Managing Schizoaffective Disorder

Schizoaffective disorder can be difficult to diagnose and treat because its symptoms are a combination of other mental-health conditions. Although there is no cure, establishing an appropriate treatment plan can give you or your loved one the best chance at living a fulfilling life.

Knowing That In-Patient Treatment Is Important

Treating schizoaffective disorder can be difficult in the early stages of diagnosis, and it can be difficult to maintain stability throughout life. Some people with severe mental illness need frequent in-patient hospitalization and may not be able to live independently once they leave the hospital. Outpatient treatments can make it difficult to establish a treatment plan, and it is nearly impossible to ensure the patient is taking their medications and abstaining from alcohol or recreational drugs. There are several benefits to in-patient settings.

With schizoaffective disorder, having an affective disorder combined with delusions or hallucinations can put the person at an elevated risk of self-harm. They may be suicidal because of depression or because their delusions cause paranoia. Self-harm can also take the form of engaging in risky behaviors, such as indiscriminate sex, drug experimentation, or driving under the influence. With in-patient treatment, the risk of self-harm behaviors is drastically reduced. If the person is deemed suicidal, they may be placed in a special room with limited items to ensure they cannot harm themselves.

In-patient treatment also makes it easier to try different medications, make sure patients are taking their medication, and monitor side effects. Abruptly stopping treatment may be common in some people with schizoaffective disorder because of significant side effects. It is much easier to find a medication that may be equally effective with fewer side effects when the person can be monitored during treatment. Additional medications can be added that may counteract some of the side effects if they are severe or if the medication is successful in managing symptoms and the psychiatrist wants to avoid trying another medication that may not be effective.

Finding the Right Combination of Medications

Regardless of the treatment setting, finding an appropriate treatment for schizoaffective disorder can be difficult. Since the mental-health condition combines aspects of affective disorders and psychotic disorders, schizoaffective disorder is easier to misdiagnose as an affective disorder or schizophrenia alone. When a psychiatrist is unsure of the right diagnosis, trying an antipsychotic might be the best approach. Although there are few treatments approved for schizoaffective disorder, antipsychotic medications are typically used to treat schizophrenia, bipolar disorder, and treatment-resistant depression, potentially making it effective for schizoaffective disorder.

Antipsychotic medications such as Abilify and Geodon tend to have a lower side-effect profile than some antipsychotic medications and will give the psychiatrist the opportunity to determine whether there is any symptom improvement with an antipsychotic alone. Changes can be made based on the patient's response to an antipsychotic. If depression becomes more of an issue after antipsychotic therapy, an antidepressant may be added, with selective serotonin reuptake inhibitors (SSRI) being the preferred class of antidepressants. A higher dose of the current antipsychotic medication or a change to a different antipsychotic medication may be warranted if schizophrenia-like symptoms are still present. The incorporation of mood stabilizers such as lithium may be necessary if symptoms of bipolar disorder remain present.

Using Multiple Types of Therapy

Various types of therapy are important for managing schizoaffective disorder when combined with medication. Psychotherapy is used to help resolve or minimize problems that may contribute to affective disorders and deal with hallucinations or delusions. Some people with schizoaffective disorder may have poor functioning and could benefit from therapeutic environments that incorporate life-skills training or occupational training.

Although some people with schizoaffective disorder may never live independently, therapeutic environments can help with social skills and encourage them to participate in activities of daily living or household management if these activities have been neglected. It is important to remember a diagnosis of schizoaffective disorder does not mean there is no hope of living a fully independent and high-functioning life. Maintaining a medication regimen and engaging in other treatments have helped people with schizoaffective disorder regain their lives.

Schizoaffective disorder is less well known than its components, schizophrenia and affective disorders, making it easily and poorly understood. Fortunately there are medications and treatment approaches to mitigate symptoms and enjoy life.