Schizoaffective disorder – Huh?

Schizoaffective disorder
I went to my pdocs office Friday for my monthly appointment and to get my prescriptions, and I was surprised to learn something new. He has diagnosed me with schizoaffective disorder. I don’t remember ever discussing that.

Doctor Rose

Before my current pdoc, I saw another one who worked under him (They work at one of the too few, grossly understaffed county mental health clinics.) Dr. Rose was in her final year of residency and I loved her to death. This was the period soon after I was finally diagnosed with bipolar disorder and we were working to find the right combination of meds that worked for me. Anyone out there who has gone through this knows it can be pure hell. I know many, if not most, of you get approximately fifteen minutes with your pdoc about once every three months. With Dr. Rose I got a full hour every two weeks. What I loved most about her was she didn’t dictate to me what I was going to take. We worked as team. She would have me sit next to her and we’d read the medical books, and medication books together, and decided together what I should try.

I did have one frustration with Dr. Rose, and that was she couldn’t stick with what my diagnosis was/is. One week she said I was bipolar I, the one after that I was told I was bipolar II. This went back and forth for about two years. She just couldn’t settle on which one. (Personally I think I’m BP II.)

Doctor Abraham

Sadly, Dr. Rose decided she wanted to be a child psychiatrist and she left the clinic to go back to school. When she left, I was assigned to Dr. Abraham. I like him. He still spends about an hour with me, once every month, but he is no Dr. Rose.

After seeing Dr. Abraham for about two years I interrupted a conversation we were having to ask one question.,

“What is my diagnosis?” which I thought was a legitimate thing to ask.

Well, the kindly old man pushed his chair back, turned towards me and chuckled. “Does it matter?”

I was somewhat stunned by this and said, “It’d just be nice to know.”

His final response was, “The meds are working, so why should it matter?” And then he changed the subject. I should have been mad, but I wasn’t. I think I was too shocked to know what to say.

Fast forward to this past Friday when I showed up for my scheduled appointment. Doctor Abraham was sick so the on-call doctor assisted me. He had never seen me or my file so he pulled it up when we got to his office. Being the good doctor he is, he verified everything that was on my file.

“Before I fill out your prescriptions, let me verify what we have for you. I show your diagnosis is bipolar disorder and schizoaffective disorder.”

“Excuse me? I don’t ever recall him saying I have schizoaffective disorder.”

“Well, it’s what he has here as your diagnosis. It’s a milder form of schizophrenia.”

Schizoaffective Disorder

When I got my prescriptions, I went to the nearest Starbucks to look up what schizoaffective disorder is. Here’s what the Mayo Clinic has on their website,

Schizoaffective disorder is a condition in which a person experiences a combination of schizophrenia symptoms — such as hallucinations or delusions — and mood disorder symptoms, such as mania or depression.

Okay, that didn’t sound too bad, or at least not as bad as I thought. Wanting to verify further, I checked out the symptoms and decided most apply:

    Delusions having false, fixed beliefs- I’m not sure what exactly this means, so I’ll skip it
    Hallucinations, such as hearing voices- I rarely heard voices, but I use to have visual hallucinations pretty regularly. I’ve had a variety of them, but the most common was a donkey in our living room, I haven’t seen him in a while. I miss him. Maurice and friends can only remember me having hallucinations when I was going through some med changes and they may be right, however I do recall having hallucinations when I was a teenager. Most of those were when I was manic and didn’t sleep for several days at a time, though none were nearly as extensive as a donkey. I guess this one is a maybe.
    Possible periods of manic mood or a sudden increase in energy and behavioral displays that are out of character Duh! Of course
    Impaired occupational and social functioning I think being unable to work for over ten years applies
    Problems with cleanliness and physical appearance I’ve bored you all enough with this problem I have
    Paranoid thoughts and ideas I don’t recall paranoia being a problem. I have believed, at times, that most people don’t like me, but I attribute that to low self-esteem or anxiety. Not so much paranoia.
    Expression of suicidal thoughts or behavior More guilty of this one than I care to admit.

    So, I scored four, maybe five out of seven. My uneducated diagnosis of myself is that it sounds like a definite maybe.


    I looked further in the Mayo Clinic’s website and found complications, which they list:

    Social isolation
    Anxiety disorders
    Developing alcohol or other substance abuse problems
    Significant health problems

    Amazingly with my weight and all I am remarkably healthy. My blood pressure is average, my cholesterol level is low. So the significant health problems doesn’t apply (at least to my physical body,) but every other one of the complications describes me perfectly.

    I guess I shouldn’t be too worked up over this. None of this is far removed from everything I’ve been living with all this time. The fact that I now know it has another name shouldn’t bother me. It’s kind of a relief actually. I do plan to have a lengthy conversation with my pdoc, though. He better be ready for a full session next month. I sure am.

    Source: Mayo Clinic

31 comments on Schizoaffective disorder – Huh?

    1. Yeah, it’s good I didn’t freak out. I think I was too stunned to get upset. It helped that I couldn’t recall any behavior that was different than bipolar.

  1. Sounds like the hallucinations make the difference. Otherwise it’d just be plain old bipolar. I’m sure you’ll make him clarify though. That’s kind of crappy that he seemed to want to hide it from you. Maybe he thought you weren’t in a good space at the time?

    1. You may be right, it could be he didn’t think I could deal with it, but I would have thought maybe he’d call Maurice. We did have lengthy discussions about the hallucinations so maybe he didn’t understand that the meds were likely the cause. I agree with your assessment that it does seem like plain old bipolar other than the hallucinations.

      1. Nothing you described sounds much different than what I used to go through before they got my cocktail right. I have been diagnosed with Bipolar I with psychotic features primarily because I have (or had) auditory hallucinations on a regular basis. When they finally found the right cocktail of meds for me, I was not surprised that what finally stabilized me were the atypical anti-psychotics. Believe me, they tried everything ~ anti-epileptics, traditional mood stabilizers like lithium, and anything else they could throw at it.. So, I agree it may be the meds you are on.

        When I finally evened out on the anti-psychotics, i was surprised. Nothing else had worked. So, I guess the “with psychotic features” part was more important than I thought.

        Your “new” diagnosis sounds an awful lot like Bipolar I with psychotic features. I have seen schizoaffective disorder in the hospital a few times, and even though you have symptoms, it sounds like normal (if you can say that) Bipolar I to me.

        1. Thanks for the feedback. I agree that it sounds more like BP I, however where do they draw the line between this is BP I and this is schizoaffective disorder? It is confusing.

  2. That’s so wild!! My pdoc told me at my last appt that he diagnosed me with the same thing!!! I don’t agree with it at all, as I’ve never had psychotic features. I don’t know why he did that. I was too shocked to ask. I will, though ?

    1. Funny that you and I got the news around the same time. I look forward to seeing how your discussion goes.

  3. I’d be very grumpy if they had something down on paper and I didn’t know about it. Thankfully, I get copies of the letters my psych sends to my pdoc, so I know what the score is.

    1. Yeah, there’s no communication between my pdoc and my therapist at all. They don’t know each other. My therapist is the one who told me to get checked for bipolar disorder. He also agrees that my pdoc keeps me too down and should change my meds accordingly. It’s another conversation that I need to have with him,

  4. i had a similar revelation-apparently i am now diagnosed with borderline personality disorder. the only problem is I don’t think it fits and its hard as heck to get it off there now.

    1. It is hard. I mentioned my therapist thinks my pdoc keeps me too much on the antidepressants. My pdoc won’t change them based on one day about a couple of years ago that I was in his office and extremely manic. He’s seen me at my worst regarding depression and he doesn’t seem willing to do something about that, but all he can focus on was that one day that I was manic. So frustrating,

  5. I don’t blame you for wanting to confront your psychiatrist. It’s a matter of trust. We are expected to be truthful with our doctors and in order to have confidence in them, we need them to be truthful with us. Perhaps you can get him to explain why he gave you that diagnosis.

    1. Thank Journey, I do plan to have that discussion. I’m kind of nervous of getting the other pdoc in trouble for going over my diagnosis, but I think that’s me just trying to avoid the issue. After all, he should been verifying that information rather than just blindly writing prescriptions.

  6. It sounds like your doc isn’t great considering he wouldn’t even tell you his diagnosis. And I’d say you have Bipolar 1 if you have hallucinations etc. I could be wrong but isn’t this is what differentiates Bipolar type 1 from Bipolar type 2?

    1. hallucinations are one of the symptoms that occur more in BP I. However, I’m far more depressive than manic, which occurs much more in BP II. I’m just one big mess. 🙂

    2. With Bipolar I, you are more likely to have full on manic episodes than with Bipolar II. People with Bipolar I who are having a manic episode frequently do not sleep at all, and the deprivation can lead to some pretty interesting psychotic reactions. When you medicate a Bipolar I with anti-psychotics, the manic episodes tend to go away, usually. Sometimes the hallucinations hang out. But, Bipolar II folks do not usually have full on manic attacks, nor do they have the same type of crashes that the Bipolar I camp experiences. Hallucinations can occur with either one, but more so with Bipolar I which is why there is the qualifier “with psychotic features.”

  7. Wow! That was a bit of a curve ball. But couldn’t the “schizo” part also be symptoms of psychosis? I dunno, the symptoms of some of the mental illnesses overlap and are so similar I just get plain confused!!

    1. It is funny how they overlap. Sometimes I think psychiatrists just have to throw some kind of diagnosis, so they randomly pick one

  8. Maybe you actually have Bipolar I with psychotic features? Schizoaffective disorder is the illness that skates the fine line between Bipolar disorder and Schizophrenia. I think your doc may be off a bit. I have never “seen” any evidence of a thought disorder in you. I have about 2.5 symptoms of Borderline Personality Disorder, but not enough to be diagnosed with it. It sounds like your research turned up some evidence of symptoms, but not enough of them to be diagnosed.

    1. I’m feeling more and more like I shouldn’t worry about my diagnosis. At least as he said, “the meds are working.” There’s a fine line between all of these

      1. The only time I really worry about my various ailments is when I am job hunting because living on disability is like treading water surrounded by Great Whites; you could go down at any minute. The only reason I have a problem with being mentally interesting is how do I explain the long, long gap in my employment history. So, it took a few years to get it right. Everything is right now, so what’s their problem with my employment history?

  9. I have asked my psychiatrist what my diagnosis is a couple of times. He has given me a few vague answers, but Bipolar II seems to fit my personality. My medications are working so I’m not really concerned with what I have, I just want to know how to live in spite of my diagnosis whatever that may be.

    1. I had a long talk with my therapist about this yesterday. He can’t make a diagnosis, of course, but he was certain that whatever I have, it is not schizoaffective disorder. We both agreed I likely have bipolar II. I have come to accept what it is doesn’t matter. What matters is it’s working…and it is.

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