Hi,

I've been diagnosed with schizoaffective disorder, but to be honest, it's been so long that I've talked to my psychiatrist about my diagnosis that I'm not even sure if that's the diagnosis that he's using anymore. At any rate, since I do have a schizoaffective diagnosis, I'll do my best to answer your questions.

I would say bipolar, because I've definitely experienced what I can now recognize as manic symptoms. I would describe my illness (or illnesses, if you will) as a psychosis with some manic aspects that is superimposed over a chronic fatigue with hypersomnia, which could very well be looked at as being a depression. The fatigue and hypersomnia began 13 years ago, and the psychosis with the manic aspects began six years ago for me. To the extent that my fatigue and hypersomnia could be described as being "depressive" symptoms, I would say that I'm basically in an ongoing mixed state, which at first made it difficult for me to recognize that there was any mania there. But I do think that I've experienced at least some manic tendencies since the onset of my psychosis, which I think would give me the bipolar subtype of schizoaffective disorder.

Overall, I would probably have to say that my affective/mood issues have been more prominent for me most of the time than my psychosis issues. For me, the chronic fatigue and hypersomnia have been more disabling than the psychosis or the mania and have been more difficult to treat, although the psychosis got me into more trouble when it was really intense for me. Certainly, though, for the majority of the time that's elapsed even since the onset of my psychotic and manic symptoms, it's been the fatigue and hypersomnia (and the difficulty concentrating that tends to go with it) that have seemed to produce the most functional impairment.

Once I started to notice feelings of fatigue and hypersomnia, it was obvious to me that something was wrong, although I didn't know exactly how to best describe what I was experiencing in terms of a specific illness. I was diagnosed first with dysthymic disorder, then bipolar disorder (without psychotic features), and then recurrent major depressive disorder before the onset of my psychotic and manic symptoms. I had no problem accepting any of those diagnoses. When my psychotic and manic symptoms first came on, I didn't think that these new phenomena that I was experiencing were symptoms of a mental illness. Instead, I thought that I was having a spiritual awakening of sorts that was brought on by thinking certain things about the nature of humanity. I haven't completely abandoned the idea that what I call my psychosis might involve some sort of spiritual component, but I think that my symptoms fit too well with those that others with schizophrenia, schizoaffective disorder, and bipolar disorder with psychotic features experience for me to say that there's no mental illness other than my original symptoms (the fatigue and hypersomnia) going on. But anyway, to answer your question about how long it took for me to recognize that I was experiencing psychotic symptoms following the onset of such symptoms, I would say that it gradually happened about 7-10 months after I started experiencing my psychotic symptoms.

I don't doubt that I have some sort of mental illness with psychotic symptoms and affective symptoms, but I'm not 100 percent sure that schizoaffective disorder is the best fit for the symptoms that I experience. I tend to think that my psychosis is probably more of a manic psychosis than it is a schizophrenic psychosis because it's hard to separate my psychosis from feeling sleepless, feeling restless, feeling distractable, feeling irritable, and having what I think are racing thoughts. So, maybe bipolar disorder with psychotic features would be a better diagnosis for me, but I'm not sure about that, either. I should probably ask my psychiatrist for his explanation concerning his diagnosis for me the next time I go in to see him so I could get a better understanding of where he thinks I fit in as far as having schizophrenia, schizoaffective disorder, or bipolar disorder with psychotic features is concerned.

T.