Tuesday, May 9, 2017

Living With Mental Illness in America: Schizoaffective Disorder

"I grew up stuck between two dramatically different factions in my head. When I was in a Manic State, I was accompanied by a trio of friends, an old man, a large dog, and a small girl whose efforts helped me to remain positive. When I was in a Depressive State, I was stuck in the middle of a war for my mind. Angels and demons battled it out, right before my vary eyes, in their effort to take over my reality. The chaos was unbearable, and there was no middle ground." - Kent Allen Halliburton

Schizoaffective Disorder is a mental disorder characterized by abnormal thought processes and deregulated emotions. The diagnosis is made when the patient has features of both Schizophrenia and a mood disorder, either Bi-Polar Disorder or Major Depression, but does not strictly meet diagnostic criteria for either alone. The Bi-Polar type is distinguished by symptoms of mania, hypomania, or mixed episodes; the Major Depression type by symptoms of severe depression only. Common symptoms of the disorder include hallucinations, paranoid delusions, and disorganized speech and thinking. The onset of symptoms usually begins in young adulthood, currently with an uncertain lifetime prevalence because the disorder's diagnosis has been refined over time. It is generally estimated that the disorder is prevalent in at least one percent of the population, and now includes an acceptance that symptoms can appear in pre-teens, as well. Diagnoses are based on observed behavior and the patient's reported experiences.

Genetics, neurobiology, early and current environment, behavioral, social, and experiential components appear to be important contributory factors to the onset of the disorder. Some recreational and prescription drugs may also cause or exacerbate certain emerging symptoms. No single isolated organic cause for the disorder has been found, but extensive evidence exists for abnormalities in the metabolism of neuro-transmitters like tetrahydrobiopterin, dopamine, and glutamic acid in people with Schizophrenia, Schizoaffective Disorder, and other psychotic mood disorders. People with Schizoaffective Disorder are likely to have co-occurring conditions which may include a variety of anxiety disorders and Substance Use Disorder. Social problems such as long-term unemployment, poverty, and homelessness are also common. The average life expectancy of people with the disorder is shorter than those without it due to increased physical health problems from an absence of health promoting behaviors, which may include a sedentary lifestyle, poor eating habits, and a higher suicide rate.

Schizoaffective Disorder is presently treated with a combination of Anti-Psychotic drugs, Mood Stabilizers, and Anti-Depressants, though there is growing concern by some researchers that Anti-Depressants may increase psychoses, mania, and long-term mood episode cycling in the disorder. When there is a risk to self or others, usually early in treatment, brief hospitalization may be necessary. Psychiatric rehabilitation, psychotherapy, and vocational rehabilitation are very important for recovery of higher Psycho-Social function. As a group, people with Schizoaffective Disorder tend to have a better outcome after treatment that do people with Schizophrenia. However, they do have variable individual Psycho-Social functional outcomes compared to people with other varied mood disorders, from worse to the same. There are studies comparing these diagnoses, but they have yet to be completed.

In the past Schizoaffective Disorder and Schizophrenia were not usually classified separately from one another in psychological studies. This, however, has begun to change. The definition of Schizoaffective Disorder began to change in the early to mid 1990s. The research conducted since this period is what has made it clear that there is, in fact, a difference between the two disorders. It is the fact that the hallucinations, paranoid delusions, and disorganized speech and thinking in Schizoaffective Disorder are accompanied by varied signs of Bi-Polar Disorder and Major Depression that make this distinction.

"It was not until just a few years ago that I began to get treatment for my disorder, and I am now finally approaching a sense of balance amidst the chaos. Unfortunately, that balance has come at a cost. See, while I was glad to see the angels and demons of my Depressive State go, I now feel a deep pain as I realize that my Manic friends have to go also as, over the years, I have developed a deep affection for them." - Kent Allen Halliburton

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