Schizoaffective Disorder Bipolar Type: Symptoms & Treatment

Instructor: Laura Gray

Laura has taught at the secondary and tertiary levels for 20+ years and has a Ph.D. in Instructional Design for Online Learning.

In this lesson, we will discuss the symptoms of schizoaffective disorder bipolar type, what makes it different from the depressive type, and what treatment options exist for this disorder.


Looking at the title, you probably thought this was going to be a lesson on schizophrenia. Nope. Not at all. In this lesson, we are talking about a cousin of schizophrenia: schizoaffective disorder, specifically the bipolar type (also known as SDBT). Imagine not only feeling the extreme ups and downs that someone with bipolar disorder experiences, but also having false beliefs that seem really, really real and feeling like the whole world wants to see you fail! That's what life is like for someone with this illness.

People diagnosed with schizoaffective disorder bipolar type experience many symptoms of schizophrenia (the false beliefs and feelings we mentioned above), which is a thought disorder characterized by delusions and hallucinations, as well as symptoms of bipolar disorder (the abnormal ups and downs mentioned above), which is a mood disorder that often involves periods of extreme depression followed by periods of extreme activity and energy. Because it is a unique combination of two distinct conditions, SDBT is not nearly as well understood as many other mental illnesses. It's also complicated because everyone experiences SDBT differently.

There are actually two types of schizoaffective disorder: bipolar type and depressive type. What differentiates the two is the presence or absence of mania, an extremely elated mood, increase in energy, and behaviors that are not typical, such as extreme spending or reckless behavior. If someone has all of the symptoms listed below but has never experienced a period of mania, that person would be diagnosed with schizoaffective disorder depressive type. If someone has the symptoms below plus has had at least one manic episode, that person would be classified as the bipolar type. It is possible for someone who is initially diagnosed with the depressive type to have a manic episode (even after years and years of no signs of mania) and be re-diagnosed with SDBT. Sound confusing? If it does, you're not alone. SDBT really can be mind-boggling.

Symptoms of SDBT

For a person to be diagnosed with schizoaffective disorder bipolar type, the following symptoms may be present:

1. Delusions, or false beliefs that just don't go away. For example, if your friend, Doug, is a superstar at work but he really and truly believes that his boss wants to fire him, that could be a delusion.

2. Hallucinations, such as hearing voices or seeing things that aren't really there. For example, Doug might hear voices coming through the air conditioning vents or the TV signal.

3. Periods of extreme depression. This goes beyond just feeling sad or down, to the point that Doug might stay in bed for days and lose interest in things he used to love, like football or hanging out with friends.

4. Periods of mania. Mania can be different for different people, but Doug's version of mania might include sleeping only an hour or two a night and cashing out his life's savings and blowing it all at the casino.

5. Difficulties on the job and/or with social functioning. In this case, Doug's delusions about his boss might keep him from getting along with others at work, and he might begin to feel suspicious about them, too.

6. Problems with physical appearance or cleanliness. For example, Doug might not shower for days and he might wear the same shirt (without washing it) for a full week.

7. Paranoia, which is a feeling that others want to do harm to you or want to see you fail. This could be part of Doug's delusions about his boss, and the paranoid feelings may also extend to his co-workers.

Of course, there may be other symptoms as well, but these are the most common.

Treating SDBT

SDBT can be relatively difficult to treat because the doctor must, essentially, treat two problems instead of one. Most commonly, patients with SDBT are given a mood stabilizer, which is a drug that helps to prevent extreme highs and lows, as well as an antipsychotic, which helps to control delusions, hallucinations, and paranoia. In some cases, an antidepressant, which helps treat depression, is also prescribed. Treatment can be really complicated, because there are symptoms of both a thought disorder and a mood disorder to treat, so the doctor who is prescribing the medication (most often a psychiatrist) must be sure that both the symptoms of schizophrenia and the symptoms of bipolar disorder are being addressed.

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