A Conversation About Schizoaffective Disorder


Often times when looking at mental health, we look to understand the disorders and not the impact on daily life. As a college student, you are exposed to high-stress environments and people from all walks of life. In addition to working towards excellent grades, graduation, grad school, or a place in the work field, our own mental wellbeing can sometimes take the backseat.

Schizoaffective disorder is a chronic mental health condition characterized primarily by symptoms of schizophrenia, such as hallucinations or delusions, and symptoms of a mood disorder, such as mania and depression. Many people with schizoaffective disorder are often incorrectly diagnosed at first with bipolar disorder or schizophrenia because it shares symptoms of multiple mental health conditions. Schizoaffective disorder is seen in about 0.3% of the population with men and women experiencing the disorder at the same rate, but men often develop the illness at an earlier age. 

Depending on the type of mood disorder diagnosed, depression or bipolar disorder, people will experience different symptoms:

  • Hallucinations: which are seeing or hearing things that are not there.
  • Delusions: which are false, fixed beliefs that are held regardless of contradictory evidence.
  • Disorganized thinking. A person may switch very quickly from one topic to another or provide answers that are completely unrelated.
  • Depressed mood. If a person has been diagnosed with schizoaffective disorder depressive type they will experience feelings of sadness, emptiness, feelings of worthlessness or other symptoms of depression.
  • Manic behavior. If a person has been diagnosed with schizoaffective disorder: bipolar type they will experience feelings of euphoria, racing thoughts, increased risky behavior and other symptoms of mania.

In attempting to understand the way schizoaffective can impact an individual daily and the impact it has on the college career of a student, we sat down with a current college senior to hear their experiences with the disorder:

When did you get your diagnosis?

“I got my diagnosis last year in October of 2016, I started exhibiting symptoms when I was a sophomore in college, so Fall of 2014. I was first diagnosed with Bipolar, and then they bumped it to Schizoaffective.”

Symptoms for which diagnosis?

“I was experiencing symptoms for both [Bipolar and Schizoaffective] because they came in at the same time. That was when I had the most stress I’ve had throughout college, and I didn’t pay any attention to it; I just kept going with it. It wasn’t until the end of junior year that I had to get hospitalized.”

Were you hospitalized for your symptoms?

“I was hospitalized for my symptoms, because of the visual and auditory hallucinations. The auditory hallucinations were basically telling me what to do and it got to a point where they were telling me to do just crazy things–anything; and attack people, attack family or even attack myself. My parents could tell something was off, and that’s when they decided, basically had, to get me treated…I was just acting really strangely, and I started acting more like my cousin who was diagnosed with schizophrenia, so they were used to seeing that kind of thing, so they knew that they needed to take action”

Did you have any of the bipolar symptoms?

“The bipolar is part of the schizoaffective, I exhibit the schizophrenic symptoms even without the bipolar symptoms during the off times of my manic and depressive states, but my schizophrenic symptoms become more rampant and pronounced when I’m in the middle of one of my manic or depressive states.”

How long was it between the time you started exhibiting these more intense symptoms to the time you were hospitalized?

“Probably a year, a year-and-a-half till I ended up getting hospitalized”

So when you said you were hospitalized, what did your parents do?

“They called the police and the police came and took me”

And then from there, they took you to?

“One of the LIJs (Long Island Jewish Medical Centers)…they have their own sort of program for college students so that’s where I was taken. I wasn’t taken to any of the really severe ones…they keep you there for a minimum of two weeks.”

What did they do during those two weeks?

“During the two weeks they basically assess you and monitor how you’re doing, but you’re not allowed to go on the internet, you’re not allowed to leave the hospital grounds or go outside; you’re basically stuck in your room for two weeks. It was just a hospital room…one of the ones I had to go to, one of the bad ones, that was like something you’d see out of a movie. It was basically me and a bunch of people [of different levels on the spectrum] so I had one person who was screaming constantly 24 hours a day, and one person just sleeping most of the time. That was in the city; I think I’ve gone to a total of 4 hospitals.”

During those two weeks you were in the hospital, had you taken time off from school? (Decided to take a semester off, etc.?)

“I didn’t take a semester off, that semester I basically just never went to classes. During that time where I was exhibiting symptoms I didn’t find the point in going to class or seeing people, because I felt threatened by people. So I didn’t show up to classes. I just gave my clickers to my friends and my friends would click in for me, or I would email my professors and come up with excuses.”

But you didn’t outright say what was going on?

“No.”

Why not?

“Because no one really knew at the time, during the stressful increase [in classes] that was also the year (Junior Year) I was exposed to the most people because I was TA (Teaching Assistant) and that was the year I was starting to exhibit more and more of my disconnection with people. But at the same time because I was a TA, I was becoming more paranoid around people [because of issues between the head of the department and I] which weren’t true, and I was spending most of my time paranoid of other people threatening me, so that made me even more paranoid because the head of the department never trusted me.”

So if this all happened at school, what did you tell extracurricular clubs/organizations you were involved with?

“I told  [one executive board] the symptoms I was exhibiting, but I told them last year- fall of 2016. I told them exactly what was happening, because I just kind of told them I needed a medical break but for the reason I just told them what was happening because at that point I started getting treated and becoming more and more stable. So even now, since I’m being treated I’m more stable than I have been.”

What kind of treatment are you on?

“So I take 20 mL of Latuda (Lurasidone). So my doctor has me on the lowest dosage of everything pretty much and 150 mG of an anti-depressant. The Latuda treats both the manic states of my bipolar, and it also treats the psychotic states of my schizophrenia and the anti-depressants treats the depressive states of the bipolar.”

Are you saying schizophrenia interchangeably with schizoaffective?

“Because schizoaffective is two things at once, you can’t just treat for the schizophrenia portion; you’ll still exhibit the manic and depressive states of schizoaffective states. The manic and the hallucinogenic states are treated with the anti-psychotics and the depressive states have to be treated with their own anti-depressants.”

So how do the manic and depressive phases come and go, how do you know which you’re in?

“So during the manic states what happens is it feels like your thoughts are racing at 100 mph, and you have a limitless amount of energy. You can’t even sleep because you can’t turn your thoughts off so they just run. You become very aggressive and you start to spend a lot of money. So for me, I get this feeling where I get this newfound passion that I have to work towards, and I try to spend as much money as I can just to get to that point. So one state I was like, “I have to become a businessman” so I spent thousands of dollars just to start up a business. Or even that I need to become a chef, just because it’s a new-found passion, I would be online trying to spend like $600 on a set of knives. But my parents were smart about it and made it so the credit cards were towards them and I wasn’t able to really spend that money. I would only be able to spend in smaller increments of a couple hundreds of dollars.”

What about the depressive states?

“The depressive states feel like the complete opposite where your thoughts feel like they’re moving at a centimeter an hour, and you feel like you have no energy whatsoever and your body aches because one of the points in depression is that you start to feel joint pains and physical pains. So I’ll get a lot of back pains and joint pains, so one of the summers I was here taking classes, that was during one of the worst times during my depressive states so I was sleeping on average 17 hours a day. I had gotten charged for plagiarism, which wasn’t true, but when that happened I slept for 36 hours straight. Because my escape is sleeping. So I felt like I couldn’t leave the house, like right now I feel normal like I feel kind of upbeat, I don’t really know what is normal anymore. Like I don’t know if me being normal is me being manic or me being depressive, I don’t know how to define it in regards to being normal.  There is less color to the world when you’re in your depressive state and more color to the worlds when you’re in your manic state, everything moves relative to speed.

What happens when you experience your schizoaffective episodes?

“Depending on what state I am in, I will still be experiencing hallucinations; so what happens is that I’ll become very distant from people and I’ll usually become a lot smarter than what I normally am, I’m not really sure how to describe it but my overall language advances but I’ll become very abrasive towards people. I’ll start to spend more of my time in solitude and I’ll spend most of the time with the voices in my head so for me I’ll have 3 different voices, but they’ll be three different versions of myself, but they all sound different.”

Different in what sense?

“So one I hear in a prophetic voice, which basically sounds like god’s message is being told towards you, and then there’s a very negative voice which is telling you how to harm people. And then you have the very intellectual driven person who’s telling me what to do to not fail. So even at the cost of sleep, I’ll be told to sacrifice sleep and stay awake doing work. But at the same time, I’ll also be seeing images, so I’ll be seeing flashes of images of people being killed or figures behind me. So a lot of the times I’ll see some shadow figure standing behind me and watching me other times I’ll see shadow figures in front of me. One time I was driving back from a party and I basically had a little girl sitting behind me in the back of the seat and she just kept tapping on the shoulder. And then One other time I saw a hand just extending over my dashboard, but a lot of the time it’s just violent images of like other people I know just being attacked or a lot of the times it’ll be a knife coming out of nowhere randomly.”

What happens when you have your hallucinations when you’re driving, or out and about?

“Normally when the hallucinations happen I just sort of freeze, like I’m stuck in that moment. When I am driving, a lot of the times I don’t even realize I’m driving, like I don’t even know how I get from point A to point B it just happens. But I become very disconnected from reality when it happens and I don’t know where I am.”

Is there any difference in the hallucinations when you’re in a manic versus depressive state?

“Not really, they’re pretty much the same. It just depends how I take them. So the way you analyze information depends on the way you’re feeling in the moment, so if I am feeling more manic then I interpret the things differently. Usually, when I am in my manic states, I become more prophetic, where I feel like I have to save humanity, but then in the depressive state that’s when I see more of the violent images and I feel more threatened by people. I even have writings from when I was going through m different states, and I showed it to my doctor and my doctor says it just kind of sounds like I’m ruminating where it sounds like a teenage becoming very philosophical and when I read then they sound a lot different, they sound completely different because of the narrative voice of sort of each. Some of them go from being very upbeat to very angry, to very down and abrasive.”

Do you remember writing them?

“I just remember starting; I don’t remember how I got there. All I know is that I felt the need to go and write. So whenever any one of those states would start or I would be in the middle of one of those states, I would just go straight and write and they would all be written in one document.”  

Did you handwrite them?

“Typed.  I handwrite some things when I was in writing class, but I don’t know what happened to those. During some of my states, I started hearing music in color, which was really cool for me. I also started reading in color. Like whenever I would read, so I would become very image oriented when I was in these states, whenever I would read it would feel as if I was watching a movie scene play out in front of me and a lot of the times the words themselves would change color depending on how I interpreted them. So the sadder sort of words would become very mellow yellow hue where the happier things were like a very bright blue.”

Does that happen regardless of whether you’re having hallucinations or not, or does that only happen when you’re having hallucinations?

“It happens when I’m in my manic states when I’m not in my manic or depressive states I’m basically like 1/10th of what I am [if I am in one of those states]. It’s weird because people talk about how when they’re having their episodes they lose all sense of being able to do any academics but for me it’s the opposite. When I am in those states is when I can really do any sort of academic work.”

So how has it affected you in your ability to do schoolwork?

“I really can’t do work nowadays because I get tired a lot quicker, my body just feels like its 60 years old, but also at the same time I can’t really go out; like if I need to go to classes or interact with people I can’t, even though I know there’s nothing wrong with interacting with people it just sort of the post-effects of it just stuck with me and I’m not able to really trust people to work with them.”

 

References

N. (n.d.). Schizoaffective Disorder. Retrieved from http://www.nami.org/Learn-More/Mental-Health-Conditions/Schizoaffective-Disorder

 

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