What’s the difference between schizophrenia, schizoaffective, and psychosis?
Psychosis is a symptom that is seen in many different disorders. Basically, it’s becoming disconnected from reality. The primary symptoms are hallucinations and delusions.
Excerpt from an earlier post:
Schizophrenia - severe psychotic disorder that causes alterations in perceptions, thought, and behavior.
Schizoaffective - basically schizophrenia AND a mood disorder (depressive / manic episodes) at the same time.
Can someone have depression, schizophrenia, and bipolar disorder at the same time? If so how would that work?
They can’t be diagnosed with all three of those disorders at the same time. They’re mutually exclusive.
Your character can’t be diagnosed with Major Depressive Disorder if they’ve ever had a full manic episode (which is required to diagnose bipolar I) or a full hypomanic episode (which is required to diagnose bipolar II). There’s also something known as a mixed episode, where a depressive / manic episode has elements of the other, but not enough to qualify for a full diagnosis.
There is a disorder that combines the symptoms of schizophrenia and major mood episodes - schizoaffective disorder.
Things get a little mushy when we’re talking about Bipolar I with psychotic features versus schizoaffective disorder.
The basic difference is that:
Schizoaffective disorder - at least two weeks of psychotic symptoms WITHOUT a mood episode
Bipolar I with psychotic features - only having psychotic symptoms DURING a mood episode, and having at least two weeks of a mood episode without psychotic symptoms.
Hope that helps!
Part of my character's arc is being shamed by overly religious parents for being possessed by a demon, when in actuality she's got a mental illness. My problem is that I actually don't know which one she would have? Her symptoms are that she has violent fits of manic energy, her personality changes drastically, she speaks in a different voice and sometimes begins to speak in Latin instead of English. I hope this isn't insensitive of me, but is there anything that fits this description?
This premise needs some work. If you want your character to have been mentally ill all along, you can’t work backwards from the demonic-like symptoms.
You’re going to need to come up with the disorder first, then figure out how the symptoms of said disorder could be misinterpreted as demonic possession. You’re also going to have to include symptoms that don’t fit with the stereotypical depiction you’ve described.
As a starting point, you might take a look at the following disorders:
However, as it is right now, your character does not meet the criteria for any of those disorders. You can’t slap one of those labels on your character and call it done.
You’ve got your work cut out for you, Anon, but I promise you, this will make for better representation and a better story.
Good luck!
There needs to be an continuous period of time where the character has a major mood episode (major depressive or manic) while meeting Criterion A of schizophrenia.
Let’s look at the other demystifying posts I’ve done to see exactly what that means.
In a two-week period, the character needs 5 or more of the following symptoms. These symptoms need to be different from how the character usually acts.
NOTE - for schizoaffective disorder, #1 is required!
These symptoms cause the character significant stress or make their life more difficult in some way.
It’s not because of another medical condition or substance. Make sure not to include symptoms that are clearly part of another medical condition (such as excessive sleepiness due to a sleep disorder).
There needs to be a distinct period of time where the character experiences at least one of the following moods most of the day, nearly every day, for at least a week:
The character also needs to be consistently energetic OR increase their level of goal-directed activity most of the day, nearly every day, for at least a week. Goal-directed activity means that the character frequently takes on ambitious new projects without necessarily thinking it through or completing previous projects first.
While the character is in this state, they have to show at least three of the following symptoms (4 if their mood is irritable), which have to be a significant change in behavior from how the character usually acts:
These symptoms cannot be the result of a drug (such as meth) or a medical condition.
The character needs to have two or more of the following for a significant amount of time in a 1 month period.
NOTE - At least one HAS to be 1, 2, or 3. These are known as the “active-phase symptoms.”
Phew. That’s a lot of symptoms. We’re not done yet, though! There are a few more requirements.
The character needs to experience 2 or more weeks of delusions or hallucinations WITHOUT being in a depressive or manic episode.
The manic or depressive symptoms need to be present the majority of the time that your character is having psychotic symptoms.
It can’t be because of a medication / drug or another medical condition.
how long does it take for a person to get diagnosed with the mental illness they have. I have a character who has Schizoaffective disorder, depression and extreme paranoia. How long would it take for him to be diagnosed by a doctor for his illnesses? He's been dealing with it for 10 years and hasn't gotten previous psychiatric help so he self medicates with pot.
That depends on the person doing the diagnosis. Some therapists will give a diagnosis after one session; other times, it may take years from when your character first seeks treatment to get an accurate diagnosis. This is true of medical diagnoses, too.
Note - Pot can actually trigger psychosis in people who are predisposed to developing schizophrenia. It’s not going to cause it on its own, but studies have shown that ~40% of people at extremely high risk for psychotic disorders developed their first psychotic symptoms when using pot. It can also cause a relapse in psychosis. [Source here]
It’s generally not a good way to self-medicate for psychotic disorders, is what I’m saying.
Schizophrenia - severe psychotic disorder that causes alterations in perceptions, thought, and behavior. This is the word you probably mean, as it’s the most commonly used.
Schizophreniform - a psychotic disorder that’s basically schizophrenia-lite. Not as many symptoms required, and you can’t have had it for more than 6 months.
Schizoaffective - basically schizophrenia AND a mood disorder (depressive / manic or hypomanic episodes) at the same time.
Schizotypal (Personality Disorder) - a personality disorder that involves difficulties with social interactions and odd & eccentric beliefs and behaviors.
Schizoid (Personality Disorder) - a personality disorder that involves being detached from and lacking a desire for social relationships.
None of these words mean having “split” or “multiple” personalities. That’s dissociative identity disorder.
Say if a character has both PTSD and schizophrenia, how would the two disorders interact? Would the trauma that they suffered be a constant part of their hallucinations?
Oooh, that’s an interesting question! It seems like the two disorders would absolutely feed off of each other, so to speak; the hypervigilance in PTSD could make paranoia so much worse, and yes, I think that flashbacks to the trauma could easily be interlaced with the hallucinations.
However, in order to get a diagnosis of schizophrenia, there has to be hallucinations or delusions unrelated to the trauma, and/or there needs to be evidence of or a full diagnosis of schizophrenia that predates the traumatic event and development of PTSD. Otherwise, the schizophrenia-like symptoms would likely be just rolled into the diagnosis of PTSD (unless they were incredibly severe).
Followers, does anyone have experience with both PTSD and psychosis?
I have ptsd and schizo affective disorder and yeah my trauma has been laced all through my delusions and psychosis. Like I would start to believe the trauma happened because of devine force and what not I guess hallucinations too, shit. Yeah they play off each other like hella.
Thank you for sharing your experiences.
hi how can i tell the difference between having depression with psychotic symptoms and having schizoaffective disorder? also can you possibly explain disorganized speech and thoughts? tysm
Basically, to be diagnosed with schizoaffective disorder, your character needs to have experienced psychotic symptoms for at least two weeks WITHOUT being depressed whatsoever. In depression with psychotic features, the character’s psychosis is confined to when they’re in a depressive episode.
