The National Institute for Health and Care Excellence (NICE) guidelines on the treatment of schizophrenia also cover schizoaffective disorder. They suggest that:
When deciding what treatment you should be offered, your doctors should discuss all the options with you – including their possible benefits and harms. Your views and preferences should always be taken into account when making decisions about your treatment.
You may be offered some form of counselling or psychotherapy. There are many different types, which each varying slightly in their approach. With all of them, the most important thing is the quality of the relationship you develop with your therapist. The treatment is far more likely to be successful if you find your therapist supportive and helpful.
The main types of talking treatment suggested by NICE 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 life 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.
Talking treatments should be available free from your GP or mental health team, and you have the right to ask for them. However, there may be a waiting list.
If you wish to seek help privately, you can find details of local therapists from the BABCP or BACP (see Useful Contacts). You may also be able to find a service from a local Mind.
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.
This is the treatment you are mostly likely to be offered first – especially if you are first diagnosed during a psychotic episode.
You may be prescribed:
- an antipsychotic, such as olanzapine or quetiapine, to treat the psychotic symptoms
- a 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 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.
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
As your physical health may be affected by medication (especially antipsychotics) you should receive regular check-ups from your GP on your weight, blood pressure, blood sugar levels, cholesterol and heart function.
Art, music and dance therapies may help you to express how you are feeling, especially if you are having difficulty talking about things.
Drama therapy may help you come to terms with traumatic events that you may have experienced in the past and which may contribute to your psychotic experiences.
Some people have been able to make a complete recovery through such therapies.
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
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 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. Further information about family intervention is available here. Further advice for friends and family members can be found here.
This information was published in July 2016. We will revise it in 2019.