Bipolar 2, Bipolar 1, Schizoaffective Disorder

As someone who has been diagnosed with all three at different times...

Bipolar 2: Severe depression with mild mania that doesn't interfere with life
Bipolar 1: Severe depression AND mania that interferes with life and/or needs hospital to keep safe
Schizoaffective: Same as the bipolars, but with the addition of psychotic symptoms (hallucinations and delusions) that occur even when mood is normal ("euthymic")

I was diagnosed with schizoaffective disorder bipolar type 8 years ago. I have many of the symptoms of schizophrenia, in addition to the psychotic (positive) symptoms, I've dealt with many of the negative symptoms as well (such as flat affect, cognitive problems, poverty of speech, and thought problems as it is a thought disorder, like not making much sense when I'm unwell and speaking with loosely connected ideas/words). Then of course with the bipolar part of the dx I experience manic and depressive episodes.

I just want to add after seeing some posts in here that there's already a lot of stigma with having schizoaffective or schizophrenia, as there is with any mental illness but especially so because "schizo" anything scares people. I don't believe having this dx has wrecked my life or will prevent me from reaching my full potential in life and being successful, it's definitely possible to thrive with it.

ugh. diagnosis. psychiatry is subjective...and that opens it up to all sorts of problems. anyway...

bipolar II usually means no mania, frequent depression, hypomania and/or milder mixed states (agitated depression I think qualifies with some shrinks). at the softer end, it seems to overlap with some 'personality disorders' ... at the more severe end, it can overlap with what would once, perhaps not so long ago, been considered 'severe endogenous depression.'

bipolar i- mania. severe depression. it used to be understood that the person was normal(ish), even high functioning when not in the midst of an episode...that's changed, somehow. psychosis, if it occurs, is limited to the mood episode...severe mania might bring psychosis, less often psychotic depression is an issue.

schizoaffective-- the manic type is more similar to bipolar I, in terms of long term outlook. psychosis occurs outside of mood states, but is not the core, defining feature, as one sees in Schizophrenia. the depressive sub-type is, from what I understand (and I could be wrong) a lot more like Schizophrenia, in terms of long term outlook and such...severe depressive states, psychosis both during the depressive states and when in a more or less normal mood.

now, that's just -my- understanding of dsm-checklists. i could be wrong. i think its also worth noting that the labels are mostly useful for billing and guiding treatment, to a point...where the rubber hits the road, go to 2 shrinks, get 3 opinions. it is what it is...

:-)

As someone who has been diagnosed with all three at different times...

Bipolar 2: Severe depression with mild mania that doesn't interfere with life
Bipolar 1: Severe depression AND mania that interferes with life and/or needs hospital to keep safe
Schizoaffective: Same as the bipolars, but with the addition of psychotic symptoms (hallucinations and delusions) that occur even when mood is normal ("euthymic")

No, having psychosis outside of an episode does not mean you qualify for a schizoaffective diagnosis. I think that's a common misconception about the diagnosis. In fact, I think it is a bad idea to diagnose someone with schizoaffective just because they have psychosis outside of an episode, even if the psychosis is persistent or occurs more than a few times.

Schizoaffective bipolar type *literally* implies that you have bipolar with schizophrenic symptoms. For example, flat affect, catatonia, word salad, warped thought processes, etc.. (Basically, there are certain behaviors/mannerisms that come packaged with disorders on the schizophrenic spectrum.) Also, in some cases, level of functioning is taken into consideration as well. Psychosis is just one symptom of schizophrenia.

I know personally that psychologists at one point thought I might have schizoaffective disorder because of my stubborn psychosis that never goes away no matter what. However, when I underwent specialized psychological testing, the psychologist said I didn't have enough of the schizophrenic type symptoms to qualify for such a schizoaffective diagnosis. For example, I have flat affect, flat vocal tone, social problems, isolation, etc., but the psychologist said I didn't 100% portray as someone who actually has schizophrenia or schizophrenia-like disorder. (Basically, I only somewhat portrayed and she wrote that down.)

People who do not have schizoaffective disorder but who have psychosis independent of mood episodes are supposed to be Dx'ed with bipolar w/ mood-incongruent psychotic features, using the shortened "with psychotic features" specifier. Since there is no such "bipolar 2 w/ psychotic features" label, I guess you're automatically Dx'ed with bipolar 1 even though you technically have bipolar 2 w/ psychotic features. I'm not sure why there is no such "bipolar 2 w/ psychotic features" label, but I don't think bipolar 2 has more than one diagnostic code to begin with.

Whatever you end up having, though, as long as you get treatment for your symptoms and your insurance doesn't complain about said treatment, then that's all that matters. But I just wanted to point out the differences between schizoaffective and the "psychotic features" BP specifier since, well, that was asked. I was confused myself until the psychologist who did my assessment told me the differences, and my therapist (also PhD psychologist) chimed in down the road.

Hi Franz! How wonderful to have you around PC! I know your schedule and/or commitments often make your participation here very difficult. Are you still traveling?

I'd wanted to take a moment here to share some info with you. My diagnosis is BPII. I find my BPII experiences with both depression and with hypomania absolutely interfere with life. BPII is often very disabling.

The idea that BPII has no major effects upon one's life is a frequent misunderstanding and, unfortunately, contributes to further misunderstanding of the struggles of many people diagnosed with BPII.

Thank you for your patience while I have addressed a common misunderstanding.

I do hope to see you around more often!
Much Love to You!

What I meant to say is that in my experience hypomania doesn't make it so I can't function. I might be silly and distractable, but I'm not hiding under my bed trying to escape the angels swarming around me or ending up in the hospital because I'm engaging in dangerous behaviors.

Bipolar II is hugely debilitating, often more so than someone with Bipolar I who, for example, had less frequent episodes. I was merely explaining my experience of the difference between hypo and mania.