Family and Caregiver Schizophrenia Discussion Forum

I have a question on Possible misdiagnoses of schizophrenia disorder with bipolar

I’m trying to find out if it’s possible to have both Schizoaffected disorder with bipolar and also have DID? I have found many articles telling the difference between the two in the symptoms but I cannot find any articles which suggests the two May overlap.
I just went through a 10 day episode with my girlfriend. I thought I knew what schizophrenia was as my half brother is diagnosed with it as well. I just got a 10 day crash course in how little I truly understand about this illness. All I’ve been able to uncover so far is comparisons of symptoms showing the difference between the 2.
I have not been able to find any articles suggesting the two can over lap. I am sure she has both. The articles I have read say that one way to tell the difference is that with DID the individual knows the voice its the same personality eveytime while with schizophrenia the voices are random and different with each episode. I am fairly certain that my girlfriend has both she hears the multiple voices constantly talking during these episodes but there is one voice she talks to. Her command voice telling her to do things. I myself have talked to “Mr. A”, as I’ve come to think of him, 4 different times during this. The last time I tried to record the conversation. As soon as she saw the phone she knew I was recording her and wanted the phone. When I refused to give her my phone. Her and Mr. A had a 10 minute conversation whispering too quietly for me to understand completely but from what I gathered he was asking her questions about me and she was answering. He has not talked to me since and eveytime
I’ve tried to comfort her or offer support she would go straight to a 5 to 10 minute hallucination until i would go sit down then she would go back to pacing I can tell when its him by her mannerisms and expressions. Today I tried to tell her what I suspected and tried to show her a YouTube video on Schizoaffected disorder. She watched about 45 seconds of it and went berserk. I had to restrain her and call an ambulance. As soon as I called the ambulance she stopped struggling and started whispering. from the parts I could make out she was hallucinating she under arrest and was being interagated this continued until the moment she was aware the ambulance had arrived then she stopped whispering and was completely unresponsive. I really need help with this i haven’t slept more than 10 to 15 minutes at a time for last 10 days and feel a litte crazy my self.

She has schizoaffective disorder bipolar type, that’s it. She does not have dissociative personality disorder from what you describe. Hearing a voice that is Mr. A talking to her and her responding to it is a simply another voice that she hears. These are signs of psychosis, not DID. Now, if her personality and actual words and behaviour turned into Mr. A talking to you and then afterwards she does not remember it, then it could be dissociative persoanlity disorder.

In any case, tell her psychiatrist this and he will give her the proper medications.

I tend to agree with @Lirik here. I’ll add your information about both conditions is incorrect or misinterpreted. Throughout the spectrum of psychotic disorders from Schizophrenia, Schizoaffective Disorder (NOT “schizoaffected“ [sic] disorder) and others, voices can be and often are persistent and not random. In my case, I had conversations (one-sided to outside observers) with a male/female pair of imagined FBI agents I thought were surveilling me. They had names and “spoke” to each other and to me. It was not unlike the dialog of the X-Files, but my episodes predated the shows.

DID’s primary characteristic is disassociation. Symptoms include: amnesia, depersonalization, derealization, identity confusion, identity alteration, loss of feeling or control of movement. The name of the disorder was changed specifically to avoid confusion with schizophrenia related disorders which in turn was confused with “split personalities” due to misunderstandings about the name coined for the disorder which literally means “split mind”. The “split” in schizophrenia is between thought and emotion and personality doesn’t enter into it.

DID is generally thought to be relatively rare, and some psychiatrists (largely in the US) question its existence. It’s not uncommon for people to be deluded or coached into thinking that they have it within or without therapy. While it is possible for the two conditions to be comorbid, it’s not common and given DID’s rarity and difficult treatment, a psychiatrist would most likely treat for schizophrenia/schizoaffective disorder and worry about any DID symptoms later.

Disclaimer: While I am a part-time caregiver of my brother and father with SMI, I was diagnosed with SZA over thirty years ago. I’m an advocate of appropriate drug treatments for SMI, but I feel they are incomplete treatments and additional CBT, supportive talk and psychosocial therapies are helpful where feasible. Any drug advice is from personal experience or research and not a substitute for qualified Psychiatric care.