I wanted to use the expression “The Best of Both Worlds” but Michael D Crawford*1 already used that to describe schizoaffective disorder. It is a combination of a thought disorder like schizophrenia, and a mood disorder like bipolar disorder, but has a quality of it’s own.
*if you haven’t read his essays on schizoaffective disorder, go now
There are 2 types of schizoaffective disorder, depressive and bipolar. I have the bipolar subtype which means i have experienced mania. It is very similar to bipolar 1 with psychotic features.
I was originally diagnosed with social anxiety, which I have, before I started displaying obvious psychotic symptoms. (I had more going on but psychiatrists are not mind readers.) Then, psychosis nos, when I had a psychotic break and they were not sure what to make of me. Next, bipolar 1 with psychotic features, eventually landing in the schizoaffective box.
The dsm (the psychiatrist’s diagnostic bible) has changed recently to the dsm5. This is part of the criteria for schizoafffective disorder from the dsm5:
“The occurrence of the delusions or hallucinations must be in the absence of any serious mood symptoms for at least 2 weeks. The mood disorder, however, must be present for a significant majority of the time. The symptoms of this disorder also can not be better explained by the use or abuse of a substance (alcohol, drugs, medications) or a general medical condition (stroke)”2
Most of my delusions haven’t been too scary. I thought people were watching, following and filming me because I had special talents. So secret, even i didn’t know what they were, but I was going to come into a fortune. Boy, was I disappointed.
I heard voices, but they were mostly people I know. Some, I thought were guiding me, others mocking me, others just in another room where I couldn’t see them.
I have had visual hallucinations. From the walls and floors moving to scales falling from the ceiling. But, mostly auditory. And, the thing is at the time, you don’t know they aren’t real for the most part.
I have had periods of “insight” where I could reality check, but also times where I couldn’t. Lots of times. I argued with my psychiatrist that I didn’t need an anti-psychotic because I wasn’t psychotic, while I was delusional.
But, I seemed to know what was “appropriate” conversation. I had fears long before I started saying anything about mind control to anyone. I even took a group therapy cbt course where we would work out our hot thoughts to have more balanced, less negative thinking, at that time. I slid past everyone undetected or they just could not do anything. All this time I had the bipolar1 diagnosis and was taking my medications and doing the “right” things.
With medication, therapy, time, eventually the voices stopped. I had been receiving “messages” from the media and everywhere and it stopped. You would think I would feel happy, but I felt lost. I didn’t have the guidance, companionship, entertainment. I had to figure things out on my own. It was scary. People would question the thoughts I remembered as real events and call them delusions. It hurt.
I still am at a point where there are some things that I am not sure what is real. I remember it how I experienced it. But, I am able to put it aside, go about my day, live in consensus reality. And keep my doubts to myself
Originally posted on Medium