Parenting an Adult Child with Schizoaffective Disorder

Schizoaffective disorder is a very serious mental illness that can cause significant disability. It is characterized by psychotic symptoms of schizophrenia as well as mood symptoms of bipolar disorder. The exact symptoms vary by individual, but generally may include:

• Delusions and hallucinations
• Difficulty communicating, racing or confused thoughts and speech
• Poor social functioning or social isolation
• Difficulty managing self-care
• Regular depressed moods, with sadness, guilt, fatigue, and loss of interest in activities
• Manic moods characterized by high energy and activity levels, impulsive behaviors, restlessness, and irritability

Some people with schizoaffective disorder will experience both manic and depressed moods and episodes, while others only have depressive episodes. The age of onset can vary, but most people begin experiencing symptoms before the age of 35.

If your child is showing signs of mental illness, the first and best thing you can do for him is to get an evaluation for a diagnosis. The only way to diagnose mental illness is to work with an experienced mental health professional. There can be significant overlap of symptoms between this condition, schizophrenia, mood disorders, and even trauma disorders or substance use disorders.

It is also possible that your son or daughter is struggling with more than one mental illness or schizoaffective disorder along with substance abuse. Getting a diagnosis for all conditions is essential for being able to take the next, crucial step, which is treatment.

Once your adult child has a diagnosis, it is absolutely essential that you insist on treatment. You may face resistance, but long-term, intensive treatment is the only way that he or she will learn to live with this chronic illness. Residential treatment includes medical care and the chance to find the right medication that is most effective with the fewest side effects.

A residential program is also an opportunity to benefit from intensive therapy, where your child will learn coping strategies, how to recognize the onset of symptoms, how to manage and change negative thoughts and behaviors, and other important ways to live a more normal life with schizoaffective disorder.

It’s possible, and likely even, that your adult child will need to be or has already been hospitalized for stabilization. This is a sometimes necessary part of treatment because he or she will not be ready for ongoing care in a psychotic or unstable state. But don’t make the mistake of thinking that a short stay in the hospital is adequate.

Hospitalization is a temporary solution. Your son or daughter will need ongoing care to achieve greater symptom control, to be more independent, to have fewer episodes of psychosis, mania, and depression, and to avoid being hospitalized again in the future.

Treatment in a residential facility will help your son or daughter learn important skills for managing schizoaffective disorder. With this solid foundation of treatment, along with any necessary medications, your child will be able to return home, either to stay with you or, if possible, to live independently. Being the active caregiver for an adult child with serious mental illness can be challenging, and there are some important considerations to make as you face this situation:

• Be supportive, without judgment. Your adult child needs support, but resist the urge to judge, be overly demanding, or criticize. He is struggling and trying to manage this very difficult illness. Listen, show that you are trying to understand, and help him to feel that he is heard. Ask questions about what he needs to feel safe, loved, and understood, and try to provide it.
• Set boundaries. Just because your child has a mental illness does not mean he should be allowed to do or say anything. Set boundaries that you need to feel safe and healthy, but that will also help him manage his condition. For instance, put a limit on negative language or set aside specific times for getting time apart from each other.
• Know when you need more help. Sometimes a parent is not the best caregiver for an adult child with mental illness, or should not be the sole caregiver. You may want to be the one to provide what your child needs, but recognize your limitations. Ask for help sharing the caregiving duties with other family members if necessary.
• Insist on ongoing treatment. Long-term residential care is a great foundation for managing schizoaffective disorder, but your child is not cured. This condition is chronic, and ongoing, regular therapy is important. Consider trying family therapy too, as this can help you and other family members learn more about the illness and how to best help your adult child.