Schizoaffective Disorder: Depression and Elevation

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  • 0:07 Schizoaffective Disorder
  • 1:37 Diagnosis and Treatment
  • 4:27 Comorbidity
  • 5:59 Lesson Summary
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Lesson Transcript
Instructor: Natalie Boyd

Natalie is a teacher and holds an MA in English Education and is in progress on her PhD in psychology.

What is schizoaffective disorder, and how is it like the color purple? In this lesson, we'll look at the symptoms, diagnosis, and controversy surrounding schizoaffective disorder.

Schizoaffective Disorder

Imagine that you are a psychologist. Chris comes into your office and complains that he thinks something's wrong. He's been experiencing mood swings. For several weeks, he feels like he's on top of the world, and his thoughts race. He has so much energy that he barely has to sleep and he can't sit still.

But then, everything changes. He feels completely deflated and has no energy at all. He spends days at a time in bed and isn't interested in any of the things that he normally likes to do.

At first, Chris' symptoms seem to fit the pattern of a mood disorder called bipolar disorder. But then, as Chris talks, you realize that there's something else going on. He hears voices that aren't there, and he believes that the people he works with are trying to get him fired. These hallucinations of voices and delusions that his coworkers are out to get him are not common in bipolar disorder. Instead, they are common symptoms of schizophrenia, a psychotic disorder.

What gives? What's wrong with Chris? Schizoaffective disorder is a mental illness that is a combination of a mood disorder, like bipolar disorder and schizophrenia.

Think about the color purple for a minute. Any kid can tell you that purple is a mixture of blue and red. Schizoaffective disorder is kind of like that; it mixes two kinds of mental illness: mood disorders and schizophrenia. Mood disorders are mental disorders that are characterized by abnormal feelings, such as depression. Schizophrenia is a psychotic disorder that involves a break from reality.

Diagnosis and Treatment

Let's get back to Chris. He's in your office, complaining of symptoms that are similar to a mood disorder and symptoms that are similar to schizophrenia. That sure sounds like schizoaffective disorder. But how do you know for sure if he's got it?

To diagnose patients with any type of mental disorder, psychologists turn to a book called the Diagnostic and Statistical Manual for Mental Disorders, or the DSM for short. Each disorder in the DSM comes with a list of symptoms, or criteria, for diagnosing a patient with that disorder.

So you open up your DSM and turn to schizoaffective disorder. Let's check Chris' symptoms against the list in the DSM'.

  1. A continuous period of time with both symptoms of a mood disorder and schizophrenia - As you talk to Chris, he tells you that he's been feeling this way for several months without a break, so he fits this criterion.
  2. At least two weeks of hallucinations and delusions - Chris has had his hallucinations and delusions for over a month, so he fits this criterion, too.
  3. Mood disorder symptoms are present both when there are hallucinations and delusions and when there aren't any hallucinations and delusions - Chris is still having his hallucinations and delusions, so he fits the first part of this criterion. If his hallucinations and delusions stop, you would expect his mood swings to continue.
  4. There is no drug-related or other medical condition that might explain the symptoms - Chris is healthy and doesn't use drugs, other than a beer every once in a while, so he meets this criterion.

Because we can check off all four of these, you can diagnose Chris with schizoaffective disorder.

When you read a little further down in the DSM, though, you realize that there are actually two types of schizoaffective disorder: bipolar type and depressive type. Bipolar type schizoaffective disorder includes mood swings and symptoms of bipolar disorder, whereas depressive type schizoaffective disorder only includes a major depressive episode.

Chris has experienced a depressive episode when he had very little energy and no interest in the things around him. But he also experienced the flipside of that, a manic episode where he was very energized and had racing thoughts and lots of energy. Together, those are symptoms of bipolar disorder, so we can conclude that Chris has bipolar type schizoaffective disorder.

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