anxiety bipolar Coping skills life lessons mental illness psychosis schizoaffective

Coping With Schizoaffective Disorder

Originally published Psych Central

With schizoaffective disorder and social anxiety, I have a number of different types of symptoms to cope with.

For me, psychotic symptoms can be the hardest to deal with. The first thing I turn to is medication. I have tried a few of the newer atypical anti-psychotics and fortunately, I respond well. It takes more than medication alone, though.

Some things that can help people cope with psychotic symptoms:

• Help from others– I have issues with fatigue and motivation. If someone can help me with chores: childcare, housecleaning, cooking it is a big relief.
• Music– Listening to music can help drown out voices.
• Cognitive Behavioral Therapy (CBT) – This is a type of therapy based on moving from distorted thinking to more rational thinking. It can be used to treat people with psychotic symptoms, but anyone can have distorted thinking.
• Asking– If I trust someone I can ask them to help me determine what is real.
• Acting “As If” – I can act like consensus reality (what everyone else believes) is real. The longer I do the more I start to believe it.
• Psychiatric Service Dogs– Dogs can be trained to perform specific functions that help with your disability.
• Technology– Apps like snapchat can be used to verify that what you are seeing is real.

My mood symptoms are varied. I rarely am euphoric. I am more typically irritable and paranoid. Or sad and anhedonic. But, I can be reckless and impulsive. Some things that help me with different mood symptoms. (There is overlap with the different coping skills):

• Support groups – A number of organizations have support groups for people with mental health conditions. Depression and Bipolar Support Alliance (DBSA) and National Alliance on Mental illness (NAMI) are two national organizationsOkay.
• CBT– like I mentioned above this is a type of therapy that helps with distorted thinking. Distorted thinking can lead to depression and CBT can help your mood.
• Acting against Impulse– This is a Dialectical Behavioral Therapy (DBT) technique. If your first impulse is to do something reckless, push yourself to do the opposite.
• Talk Therapy– This goes for all the sections, but if I am irritated at something specific my therapist can help me put it in perspective.

For now, I have my psychotic symptoms pretty well under control and my depressions are mild. I haven’t been manic in years. I am still plagued by anxiety. Here are some of my anxiety coping skills:

• Breathe– I take a deep breath and let it out slowly to help me calm down.
• Visualization– I picture an event coming up, going well and I don’t get so nervous about it.
• Routine– I take my medications and go to bed, wake up at the same time, plan for change ahead of time.
• Journaling– getting my thoughts out helps me to organize them and take some of the emotion out.
• Calling someone-talking to a friend helps me to not feel alone.
• Avoiding over-stimulation– Sometimes I just need quiet time. A big crowded place is too busy for me.
• Breaking Tasks into Pieces-If I try to take on a project all at once I freeze, but if I break it up into more manageable pieces I can get it done.
• Socialize- I tend to isolate which isn’t healthy so if I am invited out, I push myself to go. I usually have at least an okay time, it is just getting out the door.

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The Power of Words

sometimes people don’t know what to say when they find I have a mental illness. I found a list from the DBSA and made a short video of things thst could be hurtful and alternatives.

gun control mental illness politics schizoaffective schizophrenia stigma

Don’t Use Me As A Pawn

Originally posted on Medium

Note: I know this is a controversial post. I am open to discussion. I am not against any of these laws, I just don’t like being presented as a problem.

alcoholism anxiety disclosure life lessons mental illness schizoaffective writing

Feeling Exposed

I have social anxiety and used to barely interact with others. Enough to do my job, get my groceries, but not much more. I have slowly been building on that and as far as overcoming my anxiety- I think I have come a long way.

I have been slowly disclosing information about myself to others. People close to me and people I don’t know. I give talks on my experience with mental illness for NAMI. I have been blogging on a private site. I made a YouTube video and did periscope chats. I have been posting more personal info on social media.

Now, I am blogging out in the open and I feel vulnerable. I showed my co-worker some articles I wrote and he followed a link here. It is fine. That is what it is there for. But, I felt like he was reading my diary at the same time.

And, I put a disclaimer on twitter that my views don’t represent my employer. I know you have to be careful what you say. My work knows about my mental illness. I work in the field. I just was pretty casual on the more private site. I worry I am going to get comfortable and say the wrong thing (like complain about someone or something).

And, I just announced some things about myself that people didn’t know. Not everyone that follows me on Twitter knew of my mental health or alcohol abuse issues. I feel like I need to explain everything, right now.

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What Did I Get Myself Into?

I am blogging for Psych Central. I have published 2 posts so far.

Shameless plug:


It is about schizoaffective disorder and alcoholism.

I am supposed to write about 2 posts/week.

Did I mention I am really insecure and worry a lot and am a bundle of nerves????

I am so afraid I am going to run out of topics.

Or crash and burn in some humiliating fashion.


I already have 2 ideas for next week.

It is just the “what if?

I am going to try to stay in the present.



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Supplements for Mental Illness

Edit: It appears some people are reading this as supplements instead of medication, my intention was supplements along with any medication and after consulting your doctor.


A few disclaimers:

Supplements can interfere with your health and other medications. You should run it by your doctor before you start taking them.

Buyer beware. I trust the companies I purchase from, but I have heard of people getting products that were different from what they ordered.

And, as far as results, YMMV

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Perpetual Patients

I  don’t know if I do this. It is easier to recognize in others. Every bad day is depression, any agitation is mania. They tell you every morning how many hours they slept the night before.

A friend was telling me much of what people think are mood swings have to do with distress tolerance and has more to do with therapy than medication. Specifically DIaletical Behavioral Therapy(DBT).

I don’t know if that is correct. I don’t think everyone that rapid cycles really has a personality disorder. That was what he seemed to be eluding to. But, if you can’t get mood swings under control and you can get into a DBT program that could be an option.

I want to be well and in recovery. I know I can relapse, but I try not to worry. The longer I go without psychotic symptoms, the more assured I get that it will stay this way. I get some minor dips. They don’t seem like they will end, but they do.

My major issue is anxiety. I have made great progress. At one point, I would just go to work and come home. I would shop at night and avoid people. Now, I work with people and even do some public speaking (I am not a good speaker, but I do it).

I think if you spend too much time focusing on possible symptoms you miss out on  what is around you.


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Not long ago, I volunteered at a state conference for NAMI, the National Alliance on Mental Illness. I was able to see a few speakers throughout the event.

One lecture I went to was on schizophrenia. I was very interested since I have a thought disorder (schizoaffective disorder). The psychiatrist speaking was a good speaker, intelligent and down to earth. He spoke about getting through the illness and to the person.

There was time for questions. Hands were raised and you could also fill out questions on paper. I filled out the paper and waited, but he never read mine. The audience was mostly clinicians and family but there were a few others with the diagnosis, like me.

Afterwards, there was time to talk with the speaker. i waited for my turn. Finally, I got to ask him my question. He said he had not read it because there really is no answer. I asked about remission. I have been stable for years. I have pretty much not had psychotic symptoms for 10 years (I am on medication). But, still I wait for the other shoe to drop. When is it going to happen again?

My question was “When can I take a breath and not worry about relapse?” His answer was simple. “Breathe Everyday”. You aren’t having symptoms now. Enjoy the moment.

Originally published in “Invisible Illness”

View at

mental illness schizoaffective

Double Whammy

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

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I hope it is easy to find, or

i have been blogging, more like journaling for years, but not for an audience. I have published on The Mighty, recently started posting on Medium and published on Psych Central.  The title there is Triple Winner.

I have a diagnosis of schizoaffective disorder and social anxiety, along with overcoming an alcohol addiction. I plan to blog about those topics and other ramblings.

I will repost some but also have new posts here.

I will do my best to respond to comments.

where I can be found:

twitter lorib641 Lori Bernstein