What Are the Symptoms of Schizoaffective Disorder?

Schizoaffective disorder is a lifelong mental health condition characterized by a combination of symptoms of psychosis and symptoms of mood disorders.

Symptoms of psychosis include hallucinations and delusions, while mood disorder symptoms include mania and depression.

In other words, schizoaffective disorder presents as depression or bipolar disorder layered on schizophrenia symptoms.

The Diagnostic and Statistical Manual of Mental Disorders (5th ed.) establishes the criteria for diagnosing schizoaffective disorder.

This reference book for mental health professionals states that to receive a diagnosis of schizoaffective disorder, you must meet the primary criteria for schizophrenia and also have symptoms of a mood disorder.

Criteria for schizophrenia must be met in every case, even if temporarily. For this, two or more of the following symptoms must be present for an uninterrupted period of time:

1. delusions
2. disorganized speech
3. hallucinations
4. disorganized or catatonic behavior
5. negative symptoms (e.g., loss of pleasure, flat expressions, lack of motivation)

But that’s not all. These criteria must also be evident for a doctor to diagnose schizoaffective disorder:

1. having hallucinations or delusions without mood symptoms for a period of 2 or more consecutive weeks
2. experiencing a major mood episode like depression or mania
3. having mood symptoms that are present for most of the duration of the condition
4. having symptoms that are not explained by substance use, like drugs or alcohol consumption

In sum, schizoaffective disorder affects your mood, thoughts, and behavior.

Your symptoms and the duration of the episodes may vary. Sometimes, you might not have any dominant symptoms between episodes.

You might also experience recurring episodes of mania or depression with or without hallucinations or delusions.

Just as there is more than one type of mood disorder, there are also different subtypes of schizoaffective disorder.

Each type presents with different symptoms.

Schizoaffective disorder bipolar type

Bipolar type is diagnosed when symptoms of schizophrenia overlap with symptoms of bipolar disorder, specifically manic episodes.

If you have this type of schizoaffective disorder, you may experience symptoms such as:

• agitation and distraction
• major depressive episodes
• disorganized thinking
• episodes of mania — feeling overly energetic or excited
• inflated self-esteem or grandiosity
• racing thoughts
• restlessness
• low impulse control

Schizoaffective disorder depressive type

Depressive type is diagnosed only if you mostly experience symptoms of major depression together with symptoms of schizophrenia.

Symptoms of depressive type include:

• change in appetite and weight
• major depressive episodes
• disinterest in everyday activities
• fatigue
• feelings of worthlessness or helplessness
• indecisiveness
• recurrent thoughts of self-harm or suicide
• sleeping too little or too much

Mood disorders like depression and bipolar disorder mainly affect your emotional expression and regulation. In other words, they’re affective disorders or conditions that impact how you feel.

On the other hand, schizophrenia primarily affects your cognition. In other words, the way you think and behave.

With schizoaffective disorder, you experience a combination of symptoms that affect both your emotions and your thinking abilities.

Some people mistakenly think schizophrenia and schizoaffective disorder are the same condition. People with schizophrenia, however, do not experience predominant mood episodes. That’s the main difference.

In the psychiatric community, some experts also believe schizoaffective disorder should be considered a subtype of schizophrenia instead of a stand-alone psychotic disorder.

This is because when you look at the dominant symptoms, schizoaffective disorder may resemble schizophrenia more than it does depressive or bipolar disorders.

In fact, a set criterion to receive this diagnosis is that you must have two or more symptoms of psychosis, which are typical of schizophrenia.

The DSM-5 considers schizoaffective disorder a stand-alone diagnosis, although it appears in the chapter on schizophrenia spectrum and other psychotic disorders.

You can manage symptoms of schizoaffective disorder through long-term treatment that typically involves a combination of medication and therapy.

Symptoms of psychosis, however, often require immediate medical intervention.

If you have schizoaffective disorder, it’s important to seek immediate help if you are experiencing any of the following:

• depression with feelings of hopelessness or helplessness
• inability to control your impulses, which might lead you to engage in behavior that puts your safety or that of someone else in jeopardy
• difficulty caring for your personal needs or the needs of those under your care
• hallucinations
• thoughts of suicide or harming yourself or others

The symptoms of schizoaffective disorder are longstanding and may impact the way you see yourself and the world.

These symptoms can be managed, however. It’s possible to live a functional life with schizoaffective disorder.

You might want to consider these resources when reaching out for support:

• American Psychiatric Association’s Find a Psychiatrist tool
• American Psychological Association’s Find a Psychologist tool
• National Alliance on Mental Illness Helplines and Support Tools
• National Institute of Mental Health’s Helpline Directory
• Early Assessment and Support Alliance (EASA)
• Prodrome and Early Psychosis Program Network (PEPPNET)
• The Schizophrenia and Psychosis Action Alliance
• Inclusive Therapists