Manic-depressive psychosis (bipolar disorder) - symptoms and treatment

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Schizoaffective disorder is an endogenous mental disorder, the symptoms of which simultaneously resemble the symptoms of both schizophrenia and affective psychoses. It is characterized by impaired thinking and unregulated emotions. May include disorganization of speech, hallucinations, and paranoid delusions. The diagnosis of the disease is made based on observation if a person has simultaneously signs of bipolar disorder, depression and schizophrenia, but there are no clear criteria for each of these deviations. The pathology usually manifests itself at a young age and is treated by a psychiatrist.

Causes of schizoaffective disorder

The exact causes of the pathology are unknown, like many other mental disorders, but there are several individual characteristics of the body that increase the likelihood of developing schizoaffective disorder. Most often it is observed in individuals with a hereditary predisposition.

Researchers have identified a risk gene that causes the development of schizophrenia. But under certain conditions, it is in a “dormant state” and begins to manifest itself after exposure to severe stress, severe somatic illness, etc. In addition, the appearance of this gene in the fetus may be due to mutational processes. There is also an assumption of the etiological and pathogenetic similarity of this disease and epilepsy, since in both cases there is a periodicity of manifestations and characteristic changes in the electrical activity of the brain on the EEG.

Provoking factors for the development of schizoaffective disorder can be:

• low social status;
• hunger and poverty;
• hostilities;
• forced migration;
• complete loneliness and lack of help from other people;
• alcohol and drug use.

In the case of the use of psychoactive drugs and alcohol, the possibility of developing this mental disorder increases. At the same time, people with this pathology also often have chemical dependencies, with the help of which they try to get away from their painful sensations, but this only aggravates the process of degradation. To determine what is primary – a mental illness or an addiction to alcohol or drugs, an experienced specialist and monitoring of the patient’s condition in a psychiatric hospital are required.

Dr. Isaev’s clinic has all the conditions for conducting differential diagnosis and providing professional assistance for schizoaffective disorder. For more detailed information, you just need to call the number listed on the website.

Will children inherit bipolar disorder?

According to the Center for Clinical Interventions, children of patients with bipolar disorder have an 8% risk of inheriting the disease. According to Bebbington (2004), the probability of inheriting bipolar affective disorder is 5-15%. At the same time, the likelihood is twice as high that relatives of bipolar patients will develop unipolar depression (that is, ordinary depression without the second pole - without mania/hypomania).

This in no way means that you shouldn’t have children. This is a reason to take care of the biological, psychological and social components of their development. Do not forget that the probability of remaining healthy in children of patients with bipolar disorder is 65-75%.

Types of Schizoaffective Disorder

Depending on the predominance of a particular clinical picture, the following types of shazoaffective disorder are distinguished:

• manic;
• depressive;
• mixed;
• unknown etiology;
• other types of deviation.

The manic type is difficult, and the prognosis is often unfavorable. Such a person poses a danger during an exacerbation period and requires placement in a psychiatric ward. The depressive form of the disorder resembles prolonged or moderate clinical depression. In the mixed type, signs of schizophrenia and a picture of affective disorders are noted. Symptoms of schizoaffective disorder begin with the pre-manifest stage, then the attack itself is observed, and after that a remission of varying duration occurs. On average, the acute period lasts for 6-8 months.

Any form of schizoaffective disorder requires timely help. If such a problem has arisen in your family, call us and an experienced specialist will tell you what can be done in this case.

Schizoaffective disorder: symptoms

The first symptoms of this mental disorder are usually observed in adults; children, as a rule, do not suffer from it; the pathology is more often described in women. The first attacks, reminiscent of schizophrenia, alternate with affective manifestations and delusions, while relatively preserved social adaptation and ability to work are observed. Sometimes, at first, emotional disturbances come first, which are replaced by delusions and hallucinations. In some cases, deviations occur simultaneously, and then diagnosis does not cause difficulties.

Schizoaffective disorder refers to transient conditions of an endogenous nature. In this case, disturbances of the emotional type prevail over productive symptoms. The attack is characterized by significant polymorphism of manifestations; its structure includes depressive-paranoid and manic-paranoid types of attack.

The main symptom accompanying schizoaffective disorder is frequent changes in the patient's mood. This happens suddenly, unpredictably and cannot be controlled. After that, attention deficit disorder, hallucinations, and a person’s ability to control their behavior are added to the overall picture. He ceases to understand the difference between reality and his own far-fetched illusions; imagination begins to play the leading role. The disease can manifest itself as pronounced deviations that become noticeable to everyone around, or it can occur in an erased form, when the changes are visible only to those close to you. Typically, schizoaffective disorder is accompanied by the following symptoms:

• depression;
• depression;
• loss of appetite;
• change in body weight;
• addiction to drinking alcohol;
• disturbance of the alternation of sleep and wakefulness;
• lack of interest in what is happening around;
• weakness, loss of strength;
• self-flagellation, decreased self-esteem;
• decreased concentration;
• lack of control over thoughts and actions;
• inadequate emotional reaction;
• suicidal tendencies, thoughts of death;
• strange behavior.

A person with schizoaffective disorder suffers from hallucinations, stops performing simple hygiene procedures, and develops obsessive ideas. The acceleration of thought processes leads to the fact that speech becomes fast, words seem to be layered on top of each other, endings are swallowed.

When the first signs of schizoaffective disorder appear in a loved one, you should not expect the problem to solve itself. The sooner you seek help, the more effective the therapy will be.

In depressive-paranoid types of attacks, the pathology manifests itself in the form of decreased mood and delusions of self-deprecation, ideas of poisoning, destruction, the presence of a fatal incurable disease, and sinfulness. A person suffers from apathy, depression, insomnia. A severe form of the seizure is manifested by depressive oneiroid or stupor. Depressive attacks, if left untreated, can result in the development of addiction or attempted suicide.

The manic form of the attack is accompanied by a decreased need for sleep, unbridled joy, agitation that does not correspond to the situation, and ideas of one’s own importance and greatness. With severe psychosis, delusions of fantastic content and other productive schizophrenia-like symptoms appear. There is a decrease in concentration, increased energy, and inappropriate social behavior due to disinhibition of the nervous system. Clinical manifestations do not appear immediately, but gradually increase in intensity. Sometimes there are ideas of persecution and pronounced aggressiveness, in which a person begins to pose a danger to those around him.

Mixed states represent frequent fluctuations from hypomania and mania to depression. These affects are accompanied by delusions, which contain the theme of the struggle between good and evil with auditory hallucinations of a positive and negative type. They are contradictory and often mutually exclusive in meaning. The mixed type of schizoaffective disorder manifests itself in the form of alternating depressive-paranoid and manic-paranoid disorders (happiness-fear psychosis).

During the period of remission, a person does not have an emotional-volitional defect; after an acute attack, residual symptoms of schizophrenia or affective deviations persist for some time.

Schizophrenia is a chronic mental illness, which is characterized by a violation of the unity of thinking processes, with relatively intact intelligence, which is combined with significant emotional impoverishment and decreased will. Hallucinatory and delusional disorders are often associated.

The term “schizophrenia” itself is made up of two Greek words - “schizo” - split and “phreni” - reason.

This term was first used by the Swiss psychiatrist Eugen Bleuler in 1908. Schizophrenia, of course, existed before, but only by the beginning of the 20th century did the idea of ​​it mature as a special type of psychosis.

In the mass consciousness, there is an unfounded identification of schizophrenia with “split personality” - that is, in fact, with a very rare mental disorder in which different “selves” are alternately activated in one person.

Schizophrenia, unfortunately, occurs quite often. Its prevalence among the Russian population is 35 per 10,000 people, with no significant difference between the sexes. Thus, in Russia there are at least half a million patients with this serious pathology.

Schizophrenia is an endogenous mental illness, which means that it is an internal breakdown of the psyche. It cannot be caused by any factors acting on the brain from the outside (trauma, intoxication, severe stress). Of course, the listed factors can affect the rate of development of schizophrenia, but not its occurrence. However, the mechanism of development of the schizophrenic process has not yet been established with any certainty. There are several hypotheses on this matter. Thus, there is evidence of a connection between schizophrenia and a disturbance in the distribution of dopamine in the central nervous system.

The role of heredity is very large. So, if one of the twins gets sick with schizophrenia, then the risk for the other twin to get sick is 17% in an fraternal pair and 48% in an identical pair. However, it is believed that in half of cases, schizophrenia arises from a random mutation, that is, based on genetic changes that were absent in the parents and appeared after conception.

Symptoms can develop at any age (possibly even in utero), but usually their onset is confined to the third pubertal crisis, that is, at the age of 12–18 years or the next few years (up to approximately 30 years).

Most often, the disease begins with negative symptoms associated with the loss of normal functioning - a person changes in character for no apparent reason, becomes withdrawn, isolated, loses social contacts, and emotional warmth in relation to loved ones disappears. Previous interests disappear, academic performance at school or university sharply declines, or official duties are not fulfilled. Thus, from the very beginning of clinical manifestations there is a very high risk of disability. In the most unfavorable variant, which is designated as simple schizophrenia, the patient may lie all day long, look at the ceiling and, with a clear consciousness and normal physical strength, is not able to provide basic care for himself. Even with more favorable options, thinking disorders increase, which are expressed in influxes of thoughts or in the feeling that there are no thoughts at all. Reasoning becomes unproductive, unfocused, and a dual attitude towards life phenomena (ambivalence) is formed. The speech is florid, sometimes with neologisms that the patient himself comes up with. During a conversation, there are distractions from the topic (slipping), and not to specific details and circumstances, but to the “bad” attitude of certain characters towards the patient, or to global philosophical topics. People suffering from schizophrenia tend to be somewhat cynical about many aspects of their surroundings.

Patients have a painful feeling that everything around them is somehow changed, devoid of naturalness, harmony (- derealization), the same sensations can arise in relation to their personality (- depersonalization). With depersonalization, consciousness (but not personality!) seems to split into two: one part of it looks at what is happening from the outside, and the other experiences horror from the awareness of the loss of control over itself.

One’s own thoughts and ideas begin to be perceived as alien. According to modern views, this is why verbal hallucinations (“voices”) occur in schizophrenia, and it is not surprising that the sound of “voices” inside the head is typical for this disease. For the same reason, it seems to the patient that someone is controlling him from the outside, even to the point of controlling movements and the functioning of internal organs. Visions occur less frequently.

Such a growing wave of unusual sensations is very painful. In many cases, internal tension is somewhat alleviated due to the formation of delusional ideas (quickly - like an insight - crystallization of delirium occurs). It suddenly becomes “clear” to the patient that what is happening to him is, for example, the “machinations” of some “organization”, which, with the help of modern equipment, exerts “influence” on him from the outside (delirium of persecution, influence). There are also delusions of jealousy and damage. It is clear that the plot of experiences is influenced by the level of development of society, including the plots of popular works of literature and cinema.

This entire clinical picture often develops acutely, in the form of an attack that lasts from several days to several months, and then can be repeated. Paroxysmal forms of schizophrenia are more favorable prognostically than continuous forms. The intervals between attacks can be very long (sometimes decades), and between them the person looks almost the same as before, before the illness. But this is rather an exception. Much more often, exacerbations of symptoms are repeated annually or several times a year, and upon recovery from each new attack, it turns out that the will has become even weaker and emotions have faded even more. Gradually, over many years, hallucinatory experiences become less relevant. At the same time, but also very slowly, delirium as a system of pseudo-logical conclusions is falling apart - only fragments of delirium remain. As a result, a defect condition develops that resembles simple schizophrenia.

Patients either do not recognize themselves as sick or have conflicting thoughts about this. As a rule, they react negatively to the persuasion of loved ones about the need to see a psychiatrist. There are attempts to alleviate one’s condition with alcohol and drugs, which only complicates the clinical picture and leads to further social maladjustment.

Under the influence of commanding “voices” and against the background of delusional experiences, the risk of socially dangerous actions of patients increases. For example, there are known cases of attacks on imaginary “persecutors.” But much more often, patients with endogenous mental pathology commit OOD through other mechanisms, including when their behavior is influenced by alcohol or drug intoxication, which is superimposed on negative symptoms.

Schizophrenia is the most common disease among patients in PKB No. 5 in Moscow.

A common diagnosis: “Paranoid schizophrenia, episodic type of course with an increasing defect, incomplete remission.” The clinical picture with this diagnosis includes delusions and hallucinations (usually persecutory delusions and verbal hallucinations - “voices”).

Treatment of schizophrenia includes antipsychotics, antidepressants, and nootropics. The leading role belongs to neuroleptics, whose action is aimed primarily at combating delusions and hallucinations. During treatment, at first, as a rule, the patient’s affective reaction to his own experiences becomes dulled - he becomes calmer, and psychomotor agitation goes away. Then the hallucinations decrease in intensity or disappear completely. All these positive changes become noticeable already in the first days of using antipsychotics. But the plot (that is, the plot) of delirium can linger for a long time, although in the picture of internal experiences it significantly fades in relevance. After relief of acute symptoms, the task that comes to the fore is how to reduce negative symptoms and eliminate psychopathic-like (that is, as in psychopathy) behavioral disorders. The latest generation of antipsychotics, such as olanzapine, paliperidone, and risperidone, help with this. Already at this stage it is worth thinking about the patient’s rehabilitation. Contrary to previously held opinion, psychotherapy is indicated for these patients, and it helps strengthen remission and resocialization. A good prognostic sign is the patient’s participation in physical labor, which, in itself, brings a significant therapeutic effect.

Although schizophrenia is a very dangerous disease, this is not a death sentence. Due to the partial preservation of individual abilities (especially intellectual ones) and non-standard thinking, many such patients have significant creative potential, which is evident, among other things, from the works presented at the Ariadne’s Thread arts festival.

Signs of affective disorders

Clinical symptoms of schizoaffective disorder include mood disturbances and schizophrenic features. The degree of their expression is approximately the same, while they alternate or are observed simultaneously. Deviations of an emotional nature are:

• manic;
• depressed;
• agitated.

During mania, a person feels a surge of energy and strength, is always in a great mood, even to the point of euphoria, and is constantly busy doing something. His thinking speeds up greatly and he has difficulty trying to concentrate on a specific job, and problems with concentration arise. His speech becomes fast and incomprehensible due to constant jumping from one topic to another. The patient feels able to “move mountains.”

One of the variants of mania is increased irritability and anger. The person becomes aggressive, behaves rudely with other people, is rude, interrupts, and counteracts. Often this state accompanies the delirium of saving humanity from an alien invasion or another fictitious global problem of the world level.

When depressed, the patient loses his appetite, and sometimes he does not even have the strength to get out of bed. The pace of thinking processes slows down, a person feels melancholy and engages in self-flagellation, and does not find any sources of joy in life. If help is not provided in time, then during this period the likelihood of suicide greatly increases. A subtype of depression is considered to be agitation, when the patient’s sharply depressed mood is masked by active and unproductive activity, which is chaotic in nature.

Mixed states

In mixed states of bipolar disorder, manic and depressive symptoms are observed. They can occur either simultaneously or alternately with a difference of several hours. As a rule, this form of the disease occurs in young patients, especially in patients whose disorder manifested itself in adolescence.

This type of bipolar disorder is more difficult to diagnose due to the inconsistency of symptoms. A person can be both excited and anxious-depressed at the same time. The course of the disease is also quite severe. 60% of such patients think about suicide. Moreover, about 50% of patients who committed suicide had a mixed form of bipolar disorder.

Signs of schizophrenia

Typical signs of schizophrenia in schizoaffective disorder include:

• delusional ideas;
• hallucinations.

The patient's delirium usually corresponds to his mood. With depression, ideas of one's own worthlessness and uselessness arise. Sometimes hatred appears towards family and friends, as well as towards humanity as a whole. If mania develops, the patient insists on his greatness, considers himself perfect, is confident in his own superpowers, and points to the mission entrusted to him to save the world.

Hallucinations in schizoaffective disorder are usually auditory, but can also be visual or tactile. During an exacerbation, a person sees something that is not really there or hears non-existent voices and sounds. The situation is greatly complicated by concomitant catatonia, usually in the form of stupor.

How to explain to loved ones what is happening?

Society still maintains a negative attitude towards mental disorders, so it is difficult for a person with a psychiatric diagnosis to tell even close people about it. At the same time, the support of family and friends plays a very important role in psychological well-being and gives strength to cope with stressful situations.

When talking about the features and symptoms of bipolar disorder, you can always use the description of its symptoms given at the beginning of this article.

Why is it important to inform loved ones about your condition:

1. Family and friends will be able to spot dangerous changes in behavior that precede episodes and advise you to make an unscheduled appointment with a doctor. The doctor will have the opportunity to adjust pharmacotherapy in a timely manner, which will reduce the duration and intensity of the episode.
2. Relatives will not take the behavior during the episode personally and will be more able to tolerate hot temper, touchiness, and aggression. The number of conflicts and additional stress for you will decrease. Telling significant people about your diagnosis will help make communication with them more environmentally friendly, positive, and less traumatic.

If you don't want to explain your condition in detail, at least don't isolate yourself from loved ones. Do not create new stress for yourself in the form of conflicts and severance of relationships with family and friends. You can simply reduce the amount of communication. If you have less or less frequent contact with loved ones during an episode, this will not necessarily raise suspicion. We all go through periods of high workload and busyness. And only you can decide whether to tell someone about your diagnosis or not.

And only you can decide whether to tell someone about your diagnosis or not.

Support can be found in psychotherapy and bipolar disorder support groups. These are special groups with certain rules in which you can meet people with the same diagnosis, discuss issues that concern you about bipolar disorder, and receive understanding and support.

Differential diagnosis of schizoaffective disorder

Since schizoaffective disorder includes symptoms of schizophrenia and manic-depressive psychosis, it is important to distinguish between these diseases. Schizophrenia is a severe chronic mental illness in which remission is difficult to achieve and complete recovery is impossible. It differs from schizoaffective disorder in the absence of a residual defect in the period after an exacerbation. In this case, we mean passivity, apathy, desocialization, flattening of emotions.

The bipolar state is accompanied by mood swings, but does not lead to a decrease in socialization. Its similarities with schizoaffective disorder include the following symptoms:

• episodic manifestation;
• being in a depressed or highly excited state;
• severe anxiety.

The difference is that with schizoaffective disorder, productive symptoms are present simultaneously with affective deviations. Therefore, it is impossible to immediately diagnose this pathology even with knowledge and experience. This is especially difficult if the disease does not immediately develop with signs of schizophrenia and affect during the next exacerbation. It is possible to verify the presence of the disease only after some time, and this requires constant medical supervision.

Depressive phase of bipolar disorder

The depressive phase is the opposite of the manic phase and is characterized by a decrease in mood and activity. First, the general mental tone drops. Anxiety gradually increases. A person works less, because there is not enough physical and mental strength for long-term activities. The patient's speech is slow and his actions are inhibited.

Further progression of the disorder leads to the development of symptoms of severe depression. Anxiety, melancholy, decreased appetite, silence, and delusional ideas are observed. The person does not answer questions or does so reluctantly and in monosyllables, eats little, and engages in moral self-flagellation and self-abasement.

In this state, the patient often thinks about death and suicide. Moreover, suicide attempts happen quite often, although they do not always lead to death. Illusions and hallucinations are rare, but some patients complain of voices that tell them to commit suicide.

Exit from the phase is accompanied by speech and motor activity. Gradually the symptoms weaken and disappear. But this depends on the development of the depressive stage. She can be hypochondriacal, asthenic, delusional, etc. The name is due to the dominance of one or another characteristic.

Schizoaffective disorder: drug treatment

Therapy for schizoaffective disorder at Dr. Isaev’s clinic includes the use of medications to relieve symptoms and psychotherapy. If the patient shows severe aggression during an attack, he is hospitalized until a stable condition is achieved. Taking medications is the main form of assistance for this disease, while working with a psychologist is considered no less important, but auxiliary.

To treat and eliminate negative symptoms, the following are usually prescribed:

• antipsychotics, they eliminate delusions, hallucinations and other symptoms of psychosis;
• anxiolytics for sleep disturbances and severe anxiety;
• antidepressants, which stop low mood, apathy, a feeling of uselessness, the desire for one’s own death, encourage action;
• mood stabilizers to normalize mood in case of low mood or manic disorder;
• sleeping pills that help normalize a good night's rest.

Acute psychosis with this deviation is usually treated with a combination of two or more medications. But it is best for the doctor to select a dose with constant observation, and therefore the person needs to stay in the hospital for some time. After achieving remission, the patient begins outpatient treatment with periodic visits to a psychiatrist. He comes to see him or a specialist is called to his home for a routine inspection.

In our clinic, only proven, certified drugs are used to treat schizoaffective disorder. They give the desired result and at the same time have minimal side effects.

If a person has schizoaffective disorder and dependence on alcohol and psychotropic drugs, then in this case a narcologist is involved in the therapy process, since chemical addictions greatly aggravate the condition and reduce the effectiveness of treatment.

Where to go for advice and help?

There are different options for receiving psychiatric and psychotherapeutic help.

State psychiatric hospitals and psychoneurological dispensaries at the place of residence.

Crisis helpline - you can call if you are having suicidal thoughts. Phone: 8 (800) 100-49-94.

Private clinics licensed to provide medical care. The authenticity of a license can and should always be checked on the website of the licensing authority. Do not forget to check the authenticity of the education of the specialists you contact.

No one option can guarantee the best mental health care one hundred percent. If you have doubts or discomfort, you can always change your doctor, listen to several opinions and try different treatment options. A good specialist will always be able to talk about the diagnosis and course of treatment, and will back up his words with data from modern research. The choice is yours.

Application of psychotherapy

Psychotherapy for patients with such a diagnosis is an auxiliary method of providing assistance; it accelerates the effect that can be achieved by precise selection of medications, consolidates the result, prolongs remission, and adapts the person to a society of healthy people. Talk therapy is often used for schizoaffective disorder. It allows you to better understand your condition, understand your own feelings and reduce their influence, identify negative attitudes that provoke destructive behavior, and replace them with constructive thoughts and actions. For this purpose, cognitive-behavioral techniques are used for individual lessons and work in groups. If the cause of the disease is psychotrauma at a young age, psychodynamic therapy is used.

If the patient is unable to express all his problems, art therapy is of great help. Taking part in art, music, or dance can help you express yourself and cope with current triggers for your attacks. Family therapy plays a leading role in the treatment of schizoaffective disorder, which allows one to influence the home environment. Thanks to the participation of loved ones in the treatment process, they can understand:

• the feelings that the patient experiences;
• what actions on their part help or hinder recovery;
• what needs to be done to make positive changes.

Many relatives behave incorrectly towards a mentally ill person. With their hypertrophied care, they cause or strengthen his feeling of inferiority. Understanding his problem, but at the same time constantly recognizing himself as weak and incompetent, the patient only aggravates his difficult situation. Thanks to family psychotherapy, a person understands how his condition and signs of the disease can affect those who live nearby. After treatment, all family members begin to act together, directing their efforts to eliminate existing difficulties and problems, and work on a strategy to prevent the next exacerbation of the pathology.

A person who has been diagnosed with schizoaffective disorder, if he contacts Dr. Isaev’s clinic in a timely manner, has the opportunity to completely get rid of the manifestations of the disease. Qualified specialists help a person with this diagnosis reduce the number of attacks and increase the time of remission for a long time.

Psychotherapeutic techniques aim to remove not only causative factors, but also reduce the likelihood of stressful effects. Work with a specialist begins after the acute attack has stopped, otherwise the doctor will not be able to achieve full contact and awareness of the problem. In general, the prognosis for this disease is favorable, but the outcome depends on the timeliness of the start of treatment and the characteristics of affective and schizophrenic manifestations.

The use of psychotherapy significantly increases the effectiveness of drug treatment. The specialist’s job is to detect hidden factors that provoke attacks, eliminate them or reduce their impact. A person is aware of the reasons for the development of deviations and understands their destructiveness. Family psychotherapy also plays a significant role, thanks to which mutual understanding between the patient and close relatives improves.

How is bipolar personality disorder treated? Will I be in a mental hospital?

The need for hospitalization may not arise if you take a responsible approach to treatment. If left untreated, episodes of mania and severe depression are likely to result in hospitalization. However, hospitalization does not put an end to a person’s life, but helps to get out of an episode of depression or mania and return to normal life.

As mentioned earlier, the course of bipolar disorder is influenced by three factors - biological, psychological and social. To minimize the impact of bipolar disorder on your life, you need to take control of all three factors. In this case, you will not have to go to the hospital and outpatient treatment will be sufficient.

The biological factor will be taken over by medications and a healthy lifestyle. A psychiatrist will prescribe the necessary medications for you. The medications must be taken regularly; you should not pause without consulting your doctor. If you experience unpleasant side effects, discuss this with your doctor and decide together whether to wait, change the dosage, or switch to another drug.

A healthy lifestyle helps maintain the normal state of all body systems, including the nervous system. Taking medications will not have a good effect if drugs or alcohol are simultaneously affecting the brain. The following will help you maintain your nervous system, and therefore all mental activity, in good condition: stable good sleep (at least seven hours), absence of bad habits (alcohol, drugs, smoking), regular physical activity, proper rest, adherence to a daily routine, proper nutrition.

The medications must be taken regularly; you should not pause without consulting your doctor. If you experience unpleasant side effects, discuss this with your doctor and decide together whether to wait, change the dosage, or switch to another drug.

Psychotherapy will help regulate and take control of the psychological factor. The recommended type of psychotherapy for bipolar disorder is cognitive behavioral therapy (CBT). Psychotherapy will not cure the disease, but will allow you to develop problem-solving skills, effective communication, and coping strategies. New skills or habits will help you cope with stress and anxiety, and resolve intrapersonal conflicts. At the end of psychotherapy, you will be able to independently apply these skills in life. Depressive episodes will be easier to experience, and their consequences will no longer be so severe. Psychotherapy promotes the development and harmonization of personality, which prevents the occurrence of certain stressful situations (conflicts, destructive relationships).

The social factor in the development of bipolar disorder is relationships with loved ones, work or study, social activity. The support of relatives and friends has a positive effect on the psychological state and helps to cope with episodes more easily. Stable work is also important, not only to ensure economic stability, but also to maintain a daily routine, expand your social circle, and feel important and needed. Spending time with friends and comrades has a positive effect, brings positive emotions, and distracts from sad thoughts during a depressive episode.

I would like to summarize the above about the treatment of bipolar disorder:

Questions and answers

Can schizoaffective disorder be completely cured?

With a mild form of the pathology, stable remission can be achieved for many years. Properly selected therapy can stop their manifestations even with severe attacks and preserve the person’s ability to work. In general, the prognosis in each specific case is individual and depends on many factors.

Is it possible to identify schizoaffective disorder in a loved one?

The symptoms of this disease are very similar to other mental disorders, so only an experienced doctor can make a diagnosis. To do this, it is best to hospitalize the patient and observe him over time.

Difficulties in diagnosis

To make a diagnosis, the patient must have at least 2 episodes of alternating phases of mania and depression. During the diagnosis, the doctor pays attention to a large number of factors - facial reactions, family history, disorders in the functioning of the psyche. The patient undergoes a series of procedures:

• physical examination;
• psychiatric assessment of the condition - conducting psychological testing;
• EEG, MRI to exclude organic disorders and differential diagnosis with other pathologies;
• a thorough examination of the family history, consultation with the patient’s family;
• identifying hidden symptoms;
• consultations with doctors of related specialties - therapist, endocrinologist, neurologist.

The disease is not detected by blood tests, CT scans or MRIs. Therefore, the decisive stage is a detailed consultative conversation with a psychiatrist or psychotherapist. For differential diagnosis with classical types of schizophrenia, neurotesting is performed - it can show an increase in inflammatory markers in the blood, characteristic of schizophrenia. It is relevant to use a neurophysiological test system that registers deviations from the norm in the patient’s response to external physical stimuli.