A Diagnosis in Between Bipolar and Schizophrenia: Schizoaffective Disorder
Schizoaffective disorder is similar to schizophrenia to the extent that both conditions share similar symptoms, yet they are much more different with regards to their causes. Both disorders share the symptoms of psychosis or hallucinations, abnormal thinking, and mood issues. Schizoaffective disorder is a very difficult diagnosis and very similar to the condition of bipolar disorder with psychotic features. In fact both are treated the with the same medications, so the differences might only be semantic.
In some cases, schizoaffective disorder might resemble schizophrenia, and in other cases schizoaffective disorder might resemble bipolar disorder with psychotic features. Psychotic episodes, and mood swings would be the salient symptoms of schizoaffective disorder. Other symptoms of this disorder include lost of appetite and body weight, agitation, suicidal ideations. Individuals with schizophrenia tend to have a flat affect or are almost without emotion.
Symptoms to Demarcate Between Schizoaffective Disorder from Schizophrenia
Schizophrenia is typically a disorder characterized by psychosis, and another salient symptom whereby the individual believes that people are esoterically communicating to them by certain gestures. These symptoms are called ideas of reference and are a good indicator of schizophrenia. Often the individual is withdrawn, emotionally flat, and therefore doesn’t experience the depression or mood swings as one would with schizoaffective disorder; with the exception of the paranoia. Schizoaffective disorder would include the symptoms of schizophrenia with conspicuous mood swings between depression or mania, and often during a time period apart from the psychosis. The symptoms of this disorder can manifest in varying degrees and length of time which make it a difficult diagnosis between bipolar disorder or schizophrenia.
Treating Schizoaffective Disorder
Bipolar disorder with psychotic features, schizoaffective disorder, and schizophrenia are all difficult to diagnose and treat. Schizoaffective disorder can be mistaken for bipolar disorder with psychotic features or major depression with psychotic features. Again these differences might be moot and a matter of taxonomy or semantics because the treatment and prognoses are nearly identical. Schizoaffective disorder is probably the most difficult illness to diagnose and the criteria to assess the symptoms are not distinct. Often this illness is referred to as a “grab bag” diagnosis in that if someone cannot be conclusively diagnosed with schizophrenia or bipolar disorder, they are usually considered to have schizoaffective disorder ad hoc. The four diagnostic criteria are so close to schizophrenia or on the other end bipolar disorder; many psychiatrists tend to diagnose one or the other and avoid the diagnosis of schizoaffective disorder all together.
Both illnesses involve an imbalance in the neurotransmitters with the psychosis being caused by a plethora of dopamine in the system. The causes of the excess dopamine are the subject of research and most likely vary with each situation.These illnesses are often grounded in genetics and sometime triggered by environmental issues. Some studies have claimed to be able to prevent schizophrenia from manifesting, by having the individual avoid the environmental stresses that bring about this disease. This seems to beg the question in that since there are not yet any bio-markers, one would not know that they were suffering from the illness until it has manifested in which case, prevention is a not possible. With schizoaffective disorder, the sooner the diagnosis, the better the prognosis. The treatment for this disorder would involve the anti-psychotic medications, psychotherapy, and a mood stabilizer. The prognosis for schizoaffective disorder is somewhere in between bipolar disorder and schizophrenia, this will of course vary on the individual. Researchers are currently looking for bio-markers or genetic indicators so that these illnesses can be prevented or better treated as they are identified earlier or even prior to the disease manifesting. If someone is experiencing delusions or hallucinations with schizoaffective disorder or schizophrenia, medication is usually the best way to address these issues. Secondly if the patient can gain some insight and learn to distinguish between hallucinations vs reality, they can then learn to ignore the thoughts, auditory, olfactory, and visual hallucinations. Supposedly TCM Transcranial Magnetic Stimulation has had some success with the auditory hallucinations.