Tag: schizoaffective disorder

Schizoaffective Disorder: a clinical paper

by Midnight Demon, posted in mental disorders, mood disorders

Schizo-affective disorder is a mixture of two kinds of major mental illnesses, mood disorders and schizophrenia. The patient meets criteria for either major depression or bipolar disorder and criteria for schizophrenia. The illness usually begins in early adulthood and is treated with both pharmacotherapy and psychotherapy. The diagnostic criteria for schizo affective disorder is an uninterrupted period of illness during which, at the same time, there is either 1) major depressive episode, 2) a manic episode, or 3) a mixed episode concurrent with symptoms that meet criteria for schizophrenia. The type is usually specified as either bipolar type, if it includes mania or a mixed state or depressive type if the disturbance only includes major depressive episodes.
Criteria for Major depressive episode is as follows:
Five or more of the following has been present for at least 2 weeks and represent a change in functioning; at least one of the symptoms is either depressed mood or loss of interest or pleasure. Depressed mood is present most of the day, nearly every day, marked diminished interest or pleasure in all or almost all activities during the day, significant weight loss or gain, insomnia or hypersomnia, psychomotor agitation or retardation nearly every day, fatigue or loss of energy, feelings of worthlessness or excessive or inappropriate guilt nearly every day, diminished ability to think or concentrate, and recurrent thoughts of death, suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide. The symptoms do not meet criteria for mixed episode or cause significant distress or impairment in social, occupational or other important area of functioning. The symptoms are not due to drugs or a general medical condition or caused by bereavement, i.e., after the loss of a loved one, the symptoms persist longer than 2 months.
The criteria for Manic episode is a distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least 1 week. During the period of mood disturbance, there are three of the following symptoms: inflated self-esteem, decreased need for sleep, more talkative than usual, insomnia or hypersomnia nearly every day, psychomotor agitation or retardation nearly every day, flight of ideas or racing thoughts, distractibility, increase in goal-directed activity, and excessive involment in pleasurable activities that have a potential for painful consequences (e.g. unrestrained buying sprees, sexual indiscretions, foolish investments.) The symptoms do not meet the criteria for mixed episode and are not caused by drugs or a general medical condition.
Criteria for mixed episode are met both for a manic episode and major depressive episode for nearly every day for one week. The disturbance is sufficiently severe to cause marked impairment in occupational functioning or in usual social activities or to necessitate hospitalization to prevent harm to self or others or there are psychotic features. The symptoms are not due to the direct effects of drugs or a general medical condition.
Criteria A for schizophrenia is the following symptoms that last for at least 1 week: delusions, hallucinations (auditory and visual), disorganized speech (incoherence), grossly disorganized behavior or catatonic behavior, and negative symptoms such as affective flattening, alogia, or avolition. Only one symptom is required if delusions are bizarre or hallucinations consist of a voice keeping up a running commentary on the person’s thoughts or behaviors, or two or more voices conversing with each other. During the same period, there have been delusions or hallucinations for at least 2 weeks in the absence of prominent mood symptoms and meet the criteria for a mood episode that are present for a substantial portion of the illness. The disturbance is not caused by drugs or a general medical condition. (from http://www.psychologynet.org/schizaff/html).

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everything is a bother

by Midnight Demon, posted in blogging, depression

Should have stayed home

I should have stayed home today than embrace this hot weather just to get an iced coffee at Starbucks. I didn’t think it would be too bad out but I was wrong. Least it wasn’t humid out. I can take the dry heat but not the humidity.

I got my coffee and then contemplated how I was going to get home as there is no bus from the square to my house. I had to finagle things.

I became psychotic again last night. I don’t know why I am having break through psychotic symptoms. I am not stressed to the max or anything. It is weird. I also have been having weird dreams. I fell asleep earlier than usual last night and woke up around 0230. I didn’t go back to sleep till around 0430. I don’t know if I blogged another blog or not. I didn’t. I guess this heat is making me crazy even with the a/c cranked. I hope I don’t have another episode before I see my pdoc on Friday. Maybe she can make sense of it. I sure can’t.

I am glad I am home and in my room. I need to take a shower but that can wait for now. I have to do it before tonight as I need to change patches. I hate taking a shower in the heat. Even though we have a cooling fan it doesn’t do much but blow around the hot air.

My therapist never texted me back on what I was to write on. Bugger. I will yell at her tomorrow when I talk with her. I still have had fleeting thoughts of dying. Today while waiting for the bus stop I am not familiar with, I was hoping someone would kill me. Just slice my throat open or shoot me. I mean those things happen all the time, why can’t it happen to me. It would save me the trouble of trying to kill myself. I once thought of hiring someone to kill me but I don’t think I could ever raise enough funds to do that. I know my life isn’t worth much to begin with but to someone who would end up in jail because they took my life, might mean more than just a few hundred dollars.

I got my annual retirement statement from my work. I don’t know what to do with it now. It’s not like I can touch the money without penalty. And even if I did, I bet the US treasury would want some for my student loans. But I don’t think they can touch it. I hope not anyways or I will have nothing. Course if I kill myself, it doesn’t matter anyways.

I want to read but I don’t know what to read. I have books piled on my bed and around my bed. All I have to do is choose one and I can’t even do that. Decision are so hard when you have a deep depression. I’m so glad I don’t have to work for now because I HATED having to choose my attire for the day. Not like I had to get dressed up. But I hated choosing which color jeans and what socks to wear (black or white, ankle or tube, etc.) My friend just told me to grab the closest one and usually I did that. I would sometimes wear the same jeans all week because I didn’t want to bother with emptying the pockets for another pair. I have to carry my pens, wallet, change (if I felt like it), and money. I never carry my money in my wallet. I don’t think anyone does. It’s just a safety measure I learned while living in Boston.

I feel really down despite having an ok day. I really want to take a nap right now but I am fighting it. I am exhausted from my trip today just to get my coffee but also from not sleeping through the night and waking up at fricken nine. I finally gave up around ten and got out of bed to have breakfast. Then went out of this stupid coffee. Starbucks is coming out with a home iced brewing system. I am thinking about getting it so that on days like today I don’t have to leave the house. Course I don’t know if I can have some counter space in the kitchen. My mother has this coffee pot, Gevalia, that she never uses but yet it has to be on the counter. If I get this brewing system, it could go there. It would be so nice to make iced coffee at home. I have a French press that I use for hot coffee but it’s a pain to clean because it doesn’t have a filter. When you clean it, you get the grounds all over the place except the bucket. Least that is my luck.

Maybe I should go back on antidepressant. Trouble is that I have been on all of them and each one has upset my stomach. After a few months, I get nauseous in the morning and sometimes I vomit if it gets too bad. I thought at first it was something wrong with my stomach but tests have not shown anything wrong. Once I stopped the antidepressant, the nausea stopped too. And I was taking the lowest dose possible. It sucks. I am glad the mood stabilizer doesn’t give me any side effects other than drowsiness. It also helps my appetite in check. I don’t know how but I lost another few pounds. Course I have not been eating that much lately. I mostly just have been eating cereal and sometimes eggs, if I am up to making them. I used to eat eggs all the time until the depression hit me bad. Now it’s too much of a bother. Everything is too much of a bother.

I think I’ll go back to reading Team of Rivals…

psychosis while reading

by Midnight Demon, posted in psychosis, writing

Just wrote a few pages for my book. I don’t know if it will ever get finished or published but it is a start. I add to it every now and then. I should edit it a little bit to add more to it but then I might want to scrap the whole thing.

I got to my Starbucks and am having my Kati Kati coffee. It’s so good, I might get another one before I go. But I think one coffee per day is my limit. Otherwise I might have a night like last night where I was up most of the night. But it wasn’t because I was restless, it was because I was in pain. The pain finally settled down around three in the morning. I fell asleep shortly there after.

I started writing about my past in the book. And about my diagnosis of Bipolar II disorder. I am not sure I can explain it as I don’t understand it too well myself. But it is basically episodes of hypomania and severe depression, mostly severe depression as the hypomania come infrequently. I have had this diagnosis since I was sixteen. I thought it was just due to a medication reaction (Prozac made me hyper and crazy) but when it lingered long after the half-life, I knew that I had it. But I still have the psychosis that is inherent in my illness. I have been having voices since I was five years old. It’s hard to explain how the voices evolved. But they are still with me and they are not my voices. I know because usually when I read, there is a man voice that reads with me. When I don’t hear this voice then I know it is my voice reading. I once asked my therapist if she hears a voice while she is reading and she says that she doesn’t. I find that odd. I thought everyone had a voice that changes with the way that the book’s words go. I guess I am truly psychotic.

Last night while I was reading it was difficult because I didn’t hear a voice. I don’t know if it was because I was too tired to read or that I just didn’t want to get into the book. I finally gave up after reading for a half hour. I am tempted not to take my meds to see if the voices to do come back while I read. It does make for interesting reading when the voice changes when there is dialog in the book. Usually I hear a man’s voice narrate as I read. He wasn’t there last night and I found it odd. I tried to imagine voices while I read but it just took more effort to try and pay attention to what I was reading. It was very difficult concentrating.

hypomania sucks

by Midnight Demon, posted in blogging, depression, mood disorders, psychache, suicide, suicide attempt

Been going through a difficult past few days. I have been feeling up, almost happy, and I find it disturbing because I never have felt that way before. If I have I don’t remember it and it definitely has not lasted more than a day or so. I know it’s better than being down but I just am not used to being this way. I am waiting for the other shoe to drop. I just am not accustomed to feeling this way.

I wrote a blog this morning but I had the need to write another one tonight. I just can’t help but think that there is going to be some gloom soon because of the way I have been feeling. My cousin says that maybe I am “getting out of it”, what ever that means. I know that I can’t be happy for too long. I just don’t trust it. I also know that when I crash, I will crash big time. And I am not looking forward to it. I know it will happen, maybe not right away but it will happen. That is the pattern of being bipolar, though I mostly stay on the depression spectrum rather than the hypomania side of things. I just dread it because I know that I most likely will have to go into the hospital and I am not looking forward to that either. Every time I have crashed, I have needed to go in the hospital because I got intensely suicidal. How is that different than what I am planning? Easy, I just become more impulsive about taking my life and feel the urge to do so. It becomes a compulsion that I need to get out of my system so I don’t feel such misery. But after this phase passes, I am usually back to my norm and won’t feel good again for a long while. The last time I felt this good was back in 2002. I kid you not. I go for stretches of time between hypomania. That is why I am worried. But this time I am on a good mood stabilizer so I am hoping that by increasing it or tinkering with it, will bring me back to the doom and gloom that I always feel. I am comfortable with that. It’s not pleasant but it’s my norm.