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Supporting Someone With Schizoaffective Disorder

If you are a friend or family member of someone diagnosed with schizoaffective disorder (ScAD), you can play a helpful role in that person's life. Understanding as much as you can about ScAD will help you to be as supportive as possible.
What do I need to know about this condition?
ScAD is a lifelong mental illness that causes periodic episodes of mood swings and severe loss of contact with reality (psychosis). It may interfere with personal relationships or normal daily activities. A person with this illness has symptoms of a psychotic disorder (schizophrenia) and a mood (affective) disorder. There are two types based on the mood disorder that is present:

  • Bipolar ScAD. The person goes through episodes of emotional highs (mania) and emotional lows (depression).
  • Major depressive ScAD. The person only has episodes of depression

Symptoms of schizophrenia include:

  • Hearing, seeing, or feeling things that are not there (hallucinations).
  • Having fixed, false beliefs (delusions). These often involve a person believing that he or she is being attacked, harassed, cheated, persecuted, or plotted against.
  • Speech or behavior that is odd or disorganized or does not make sense to others (incoherent).

Symptoms of mood disorders include:

  • Symptoms of mania, such as increased energy and activity, restlessness, and reckless behavior.
  • Symptoms of major depression, such as low energy and activity, feeling hopeless or worthless, and loss of interest in activities that used to be enjoyed.

What do I need to know about the treatment options?
ScAD requires long-term treatment. Treatment may include:

  • Medicines, such as antipsychotics, mood stabilizers, or antidepressants. The exact combination of medicines depends on the type and severity of the person's symptoms.
  • Counseling or talk therapy. Individual, group, or family counseling may be helpful in providing education, support, and guidance. Many people with ScAD also benefit from social skills and job skills (vocational) training.
  • Electroconvulsive therapy (ECT). This procedure involves applying short electrical pulses to the brain through the scalp to change brain chemicals (neurotransmitters). ECT may be used to treat people with severe symptoms if other treatments are not effective.

A combination of medicine and counseling is usually best for managing this disorder over time.

How can I support my loved one?
Talk about the condition
Good communication can be helpful in supporting your friend or family member. Here are a few things to keep in mind:

  • Be careful about too much prodding. Try not to overdo reminders to an adult friend or family member about things like taking medicines. Ask how your loved one prefers that you help.
  • Be patient, listen well, and speak encouraging words.
  • Be available if your loved one wants to talk. Make an effort to acknowledge his or her feelings.

Find support and resources
A health care provider may be able to recommend mental health resources that are available online or over the phone. You could start with:

  • Substance Abuse and Mental Health Services Administration (SAMHSA): www.samhsa.gov
  • National Alliance on Mental Illness (NAMI): www.nami.org

Think about joining self-help and support groups, not only for your friend or family member, but also for yourself. People in these peer and family support groups understand what you and your loved one are going through. They can help you feel a sense of hope and connect you with local resources to help you learn more. You could also try family or couples therapy.

General support

  • Make an effort to learn all you can about ScAD.
  • Ask your loved one how you can best help him or her. Offer to help with daily responsibilities, such as laundry or meals.
  • Help your loved one follow his or her treatment plan as directed by health care providers. This could mean driving him or her to therapy sessions or suggesting ways to cope with stress, such as going for a walk together.
  • Do not argue with your loved one about his or her perception of reality.

How can I create a safe environment?

  • Create a written crisis plan. Include important phone numbers, such as the local crisis intervention team. Make sure that:
    • The person with ScAD knows about this plan.
    • Everyone who has regular contact with that person knows about the plan and knows what to do in an emergency.
  • Be aware that sometimes there is a risk of violence toward you when a person has schizoaffective disorder. Set limits when it comes to physical or verbal abuse. One thing you could do is tell your loved one that if he or she is getting violent, you will leave and then call the police. Talk ahead of time about your plans for handling violent situations. Doing that will help to make violent episodes easier to manage if they happen.
  • To lower the risk of violence or suicide during a crisis, remove or lock up guns and other weapons. If you do not have a safe place to keep a gun, local law enforcement may store a gun for you.

How should I care for myself?
Supporting someone with ScAD can cause stress. Be sure to find ways to care for your body, mind, and well-being.

  • Find someone you can talk to who will also help you develop coping skills to manage stress.
  • Try different techniques for coping with stress, such as:
    • Muscle relaxation, meditation, and breathing exercises.
    • Exercise, even if it is just taking a short walk a few times a week.
    • Getting the right amount of good-quality sleep.
  • Try to maintain your normal routines. This can help you remember that your life is about more than your loved one's condition.
  • Make time for activities that help you relax, and try to not feel guilty about taking time for yourself.

What are some signs that the condition is getting worse?
Warning signs that your loved one's condition is getting worse include:

  • Clear, sudden change in behavior or symptoms.
  • Struggling with daily activities.
  • Increased use of drugs or alcohol.
  • Not being able to fulfill basic needs (food, clothing, shelter).

Warning signs that your loved one is thinking about suicide include:

  • Withdrawing from friends and family.
  • Talking about suicide or searching for methods.
  • Expressing feelings of being trapped or not having a purpose in life.

Ask a counselor or your loved one's health care provider about when to get help if you are concerned about behavior changes. Privacy laws limit how much a health care provider can share with you without your loved one's permission, but if you feel that a situation is an emergency, do not wait to call a health care provider or emergency services.
Get help right away if:

  • You are in a situation that threatens your life. Leave the situation and call emergency services (911 in the U.S.) as soon as possible.

If you ever feel like your loved one may hurt himself or herself or others, or may have thoughts about taking his or her own life, get help right away. You can go to your nearest emergency department or call:

  • Your local emergency services (911 in the U.S.).
  • A suicide crisis helpline, such as the National Suicide Prevention Lifeline at 1-800-273-8255. This is open 24 hours a day.


  • ScAD is a lifelong illness that causes periodic episodes of mood swings and severe loss of contact with reality (psychosis).
  • Treatment for ScAD is ongoing, and it may include medicines, counseling, therapy, support groups, and social skills or job skills training.
  • Support that you give to your loved one is an important part of a successful treatment plan.
  • Make sure to take care of yourself while supporting someone with ScAD. Get help when you need it.
  • Expect mood swings and behavior episodes, and have a plan for how to help your loved one manage them. If you feel threatened or are worried about your loved one's safety, contact your local emergency services as soon as possible.

This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.

Document Released: 05/01/2018 Document Revised: 05/01/2018 Document Reviewed: 05/01/2018
Elsevier Interactive Patient Education © 2018 Elsevier Inc.


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