Challenges of Schizoaffective Disorder and Relationships

About Schizoaffective Disorder 

Schizoaffective disorder is a clinical disorder on the schizophrenia spectrum. Schizo refers to the psychotic symptoms like schizophrenia. The affective refers to the dysregulated mood symptoms. Someone diagnosed with schizoaffective disorder is going to have either bipolar type, referring to the mania and impulsivity or depressed type, though the individual may have mixed episodes. (1)

Positive symptoms include the presence of thoughts, perceptions, and behaviors that are ordinarily absent in individuals without the diagnosis. These can include hallucinations, delusions, thinking disturbances or difficulty communicating reciprocally with others such as hyper verbalizations and racing from one topic to the next. (1)

Negative symptoms are the absence of thoughts, perceptions and behaviors that are ordinarily absent in individuals without the diagnosis. Symptoms can display a blunted affect, apathy – low motivation, anhedonia – difficulty feeling pleasure from usually enjoyable activities, poverty of speech or content of speech, and inattention. (1)

Schizoaffective disorder, bipolar type displays a general appearance of behaviors in excess. Euphoric or expansive mood problems may be present, you will see irritability, inflated self-esteem, or grandiosity, decreased need for sleep, hyper verbalizations, and presence of racing thoughts, easily distracted, goal-directed activities, and excessive involvement in pleasurable activities that may create risk. (1)

 Schizoaffective disorder, depressed type will display a low mood and behavioral inactivity. A depressed mood will be present most of the time. A person with depressed type will also experience diminished interest in usually pleasurable activities, change in appetite with weight gain or loss, sleep disruptions, fatigue, and loss of energy, feeling worthless, helpless or hopeless, inappropriate guilt, difficulties making decisions and difficulties concentrating, recurrent thoughts of death can be present or even suicidal thoughts. (1)

Schizoaffective Disorder and Relationships

Due to the positive and negative symptom displays with potential manic and/or depressive episodes, forming relationships can be challenging. Unpredictable moods, disordered thinking with delusions or a vivid hallucination, withdrawal, difficulty concentrating, easily overwhelmed, insecure, difficulties expressing and identifying emotions within themselves and within others reinforces disconnection with others in the workplace, in the family, and in romantic and social relationships. 

Relationships have the power to build confidence, uplift mood, give a sense of security, and keep activity level going when positive interactions are present. Though not even in everyday living is every moment positive. The reality is everyone experiences off days. Though a person with an untreated schizoaffective disorder having an off day can experience more barriers and challenges and can have relationships be triggering, push them to isolate and to withdraw from interactions more. 

Feeling reciprocally misunderstood perpetuates in relationships with schizoaffective disorder present. We need human communication; we are hard-wired to connect, disconnecting worsens symptoms. Brenè Brown, professor and researcher of shame, vulnerability, and leadership shares, “connection is the energy that exists between people when they feel seen, heard, and valued.” (3) Striving for connection improves our overall health and it begins with symptom identification and management. 

Treatment and Coping (2)

Schizoaffective disorder is treated and managed in several ways:

  • Medications, including mood stabilizers, antipsychotic medication, and antidepressants – it’s important to remain patient though consistent with medications. Once the most effective medication regimen for the individual is established, consistently taking the medications daily and at the same times will help stabilize symptoms and keep them from worsening. It’s equally important to keep regular visits with medication management so symptoms can continue to be monitored along with medication efficacy. It’s important to note that often symptoms increase with high levels of stress. 
  • Individual, group, and family psychotherapy such as cognitive behavioral therapy or family-focused therapy – professional assistance and guidance is recommended to navigate the relational growth for the individual diagnosed along with the loved ones so effective strategies can be practiced in connecting with one another and in healthy communication.
  • Self-management strategies and education – getting to know symptoms and their onset can help with being proactive with coping strategies.
  • Life skills training for social and vocational skills 
  • In some cases, inpatient hospitalization is necessary to stabilize schizoaffective disorder symptoms
  • For continued stabilization and skill streaming, residential schizoaffective disorder treatment is recommended.

Coping Skills 

  • Learn about the mood disorder symptoms
  • Pay attention to warning signs of a mental health condition
  • Join a support group for a mental health disorder
  • Avoid recreational drugs, tobacco, and alcohol as these can worsen symptoms and interfere with antipsychotics.