The treatment of these disorders depends on the type. Treatment includes medication which is usually started and monitored by a psychiatrist, along with talking therapies.
Medication
How can medication help?
- Taking medication regularly can help to control the most distressing symptoms of the disorder. They can help you to feel calmer by weakening the delusions, and gradually reducing the frequency and intensity of the hallucinations.
- Your thinking becomes clearer and you may feel well enough to look after yourself, your home and re-start your studies or work, and concentrate on other aspects of life which are important to you.
- If these medications are taken regularly, they can prevent you having another episode. It is important to continue to take these medications, even if you feel well.
How long will I have to take the medication?
- Usually these medications will need to be taken for the rest of your life.
- In some cases, the medication can be gradually reduced and stopped. However, this must be done under the supervision of a doctor.
What will happen if I stop the medication?
- If a person has diabetes and stops taking their medication, they may become unwell. Similarly with schizoaffective disorder, if you stop taking your medication, you too may become unwell. This may not happen immediately, but may take 3 to 6 months.
Types of medication
- An acute episode of schizoaffective disorder may benefit from antipsychotics. Atypical antipsychotics include Olanzapine, Risperidone, Quetiapine and Amisulpride.
- In the treatment of depressive symptoms, medication may include antidepressants. There are many different types of antidepressants and you may be started on one of the newer one, a SSRI (Selective Serotonin Reuptake Inhibitor), such as Sertraline or Citalopram.
- In the treatment of manic symptoms, mood stabilisers such as lithium, sodium valproate and carbamazapine may be useful.
- The long-term treatment of schizoaffective disorder involves the use of antipsychotics with psychological (talking) treatments.
- For the manic type, often a combination of a mood stabiliser and an antipsychotic are prescribed.
- For the depressive type, a mood stabiliser and an antidepressant is preferred.
The effects and side-effects of these medications should be fully explained to you and your carer(s).
Talking therapies
Cognitive Behavioural Therapy (CBT)
People are helped to monitor their thoughts, feelings and actions. The therapist will help you to find out the unhelpful thoughts and behaviours which may be contributing to your distress.
These thoughts could be linked to your delusions and your behaviours to your hallucinatory experiences.
The therapist will help you to work out helpful ways of thinking and reacting and then to put these positive thoughts and behaviours into real situation.
CBT is recommended if you are suffering from psychotic symptoms as it can help you cope with troublesome delusions and hallucinations. It equips you with various coping strategies so that you are able to solve your issues and problems.
Family meetings
This is especially helpful if you live with your family or are in close contact with them. Family therapy will help your family to understand your problems and how best to support you.
Supportive Psychotherapy and Counselling
People are able to discuss their problems and issues with a professional in detail and gain support from telling your story to someone who will listen.
Art Therapy
Some people may have difficulty talking about their emotions. Art therapy can help you to express your emotions through art.
Self-help groups
This is an opportunity to meet other people with the same illness and to discuss alternative coping strategies, recognising early signs that you may be starting to feel unwell again.
What will happen without treatment?
The symptoms may get worse and you may have more frequent and longer episodes. There is also a risk of suicide.
Community Mental Health Services
These services are important in keeping you out of hospital or in managing your gradual return back into the community after being discharged from hospital.
Specialist services may be needed including community psychiatric nursing, social services and occupational therapy as well as support in managing your domestic and financial affairs.
There are different teams that can support you in the community:
- Early Intervention Team: provides intensive support to young people who have recently been diagnosed with schizophrenia or schizoaffective disorder.
- Assertive Outreach Team: provides extensive help and support for people who have had a diagnosis of schizophrenia or schizoaffective disorder for quite some time, especially for people who find it difficult to work with other services or have not been able to take their medications regularly for various reasons.
- Crisis Resolution Home Treatment Team: can help at you at home, prevent a hospital admission and provide intensive support after a hospital admission.
- Vocational Rehabilitation: includes day centres, day hospital or community health centres. These facilities offer different creative activities such as back to work courses, education, art and cooking.
Care Programme Approach (CPA) (England and Wales only)
This is a way of making sure that you get the right care and support. You may be given a care co-ordinator who is responsible for organising different parts of your treatment.
You will have regular meetings every 6 to 9 months which can include your family or carer(s). A plan will be made about what to do in an emergency, including what has helped in the past.
Your plan will be amended at each CPA meeting to take into account what you and your family/carer(s) would like to happen.
Self-help
If you think you are becoming unwell or need help:
- Call your local mental health team/care co-ordinator.
- Call the local Crisis Team or Emergency out-of-hours phone numbers .
- Go to your local Emergency Department if the situation is such that it cannot be dealt with at home.
- Learn to recognise the early signs that you may be getting unwell, such as not being able to sleep, feeling persecuted or anxious. Some people may start hearing voices or whispers when no one is around. It is important to get help as soon as possible, for example by calling your care co-ordinator.
- Exercise regularly and eat a healthy balanced diet.
- Learn to talk to someone you trust in your family or a friend.
- Learn relaxation techniques.
Try not to:
- Use illicit drugs as they can cause another episode.
- Drink too much alcohol - remember the safe alcohol drinking limits of 21 units per week for a man and 14 units per week for a woman.
- Get stressed.
- Smoke cigarettes - 30 to 40 people out of a 100 with mental health problems smoke. They may help you to relax and focus your thoughts in the short-term but interferes with your medication and is very harmful to your body in the long-term.