Schizoaffective Disorder

WHAT YOU SHOULD KNOW:

• Schizoaffective disorder (SAD) is a mental illness that may change how you think, feel, and act around others. You may have symptoms of psychosis (loss of reality), along with symptoms of a mood problem. A mood problem includes being depressed (very sad), manic (very happy), or both. With SAD, you may not know what is real and what is not real. Your mood symptoms will be present for a large portion of the illness. SAD is a long-term disease. Symptoms may go away on their own, only to appear again later. Your illness may change how you live and how you get along with the people around you.
  
  
• The cause of SAD is not clear. Caregivers feel it may be caused by problems with your brain, or how it works. Causes may include genetics or having family members with the same condition. It may also be caused by stress or a chemical imbalance in your brain. Your caregiver will look for psychotic and mood symptoms. Treatment may include medicines for psychosis, side effects, mood changes, special forms of therapy, and electroconvulsive therapy (ECT). Having your SAD treated may help decrease your symptoms and help you return to your daily activities.

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You have the right to refuse treatment. This right holds strong unless your life or the lives of others may be in danger. You may also make advance care plans. These plans are made ahead of time in case you lose your ability to make decisions for yourself.

RISKS:

• Medicines used to treat SAD may cause an allergic response. Some medicines may take a few weeks to work. Others may change the way you eat and sleep, cause weight gain, and make you anxious. Changes in your sleep and eating may cause other problems and medical conditions. You may have heart, eye, stomach, and movement problems from certain medicines. You may also feel shaky, dizzy, have sexual problems, or urinary problems because of the medicines. Medicines may also cause dry mouth, drooling, and slurred speech.
  
  
• If your SAD is left untreated, your condition may get worse. It may affect the way you think of yourself and how you get along with others. Your condition may make it hard for you to do your normal activities. You may be at increased risk for diabetes and heart and lung disease. You may start to abuse alcohol or drugs. You may have thoughts of hurting or killing yourself or others. Call your caregiver if you are worried or have questions about your condition, treatment, or care.

WHILE YOU ARE HERE:

Informed consent: You have the right to understand your health condition in words that you know. You should be told what tests, treatments, or procedures may be done to treat your condition. Your doctor should also tell you about the risks and benefits of each treatment. You may be asked to sign a consent form that gives caregivers permission to do certain tests, treatments, or procedures. If you are unable to give your consent, someone who has permission can sign this form for you. A consent form is a legal piece of paper that tells exactly what will be done to you. Before giving your consent, make sure all your questions have been answered so that you understand what may happen.

IV: An IV is a tube placed in your vein for giving medicine or liquids. This tube is capped or connected to tubing and liquid.

Vital signs: This includes taking your temperature, blood pressure, pulse (counting your heartbeat), and respirations (counting your breaths). To take your blood pressure, a cuff is put on your arm and tightened. The cuff is attached to a machine which gives your blood pressure reading. Caregivers may listen to your heart and lungs by using a stethoscope. Your vital signs are taken so caregivers can see how you are doing.

Medicines: Your caregiver may give you the following kinds of medicines:

• Anti-anxiety medicine: This medicine may be given to help you feel less nervous and more relaxed.
  
  
• Anti-depressants: These medicines are given to decrease or stop the symptoms of depression. Other behavior problems may also be treated with anti-depressants.
  
  
• Anti-psychotics: These medicines help decrease psychotic symptoms or severe agitation (very tense and unable to relax). Anti-psychotics may cause problems with how your body moves. This medicine can be taken as a pill or given as a shot.
  
  
• Atypical anti-psychotics: These are also called second generation anti-psychotics. These medicines also help to decrease psychotic symptoms but have a decreased risk of movement problems.
  
  
• Mood stabilizers: These medicines help control quick changes in your mood that happen for no reason.
  
  
• Other medicines: These medicines may be added by your caregiver to help with other problems. Some of these medicines may help decrease the side effects of anti-psychotic medicines. Your caregiver may give you any of the following:
  
  
  • Anticholinergic medicine: This medicine may be given to decrease the side effects of other needed medicines.
    
    
  • Anticonvulsants: This medicine is given to control seizures. It may also be used to decrease violent behavior. This medicine may help control your mood swings.
    
    
  • Anti-Parkinson: These medicines are also sometimes called side-effect pills. These may be given to control muscle stiffness, twitching, and shaking caused by anti-psychotic medicines.
    
    
  • Blood pressure medicines: These medicines are usually used to control high blood pressure. They may also be used to help decrease motor tics (uncontrolled movements). Blood pressure medicines may help you feel calmer, more focused, and less irritable.
    
    
  • Sedative: A sedative medicine may be given to help you stay calm and relaxed.

Tests: Tests may be done check for conditions that may have caused your symptoms.

• 12-lead ECG: This test, also called an EKG, helps caregivers look for damage or problems in different areas of the heart. Caregivers may need to prepare your skin by shaving off some hair, or cleaning it with a gritty lotion. Sticky pads are placed on your chest, arms, and legs. Each sticky pad has a wire that is hooked to a machine or TV-type screen. A short period of electrical activity in your heart muscle is recorded. Caregivers will look closely for certain problems or changes in how your heart is working. This test takes about 5 to 10 minutes. It is important that you lie as still as possible during the test. You may need this test more than once.
  
  
• Blood and urine tests: These tests may help your caregivers learn more about your health condition. Blood and urine tests may be used to check for drug or alcohol use, or infection. Your blood sugar, blood cholesterol (fat), and how your liver, kidneys, and thyroid are working may be checked. If you are female, a pregnancy test may be done. You may need to have these tests done more than once.

Treatment options: You may need one or more of the following:

• Psychotherapy:
  
  
  • Assertive community treatment: This treatment is also called ACT. A team of caregivers and support groups in your own community help you with your therapy.
    
    
  • Cognitive behavior therapy: This therapy helps you to change your behavior. It will help you handle symptoms like hallucinations and delusions. It also trains you how to get along with others, and helps you cope and handle your disease.
    
    
  • Compliance therapy: This therapy looks at why you would not want to take your medicine or see your caregiver. Your caregiver will help you find ways to make it easier to do your treatments. You may also get telephone calls and letters to help you remember your scheduled visits with your caregiver.
    
    
  • Counseling: You and your caregiver will work together to decrease your symptoms, and prevent them from coming back. Your caregiver will tell you about the importance of taking your medicines everyday, and help you make an action plan. This plan is a set of instructions for what to do when you have symptoms of SAD. It shows a list of your medicines, their dosage, and side effects. It tells you when to seek help if your symptoms get worse. He will also teach you how to cope with daily activities like working or dealing with other people.
    
    
  • Family intervention: These visits let your family be part of your therapy. Meetings are set by your caregiver with your family. These may be done with all of your family together or with one person at a time. In these meetings your family learns about your condition, and they can talk about their concerns. Your family may learn ways they can help you manage your disease. They may be given special training to help them cope and handle your condition. Special services may also be given to your support people when they need a break from caregiving. This form of therapy may last for at least nine months.
    
    
  • Skills training: This trains you how to get along with other people. Your caregiver will teach you how to behave with others and talk to others properly. You will also learn how to do everyday activities. These may include knowing how to budget your money, and finding a good home and means of transport. Learning these skills may help you be able to live on your own.
    
    
  • Supported employment: This program helps you find a job that is good for you, when you are ready to work. You may be given job skill training and emotional and mental health support while you are working. This may help give you independence and self-confidence.
  
  
• Electroconvulsive therapy: Electroconvulsive therapy (ECT) is a type of shock therapy. This treatment sends small electric shock to your brain. ECT may be used if your condition does not get better after medicines or other therapies.

Restraints for behavior management: There are two types of restraints that may be used while you are in the hospital. They will only be used if caregivers feel you are in danger of hurting yourself or others. Physical restraints, such as cloth or leather bands, may be put on your wrists or ankles and tied to something else. Other things will be tried first before using physical restraints, such as going into the quiet room or seclusion. Caregivers may use "chemical" restraints, which is medicine used to help you calm down and relax. Restraints should never be used to punish you.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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