What is Schizoaffective Disorder Bipolar Type, Depressive Type, and Overall?

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What is Schizoaffective Disorder Bipolar Type, Depressive Type, and Overall?If you or your loved one is suffering from schizoaffective disorder, it can be difficult to understand what this means for the future. Hearing words like, schizophrenia, psychosis, combined with mania and depression can be overwhelming and scary.

Breaking the diagnosis down and understanding what you can do to treat it will help you manage your symptoms and prevent the schizoaffective disorder from taking over your life.

What is Schizoaffective Disorder?

Schizoaffective disorder is a mental illness that presents with a mix of symptoms from schizophrenia(psychosis) and a mood disorder (depressive or manic episodes).

Psychosis Definition

“The word psychosis is used to describe conditions that affect the mind, where there has been some loss of contact with reality. When someone becomes ill in this way it is called a psychotic episode. During a period of psychosis, a person’s thoughts and perceptions are disturbed and the individual may have difficulty understanding what is real and what is not”- National Institute of Mental Health

The Diagnostic and Statistical Manual of Mental Disorders- 5th Edition (DSM- 5) classifies provides the following categories as the key features that define psychosis:

  • Delusions: Believing something even when there is contradicting evidence that it is not true.
    • Persecutory: Believing someone is out to get you, that you are being watched. This is the most common type of delusion.
    • Referential: Believing that strangers’ facial expressions or gestures, commercials on TV or other external cues are messages directed especially at you.
    • Grandiose: Believing you have special powers, you are famous or have extraordinary skills.
    • Erotomanic: Believing someone is in love with you when they are not.
    • Nihilistic: Believing a major catastrophe will occur.
    • Somatic: Believing there is something wrong with your health or organ function.
  • Hallucinations: Believing you see, hear, taste, or feel things that are not there.
    • Auditory(hearing) hallucinations such as hearing voices are most common.
  • Disorganized Thinking (Speech): Switching from one thought to another, gives answers completely unrelated to a question, puts together unrelated words when talking (“word salad”).
  • Disorganized or abnormal motor behavior: Experiencing repetitive, odd movements, involuntary facial expressions.
  • Catatonic behavior (not moving and holding a bizarre posture or not talking) can sometimes also be observed.
  • Negative Symptoms: Decrease or lack of emotional expression, interest in self-care or motivation for pleasurable activities.

Mood Disorder Definition

According to the Social Work dictionary, a mood disorder is defined as a serious mental disorder involving significant changes in a person’s emotional state.

Schizoaffective Disorder VS Schizophrenia: Is This Mental Disorder One of the Types Of Schizophrenia?

Schizoaffective disorder diagnostic form and book on a table

The DSM-5 categorizes schizoaffective disorder under the Schizophrenia Spectrum and Other Psychotic Disorders section as both share psychosis symptoms, but they are not the same thing. Schizophrenia does not present with manic or depressive episodes.

Schizoaffective Disorder Test: How is it Diagnosed?

Your mental health provider will conduct a thorough assessment and will ask you questions regarding your current symptoms, mental health, substance abuse and medical histories.

Mental health professionals use the Diagnostic and Statistical Manual of Mental Disorders- 5th Edition (DSM- 5) and the International Classification of Diseases, 10th revision, Clinical Modification (ICD-10-CM) as tools to help them in the assessment and diagnosis process.

  • The DSM-5 is published by the American Psychiatric Association, has detailed descriptions of mental health disorders and provides clinicians with the ability to have a common language about diagnoses.
  • The ICD-10 is produced by the World Health Organization and includes conditions and diseases not pertaining to mental health. It serves as the official coding system used for billing purposes in clinical and medical settings.

Diagnosis Criteria

The DSM-5 provides the following criteria for schizoaffective disorder:

A. The presence of a major mood episode (manic or depressive episode) while also experiencing at least one of the psychotic features of schizophrenia.

B. Delusions or hallucinations for at least 2 weeks without the presence of a major mood episode.

C. Symptoms of a major mood episode are present for most of the illness.

D. Symptoms are not because of substance abuse or a different medical condition.

Depending on the presenting symptoms, your LMHP will specify whether you fit the criteria for a Bipolar or Depressive type.

Schizoaffective Disorder Symptoms

Symptoms of schizoaffective disorder can vary based on the subtype of the disorder and the person.

Schizoaffective Disorder Bipolar Type:

  • Psychosis
  • The person experiences a manic episode which is a period of at least one week of 3 or more of the following symptoms:
    • Inflated self-esteem
    • Decreased need for sleep
    • More talkative than usual
    • Racing thoughts or ideas
    • Increasingly distracted
    • Increased desire to accomplish a goal
    • Risky, impulsive decisions (investing without thinking, shopping sprees)

Schizoaffective Depressive Type:

  • Psychosis
  • The person experiences a depressive episode which is a period of at least two weeks of 5 or more of the following symptoms:
    • Depressed mood
    • Lack of pleasure in activities previously enjoyed
    • Changes in weight or appetite
    • Insomnia or excessive sleep
    • Physical agitation or moving slowly
    • Fatigue
    • Difficulty concentrating or making decisions
    • Recurrent thoughts of suicide

What are the common behaviors/characteristics?

It is common for a person to experience shame and low self-esteem after being diagnosed. Many people had a “normal” childhood and adolescence, therefore the changes that come with the symptoms of a schizoaffective disorder can be devastating.

There is a lot of stigma around psychosis and it may be difficult for people to ask for help. They may experience difficulties at work or in social situations which can lead to social isolation and decreased performance in occupational or daily life activities.

Schizoaffective Disorder Bipolar Type: What Does This Mean?

Schizoaffective disorder bipolar type applies when a manic episode is part of the presentation. Some people may refer to this as Bipolar schizophrenia, but the correct term is schizoaffective disorder.

Schizoaffective Disorder DSM-5 and Schizoaffective Disorder ICD-10: What are the Causes?

It is not known exactly what causes schizoaffective disorder, however, it is believed that genetics may be a contributing factor.

People who have a parent or sibling diagnosed with schizophrenia, bipolar disorder or schizoaffective disorder may be at greater risk for schizoaffective disorder.

Schizoaffective Disorder Stats: How Many Suffer from this Disorder?

According to the DSM-5, approximately 0.3% of the population is estimated to experience schizoaffective disorder in their lifetime.

Demographics: More Common in Adults or Children?

Girl covering her face with her hands relates to schizoaffective disorder stats

The onset of schizoaffective disorder is typically when a person is in their late teens or early 20’s. The schizoaffective disorder occurs more often in women than in men.

It is rare that a child will be diagnosed with psychotic disorders. If you do see signs of psychosis it is important to speak to a mental health professional right away.

Culture and religion will also be considered when diagnosing a person with schizoaffective disorders as what appears to be delusional for some may be normal in others.

3 Facts You Didn’t Know About ICD-10/DSM-5 Schizoaffective Disorder

  1. Often misdiagnosed due to the overlap of symptoms with other mental health disorders.
  2. With proper medication management and treatment, symptoms can improve over time.
  3. People with schizoaffective disorder can have fully functional work and life experiences.

Case Example for Schizoaffective Disorder DSM 5/ICD 10

James is 20 years old and is starting his junior year of college. He is normally a mellow guy who has done relatively well in school. James begins to be overly preoccupied with being watched by others and he begins hearing voices telling him to avoid classmates. He believes some of his classmates are out to get him. James finds himself unable to concentrate in class. He begins skipping classes and feels exhausted, so he sleeps all day. James’ roommate notices the drastic change and calls James’ parents. They take him to the hospital where the doctor prescribes him medication and connects him to an outpatient therapist.

Schizoaffective Disorder Leave Policies

Depending on the severity of your symptoms and your treatment needs, you may be eligible to request reasonable accommodations from your employer. Accommodations can vary depending on the employer and the type of work you do.

Your therapist may need to provide documentation verifying that your symptoms are limiting your job performance and provide an explanation of how an accommodation could help you.

Coping With Schizoaffective Disorder: Look out for These Complications/Risk Factors

Talk to your mental health provider right away if you notice:

  • Your symptoms have worsened.
  • You develop new symptoms.
  • You are having thoughts of suicide.

Many people with schizoaffective disorder may have a higher risk of being diagnosed with substance use disorders or anxiety disorders.

Schizoaffective Disorder Treatment

To effectively treat schizoaffective disorder, it is best to work with a team of providers.

The first step and most important step will be to address the psychosis with medication. The quicker the psychosis symptoms are treated, the better you will be able to manage your condition.

Therapy will also be an important part of your treatment. Cognitive-behavioral therapy (CBT), a therapy that focuses on thoughts and behaviors, has been known to be effective for addressing schizoaffective disorder. CBT can help you recognize thoughts that may not be real and challenge any unhelpful thoughts. CBT also helps you learn coping skills, identify areas of vulnerability and reduce the risk of future episodes.

Family therapy can also be helpful to help family process changes resulting from diagnosis and finding ways to best support patient.

Group therapy may be helpful to increase your support system.

Electroconvulsive therapy (ECT) has also been used to treat severe cases of schizoaffective disorder. This is a series of treatments where a person is put under anesthesia and is given a brief electrical current to the scalp which causes a brief seizure that may help in “rebooting” your brain.

Possible Medications for Schizoaffective Disorder

An antipsychotic medication will be prescribed to manage psychosis.

A mood stabilizer or anti-depressant may be added depending on your symptoms.

Home Remedies to help Schizoaffective Disorder

Medication Management: It is crucial to take the medication as directed and let your medical provider know if there are any concerns about the side effects. Do not stop taking any medication without first talking to your doctor.

Self-Care: Your therapist may give you “practice assignments” to help you practice ways to reduce stress and increase coping skills. Practicing meditation or relaxation exercises and stick to a healthy lifestyle. Most importantly, avoid alcohol and drugs!

Support: Talk to your family or friends for support! Find a person who is aware of your condition and is willing to help. Have them attend sessions with you in order for them to learn ways to help you when you are experiencing psychosis, mania or depression.

Living with Schizoaffective Disorder

It is possible to live a full life with a schizoaffective disorder diagnosis. Maintaining a healthy lifestyle and taking your medication as prescribed are essential.

Insurance Coverage for Schizoaffective Disorder

Schizoaffective disorder is usually covered by most insurance providers. Call your insurance provider to get information on preferred providers in your area and the specifics of coverage.

How to Find a Therapist

  • Ask your medical provider for referrals.
  • Call one of the helplines identified in this article and request a referral for local therapists.
  • Call your local hospital and ask for their “behavioral health,” “psychiatry” or “mental health” unit.

What Should I be Looking for in an LMHP?

Female schizoaffective disorder therapist wearing glasses posing with a clipboard in therapy office

You will need to work with a professional who can prescribe medication:

  • Medical Doctor
  • Psychiatrist
  • Psychiatric Nurse Practitioners

Concurrently, you will also benefit from working with a professional who can provide you with psychotherapy, skills training and/or social skills education:

  • Psychologist
  • Licensed Clinical Social Worker
  • Marriage and Family Therapist
  • Licensed Professional Counselor

Questions to ask for Potential Therapist

  • What kind of therapy will you provide?
  • Are you comfortable working with people with psychosis?
  • How will you work with my medical provider?
  • How often will I see you for sessions?
  • How will I know if I’m getting better?
  • What method of payment do you accept?

Schizoaffective Disorder Support Helpline

National Alliance on Mental Illness: NAMI offers support options for families and individuals living with mental illness.
[email protected]

National Suicide Prevention Lifeline: 24-hour toll-free crisis hotline to help connect you to a local crisis center that can help you seek help in your area.

The Mighty: Digital health community that provides information through blogs from writers who experience schizoaffective disorder and other mental health issues.
Living a full life is possible with schizoaffective disorder! Look for support in those around you and stick to a healthy lifestyle. Talk about your feelings with people you feel are safe and supportive! Do not let schizoaffective disorder stop you from dreaming big and pursuing your goals!

About the Author:

Celia Viveros is a Licensed Clinical Social Worker in Washington State. The majority of her work has been with adolescents and families dealing with traumatic stress due to immigration, sexual abuse, and community violence. A great deal of her work has also been focused on helping adolescents with sexual behavior problems. Celia was inspired to write in order to provide an accessible way for people to get information on mental health issues. She hopes to provide helpful coping skills and most of all, normalize, the many issues people face but are too ashamed to talk about. Her goal is to provide people with tools that will help them find a healthy and joyful life.

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