With part of the plan with this project being to try to lift the grey veil of mystery surrounding mental illness, I am planning to write a few posts over the coming weeks to shine a spotlight on various diagnoses. The logical start point for this for me is with my own diagnosis – Schizoaffective Disorder (or Sza for short).
Sza is a real mixed-bag disorder – neither schizophrenia nor a mood disorder, this label fits those who exhibit features of both illnesses. Taking into account that mood disorder includes either bipolar or unipolar depression, sza can vary wildly from person to person. But the basic diagnostic criteria are that the person presents with psychotic features along with altered mood, and the episode lasts a continuous two weeks; altered mood can be depression, mania, hypomania (a ‘milder’ form of mania) or mixed mood. Psychotic features refers to delusions, hallucinations, disorganized speech, thinking or behaviour. In real terms, some common features would be delusions of grandeur or identity (“I am the incarnation of Jesus/God”) and hallucinations such as hearing voices giving instructions or commenting on the person’s actions (or indeed visual, olfactory or tactile hallucinations)
Over and above this, sza is divided into two types – bipolar type and depressive type. In the bipolar variation the episode includes mania; what is of note here is that major depressive symptoms may occur as part of the bipolar cycle. It also includes mixed mood (dysphoria is an interesting symptom of mixed mood – defined as a profound state of unease). Depressive type is the diagnosis for those who solely exhibit major depressive features; there is a total absence of mania.
So that’s what it is – how is sza actually treated? The NICE (UK) guidelines suggest a combination of medication and therapy for the disorder. Medications used can include mood stabilisers, anti-psychotics and antidepressants. In some cases a newer anti-psychotic can also have mood stabilising effects; Olanzapine is one such example. Of course, with all medication comes side effects and these risks have to be weighed up against the benefits the medication will bring. Psychiatrists and patients can often work together through trying a few different medications before finding one that works without major side effects (case in point – I was on risperidone for my psychotic symptoms and it worked brilliantly but raised my hormone levels too much, so it was a no-go drug for me and we changed it to olanzapine).
Talk therapies such as CBT (cognitive behavioural therapy) can also be very helpful in a lot of cases. Cognitive behavioural therapy looks at the way we understand the world around us and helps people to understand their behaviour in light of this understanding. A holistic approach will typically see the therapy lasting around 12 months, during which time the patient will learn exercises they can use in their future life to help them maintain the good progress they make in therapy.
Looking at being able to help oneself is very important too. Factors such as exercise, diet, sleep and relaxation can all have effects on the individual’s outlook. Something I found very useful when starting on the path of getting better was keeping a journal to track my mood and symptoms. It helped me to see patterns in the swings and I started to be able to anticipate them.
Thanks for reading, I hope this has shed some light on this illness – please feel free to post any questions or comments here or on Facebook or Twitter!