Nobody actually know what's going on in the brain with "schizophrenia," "schizoaffective," "bipolar," etc. The brain differences between people with these labels and those without these labels can often be explained by other factors, the big one being brain changes caused by psychiatric treatment. Other factors include: drug abuse, stress, malnutrition, head injuries, etc.

If you'll notice...they don't do blood work or a brain scan when you're diagnosed (usually) or during treatment. I had to go to a hospital once, a teaching hospital...they did a brain scan...and my treatment was the same as it would have been anywhere else. They just did the brain scan to seem scientific, and because I had good insurance.

Not everybody responds to antipsychotics/neuroleptics/tranquilizers. Something like 1 out of 3 people with a label of "Schizophrenia" don't get any benefit from antipsychotics.

Some people just do better with the benzodiazepines. Those are tranquilizers that work on GABA. The "antipsychotics" are tranquilizers that work on Dopamine receptors, specifically D2 receptors. Benzodiazepines can cause physical dependence, sometimes doses go up over the long haul, etc. Antipsychotics can cause far worse problems over the long haul, and they tend to be more expensive.

Diagnosis isn't all that important. The DSM is there mostly so the professionals can bill insurance, medicare/medicaid, etc., and to guide treatment. I'm labeled "Bipolar I" by my current shrink. My former shrink says its "Schizophrenia." The two of them also have different IQ estimates (my current shrink's IQ estimate is higher than my former shrink's IQ estimate, by over 10 points).

So...who's "right" ? What's my "real" diagnosis? Your "real" diagnosis? There's no way to test these things like you would with physical problems. No blood work, brain scan, lab work, anything.

I guess...do what works. Don't worry about the labels.

Hope this helps.