Schizoaffective disorder

Explains what schizoaffective disorder is, including its symptoms and causes. Gives advice on how you can help yourself and what types of treatment and support are available, as well as guidance for friends and family.

Your stories

Self care for schizoaffective disorder

Claudia shares what living with schizoaffective disorder is like, and explains her self-help techniques.

Claudia
Posted on 20/05/2019

Schizoaffective disorder and Me

Charlotte talks about her journey with Schizoaffective disorder from when she was 14 years old.


Posted on 24/05/2017

My experience with psychosis

James' psychosis was the scariest period of his life, but with the right support he's living a happier life

James
Posted on 03/08/2018

What treatments are available?

Everyone is different and people's experience of schizoaffective disorder will vary from person to person, as will the treatments that work best for them.

On this page you can find information on:

These are taken from the National Institute for Health and Care Excellence (NICE) guidelines on the treatment of schizophrenia, which also covers schizoaffective disorder.

Talking therapies

You may be offered some form of counselling or psychotherapy, also known as talking therapies. There are many different types of talking therapy, each with a different approach, but they all aim to:

  • give you a safe time and place to talk to someone who won't judge you
  • help you make sense of things and understand yourself better
  • help you resolve complicated feelings, or find ways to live with them
  • help you recognise unhelpful patterns in the way you think or act, and find ways to change them (if you want to).

With all types of counselling or psychotherapy, the most important thing is the quality of the relationship you develop with your therapist. Therapy is far more likely to be successful if you find your therapist supportive and helpful.

The main types of talking therapy suggested by NICE in the treatment of schizoaffective disorder are:

  • Cognitive behaviour therapy (CBT) – this helps to identify and change any negative thoughts or behaviour that may be causing your difficulties.
  • Mindfulness-based cognitive therapy (MBCT) – this is an approach to wellbeing that involves accepting and paying attention to the present moment. It includes taking time to see what is happening around you in a non-judgemental way, rather than going over your problems again and again. Mindfulness-based cognitive therapy is usually done in groups.

Some research suggests that schizoaffective disorder is caused by trauma at a young age, so it may also be worth exploring the option of psychodynamic therapy in talking about deep-rooted or unconscious thoughts.

Talking therapies should be available free from your GP or mental health team, and you have the right to ask for them. However, there is usually a waiting list, and the length of these can vary significantly depending on which area you live in. You may also be able to find a service from a local Mind.

If you wish to seek help privately, you can find details of local therapists from the British Association for Counselling and Psychotherapy (BACP) or the British Association for Behavioural & Cognitive Psychotherapies (BABCP).

For more information see our pages on talking therapies.

I have found talking therapies to be really helpful, and a way to learn how to cope with stressful events and look after myself better.

Medication

If you are first diagnosed during a psychotic episode, you are likely to be offered medication.

You may be prescribed:

  • an antipsychotic, such as olanzapine or quetiapine, to treat the psychotic symptoms
  • mood stabiliser, such as lithium or valproate – especially if you have manic episodes rather than depression; or lamotrigine, which is licensed for depression in bipolar disorder
  • an antidepressant, which should be used cautiously because in people with schizoaffective disorder there is a risk that they may cause you to have a manic episode, or to switch between mania and depression (sometimes called 'rapid cycling’).

Some antipsychotics are licensed to treat mania as well as psychosis, so it may be that one drug might be adequate, depending on your symptoms. But it is quite likely that you will end up taking a combination of drugs to treat the mixture of symptoms involved in schizoaffective disorder.

For more information see our pages on medication, antipsychotics, lithium and other mood stabilisers and antidepressants.

You can watch Laura, Joe, Ziaul and Steve talking about their experience of taking antipsychotics in this video:

Medication really helps some people but isn’t right for others. Before deciding to take any drug, it's important to make sure you have all the facts you need to make an informed choice.

See our pages on things to consider before taking medication and your right to refuse medication for more information. Our pages on coming off medication give guidance on how to come off medication safely.

I think medicine can help with short term psychotic issues, but the underlying issues and depression side of things has been better dealt with through therapy and lifestyle changes.

Physical health checks

Medication (especially antipsychotics) can have an impact on your physical health so you should receive regular check-ups from your GP on your weight, blood pressure, blood sugar levels, cholesterol and heart function.

Smoking is also known to affect the type of side-effects you may get from medication, so support to stop smoking may be offered where appropriate.

 

Arts therapies

Art, music, dance or drama therapies may help you to express how you are feeling, especially if it is difficult to talk about things.

They can also help you come to terms with traumatic events that you may have experienced in the past and which may be contributing to your psychotic experiences.

As with all treatments, different things work for different people at different times in their lives, and it's not easy to predict which type of therapy you might find useful or effective.

Some people tell us that they have been able to reach a place of balance or recovery through non-medication based approaches such as arts therapies, while other people find that ongoing medication is needed to help manage their symptoms - there is no one approach and different treatments and forms of support work for different people.

For further information see our pages on arts and creative therapies.

Family intervention

This is a form of treatment that aims to provide support for the whole household. It can help your family, or the people you live with, to understand:

  • what you are going through
  • how their responses may help or make matters worse for each other as well as for you
  • what is helpful and unhelpful for you.

For example, if you are unwell and your family members are very worried about you, they may unintentionally focus too much attention on you, making you feel more distressed.

It can help you:

  • understand how your experience and symptoms affect those living with you
  • treat existing problems
  • work on strategies to prevent problems from coming back.

For more information see the South London and Maudsley NHS Foundation Trust's information leaflet on family intervention in psychosis and ask your community mental health team or psychiatrist to refer you.

If you are a friend or family member of someone with schizoaffective disorder, see our page on how friends and family can help.

Therapeutic communities

Therapeutic communities provide a supportive, live-in environment for people with mental health problems. They usually hold regular meetings with all residents.

You may benefit from the insights that others with similar problems can offer, and learn to live successfully in a group. The length of stay is usually limited to a set period of time.

If you are interested in being referred to a therapeutic community, talk to your community mental health team or psychiatrist.

Listen to Clarissa's story in this podcast about living in a therapeutic community.

I was part of the community for 18 months which was both unbelievably helpful, and incredibly hard work. The support I received from other patients was amazing and has provided me with wonderful friendships. 


This information was published in May 2019. We will revise it in 2022.


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