emotions
Difficulty concentrating
A lack of motivation or interest in things
These feelings can be managed with the right combination of treatment, support and self-care.
The mood symptoms of schizoaffective disorder are similar to those experienced in bipolar disorder. They can include both manic and depressive symptoms:
Manic symptoms – you may feel extremely excited or irritated. Or make unrealistic plans and behave in ways that might put you at risk
Depressive symptoms – you may feel sad and low or experience sleep problems. You may also feel disconnected from others or experience suicidal feelings
The periods of time where you experience mood symptoms are sometimes called ‘episodes’. You may experience depressive episodes, manic episodes, or both. You may also experience ‘mixed episodes’. This is when you have symptoms of mania and depression at the same time, or very quickly after each other.
Episodes can vary in length. Some people have repeated episodes, but this doesn’t happen for everybody.
Bipolar type – you have manic episodes alongside symptoms of psychosis. You may also experience depressive episodes
Depressive type – you only have depressive episodes alongside symptoms of psychosis
How is schizoaffective disorder different from schizophrenia or bipolar disorder?
Schizoaffective disorder is its own diagnosis. But schizoaffective disorder, schizophrenia and bipolar disorder can involve similar symptoms and experiences.
Diagnosing schizoaffective disorder can be complex. Not all professionals agree on how best to diagnose or describe it. A diagnosis of schizoaffective disorder may be considered if you’ve experienced:
Symptoms that have lasted for a month or longer
Symptoms of psychosis and mood symptoms at the same time
Mood symptoms for most of the time that you’ve felt unwell
A period of time (usually at least 2 weeks) of symptoms of psychosis without mood symptoms
Depressive episodes that include low mood
Schizoaffective disorder is often seen as a psychotic disorder with significant mood features, rather than a mood disorder with psychosis.
Diagnosing schizoaffective disorder
To diagnose schizoaffective disorder, a psychiatrist will assess your symptoms and ask how long you’ve had them. They’ll consider how psychosis and mood symptoms happen for you (either together or separately) during episodes. They’ll also consider how your symptoms affect your daily life or relationships.
The psychiatrist may check for any physical problems that could be causing your symptoms. Recreational drugs can also cause similar symptoms. So it might be useful for your psychiatrist to know if you are using any (or have done in the past).
Differences between diagnoses are subtle. You may be given different diagnoses by different psychiatrists. It may feel frustrating if your diagnosis changes.
You may feel like you’ve got used to one diagnosis, and now you need to get used to a new one. Or you may feel relieved and that the new diagnosis is a better fit for you. You may feel like you don’t need any diagnosis at all. There’s no right or wrong way to feel about this.
What can I do if I disagree with my diagnosis?
If your diagnosis doesn’t fit with the way you feel, it’s important to discuss this with a mental health professional. This is to make sure you’re getting the right treatment to help you.
See these pages on seeking help for a mental health problem for information on how to make sure your voice is heard. And what you can do if you’re not happy with your doctor.
What causes schizoaffective disorder?
Researchers don’t know exactly what causes schizoaffective disorder. But it’s likely to be caused by a combination of factors, such as:
Stressful or traumatic life events
Childhood trauma
Brain chemistry
Genetics
Stressful or traumatic life events
Some people find that stressful or traumatic experiences can trigger a mood episode or an episode of psychosis. Stress may also make your symptoms feel more intense or difficult to manage.
You may be able to link the start of your symptoms to a very stressful period in your life, such as:
See our pages on managing stress for more information on the links between stress and mental health.
Childhood trauma
Some evidence suggests that experiencing a great deal of emotional distress as a child may increase the risk of developing schizoaffective disorder. This can include experiences like:
Experiencing trauma and distress as a child can have a lasting effect. For example, on how you’re able to regulate your emotions as an adult. See our pages on trauma for more information.
Brain chemistry
The way mental health problems and brain chemistry are related is still unclear and debated. The human brain is extremely complex. And the research and arguments in this area are complicated.
Schizoaffective disorder symptoms can sometimes be helped by taking certain psychiatric medications. Some of these medications are thought to act on your neurotransmitters, such as dopamine. Neurotransmitters are chemicals that communicate information throughout your brain and body.
Some research suggests that schizoaffective disorder may relate to problems with how these neurotransmitters work, but no one knows for sure.
Genetics
If you experience schizoaffective disorder, you’re more likely to have a family member who also experiences symptoms of schizophrenia or bipolar disorder (even if they don’t have a diagnosis).
However, research into genetic causes is limited. Research hasn’t found a single gene that’s responsible for schizoaffective disorder. Family links are more complex.
Researchers think that environmental factors may explain why some people experience symptoms of schizoaffective disorder, schizophrenia and bipolar disorder. And family members can be a very influential part of your environment as you grow up.
We don’t know why someone might develop schizoaffective symptoms rather than schizophrenia or bipolar disorder.
Self-care for schizoaffective disorder
Many people who are diagnosed with schizoaffective disorder are able to live happy and fulfilling lives. Self-care can help with this.
Self-care is how you look after your daily routine and the things that affect how you’re feeling. For example, exercise, relationships and diet. What helps you may be different from someone else. It’s worth trying out different things until you find what works for you.
You may find that making small changes in certain areas can help prevent some problems from developing.
It can help to:
Think about your triggers
Create a crisis plan
Try peer support
Try calling a helpline
Try new ways of relaxing
Other activities
Think about your diet
Try some physical activity
Visit a recovery college
Think about your triggers
You might find it helpful to keep track of your experiences over a period of time. You could try doing this for a few weeks at first, noting things down in a diary or on your phone. It may be helpful to track:
Doing this may help you to spot patterns in your thoughts, feelings and behaviours. It may also help you to think about situations that you find difficult, as well as those which have been helpful.
There are many online mood diaries which you may find helpful. Bipolar UK has a mood scale, mood diary and mood tracker app, which are free to use.
You might want to share your observations with your close family, friends or care team. It may be helpful for them to listen to you when you’re having a bad day. Or to help you keep on top of your commitments and be aware of your triggers.
Create a crisis plan
During a crisis, you may not always be able to tell people what helps you. While you’re feeling well, it may be a good idea to talk to someone you trust about what you’d like to happen if you’re in a crisis.
You might find it very helpful to talk to other people who have similar experiences to you. Peer support can be a great way to do this.
Peer support can help you:
Feel more positive about the future
Increase your self-esteem
Find friends
Recognise patterns in your experiences
Develop and discuss ways of coping
Identify early signs of crisis
Various organisations run groups or programmes. The Hearing Voices Network hosts groups across the country for people who hear, see or sense things that others don’t.
Try an online peer support community like Mind’s Side by Side
Try calling a helpline
If you need to talk to someone but don’t feel ready to try peer support, there are helplines you can call when you’re feeling distressed. For example, Samaritans or SANEline. Talking to a trained listener could help you feel supported and make sense of what’s happening for you.
Try new ways of relaxing
It may be helpful to try relaxation techniques, such as:
Yoga, meditation or mindfulness
Taking a shower or bath
Try breathing in and out slowly – some people find it helpful to count while doing this
It can be difficult to maintain a healthy diet when we’re struggling with our mental health. But eating regularly can keep your blood sugar stable and really make a difference to your mood and energy levels.
Physical activity can have a positive impact on our mood. It can be really helpful to focus on your body and physical surroundings. Moving your body may also help you to sleep better. Activities may include:
A regular walk outdoors
Swimming
Yoga or meditation
Health walks are organised locally in some areas. Your GP surgery may organise a weekly walking group. Some doctors will also prescribe an exercise programme.
Visit a recovery college
You may also find it helpful to find a recovery college. They offer courses about mental health and recovery in a supportive environment. You can find local providers on the Mind Recovery Net website.
Treatment for schizoaffective disorder
Each person’s experience of schizoaffective disorder will vary, as will the treatments that work best for them.
Different treatments may be helpful for symptoms of psychosis, mania or depression. If you’re experiencing a combination of symptoms, you may need a combination of treatments. Or you may need different types of treatment at different times.
You may be offered some form of counselling or psychotherapy, also known as talking therapies.
The main type of therapy suggested by NICE in the treatment of schizoaffective disorder is cognitive behaviour therapy (CBT). CBT may help you to connect your thoughts, feelings and behaviour with your symptoms. It can also help you to develop ways of coping with difficult experiences.
Art, music, dance or drama therapies may help you to express how you are feeling, especially if it’s difficult to talk about things. These kinds of therapies may help you come to terms with traumatic events that you may have experienced in the past.
You might find that arts therapies are enough to manage your symptoms on their own. Or they might work best alongside another treatment, such as medication. There is no ‘right’ approach. What works for you as an individual is the right approach.
This is a form of treatment that aims to provide support for the whole household. It can help your family, or the people you live with, to understand:
What you’re going through
How their responses may help or make matters worse for you, as well as each other
What’s helpful and unhelpful for you
For example, if you’re very distressed and your family members are very worried about you, they may focus too much attention on you without meaning to. This might make you feel more distressed.
Family intervention can help you:
Understand how your experience and symptoms affect those living with you
Manage your symptoms and think of ways to cope with problems
If you’re a friend or family member of someone with schizoaffective disorder, see our page on how friends and family can help.
Medication
Depending on your symptoms and needs, you may be offered medication. You may be prescribed:
An antipsychotic, to help with symptoms of psychosis or mania
A mood stabiliser, to help prevent or reduce the symptoms of mood episodes
An antidepressant, to help treat depressive symptoms. If you also experience symptoms of mania, you’re unlikely to be prescribed antidepressants alone. This is because there’s a risk of them triggering manic episodes
Depending on your symptoms, you may only be offered one type of drug. But a combination of drugs may be offered to help with the different symptoms of schizoaffective disorder.
Remember: always check with your doctor or pharmacist before taking any medications together. The medications could interact badly with each other.
Medication (especially antipsychotics) can have an impact on your physical health. You should receive regular check-ups from your GP on your weight, blood pressure, blood sugar levels, cholesterol and heart function.
Smoking can affect the type of side-effects you may get from medication. If you smoke, you may be offered support to stop.
Watch Laura, Joe, Ziaul and Steve talking about their experience of taking antipsychotics in this video. Our thanks to Mind for allowing us to share this video.
Medication can really help some of us. But it isn’t right for everyone. Before deciding to take any drug, it’s important that you have all the facts you need to make an informed choice. If you don’t understand any aspect of a medication you’re offered, don’t be afraid to ask as many questions as you feel you need to.
Helping someone with schizoaffective disorder
Support from family and friends can play an important role in helping someone recover from an episode of schizoaffective disorder. It may reduce the likelihood of them having further episodes.
It can also be stressful to care for or support somebody. You may need support for yourself.
This page will offer some suggestions on how you can help others and yourself:
Understand the diagnosis
Ask how you and others can help
Get help in an emergency
Get support for yourself
Understand the diagnosis
Learning more about schizoaffective disorder can help you:
Recognise early symptoms or triggers
Give you the confidence to discuss problems and offer help
React calmly in difficult situations and work towards a positive outcome
If someone is experiencing symptoms of psychosis, such as hearing voices, it may be helpful if you:
Accept that the voices are real for them, even if you can’t hear them
Focus on how they’re feeling, rather than what they’re experiencing
Help them manage their symptoms. For example, you could suggest distractions
Ask how you and others can help
Ask them directly how you can be most helpful. These are some ways you could help:
If you think your friend or family member may be at risk of hurting themselves or others, it may be necessary to consider a Mental Health Act assessment for them.
The nearest relative, as defined under the Mental Health Act, can request that the person at risk be given a mental health assessment by an approved mental health professional. This assessment involves considering treatment options. This may include deciding if the person should be admitted to hospital under the Mental Health Act.
It can be very upsetting when someone you’re close to is struggling with their mental health.
You may find it helpful to get support in coping with your own feelings, either through talking therapy or peer support, where you can talk to other people who have similar experiences. This support may be available at a local Mind or other carers’ groups, such as Carers UK.
Carers are also entitled to have their own needs for practical and emotional support assessed by social services. This is called a carer’s assessment. A number of national and local voluntary organisations provide help and information for carers on these topics.
bipolaruk.org
Information and support for people affected by bipolar disorder, hypomania and mania. Offers a telephone peer support line, an online peer support community, and local support groups across the country.
British Association for Behavioural and Cognitive Psychotherapies (BABCP)
babcp.com
Information about cognitive behavioural therapy and related treatments, including details of accredited therapists.
British Association for Counselling and Psychotherapy (BACP)
bacp.co.uk
Professional body for talking therapy and counselling. Provides information and a list of accredited therapists.
If you or someone you know needs urgent mental health help, please call 111 – the NHS
non-emergency
number. It’s available 24 hours a day, 7 days a week and is free from any phone. They have
specialist
mental health nurses who can support adults and young people.
