Schizoaffective disorder

Hi, everybody, i am living with my wife who has Schizoaffective disorder, i was wondering if there is anybody here that could help me with some concerns i have going forward, she is very much dedicated to taking her meds and quite normal at the moment but i was wondering is it possible to have another psychotic episode even on meds? Its so terrifying because we have a 9 yr old son.


Welcome, Beano. I’m a caregiver diagnosed with SZA over 35 years ago, and the short answer is yes, depending on the medication and your definition of “psychotic episode”. That’s why regular psychiatrist visits are important to catch emergent symptoms and adjust or change medication(s) or other therapies appropriately.

The good news is medication compliance and the insight necessary to motivate it, generally leads to better outcomes and a DX of schizoaffective disorder has a better prognosis than for schizophrenia. I feel there are often misconceptions by caregivers that psychotic symptoms and the medications that treat them work like switches.

Although it may seem to you that her first psychotic break happened overnight, believe me it didn’t. And neither did her improvements under her medication(s) toward recovery. It’s unlikely she’s going to quickly change from Mrs. Jeckle to Ms. Hyde if her medication(s) loses effectiveness. That’s why psychiatrists typically pace their follow ups every 3 to 6 months, to check in and see how things are going, so they have time to make changes before episodes occur or to blunt the severity of them if they do.

To me it’s a bit like lawn maintenance. My first house was in a state where lawns were much less tolerant to neglect than where I grew up. I struggled with weeds in my front lawn the first year, and the next fall I ended up re-sodding it and hiring a maintenance company. Even so, weeds popped up from time to time and I’d get detailed reports about various issues and how they applied this chemical and that. My lawn was far from perfect, but I never had to resod it again. So far I can handle the lawn in my new house on my own, and it’s even further from perfect, but to me it’s acceptable. But I know what signs to look for and who to call, if conditions warrant it.


Thank you for your lengthy reply, yes i get what you are saying, and you are right the signs are there for days if not weeks before hand but unfortunately the mental health services in ireland are really bad and even though my wife is tied in with the mental health services for years now they never do anything until things get so bad the police have to be called even though i would have voiced my concerns to them in the lead up to her episode, she has been hospitalised now six times in the last three years, its only now that she is really committed to taking the meds properly, but hopefully because of that , things wont be as severe as previous episodes

I have a family member who is mentally ill and has been on meds since sept 2018… my experience with this that in my family member’s mental health has deteriorated within the last year while in tge same meds from 4 + years ago. Tolerance or what I don’t know … it certainly now is difficult until to manage.


It can take a while for it to sink in that you really need medication and that there are consequences if you don’t take it. It’s important also to look for environmental and situational stressors that led to her previous incidents and see if you can help mitigate them.

Mental health history like all history may not exactly repeat itself, but it does rhyme. By now you may have amassed a catalog of what I call in my brother and myself, her “greatest hits” as far as delusions, triggers and behaviors are concerned. When you hear variations on familiar themes, consider what sparked them and what you might do to mitigate them.

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Thank you so much for the information i will be mindful of all of it

@Beano Just a thought. One thing my sons Dr would do is give him a prn prescription (as needed -higher dose) to have on hand if symptoms would flare up.
It helped to tone symptoms down until he could get in for an appointment.
It was nice to have something on hand when things were getting out of hand.

I think its possible, and can be cyclical , I read. My son only had noticable episodes when he went off medication for 3 weeks to 3 months.

Glad you came to this forum, I found it absolutely helpful. After experiencing my son’s SMI for quite a while I’m trying to stay calm, he was diagnosed with schizoaffective disorder as well and he’s been on/off meds for periods of time, of course when he’s been going unmedicated he gets in trouble, I’ve called 911 so many times I lost count; one way I found recently to help me cope is watching videos of Teepa Snow, her focus is dementia but much of what I have experienced with my son is so similar to the Neuro Cognitive Deterioration of dementia, after all those periods of going unmedicated now it seems that he has a paranoid schizophrenia, which in my son’s case he has a little bit of autism, dementia, Alzheimer’s and manic depressive features and anosognosia. I’ve read the book ‘I Am Not Sick, I Don’t Need Help’ by Xavier Amador, taken the F2F offered by NAMI and it helps but Teepa Snow offers more detail in caregiving, at least for me and many others with similar issues in behavior. It’s great that your wife takes her medication and seems that she has caught on fast to hopefully stay on it always. BTW, here in the US in my State mental health isn’t that great either, I’ve had to hurdle many obstacles to advocate for my son. Your son is young and I would be concerned as well but your wife is taking her meds now, if you start seeing behavioral changes it might be that she’s skipping the meds or they’re not working but I can tell my experience with my son: I know when he stops taking the meds, I found the pills half chewed under his bed worth couple of months, he was cheeking them so to make sure he was medicated he had monthly injections at times. It might be necessary to start educating your son gradually, not to scare him but to be cautious.

Take care.

Thanks for sharing. I think this is a fear that we all have to accept and admit that their illness has brought a new package for us such as PTSD or anxiety. Definitely recommend getting counseling help for yourself if you haven’t done it yet. In NAMI we are saying that “ we can always do better “. Each circumstance is unique. In my way, making more connection to my kid is a treatment in its own way. We have to accept the sadness that life has not been fair to us especially our kids and as a healthy component of the family we are responsible to compensate for their loss. Wish you the best in your journey putting your family together in a best way possible to provide a better future for all especially your kid/s.