The Challenges of Schizoaffective Disorder and Relationships

As a condition that presents both psychotic and mood-related symptoms, schizoaffective disorder can be very upsetting for the afflicted individual. Not only does their inner landscape feel unsettled and unpredictable, but the outside world can also begin to feel obscure in relation to the inner confusion—it can even feel threatening if hallucinations or delusions influence one’s perception in that direction. These imbalances make a close relationship very difficult, but with continued awareness and early intervention, partners can thrive in the relationship and embrace the advantages of working through mental health challenges together.

The following are some of the challenges that might come up when someone has schizoaffective disorder in a relationship:

• Unpredictable moods. A partner with schizoaffective disorder might experience waves of anger or irritability, sadness, emptiness, high energy of mania, and generally unusual—perhaps even inappropriate—emotional responses.
• Disordered thinking. Especially if experiencing hallucinations or delusions, confusion and paranoia are possible with schizoaffective disorder. The individual may also exhibit irrational or risky behavior.
• Distance and withdrawal. Whether because they are caught up in their head or because they are uncomfortable socializing or another reason, isolation and loneliness are common with schizoaffective disorder. The person may begin pulling away if feeling uncomfortable or seem to lack presence even when with their partner. This can also result in a lack of interest and motivation to participate in activities together. People with schizoaffective disorder can also feel a lack of emotion, making it harder to relate to the people around them, and they may appear flat and emotionless on the outside, making it difficult for others to relate to them. Schizoaffective disorder can also affect interest in intimacy and sex drive.
• Difficulty concentrating. Someone with schizoaffective disorder may find that their thoughts are often racing or that things around them are moving too fast. It becomes challenging to focus on a conversation or other activity.
• Feeling overwhelmed. A person may become easily overwhelmed by social interactions, by the expectations of a relationship, or even by ordinary responsibilities and chores around the house.
• Insecurity and doubt. Someone with schizoaffective disorder may easily develop doubts about their own worth, the other person’s feelings about them, the other person’s fidelity, and the overall outcome for the relationship. They may have a short fuse and a generally negative attitude that can bring down the connection between partners over time. They may also experience suicidal ideation and attempts.
• Difficulty with expression. Someone who experiences racing thoughts, overwhelm in social scenarios, relatively flat emotions, insecurity, and difficulty relating to others will likely have a hard time expressing themselves and being vulnerable in relationship. Or they may talk very quickly in a manic state, potentially overwhelming their partner.
• Substance use disorder. Someone with schizoaffective disorder may be at risk of developing co-occurring substance use and addiction, especially if they are not receiving adequate care and comprehensive treatment. In some cases, drugs can trigger the onset of schizoaffective disorder. In other cases, a person may use substances to self-medicate and cope with the symptoms of their disorder. Misuse of substances can introduce a host of additional complications for the health of the individual and the relationship.
• Unemployment. A person may find it difficult to hold a job because of the disorder’s challenging symptoms. Over time, unemployment could even result in poverty and homelessness. And these consequences could put extra pressure and responsibility on the other partner in the relationship.
• Relapse. It is likely that someone with schizoaffective disorder may experience periods of time that are symptom-free, especially if they are following a comprehensive treatment plan. In these cases, relapse is still possible, and it’s important to sustain treatment, including any prescribed medications, therapy, and positive lifestyle practices.

Relationships are often hard enough without the additional stress of a serious mental disorder. The typical challenges of communication, finances, chores, intimacy, and self-esteem may become even more difficult when influenced by schizoaffective disorder. But just as people in relationships not complicated by mental disorders must develop their strategies for working through challenges, so can people who are managing schizoaffective disorder and a relationship.

The first important piece of the puzzle is an individual’s primary care for schizoaffective disorder. This disorder can be difficult to diagnose, so it’s critically important that the individual receives clinical attention and care. Treatment for schizoaffective disorder may involve a combination of medication to help manage symptoms and therapy to develop coping strategies and an empowered perspective through the challenges. Meanwhile, it’s important that someone with schizoaffective disorder have solid social connections and support systems: these may be peer support groups, family, and friends. As we have considered, a relationship can be a significant means of support, but it’s important that both partners are adequately supported through the challenges of schizoaffective disorder.

In addition to individual therapy, couples therapy or counseling can support the honest communication, healthy expectations, and constructive coping strategies that can make a relationship positive amidst the challenges of a mental health disorder. A therapist or counselor can help the partners to tap into a broader perspective and understand that the person is not the disease, and the disease is treatable.

No one can expect a partner to read their mind, but when one person in a relationship has schizoaffective disorder, they may need an extra helping of patience and direct communication to get on the same page. Whether the conversation has to do with the division of tasks around the house or vulnerable feelings and how one is being treated by another, a couple should have these dedicated talks early and often, and the therapeutic environment with a mediator serves as great reinforcement and support. A therapist can help partners to understand their own expectations and to express those to the other. In this safe space, they can discuss any challenges that arise with sex and intimacy and learn to maintain compassion for the self and the other.

With the therapists additional perspective, partners can begin to recognize patterns that aren’t serving them in the relationship and discover new ways to best support each other. They can develop more positive ways of communicating, coping, and diffusing problems and tension. They can become familiar with common stressors and triggers in everyday life and become more aware of the challenging patterns that arise. Ultimately, it’s important to recognize that the best chances for a healthy life and relationship with schizoaffective disorder come with generous care and support from knowledgeable experts. Through the honest and vulnerable processes of relationship, partners can become even stronger and more connected.