Is Schizoaffective Disorder Worse Than Bipolar?

Schizoaffective disorder is a condition on the schizophrenia spectrum, but it is not the same condition as schizophrenia. In general, people with schizoaffective disorder probably have more symptoms to manage than those with bipolar disorder, but this cannot be generalized to every person with these diagnoses.

Schizoaffective disorder is a condition on the schizophrenia spectrum, but it is not the same condition as schizophrenia. You may think of schizoaffective disorder as a combination of schizophrenia-like symptoms such as paranoia, hallucinations, and social isolation, as well as mood symptoms that may resemble either bipolar disorder or depression.

Schizoaffective disorder symptoms can look different from person to person. People who have bipolar disorder often have psychotic symptoms, so there can be a lot of overlap between the two conditions. Therefore, one person with schizoaffective disorder may have a more severe mental illness than a different person with bipolar disorder.  This is not a hard-and-fast rule, as bipolar disorder, especially when it includes psychotic symptoms, can be quite severe.

Schizoaffective disorder is a diagnosis that combines psychotic symptoms (like hallucinations) and mood symptoms (like depression or mania) into one label. It’s important that your doctor rules out other conditions such as bipolar disorder, depression, drug use, and schizophrenia before diagnosing you with this condition.

Experiencing psychotic symptoms for any reason is a cause for concern, and perhaps due to the influence of the media’s portrayal of psychosis, your mind may immediately jump to schizophrenia. It’s important not to self-diagnose as there are many factors that go into deciding whether a person has schizoaffective disorder or not. 

Schizoaffective disorder is divided into two categories: a bipolar type and a depressive type. Psychotic symptoms can remain consistent while mood disorder symptoms come and go. 

Schizoaffective with bipolar symptoms

This subtype of schizoaffective disorder could be worse than most cases of bipolar disorder due to the combination of both psychotic symptoms and the ups and downs of bipolar disorder. A person with this type may experience the following symptoms:

• Episodes of mania, or feeling very energetic, confident, and grandiose
• Episodes of depression that may include fatigue, low self-esteem, and sadness
• Paranoia, hallucinations, or delusions
• Speech problems (such as speaking very fast or incomprehensibly)
• Trouble in relationships, work, school, and life in general

Schizoaffective with depressive symptoms

A person with the depressive subtype of schizoaffective disorder will not experience the highs of mania, but he or she may struggle with significant depression. It’s difficult to say whether this type is more difficult to manage than the bipolar type because there is so much variation from person to person. Someone with this type may experience the following symptoms:

• Episodes of depression that may last for a long time or come and go
• Paranoia, hallucinations, or delusions
• Trouble functioning in life and in relationships

There isn’t one single cause of schizoaffective disorder, but researchers think that a genetic predisposition for the disorder combined with a stressful event may trigger most cases. If you have a close relative with this disorder, you have a greater chance of developing it yourself. If you’ve used psychoactive drugs such as LSD, this puts you at higher risk for schizoaffective disorder as well.

Learning that you have a mental illness that has schizophrenia-like symptoms in addition to bipolar or depression-like symptoms might make you feel very anxious. On one hand, schizoaffective disorder may be relatively mild when compared to bipolar I, which often features manic episodes, fits of rage, or “breaks” from reality.

On the other hand, untreated schizoaffective disorder can be disabling. In general, people with schizoaffective disorder probably have more symptoms to manage than those with bipolar disorder, but this cannot be generalized to every person with these diagnoses. Bipolar disorder can also be severe.

Bipolar disorder, even without the schizoaffective symptoms, can be very severe and can ruin a person’s quality of life if it isn’t treated. It’s possible to misdiagnose bipolar symptoms as a schizoaffective disorder if there are psychotic symptoms present. It’s possible that bipolar disorder that includes psychotic symptoms (such as hallucinating when manic) is more severe than other types of bipolar disorder.

Both people with bipolar I and bipolar II are at risk for poor quality of life, especially those with more symptoms of depression. Though it’s impossible to determine whether a single person will have a good life when living with a mental health condition, risk factors for having a lower quality of life include the following:

• How much stress you are experiencing
• Whether or not you are taking your medication 
• The health of your relationships
• A poor social support system
• Low socioeconomic status

Due to the rapidly shifting moods, symptoms of psychosis, and ability to handle stress from day to day, it might be almost impossible to tell whether someone is dealing with a diagnosis of schizoaffective disorder or another similar condition. Consider the following three diagnoses and learn how they differ from schizoaffective disorder:

• Schizophrenia. This mental illness is often severe, but you can manage it with medication and therapy. While it does not include the extreme highs or lows of schizoaffective disorder or bipolar disorder, it can include social withdrawal, bizarre behavior, and mood swings.
• Bipolar disorder. If you are already managing a bipolar diagnosis, you may worry if you experience a hallucination or a bout of paranoia that seems more extreme than before. This doesn’t necessarily mean that you’ve developed schizoaffective disorder. Ask your doctor about your symptoms and go over your medications to ensure that you’re being properly treated.
• Depression. Depression often responds well to a combination of cognitive-behavioral therapy and medication. It rarely includes psychotic symptoms unless it’s especially severe, and these symptoms usually only happen during periods of depression rather than all the time. 

Both schizoaffective disorder and bipolar can be mild or severe, but people with schizoaffective disorder may not get as many periods of “normality” as those with bipolar disorder in between episodes. A person’s stress level, relationships, and overall functioning in society can play into how severe his or her condition seems, even from day to day. If you are having strange or troubling symptoms, it’s a good idea to review them with a doctor as soon as possible.