A Guide to Schizoaffective Disorder Therapies and Treatments

Medically reviewed by: Erica Munro, MSc
Wednesday, January 24

Schizoaffective disorder can be complex and often misunderstood — which has made it difficult to diagnose. However, as clinicians perform more research in efforts to better understand this disorder, more information has emerged and more effective treatments have developed.

Below, we’ll examine this complex disorder to give you a better understanding of its many nuances and symptoms. We’ll also explore some of its potential causes, risk factors, and common treatments and therapies.

What is schizoaffective disorder?

Schizoaffective disorder is a mental health diagnosis that combines schizophrenia symptoms with mood disorder symptoms that may be depressive, manic, or both. 

This combination of such varied symptoms may lead to a misdiagnosis, making it harder for those with schizoaffective disorder to get the right help for managing their symptoms. 

Schizophrenia vs. schizoaffective disorder: What’s the difference?

Although they do share some similarities, schizoaffective disorder and schizophrenia are two separate diagnoses. 

Schizophrenia is a psychotic disorder commonly characterized by auditory and visual hallucinations. As a result, people with schizophrenia may have difficulty distinguishing reality from fantasy.

While schizoaffective disorder does have psychotic symptoms, it stands apart from schizophrenia due to its significant mood symptoms. Since the diagnostic criteria for schizoaffective disorder include both psychotic and mood symptoms, it’s often misdiagnosed as other disorders, like schizophrenia or bipolar disorder. 

Someone with schizoaffective disorder may have a period of two weeks or more with only psychotic symptoms but no mood symptoms. They may experience a major episode of depression or mania for the majority of the disorder. By contrast, the psychotic symptoms of schizophrenia are present most of the time. 

The most common symptoms of schizoaffective disorder 

Schizoaffective disorder’s dual nature means that psychotic and mood symptoms occur. These symptoms may affect different areas in your life, like interpersonal relationships, work, or school. 

There are different types of schizoaffective disorder (including depressive type and bipolar type), all of which can present with different symptoms. Below, we’ll explore the common symptoms of schizoaffective disorder. As you read, keep in mind that symptoms, their length, and their frequency vary between people and types of schizoaffective diagnoses. 

Psychotic symptoms 

  • Hallucinations
  • Delusions 
  • Disorganized thinking 
  • Catatonia
  • Paranoia
  • Incoherent or disorganized speech

Mood symptoms 

  • Depressive phase:
    • Persistent sadness/hopelessness
    • Loss of interest in enjoyed activities 
    • Fatigue or lack of energy 
    • Changes to appetite/sleep
    • Suicidal thoughts and behaviors 
    • Trouble concentrating or making decisions 
    • Unwarranted feelings of guilt 
  • Manic phase:
  • Increased energy/agitation
  • Improved mood or irritability levels 
  • Fast, pressured, or excessive speech
  • High-risk behavior engagement
  • Inflated self-esteem or grandiose thoughts and behaviors 
  • Easily distractible 
  • Racing thoughts

Mixed episode symptoms 

Individuals with schizoaffective disorder may experience depressive and manic symptoms at the same time. These mixed episodes combine the highs of mania with the lows of depression. 

Depressive phases may present as lower activity and energy levels, sadness, or loss of interest in hobbies and other activities. Mania may appear as increased activity and energy levels, euphoric feelings, and more interest in certain activities.  

Other symptoms 

Those with schizoaffective disorder might also experience one or more of the following:

  • Blunted affect 
  • Apathy
  • Social withdrawal
  • Anhedonia 
  • Speech difficulties 
  • Inattention

Causes, triggers, and risk factors associated with schizoaffective disorder

There are several potential causes, triggers, and risk factors associated with the onset of schizoaffective disorder. In the following sections, we’ll explore some of these triggers and risk factors in detail to help you better understand how and why schizoaffective disorder presents. 

Keep in mind that having one or more risk factors or exposure to possible triggers doesn’t mean that someone has schizoaffective disorder, and only a licensed clinician can make diagnoses. 

Genetic factors 

Family history may increase a person’s likelihood of having schizoaffective disorder. Different gene variants are suspected to raise this risk, including those that help regulate the sleep-wake cycle, those involved in the movement of nerve cells as the brain develops, and those that send and receive chemical signals within the brain. 

Brain structure and function

Your brain has chemicals called neurotransmitters that allow nerve cells or neurons to communicate. Problems with certain neurotransmitters, such as serotonin, norepinephrine, or dopamine, may interfere with communication in your brain. This may be linked to the development of schizoaffective disorder. 

Potential structural and size differences in some areas of the brain, such as the hippocampus, may also be a risk factor. These abnormalities are sometimes linked to schizoaffective disorder, but not always. 

Environmental factors 

Certain environmental factors may play a role in increasing vulnerability to schizoaffective disorder. Prenatal exposures, such as malnutrition or certain viruses, are among these risk factors. Adverse childhood experiences, like neglect, trauma, or abuse, might also be associated with a higher risk of schizoaffective disorder. The use of psychoactive drugs — especially during adolescence — might also elevate the risk. 

Age and developmental factors 

Schizoaffective disorder onset most commonly occurs between the ages of 25 and 35, but it can also occur outside this range.

Some studies highlight early developmental delays, such as language or speech problems, as potential risk factors for adolescents. A 2010 study in Frontiers in Human Neuroscience finds that children with early-onset schizoaffective disorder had deficits in basic academic skills. Lower cognitive function was linked to more severe illness. 

Stress or life events 

Experiencing significant stressors or trauma may trigger schizoaffective disorder symptoms or make them worse. These stressors may include major life events, like a death in the family, migration, birth, or divorce. 

For example, being in a serious accident might trigger mood or psychosis symptoms. If you already had symptoms prior to the event, they might be more intense due to stress or trauma. 

Coexisting mental health disorders

Schizoaffective disorder may occur with other mental health conditions, like depression. In some studies, participants with this disorder also reported having symptoms of anxiety disorders or depression. 

Keep in mind that there’s some overlap between schizoaffective disorder symptoms and the symptoms of bipolar disorder and major depression. For example, someone with depression might be more likely to have depressive episodes with schizoaffective disorder rather than manic episodes.  

Substance abuse 

Using drugs or alcohol may make schizoaffective symptoms more intense. If you’re predisposed to this disorder by other risk factors, drugs or alcohol might prompt the onset of schizoaffective symptoms. 

Research finds that substance use is much higher in those with this disorder compared to the general population. Those with schizoaffective disorder might use drugs or alcohol during manic episodes, which are associated with high-risk behaviors. Or they might turn to substance use to self-medicate during depressive episodes. 

Therapies and treatments for schizoaffective disorder 

Schizoaffective disorder doesn’t have a cure. However, there are therapies and treatments that can help manage these symptoms under the care of a mental health professional. 

Prescribed medication

A few different types of medication are used to treat schizoaffective disorder. Antipsychotics may help manage psychotic symptoms like hallucinations. Lithium and other mood stabilizers may help manage manic and depressive mood symptoms, especially for those with bipolar-type schizoaffective disorder. 

Other medications for managing mood and anxiety symptoms may include antidepressants, like fluoxetine, and anxiolytics (anti-anxiety medications). 

Medications are typically paired with talk therapy for schizoaffective disorder treatment. Taking any prescribed medications and talking to a mental health provider like those at SonderMind can provide the support needed to manage schizoaffective symptoms. 


Cognitive behavioral therapy (CBT) can be effective at addressing hallucinations and delusions. This type of talk therapy involves identifying maladaptive thought patterns and replacing them with more productive ones. 

Psychoeducation is a valuable resource for both patients and family members. This involves learning more about schizoaffective disorder, including how to manage symptoms. 

Though it’s not their fault, having someone with schizoaffective disorder in the family may present unique challenges. Family therapy offers a way to help reduce stress and improve communication.

Life skills training is also helpful in enhancing day-to-day functioning. This training may help people with schizoaffective disorder handle everyday tasks. 

Electroconvulsive therapy (ECT)

Electroconvulsive therapy (ECT) involves stimulating the brain with small electric currents under anesthesia in order to alter brain chemistry. This type of treatment is most commonly only used when medication, talk therapy, and other treatments haven’t been effective. 

ECT has been shown to reduce schizoaffective symptoms (including severe symptoms like self-harm and aggression) while improving daily functioning.

Work with a licensed therapist at SonderMind today

Schizoaffective disorder can be a challenging condition to diagnose and treat. But with patience and guidance from a compassionate therapist, it’s possible to manage these symptoms with the right treatment plan.

Finding support for schizoaffective disorder can feel overwhelming — but it doesn’t have to be. At SonderMind, we make it easy to connect with qualified therapists, whether you prefer to meet virtually or in person. 

Let SonderMind support you as you take the first step toward managing your symptoms: Connect with a licensed therapist today.


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