Bipolar Schizophrenia Versus Schizoaffective Disorder

Is bipolar schizophrenia a thing? The answer is yes and no. Bipolar disorder is characterized by extreme shifts in mood, energy level, and thinking, whereas schizophrenia causes a person to lose touch with reality. They are two separate and distinct mental health conditions, and the diagnosis of one typically excludes the other. However, there are rare cases where a person exhibits symptoms of both schizophrenia and bipolar disorder at the same time. When that happens, however, it is not diagnosed as bipolar schizophrenia, but rather as bipolar schizoaffective disorder.

What is schizoaffective disorder?

Schizoaffective disorder is an uncommon, chronic, mental health condition that dramatically affects the way a person thinks and copes with his or her day-to-day life. It is characterized by a mix of schizophrenic symptoms such as delusions, hallucinations, and disorganized thinking, combined with either bipolar mania or depression (schizoaffective disorder bipolar type), or a major depressive disorder (schizoaffective disorder, depressive type).

Because the condition is so rare, getting the right diagnosis can be challenging. Schizoaffective disorder is one of the most frequently misdiagnosed psychiatric disorders in clinical practice and is often misidentified as schizophrenia or bipolar disorder.

How is bipolar schizoaffective disorder diagnosed?

There are two steps to diagnosing bipolar schizoaffective disorder. The first one is a medical evaluation to rule out any other physical or neurological condition that might be causing the symptoms. The other focuses on the diagnostic criteria of the disorder.

According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR), for a person to be diagnosed with schizoaffective disorder bipolar type, he or she needs to meet the following criteria.

• The person must have an uninterrupted period of illness during which he or she experiences a major manic or depressive episode, in addition to two or more of the following symptoms of schizophrenia: delusions, hallucinations, disorganized or incoherent speech, extremely disordered or catatonic behavior, and negative symptoms such as decreased emotional expression, apathy, lack of motivation, or an inability to plan or carry out goal-oriented activities.
• At some point during the duration of his or her illness, the person must have had psychotic symptoms such as hallucinations and delusions that lasted two weeks or longer without any accompanying manic or depressive episodes.
• The person must exhibit major episodes of bipolar mania or depression for most of the duration of his or her illness.
• Symptoms are not the result of substance misuse, medications, or some other underlying medical condition.

What causes schizoaffective disorder?

To date, researchers have not been able to pinpoint an exact cause for schizoaffective disorder. However, certain conditions can increase a person’s risk of getting it, such as a family history of bipolar disorder, schizophrenia, or schizoaffective disorder; abnormalities in brain structure; a chemical imbalance in the brain; substance abuse; and environmental factors such as highly stressful situations.

Can it be treated?

There is no cure for schizoaffective disorder, but symptoms can be managed and a person affected by it can learn to live an independent and productive life by following a consistent treatment plan.

Typically, schizoaffective disorder is treated with a combination of antipsychotic, antidepressant, or mood-stabilizing drugs, and psychotherapy. Medications can provide a good measure of symptom relief, but the most effective treatment includes therapy, as well.

The goal of therapy is to educate the person about his or her disorder, help reduce symptoms, improve cognitive functioning, and normalize their thought processes.

Cognitive behavioral therapy (CBT), for instance, helps the person understand the connection between thoughts, feelings, and behavior; how to become aware of dysfunctional thoughts that are having a negative impact and reframe them with more realistic ones; how to recognize and address triggers that might worsen their symptoms; and equip them with coping techniques for managing stress.

Other forms of individual therapy include skills training, focus on managing daily activities, developing social skills, and job training. Group therapy and support groups help provide a sense of shared experiences among participants by connecting them with others who are facing similar challenges.

Navigating life with bipolar schizoaffective disorder may feel overwhelming, but you don’t have to travel this path alone.

If you have questions about this article on bipolar schizophrenia versus schizoaffective disorder or would like to set up a risk-free appointment to meet with one of the faith-based counselors in our online directory to discuss how we can help you manage the challenges you are facing and walk you through the healing process, please don’t hesitate to give us a call.