A Mind Taut with Pain

Schizoaffective disorder is a combination of a mood disorder (major depression or manic depression) and a thought disorder (schizophrenia) with at least two weeks in which only schizophrenia symptoms occur.

To get to know more about how schizoaffective disorder affects my life, you can check out my blog: A Sense of Schizophrenia

A mood disorder is an abnormal state of mood, much like saying cancer is a disorder of cells. Every one of us experiences high and low moods but for people with manic depression, these become increasingly out of control and cut off from everyday events.

A person suffering mania has an elevated or irritable mood in which he or she is excessively happy, talkative,grandiose and hypersexual, often needing little sleep. Speech may be rapid and behaviour may be reckless and outrageous.


Depressive episodes mean feelings of sadness, hopelessness, loss of interest in usual activities, slowed thinking, and often suicidal ideation. Any talk of suicide should always be taken seriously.

Check out work by artists who have bipolar disorder at:
Bipolar Artists

Schizophrenia is a brain disorder characterised by profound disruption in thought, language, perception of reality, management of emotions, and sense of self. It affects approximately 1% of the general population.


The first signs of the disorder typically emerge in the teens or early twenties. Onset can be slow or sudden. Schizophrenia is not caused by bad parenting, personal or spiritual weakness, demon possession, or childhood trauma.

The symptoms of schizophrenia are generally divided into positive, negative, and cognitive.

Experiences such as, hallucinations (false perceptions); delusions(false, fixed beliefs unshakeable by reason or facts); disorganised thinking, speech and behaviour are classed as positive symptoms. Positive symptoms refer to the characteristics which should not be present but which are.

Psychosis is a general term used to describe a state in which an individual has lost touch with reality in certain important ways, most commonly manifesting itself in delusions and hallucinations. Schizophrenia is a type of psychosis.

The negative symptoms of schizophrenia are features which should be there but are absent. They include: being unable to express emotion, deterioration of self-care, lack of motivation, poverty of speech and social isolation.

Cognitive symptoms describe problems, such as poor concentration and memory; difficulty following instructions; and integrating thoughts, feelings and behaviour.

Early warning signs differ from person to person. Listed below are some of the signs which might suggest a person is developing a mental illness. Remember that having some or several of these signs does not necessarily mean that the individual has a mental illness.

- depression
- irritability, unexpected outbursts of anger
- noticing that people and things seem strange or unreal
- social withdrawal
- changes in eating or sleeping patterns
- unusual suspiciousness
- changes in school/work performance
- strange sensations in the head
- confused, strange or bizarre thinking
- being preoccupied with particular thoughts or ideas, especially religion, the occult or spirituality
- hearing or seeing things others cannot
- bizarre behaviour, such as starting to sleep on the floor instead of the bed
- staring, whilst in deep thought, with infrequent blinking
- feeling detached from his/her body
- severe anxiety
- frequent trips or moves that go nowhere
- excessive writing or childlike printing without clear meaning

If a person is displaying several of these signs, it would be helpful to have a doctor see him/her.

Poverty of Speech The amount of spontaneous speech is limited, even monosyllabic; replies to questions are short and unelaborated.

Poverty of Content of Speech Speech is of reasonable length but is vague and empty.

Pressure of Speech Speech is fast and loud and difficult to interrrupt. There is an increase in the amount of spontaneous speech compared to the social norm.


Distractible Speech The subject of speech is changed abruptly in the middle of a conversation, often due to stimuli in the environment.

Tangentiality Replies to questions are often irrelevant.

Derailment/Loose associations The train of thought often slowly slips off track; ideas lack meaningful relationships to each other.

Incoherence/Word Salad Speech is usually incomprehensible and made up of random words strung together in a sentence.


Illogicality The conclusions reached in speech do not follow logically.

Clanging The train of speech is governed by sounds of words rather than logic; speech may be full of rhymes and puns.

Neologism A totally new made-up word.

Word Approximation A well-worn word used in a new way.

Circumstantiality The point is talked around and may never be reached unless the talker is prompted.

Blocking The train of speech is interrupted and speech falls suddenly silent. It only occurs when the person describes it as losing the thought or if on questioning, it is given as the reason.

Almost every relative of someone with schizophrenia wonders about the chances of themselves or their children getting the disorder.

Genes do play a part but the size of that role is not certain. A majority of those with schizophrenia do not have any family history of it in first or second-degree relatives.

The chance of developing schizophrenia for the general population is roughly 1 percent.

For those with a full brother or full sister with it, the chances are 9 percent.

For those with a mother or father with it, the chances are 13 percent.

For those with an identical twin with it, the chances are 28 percent.

For those with an aunt or uncle with it, the chances are 3 percent.
For those with a grandfather or grandmother with it, the chances are 4 percent.

These figures are only consensus estimates. It is realistic to remember that even with a brother or sister suffering from schizophrenia, your risk of not developing it is 91 percent.

Hallucinations
The experience of hallucinations is so real that it cannot be simply dismissed as imagination.

It is of value that hallucinations are recognised as symptoms of the illness by sufferers and those
who are close to them. Attempting to argue about
their plausibility only causes resistance and
bad feelings. However, it is helpful to make clear that what the sufferer is experiencing is not
seen, heard, smelt or felt by other people. Thereby it is identified as a unique and special
experience of the individual whether he or she can accept it as a symptom or not. It is beneficial in itself that everyone can agree that something is occurring.


Reducing stress and increasing antipsychotic medication under the supervision of a psychiatrist can lessen hallucinations. It is valuable to keep the individual occupied wherever possible to give distraction from hallucinations. Other stimuli, such as music, can sometimes overpower the voices and other auditory hallucinations. It may be helpful for the sufferer to discuss the hallucinatory experiences and when they occur with a therapist. This can identify the type of stress that tends to make them increase. The sufferer should be encouraged not to give up, and given reassurance that those close to him or her understand. It can be difficult with constant talk of hallucinations, but it is reasonable that such events preoccupy the sufferer. Chronic hallucinations have to be accepted as part of daily life but they are not usually enough of a reason to exempt the sufferer from participating in activities or chores.

Delusions
Everyone, especially in times of stress or fatigue, may personalise or misinterpret events.
However, with a sufferer of schizophrenia, the belief is unshakeably fixed, particularly during
an acute episode or relapse, and other explanations for the events are brushed aside without consideration. Attempts at reasoning or discussing other possible meanings of events may actually only convince the sufferer that everyone is in on the plot. Arguing with a delusion tends to lead to deeper anger and mistrust. Delusions are firmly held beliefs, not shared by anyone else.


It must first be understood that delusions are a symptom of the illness and not due to stupidity or stubbornness. Taunts, threats, and emotional reactions should be avoided, in spite of the fact that delusions can be a great source of irritation. There is almost always a point about the delusion that can be empathised with. "I am so sorry you feel frightened. It really wears you down to feel like that. What can I do to help you?" Or, in the case of a grandiose delusion, "I see that you are feeling special today. Maybe it is because of all the excitement here. Maybe we should try a more low-key routine for a few days." If a delusion persists even when the sufferer is well and on medication, a response that acknowledges the view, yet at the same time prevents further futile discussion, might be: "I see that is how you perceive things. I don't agree - we'll just have to agree to disagree."


Not Taking Prescribed Medications
A common and frustrating problem is the sufferer not taking medication as prescribed. Stopping medication often means psychotic symptoms return and this can be a major setback in progress that has been made and can distance the individual from support systems.

Sometimes offering a reward (positive reinforcement) for taking medication, though not preferable, may be the only possibility. You can relate to your own experiences, perhaps you stopped taking an antibiotic before the course had ended and became ill again. It is best never to slip medications into food or drink as discovery can lead to loss of trust. Sometimes coercion is needed: families may refuse a relative the right to live with them or visit them if he or she is off medication. Hopefully, the treatment team and the family can keep the person on the medication long enough for him or her to experience the benefits of it.

It must also be recognised that there may be nothing the family can do for the time being. In this case, it is advisable for the family to wait until a situation occurs in which the person is more willing to accept treatment. Unfortunately, sometimes only a
a crisis can bring about change. As of yet,
no alternative has been found for these individuals.

- Reduce stress as much as possible.
- Avoid drugs and alcohol.
- Eat healthily - three meals a day.
- Have a regular sleep schedule.
- Exercise 10-20 minutes each day.
- Build a daily routine with structure.
- Set goals even if you do not feel like doing anything.
- Take one small step at a time.
- Take your medicine as prescribed.
- Keep appointments with your doctor.

- tension or agitation
- eating more or eating less than usual
- problems with concentration
- sleeping too much or too little
- depression
- withdrawing from other people
- irritability
- anxiety
- worsening of hallucinatory experiences
- becoming more suspicious of people/things

Other signs of possible relapse may be idiosyncratic, for example, buying lots of lottery tickets, wearing only one colour all the time, or vomiting.

In dealing with difficult positive symptoms, it might be helpful to try which of the following would work for you:

- Increasing contact with other people, talking to a trusted person.
- Use relaxation techniques.
- Increase/decrease sensory stimulation.
- Reality test - seek opinions form other people.
- Distract yourself, e.g. with music.
- Positive self-talk.
- Talking back to voices.
- Maintain a sense of humour.