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Dr. Kaushik
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4037
Experience:  MD Psychiatry
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Hi ive a question about schizoaffective disorder For a psychiatrist

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Hi ive a question about schizoaffective disorder? For a psychiatrist please, im looking for an unbiased and honest information about the disorder please. Im wondering first of all, is it possible to be born with schizoaffective disorder? Or maybe if thats hard to be certain of, for it to start in childhood and continue through someones life? If it is accurately diagnosed in someone, is it definitely a life-long disorder (whether a doc is going to be honest to someone who is diagnosed with it or not). Before diagnosing someone with it, should psychiatrists take into account things such as someones IQ, social skills or general interaction knowledge to do with the world/ personality? Lastly, if diagnosed with it, is it really cured with anti-psychotics?I was diagnosed with it, but am unsure if i do have this chemical imbalance since ive had the same problems since childhood,mainly a lower stress threshold than everyone in the same situations,suffer bad moods because of this,appear spaced
Submitted: 5 years ago.
Category: Mental Health
Expert:  Dr. Kaushik replied 5 years ago.

Hi Clara,

 

Welcome to Just Answer !

 

Well, i can sense a feeling of frustration and bewilderment in you , regarding your preoccupation and uncertainity about being a Schizo affective patient or not. I will try to be as honest and comprehensive about the whole issue as possible , but i will request you to listen to me with an open mind and without jumping to hasty conclusions.

 

Now, let me first throw some light on Schizoaffective disorder , so that you can have a brief background knowledge about the diagnosis. Well, although one cannot predict a new born to have schizo affective diagnosis at the time of birth itself , but yes ,Schizo affective disorder has a strong Genetic predisposition , meaning that if there is a close relative of the child whose suffering from Schizo affective disorder or schizophrenia , then the child , due to genetic loading from that particular close relative , stands at high risk of becoming Schizo affective herself / himself, but the revealation of schizoaffective symptoms occur usually at adolescence , as uptill adolescence , no meaningful cognitive (thinking process), and affective ( mood) functions had taken place and these are brought into light as the child's social ( friends, family) , and occupational ( school) life becomes increasingly demanding, and when he/ she is not able to keep up with others and stands out due to the condition. So, i hope you can relate to what i have explained here.

 

Also, what does Schizoaffective disorder entail or mean, well it is a combination of Schizophrenic symptoms ( such as lack of insight , delusions , hallucinations, paranoid ideation, loose associations, etc) and affective symptoms ( Such as manic symptoms like excessive self confidence , excessive degree of happiness, or elation, disinhibition, easy distractibility , hyperactivity but low productivity , increased libido (sexual drive) and appetite , loss of judgemental and decision sense, etc AND/ OR depressive symptoms like low mood , low self esteem, inability to feel pleasure , lack of interest , inititaive , hope and confidence, negative and suicidal thoughts , feeling of worthlessness, and helplessness, decreased appetite, sleep and libido.

 

Now , coming to your question about , whether a psychiatrist should take into account one's IQ, SOCIAL SKILLS, AND INTERPERSONAL SKILLS, before diagnosising a Schizo affective disorder , to this i would say , yes, the psychiatrist needs to assess all this, infact it is a part of the clinical interview which he/ she takes with the patient , and is included along with other things such as cognitive testing , test of insight,reality and reasoning , orientation testing and assessment of personality etc, in the psychiatrist's scheme of things.

 

Now, addressing your question , about , if a person is diagnosed with Schizo affective diagnosis , will he/ she have it all throught his/ her life and whether he/ she will have to take anti psychotics all throughout their lives. Now, to this , i would say that , unfortunately , once a person is diagnosed with a Schizo affective diagnosis , he will have it throughout his life , it is like having been diagnoses with Diabetes or hypertension , once a person is diagnosed with such conditions , he / she has to live with it throughout life , but one can control the undesired / untoward symptoms of these conditions, Likewise, Anti psychotics and Mood stabilizers are the mainstay of treatment for Scizo affective disorder and are to be taken for a long duration of period , in order to keep off from the symptoms of the condition, although , once a person has been stabilized , showing no symptoms for a long time , then , the doctor can think of reducing the drug doses or stopping them altogether .

 

Now, lastly addressing your doubt whether you really are a case of Schizo effective disorder or not , and the fact that your main concern is your inability to keep up with your peers at work place and the episodes of ' being spaced out', which reinforces your belief in having this disorder , plus you have mentioned previously you have been diagnosed with it .

 

Well, although i am not refuting your previous diagnosis of Schizo affective disorder , but to me you are unlikely candidate for schizo affective disorder and to me you seem to be more like a case of Affective disorder such as bipolar and / or ADD ( ATENTION DEFICIT DISORDER) and the reason i cite for my probable diagnosis is due to the fact that in you there is no loss of insight or impaired reality testing , and the way you have narrated your detailed history to me with full of understanding about your condition and objectivity , would have been next to impossible for a schizo effective patient to carry out, except if you had been stabilized on the drugs for a long time and currently have been symptom free. So, if this is not the case ,i would ask you to get yourself Re - evaluated by a psychiatrist , as the episodes of spacing out or inability to keep up with scholastic performances or with peers is also seen in ADD or bipolar , so in order to confirm , you need to have a Reassessment of your condition by a psychiatrist ,.

 

So, i again suggest you to go for a Re- evaluation of your condition by a psychiatrist and things will become much clearer for you then.

 

I wish you best of health.

 

I hope my answer serves your query according to your satisfaction.

 

Regards...

Customer: replied 5 years ago.
To Dr. Kaushik,

Thank you very much for your help and honest answer so far. Before i accept,could i ask your help on just a bit more if i can, to ask your opinion on and for me to learn what i may or may not have. Firstly, i have never had a psychological assessment or insight to my life at all, both during my upbringing and school in which id problems with social skills,understanding language knowing what to do- and that i might be slower than others in both understanding things (and in socially developing), and personality wise how to tell who are friends or not and how to get on with people, and also with the psychiatrist they never assessed my understanding intelligence etc.in school and growing up i never seemed to be a fun girl and learn as an adult how to be clued in and be seen (when its appropriate) in a sexual way by guys my age, when the rest of peers starting good, genuine relationships (and knew how to appear sexy and adult like when it became appropriate)

What im wondering about most, and what has been the real problem (well im not sure from an other peoples opinions or a proffessional opinion on it), but stemming from my early teenage years from 12yrs on, and particulary from about 15 / 16yrs or so when most ppl starting making real friends and have a view on who they are around everyone, on how to interact in certain situations such as behaving in social situations, shopping, talking to relatives and adults and how this is different to your peers, also things like how to look after yourself as an adult and have a view on what to do after high school - basically ive never seemed to make good, trusting friends that lasted at all in high school, i never knew what my abilities were or on how to interact between my family (parents mainly) and my friends, like be the same person, and what way to behave socially to make friends with people that actually were friends(not people who were just acquaintances and didnt like me as i found out around 16 from a couple of girls i used to believe were/try to be friends with). i left my school and did my final year in another in an attempt to make new friends, again i seemed to make friends with a couple of girls for a while who i again seemed to be on the outside of, i never know how much of myself to bring to a friendship, so it was more like an intense friendship where i never really knew who i was, and people never come back to me. Ive had a couple of simialr experiences , not in college as i went through that alone, but in a workplace, where ive been told by ppl that at times im 'trying to hard'. none of these friendships were ever people trying to get to know me as such, or coming back to me. nor in all my experiences have i had people interact with me & my family, but maybe this is pretty normal and healthy, im not sure really. Ive never really known where my life is going, and have never really fitted in & actually connected with a group of ppl my age where ive actually felt like they were people who actually liked me, and no-one ever stays in contact or contacts me socially. Ive never had a career plan really as i was never reallly around people enough or had enough insight to know - more importantly i wasnt really developing as a person. I know that during some of my 'friendships' i appeared angry at times for not being able to keep up/ ppl not contacting me being left behing etc. Im 25 and even tho ive worked closely alongside guys ( i went to an all girls school so wasnt around them much,or in college), i have never been asked out had a relationhip or even have much an idea what it would feel like to be liked and even to know if i like someone, and not just be used in a sexual way. I havent celebrated my birthday with friends since the time i was a child, when my parents did organise a party. since then, in the couple of times i have mainly with the girls from school or once with work colleages it was probably more because id asked them, theyd felt pressure to or maybe out of pity, but i dont ever seem to have stable friends. from what ive seen with other people this isnt normal. due to the isolation and depression ive felt is when i was referred to a psychiatrist, then they diagnosed me with schizoaffective disorder. Since it might be more to do with how to treat people, who are friends and who arent and how to actually enjoy myself around people ever, im wondering do you think from this extra information does it still sound like i developed schizoaffective disorder? also to do with my interaction with people i came across the term borderline personality disorder - i dont know if id even have the intelligence around people to have this, or if my interaction with people has as friends have actually been where they were taking me seriously/viewing me as a real friend - do you think it is possible that i have or had this ? Thank you for your help.
Customer: replied 5 years ago.
Oh sorry just forgot to ask at the end aswell, it has also occurred to me (as again has Never been looked into by a psych) about anti-social personality disorder....but again not the part about breaking the law, maybe its the wrong term but for what im trying to say, where i never seem to be able to make friends or don't have it in my IQ to care about people enough/know how to interact with people to have meaningful friends or a relationship, also ive been told ive no sense of humour or that i don't get jokes/understand humour which is true, and i don't ever seem to know how to be fun for people to want to stay knowing me.Also quite important i forgot to mention on the schizoaffective thing, i was put on risperdal for apparantly having it and i can honestly say all it does is (after its put me to sleep) completely slow me down as a person and make me appear doped up around ppl,and ive been told this.it doesnt make me feel any more insecure or whatever im supposed to have.and im tired of being threatened with it like a child, it completely killed me body when i was first put on it.it doesnt change my personality.Thank you.
Expert:  Dr. Kaushik replied 5 years ago.

Hi Clara,

 

Welcome back !

 

Well, thanks for the detailed explanation about your life history . As i have mentioned earlier , i still believe that you are not a case of Schizo affective disorder as you do have insight , which by definition means awareness of oneself and her surroundings , and i believe the way you have self evaluated yourself, automatically discards the possibility of lack of insight , as if you actually were having lack of insight , you would not have a) evaluated yourself in such an objective and clear way, and b) would not have been able to present your case yourself, as people of schizo affective disorder are presented by their relatives, parents , as these people lack insight and have inability to recognize reality , which is not the case with you. So, now, i have more reasons to believe that you have been mis- diagnosed and you need a re assessment by a another Psychiatrist or a Clinical Psychologist.

 

As far as you not being able to keep up with your peers, having been socially neglected and considered as an outcast , not been able to have close trusting friends , confidants, spacing out , and kind of not being on the same page with others, and plus , as previoulsy mentioned , not able to have concentration on work at hand and lagging behind others and trying twice as hard as others to reach goal in school, college, workplace , all these features indicate towards a Personality disorder diagnosis along with ADHD .

 

No, in your case it is not anti social personality disorder , you are no way near that kind of clinical picture , but i feel that you suffer from Schizotypal personality disorder coupled with borderline personality disorder ( also known as emotionally unstable ).

 

The fact that you have not been able to maintain steady relationships with friends , peers alike , due to probable confusion in your mind as to how to act appropriately in a social gathering or public , you may have been using phrases , words, obviously unintentionally ,in your conversations , which might have repelled the others , and that made them to avoid you. You probably are socially anxious person who does not know how to act according to the demand of the circumstances or situations and this is also a common feature Schizotypal personality disorder , along with the other features explained above. And it might be a good possibility that you are having AN ADDITIVE BORDERLINE PERSONALITY AND ADHD .

 

So, i suggest that you consult a new Psychiatrist or clinical psychologist , and get your personality assessment done and also, get evaluated for ADHD , from the same therapist.

 

For ADHD , drugs such as Adderall XR or Ritalin are considered to be the mainstay , while for Schizotypal personality disorder & boderline personality , you need to undergo psychotherapy ( counseling ) , such as Cognititve behavioural therapy ( CBT), Interpersonal psychotherpy , Dynamic psychotherapy , dialectical psychotherapy and these psychotherapies are offered by psychiatrists and psychologists alike.

 

So, you have got treatment options for the mentioned above 3 diagnostic co morbid conditions , but first you need to confirm the diagnosis by undergoing personality assessment , as i am quite convinced that you are not schizo affective , as you had been diagnosed.

 

I wish you best of health.

 

I hope my answer serves your query according to your satisfaction.

 

Regards..

Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4037
Experience: MD Psychiatry
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