What does a schizoaffective episode look like?

Schizoaffective disorder is a mental health disorder characterized by a combination of psychotic and mood disorder symptoms.

A diagnosis of schizoaffective disorder necessitates repeated mood episodes alongside at least two weeks of schizophrenia’s Criterion A symptoms as defined by the DSM-V. ^[1]

While the age of onset and genetic risk closely resemble that of schizophrenia, the long-term prospects of people with schizoaffective disorder tend to be more favorable. ^[1]

However, there may be a lack of understanding about schizoaffective disorder among wider society, which can feel isolating and frustrating for sufferers, especially when they undergo a schizoaffective episode.

What happens during a schizoaffective episode?

A schizoaffective episode refers happens when an individual with schizoaffective disorder experiences a combination of symptoms related to both schizophrenia and a mood disorder (such as major depressive disorder or bipolar disorder).

During a schizoaffective episode, the individual may exhibit both psychotic and mood disorder symptoms. These episodes can vary in intensity, duration, and symptomology, but generally involve a significant disruption in the person’s thoughts, emotions, behavior, and overall functioning.

For example, a 2021 study explored the case of a 50-year-old female who had a history of hallucinations, delusional thinking, disorganized behavior, and incoherent speech. ^[2] Below are some examples of the hallucinations and delusional thinking patterns she was suffering from.

When asked why she was in the hospital, she claimed she found three homeless people in one of her beach homes, going on to allege that these people attacked her. ^[2] She went on to claim that she was 10 years old, a celebrity and her father was the president of the USA. ^[2] Her disorganized thoughts, behaviors, and impaired speech lasted for over a month. ^[2]

Alongside these psychotic symptoms, she experienced mood episodes for much of her illness. This led to her initially being diagnosed with bipolar disorder. However, upon further assessment it became clear she displayed both psychotic and mood symptoms that met the criteria for a diagnosis of schizoaffective disorder.

Overview of the symptoms of a schizoaffective disorder

Below is a more detailed discussion of the different symptoms displayed in schizoaffective disorder. The symptoms are split into two categories: psychotic symptoms and mood disorder symptoms.

Psychotic symptoms:

• Hallucinations: The person may perceive things that aren’t there, such as hearing voices, seeing things that others don’t, or experiencing tactile sensations without external stimuli.
• Delusions: False beliefs that are firmly held, often related to grandiosity, persecution, or reference to oneself. The individual may think they have special powers or abilities, or that they are being targeted or controlled by external forces.
• Disorganized thinking and speech: The person may exhibit incoherent or tangential speech, difficulty organizing thoughts, or jumping between unrelated topics.
• Disorganized behavior: There might be unusual or unpredictable behaviors, including social withdrawal, agitation, or catatonia (immobility and unresponsiveness).

Mood disorder symptoms:

• Manic or hypomanic symptoms (in bipolar type): Periods of elevated mood, increased energy, decreased need for sleep, inflated self-esteem, racing thoughts, impulsivity, and engaging in high-risk activities.
• Depressive symptoms: The individual may experience prolonged bouts sadness, loss of interest in previously enjoyed activities, changes in appetite and sleep patterns, low energy, feelings of worthlessness, or suicidal thoughts.

These symptoms can vary from person to person, as individuals experience schizoaffective episodes differently.

It is important to note that during a schizoaffective episode, a person’s ability to carry out daily activities, maintain relationships, and fulfil responsibilities may be significantly compromised.

An affected person’s work and social lives can be adversely impacted, with their relationships in all areas of life suffering as a result. It is worthwhile for individuals, in conjunction with loved ones, to seek counsel from trained mental health professionals to receive the best care possible.