Schizoaffective disorder is an illness in which there are both severe mood swings (mania and/or depression), and some of the psychotic symptoms of schizophrenia. Most of the time mania or depression mix with psychotic symptoms, but there must be at least one two-week period in which there are only psychotic symptoms without any symptoms of mania or depression.
What are the symptoms of schizoaffective disorder?
During the depressed state the following symptoms may be present:
- poor appetite
- weight loss
- insomnia
- agitation
- general slowing down
- loss of interest in usual activities
- lack of energy or fatigue
- feelings of worthlessness
- self-reproach
- guilt
- inability to think or concentrate
- thoughts of death or suicide
- increase in social, work or sexual activity
- increased talking
- rapid or racing thoughts
- grandiosity
- little need for sleep
- agitation
- inflated self-esteem
- distractibility
- self-destructive activities
- delusions
- hallucinations
- incoherence
- disorganized speech or thinking
- grossly disorganized behavior
- total immobility
- lack of facial expression, speech or motivation
The cause is unknown, but we think it stems from a mixture of biological, genetic and environmental factors.
What happens to people with schizoaffective disorder?
Schizoaffective disorder is a lifelong illness for most people. The exact course of the illness varies from person to person, but most people have a flare-up of symptoms periodically in times of stress. These periods of increased symptoms are called relapses. They may be severe enough to limit functioning and may make hospitalization necessary. After a relapse, there is usually a gradual return to the prior level of functioning. Between relapses, most people have mild, if any, symptoms.
What is the treatment of schizoaffective disorder?
Treatment usually consists of therapy, medicine and skills training.
- The medicines used to treat schizoaffective disorder include antipsychotic medicines, antidepressants, and/or mood stabilizers. Often several medicines are combined to get the best results.
- Therapy is most helpful when the patient and therapist work together to learn about the illness, to establish and work on the patient's goals, and to manage everyday problems.
- Skills training may focus on social skills, grooming and hygiene, managing money, grocery shopping, looking for a job, cooking, and so on.
What can I do to make the best possible recovery?
- Accept that you have a prolonged illness.
- Identify your strengths and limitations.
- Make clear, realistic goals.
- After a relapse, go slowly and gradually back to your responsibilities.
- Plan a regular, consistent, predictable daily routine.
- Make your home as quiet, calm and relaxed as you can.
- Identify and reduce stress. Make only one change in your life at a time.
- Work toward an active and trusting relationship with the staff involved in your care.
- Take your medicines regularly, as prescribed.
- Identify early signs of relapse. Make your own early warning list.
- Get involved with a group of people you feel comfortable with.
- Avoid street drugs.
- Whether or not you drink alcohol is a very personal decision you should make with your prescriber.
- Eat a well-balanced diet.
- Get enough rest.
- Get regular exercise.
- If you're not sure whether your feelings or fears are based in reality, ask someone you trust or compare your behavior with others.
- Accept that there may be setbacks from time to time.
Once the symptoms are under control, what can I do to help keep them under control?
During a well period, the patient and therapist should make a written plan for what to do if signs of relapse appear. A friend or family member can also be involved. The plan should include:
- Specific warning signs of relapse.
- Calling the therapist right away when warning signs of relapse appear.
- Notifying friends and family who can help limit stress and stimulation.
- Specific ways to decrease stress and stimulation and increase structure.
Where can I learn more about this illness?
There are some written materials about schizoaffective disorder and its treatment:
Xavier Amador. I am Not Sick: I Dont Need Help. 2000.
Patricia Backlar. The Family Face of Schizophrenia, 1994.
Richard Keefe and Phillip Harvey. Understanding Schizophrenia: A Guide to the New Research on Causes and Treatments, 1995.
Kim T. Mueser and Susan Gingerich. Coping with Schizophrenia: A Guide for Families. 1994.
Lori Schiller. The Quiet Room. Warner Books, 1994.
John F. Thornton and Mary V. Seeman. Schizophrenia Simplified. Hogrefe and Huber, 1991.
E. Fuller Torrey. Surviving Schizophrenia: A Manual For Families, Consumers, and Providers, 4th edition. Harper Collins, 2001.
The following organizations can provide help, information and support:
National Alliance for the Mentally Ill (NAMI). An international support and information-giving organization for people with psychiatric illness and their family members. For information about NAMI membership and availability of local meetings, call (800) 950-NAMI, or reach them online at 
www.nami.org.
Recovery, Inc.
A self-help group for people with nervous problems. The purpose of Recovery, Inc. is to help prevent relapses in former mental patients and to forestall chronicity in nervous patients by training people in a systematic method of self-help aftercare based on the system of self-help principles described in the work of the late Abraham A. Low, M.D. Recovery, Inc. has local meetings throughout the United States. For information about local meetings, call (312) 337-5661 or reach them online at www.recovery-inc.com.
Mental Health Association
A confidential source of information and referral. Also sponsors social clubs and other programs for people with mental illness. Many counties have their own mental health association. For the location nearest you, call the National Mental Health Association at (800) 969-NMHA or reach them online at www.nmha.org.
