Schizoaffective disorder

Schizoaffective disorder is a serious mental health disorder. It combines symptoms of a mood disorder (such as depression or bipolar disorder) and those of schizophrenia. Like schizophrenia, those with schizoaffective disorder experience a type of psychosis. People with schizoaffective disorder can become disconnected from reality. This disconnection affects the way you think, feel and behave.

Schizoaffective disorder usually first appears in young adults (between 25 and 35 years of age). Females seem more likely to have it than males.

There are 2 subtypes of schizoaffective disorder:

• Bipolar type, in which you have episodes of mania, depression or both at different times. This is also called schizoaffective bipolar type.
• Depressive type, in which you have episodes of depression but not mania or euphoria. This is also called schizoaffective depressive type.

If you or someone else is having urgent symptoms of schizoaffective disorder, such as harmful behaviours or having thoughts of suicide, call triple-zero (000) and ask for an ambulance.

The symptoms of schizoaffective disorder combine aspects of:

• psychosis (changes to how you think, feel and behave)
• mania (feeling very euphoric, happy or high)
• depression (feeling low, hopeless and very sad)

A wide range of symptoms are possible. You typically have extreme changes in your mood. Each person's symptoms are unique.

The symptoms of schizoaffective disorder occur in cycles (come and go). You may have periods of time with severe symptoms followed by periods with mild symptoms. You might have a mix of symptoms of schizoaffective disorder together or different types of symptoms at different times.

Symptoms of psychosis

Several mental health disorders can cause symptoms of psychosis. These symptoms impact how you think, feel and behave. They include:

• delusions (when you strongly believe things that are not true in reality, such as that someone is watching you or wants to harm you)
• hallucinations (when you hear voices or see things that others cannot hear or see)
• disorganised thoughts (when your thoughts are jumbled and you can't concentrate or make plans)
• disorganised speech (what you say is mixed up and other people find it hard to follow)
• disordered behaviours (when you act in unusual ways and do things that don't make sense)
• changes in your emotions or having extreme reactions to small things
• finding it hard to sleep

Symptoms of psychosis can be frightening. They may lead you to withdraw socially, avoid other people and take risks.

If you have psychosis symptoms, you are likely to find work or study difficult.

Not everyone with psychosis has schizoaffective disorder or schizophrenia.

Symptoms of mania

Mania can appear as sudden increased energy, elation (being extremely happy) or excitement. During an episode of mania you may behave out of character.

Some examples of manic thoughts are:

• mistakenly thinking you have great wealth
• thinking that you can achieve anything you want to
• thinking that you have special powers

People who are having an episode of mania may not realise what it is. They can be reluctant to seek help.

Symptoms of clinical depression

Everyone feels sad or down at times. Symptoms of clinical depression are different from normal feelings of unhappiness or sadness.

During an episode of depression, you can feel extremely distressed and hopeless. You can feel empty or numb, and find that you can't enjoy life normally.

People with clinical depression may have:

• decreased appetite with weight loss, or increased appetite with weight gain
• trouble sleeping or may sleep too much
• a lack of pleasure and enjoyment from activities that used to be fun
• fatigue, with an overwhelming feeling of exhaustion
• feelings of guilt, worthlessness and a sense of hopelessness
• thoughts of death

The causes of schizoaffective disorder are not clear. Doctors think that several factors work together to trigger the disorder. These factors include:

• genetic factors, when you have a closely related family member with schizoaffective disorder, bipolar disorder or schizophrenia
• changes in the chemicals in your brain such as dopamine and serotonin
• changes in your brain structure
• stress or traumatic events
• using psychoactive drugs such as cannabis or methamphetamine (ice)

It is not your fault if you have schizoaffective disorder.

If you or someone else is having urgent symptoms of schizoaffective disorder, such as exhibiting harmful behaviours or having thoughts of suicide, call triple zero (000) and ask for an ambulance.

If you or someone you know has worrying symptoms of a mental health problem, see a doctor or mental health professional.

If you notice signs of relapse (your symptoms are coming back) contact your healthcare team as soon as possible.

Some symptoms of schizoaffective disorder need urgent medical attention. People with schizoaffective disorder may do things that harm themselves or others.

A clinical psychologist or psychiatrist can diagnose schizoaffective disorder. They will ask about your personal and medical history. They will talk with you about your recent and past symptoms — such as how often and how severe they are and how distressed you get.

The symptoms of schizoaffective disorder vary. So does how it appears in different people. Many symptoms of schizoaffective disorder are like those of other mental health disorders, such as schizophrenia and bipolar disorder. It can take a while to get the correct diagnosis.

If you have symptoms of schizophrenia and symptoms of a mood disorder at the same time and for at least 2 weeks, you might be diagnosed with schizoaffective disorder.

Treatment for schizoaffective disorder usually includes a combination of medicines, psychological therapy and counselling. It's important to treat the symptoms of schizoaffective disorder as soon as possible. The sooner you can get treatment, the less likely you will have ongoing symptoms and distress.

If you and your doctor can work out what has triggered an episode you can take steps to avoid it.

The main treatments used for schizoaffective disorder are:

• Medicines, such as antipsychotic medicines and antidepressants or medicines that stabilise your mood. You might need to continue to take medicines for a number of years.
• Psychological therapy and counselling. This includes talk therapy to give you strategies to help manage the disorder. You can learn what to do in times of stress. Therapy can help you avoid getting very unwell and needing treatment in hospital.

Healthy lifestyle changes can also help. These include:

• quitting smoking
• reducing or stopping alcohol and drug use
• exercising
• improving your diet

You can take part in life skills programs to improve your personal relationships or practical skills.

There are support groups for people with schizoaffective disorder. You can also ask for help to find out if you're eligible for disability support payments.

Understanding and support from your family and friends are important. Your family and friends can also use support services. A support service can help them better understand their loved one with a mental health disorder.

There's no certain way to prevent schizoaffective disorder. You can reduce the chance of some of the causes, such as head injury. You can also reduce your exposure to symptom triggers, such as drug use and chronic or extreme stress.

You may need long-term treatment and support to live a fulfilling life with schizoaffective disorder.

The level of support you need can vary. You may need more help at times when your symptoms are worse. You may not need much support at all when your symptoms are mild.

Don't stop your treatment without talking with your doctor first.

Having schizoaffective disorder can make it harder to care for yourself.

When your symptoms interfere with your life you might:

• find it hard to eat well or stop smoking
• struggle with work or study
• put off exercise
• avoid seeing the doctor

You might have other health issues as well as schizoaffective disorder, such as problems with your cardiovascular system. Your medicines might have side effects, such as weight gain or tiredness. It's important to see your doctor regularly to get advice about your long-term health and wellbeing. They can help you stay physically healthy. An annual check-up is a good idea.

Keeping symptoms of schizoaffective disorder under control can help you reach your goals in life.

If you or someone you care about is affected by schizoaffective disorder you can get help:

• SANE (Opens in new tab) is a support group for people with complex mental health issues and their families. They have a fact sheet (Opens in new tab) on schizoaffective disorder.
• Lifeline (Opens in new tab) can give you support in a crisis by calling 13 11 14, texting or chatting online (Opens in new tab).
• Medicare Mental Health (Opens in new tab) is a free service that connects you with the mental health support you need. See this Easy Read information sheet (Opens in new tab).
• NSW Health has Easy Read (Opens in new tab) materials about finding people to help with your mental health.
• For resources in languages other than English try Embrace multicultural mental health (Opens in new tab).
• Learn more about Mental Health First Aid (Opens in new tab).

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.