What Is Schizoaffective Disorder? Everything You Want to Know (2023)

Schizoaffective disorder can involve symptoms of depression, mania, or psychosis.

Schizoaffective disorder is a mental health condition that involves episodes of combined mood and schizophrenia symptoms.

During a period of depression, mania, or both, you could also experience:

  • hallucinations
  • delusions
  • disorganized speech
  • other symptoms of psychosis

The combination of mood symptoms and symptoms of psychosis can make the condition difficult to diagnose. In fact, experts say it’s one of the most commonly misdiagnosed mental health conditions.

That’s because both bipolar disorder and depression can involve symptoms of psychosis, while people living with schizophrenia often experience depression and symptoms that resemble mania.

Without treatment, this condition can be difficult to live with. Severe symptoms can affect daily life, cause emotional distress, and prompt judgment and stigma from others. But treatment and support can make a big difference.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) categorizes schizoaffective disorder as a schizophrenia spectrum disorder.

The condition involves symptoms of mania or depression (sometimes both) as well as symptoms of psychosis, which could be described as a disconnect or break from reality.

Schizoaffective disorder is less common than schizophrenia. Current estimates suggest it affects around 0.3% of people and may appear more often in women.

Like other schizophrenia spectrum disorders, this condition most often shows up in early adulthood. Symptoms generally begin in the mid-20s, but they can appear in the teen years or middle age.

Mental health professionals might not connect your symptoms to schizoaffective disorder right away. Many people get a diagnosis of a different condition, such as bipolar disorder, depression, or another condition involving psychosis, before symptoms begin to follow a clearer pattern.

Symptoms of schizoaffective disorder

(Video) 6 Things You Need To Know About Schizoaffective Disorder

The symptoms of schizoaffective disorder can seem somewhat complex.

In basic terms, the condition involves episodes that meet diagnostic criteria for an episode of mania or depression and criteria for schizophrenia.

You might experience the following symptoms.

Symptoms of mania

Mania symptoms typically include:

  • unusually high energy
  • decreased need for sleep
  • a high or euphoric mood
  • restlessness
  • increased talkativeness
  • a tendency to get distracted
  • racing thoughts or conversation that moves rapidly from one topic to another
  • inflated self-confidence or self-esteem
  • impulsive behavior or increased risk-taking
  • sudden dedication to projects — often several at once — at home, school, or work

Symptoms of depression

People experience depression in very different ways, but these are the common symptoms:

  • persistent feelings of sadness and hopelessness
  • a sense of emptiness or emotional numbness
  • decreased energy
  • fatigue, insomnia, and other sleep disturbances
  • difficulty concentrating and remembering things
  • unusual feelings of physical or mental slowness
  • anger and irritability
  • a lack of interest in regular habits and routines
  • anhedonia, or difficulty finding pleasure in things you usually enjoy
  • feelings of guilt and worthlessness
  • thoughts of death or dying

Some depression symptoms, including anhedonia and irritability, can also appear with schizophrenia. But diagnostic criteria for schizoaffective disorder require a persistent low mood during an episode of depression.

Symptoms of schizophrenia

Schizophrenia can involve many different symptoms, including:

  • hallucinations
  • delusions
  • paranoia (extreme suspicion of others)
  • trouble concentrating
  • disorganized speech patterns, including rapid changes in topic or unrelated words and phrases strung together
  • difficulty learning and remembering new information
  • physical agitation, restlessness, or unintentional movements
  • difficulty expressing emotions
  • loss of pleasure and interest in everyday activities or life in general
  • irritability
  • social withdrawal and self-isolation
  • insomnia and other sleep problems

You can explore schizophrenia symptoms in more detail here.

When you have a combination of the symptoms above, mental health professionals will:

  • consider whether you’ve had delusions and hallucinations for at least 2 weeks without mania or depression
  • consider whether your mood symptoms have been present for most, but maybe not all, of the time you’ve had symptoms
  • rule out other health conditions
  • make sure you aren’t taking any medications or other substances that could cause similar symptoms

Experts have identified two subtypes of schizoaffective disorder.

Bipolar type

With this subtype, you’ll experience mood episodes that involve symptoms of mania, such as:

  • racing thoughts
  • elevated energy
  • impulsivity
  • increased activity

You may also have episodes of depression.

Depressive type

With this subtype, your mood episodes will involve only symptoms of depression, such as:

  • a persistent low mood
  • emotional numbness
  • irritability
  • less interest in your regular activities

You won’t have any symptoms of mania.

(Video) The 4 Schizophrenia Symptoms You Need to Know

Schizoaffective disorder doesn’t show up in the same way for everyone, but it often has a big impact on day-to-day life.

You might start to have hallucinations or delusions long before you notice mania or depression.

These experiences will be very real to you. They can make it difficult to focus on your surroundings. You might feel as if you’re dreaming or have trouble recognizing what’s real and what isn’t.

  • The things you see and hear might seem familiar and comforting: a deceased relative, a friendly animal, or soft music.
  • Hallucinations can also feel frightening, confusing, or annoying: sounds of fighting, someone following you, or whispers that say unkind things or tell you to hurt yourself or someone else.
  • Delusions are false beliefs. You might feel convinced that someone is watching you and trying to control you, that you’re famous, or that your friends are trying to harm you.

Symptoms can also affect the way your brain learns, processes, and uses information. You might suddenly find it harder to concentrate or remember things and start to struggle at work or school. Your thoughts might race or feel difficult to grasp.

Before or during this period of psychosis, you’ll also start to experience mood symptoms.

With the depressive type, you might pull back from friends and family or spend far more time than usual sleeping. It might be difficult to muster any enthusiasm for the things you usually enjoy.

With the bipolar type, you might feel energized and optimistic, make a lot of plans, or make impulsive decisions, such as taking a loved one’s car for a drive when you don’t have a license, buying an outfit that’s out of your budget, or lashing out in rage at your boss.

Mood symptoms might linger for as long as you have symptoms of psychosis. They could also taper off before the symptoms of psychosis pass. You may have some times when you don’t have any symptoms at all.

You can learn more about living with schizoaffective disorder here.

Experts have yet to pinpoint a specific cause of schizoaffective disorder.

A number of factors may play a part, including:

(Video) What is Schizoaffective Disorder?

  • imbalances of the important brain chemicals dopamine, norepinephrine, and serotonin
  • differences in the hippocampus and white matter in the brain
  • childhood trauma or abuse
  • genetics (family history)

You have a higher chance of developing schizoaffective disorder if a family member has schizophrenia, bipolar disorder, or schizoaffective disorder.

Some overlap exists between bipolar disorder and schizophrenia. These similarities have led some experts to theorize that bipolar disorder and schizophrenia lie on a spectrum, with schizoaffective disorder falling somewhere in the middle.

Schizoaffective disorder is often misdiagnosed as depression, bipolar disorder, or schizophrenia, since it can involve symptoms of each of these conditions.

The right diagnosis is often key to managing your symptoms, since a correct diagnosis can help you get treatment that’s more likely to help.

It’s a good idea to tell someone you trust about your symptoms as soon as you start noticing them. If tracking symptoms on your own is difficult, a sibling, parent, partner, or friend can help you write them down and go with you to your therapy appointment.

If possible, it’s a good idea to reach out to a mental health professional who specializes in treating schizophrenia and related conditions. They’ll be better able to recognize the pattern of symptoms.

You can start by telling your doctor about the symptoms you’ve noticed. Even changes that seem minor — like a sudden euphoric mood, emotional numbness, or persistent hopelessness — could help them tell the difference between schizoaffective disorder and other conditions.

It’s not always easy to open up about things like unsettling hallucinations, but remember: Mental health professionals should offer compassion, not judgment. They know you can’t control or prevent these hallucinations or any other symptom you experience.

Before diagnosing schizoaffective disorder, your doctor will first rule out other conditions, such as:

  • Major depressive disorder with psychotic features. With this condition, you typically won’t have any symptoms of psychosis unless you’re also having an episode of depression.
  • Bipolar disorder. You might experience psychosis during a mood episode, but you generally won’t have these symptoms on their own.
  • Schizophrenia. This condition can involve changes in mood, but any mood symptoms won’t meet criteria for an episode of depression or mania.
  • Post-traumatic stress disorder (PTSD). Flashbacks in PTSD might seem like hallucinations, while fear and anxiety might resemble paranoia. But PTSD symptoms usually relate to a specific trauma.
  • Substance-induced psychosis. Some substances, including certain prescription medications, alcohol, and cannabis, can trigger symptoms of psychosis.

If you also experience mood symptoms, your doctor will consider any substances you’re taking before making a diagnosis of schizoaffective disorder.

Although schizoaffective disorder can’t be cured, a combination of medication and therapy can go a long way toward reducing your symptoms.

Your care team might involve:

  • a psychiatrist or other mental health professional who can prescribe medication
  • a therapist or other mental health professional who provides talk therapy and other support
  • a school counselor or workplace advocate

A therapist might also recommend:

  • group therapy
  • social skills training
  • family and relationship counseling

A few different medications can help manage mood symptoms and psychosis. Your psychiatrist may prescribe one or more of the following, depending on your symptoms:

  • antipsychotics
  • mood stabilizers
  • antidepressants

Not every medication works for everyone, so make sure to tell your psychiatrist about any unwanted side effects. It’s important to keep taking the medication until they prescribe something new or tell you it’s OK to stop.

You can learn more about treatment options here.

(Video) Schizoaffective Disorder?...What is it?

Sudden mood changes can be overwhelming enough. Psychosis can affect your perception of reality, adding to your distress.

You might keep your symptoms to yourself, worrying that stigma surrounding hallucinations, delusions, and other symptoms of psychosis could lead others to judge you.

While a diagnosis of schizoaffective disorder may seem frightening, getting a diagnosis is often the only way to start managing symptoms.

Connecting with a compassionate mental health professional can make it possible for you to get relief from symptoms, learn helpful coping strategies, and get back to living the life you want.

You can start your journey toward recovery with these resources:


What is schizoaffective disorder in simple terms? ›

Overview. Schizoaffective disorder is a mental health disorder that is marked by a combination of schizophrenia symptoms, such as hallucinations or delusions, and mood disorder symptoms, such as depression or mania.

How does a schizoaffective person think? ›

Schizoaffective disorder has the features of schizophrenia, like hallucinations, delusions, and disorganized thinking, along with those of a mood disorder, like mania and depression.

What is life like with schizoaffective disorder? ›

Schizoaffective disorder can cause disabling symptoms, like hallucinations, delusions, depression, and mania. Living with this condition can cause difficulties at school or work, in the home, and in relationships.

What is the main cause of schizoaffective disorder? ›

Rather than a single cause it is generally agreed that schizoaffective disorder is likely to be caused by a combination of factors, such as: stressful life events. childhood trauma. brain chemistry.

Is schizoaffective disorder a serious mental illness? ›

Schizoaffective disorder is a serious mental health condition. It has features of both schizophrenia and a mood (affective) disorder. Schizoaffective symptoms may include symptoms of mania, depression and psychosis.

Is schizoaffective disorder violent? ›

Although most people with psychotic disorders such as schizophrenia or schizoaffective disorder are not violent, there is an association between psychotic disorders and violence, and with homicide in particular [1, 2].

Are people with schizoaffective disorder angry? ›

Some of the symptoms of schizoaffective disorder may include: Behavioral symptoms: Inability to cry or express joy. Angry outbursts.

Do schizoaffective people have empathy? ›

Taken together, these results suggest that schizophrenia patients are likely to have reduced empathic ability compared with controls interacting with others in everyday life, and these differences are greatest when interacting with highly emotionally expressive people.

Can people with schizoaffective love? ›

When a mental health condition such as schizoaffective disorder is present, a relationship can be a remarkable resource and support system, but it can also be a trigger. It can help to stabilize someone's mood, give them confidence and a sense of security, and keep them actively involved in the world.

What is the main difference between schizophrenia and schizoaffective disorder? ›

The key difference between schizoaffective disorder and schizophrenia is the prominence of the mood disorder. With schizoaffective disorder, the mood disorder is front and center. With schizophrenia, it's not a dominant part of the disorder. Another difference is the psychotic symptoms that people experience.

What are the two types of schizoaffective disorder? ›

There are two major types of schizoaffective disorder, based on which mood disorder is involved: the bipolar type and the depressive type. The bipolar type includes both dramatic "highs," called manic episodes, and "lows," called depressive episodes.

What's the difference between psychosis and schizoaffective disorder? ›

4 Conversely, a person with schizoaffective disorder will experience chronic and persistent mood symptoms. Psychotic symptoms in schizophrenia tend to be persistent, while a person with schizoaffective disorder will generally have briefer episodes of psychotic symptoms that come and go. 5.

What kind of disability is schizoaffective disorder? ›

Schizoaffective disorder is a severe mental health condition that can qualify for Social Security disability (SSDI or SSI) benefits. Schizoaffective disorder is a serious mental illness characterized psychosis (loss of touch with reality) and severe mood problems.


1. Role of a Physical Therapist in a Forensic Psychiatric Hospital | PT MEAL Podcast
(PT MEAL Podcast)
2. What Is Schizoaffective Disorder? | Schizophrenia
3. Schizophrenia - causes, symptoms, diagnosis, treatment & pathology
(Osmosis from Elsevier)
4. Living with Schizoaffective Disorder (Experiencing Psychosis, Paranoid Delusions and Hallucinations)
(Special Books by Special Kids)
5. What Is Schizoaffective Disorder?
(Ask A Psychiatrist)
6. Schizoaffective disorder | Mental health | NCLEX-RN | Khan Academy
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