Schizoaffective Disorder: What are Hallucinations?

Hallucinations are a psychotic symptom of schizoaffective disorder. People experiencing hallucinations may hear, see, smell, taste or feel things that aren’t really there, and which other people can’t hear, see, smell, taste or feel.

Auditory hallucinations are the most common type of hallucination. They are mostly experienced as voices. To a person with schizoaffective disorder, these voices sound just like people speaking to them, and people with the illness cannot differentiate between what is real – for example a friend speaking to them – and what is a hallucination.

Voices might be heard in the second person – for example someone saying “you stink”, “you’re ugly”, “they hate you”. Sometimes voices might command a person to do something – by saying, for example, “jump off the bridge”, “take an overdose”. People with schizoaffective disorder may also have third person hallucinations, which commonly take the form of two or more voices talking among themselves or commenting on the person’s behaviour. Third person hallucinations are common in both schizoaffective disorder and schizophrenia, but are seen less frequently in bipolar disorder.

In most cases the experience of auditory hallucinations in the form of voices is unpleasant. Voices are frequently accusatory, reminding the person of past misdeeds, some imaginary, and some real. However, in a minority of cases, voices can be pleasant or even helpful.

In addition to voices, auditory hallucinations can involve noises, such as buzzing, screeching and ringing. Additionally, people with schizoaffective disorder may think that their own thoughts are being broadcast, or can be heard by other people. They may also think that other people’s thoughts are being forced into their own minds, or that their thoughts have been stolen from their heads.

Hallucinations of all five senses may be experienced. In addition to auditory hallucinations, people may have tactile hallucinations – such as feeling as though you are being pushed, touched or held down – visual hallucinations – such as seeing things that aren’t there or feeling that colours are brighter than they should be – hallucinations of smell and hallucinations of taste.

Visual hallucinations occur much less frequently than auditory hallucinations, and are more common in conjunction with auditory hallucinations – for example seeing and hearing someone who no one else can see. Hallucinations of smell and taste are more unusual and tend to focus on things tasting or smelling different than usual. This can lead to people with schizoaffective disorder thinking that their family and friends are trying to poison them.

Sources: Schizoaffective Disorder Simplified

Paliperidone (Oral Route)

Brand names:

  • Invega
    • Extended-release tablet: 1.5 mg, 3 mg, 6 mg, 9 mg
  • Invega Sustenna
    • Extended-release injectable suspension: 39 mg, 78 mg, 117 mg, 156 mg, 234 mg

Generic name: paliperidone (pal ee PER i done)

Paliperidone is a medication that works in the brain to treat schizophrenia and schizoaffective disorder. It is also known as a second-generation antipsychotic (SGA) or atypical antipsychotic. Paliperidone rebalances dopamine and serotonin to improve thinking, mood, and behavior.

What Should I Discuss With My Healthcare Provider Before Taking Paliperidone?
  • Symptoms of your condition that bother you the most
  • If you have thoughts of suicide or harming yourself
  • Medications you have taken in the past for your condition, whether they were effective or caused any adverse effects
  • If you ever had muscle stiffness, shaking, tardive dyskinesia, neuroleptic malignant syndrome, or weight gain caused by a medication
  • If you experience side effects from your medications, discuss them with your provider. Some side effects may pass with time, but others may require changes in the medication.
  • Any psychiatric or medical problems you have, such as heart rhythm problems, long QT syndrome, heart attacks, diabetes, high cholesterol, or seizures
  • If you have a family history of diabetes or heart disease
  • All other medications you are currently taking (including over the counter products, herbal and nutritional supplements) and any medication allergies you have
  • Other non-medication treatment you are receiving, such as talk therapy or substance abuse treatment. Your provider can explain how these different treatments work with the medication.
  • If you are pregnant, plan to become pregnant, or are breast-feeding
  • If you smoke, drink alcohol, or use illegal drugs

Paliperidone tablets are usually taken 1 time per day with or without food.

Typically patients begin at a low dose of medicine and the dose is increased slowly over several weeks.

The dose of the tablets usually ranges from 3 mg to 12 mg. The dose of the Sustenna brand of long-acting paliperidone injection formulation usually ranges from 78 mg to 234 mg every month. The dose of the Trinza brand long-acting paliperidone injection formulation ranges from 273mg to 819mg every 3 months. Only your healthcare provider can determine the correct dose for you.

The tablets should be swallowed whole. They should not be chewed, crushed, or broken.

What Are Possible Side Effects Of Paliperidone?

Common side effects:

Tachycardia, drowsiness, extrapyramidal symptoms, restlessness, headache, increased prolactin, cholesterol abnormalities, increased glucose, vomiting, tremor.

Rare/serious side effects:

Paliperidone may increase the blood levels of a hormone called prolactin. Side effects of increased prolactin levels include females losing their period, production of breast milk and males losing their sex drive or possibly experiencing erectile problems. Long term (months or years) of elevated prolactin can lead to osteoporosis, or increased risk of bone fractures.

Some people may develop muscle related side effects while taking paliperidone. The technical terms for these are “extrapyramidal symptoms” (EPS) and “tardive dyskinesia” (TD). Symptoms of EPS include restlessness, tremor, and stiffness. TD symptoms include slow or jerky movements that one cannot control, often starting in the mouth with tongue rolling or chewing movements.

Temperature regulation: Impaired core body temperature regulation may occur; caution with strenuous exercise, heat exposure, and dehydration.

Second generation antipsychotics (SGAs) increase the risk of weight gain, high blood sugar, and high cholesterol. This is also known as metabolic syndrome. Your healthcare provider may ask you for a blood sample to check your cholesterol, blood sugar, and hemoglobin A1c (a measure of blood sugar over time) while you take this medication.

On Schizoaffective Disorder

On Schizoaffective Disorder & Hallucinations:

“I awoke, went to drink a glass of water and walked back toward my room. I stopped dead in my tracks. My room was red and four cloaked figures floated above my bed with fire circling around them. Inside of the cloaks was a black abyss and I knew they had come for me. As long as I stayed out of my room they wouldn’t see me. I stared at them for what seemed like an hour before they went away. I slept on the couch that night.”

~ Thomas Wallingford, The Mighty Contributor

#MentalHealth #SchizoaffectiveDisorder #Hallucinations #EndStigma

Postpartum Depression: Symptoms

The birth of a baby can trigger a jumble of powerful emotions, from excitement and joy to fear and anxiety. But it can also result in something you might not expect — depression.

Most new moms experience postpartum “baby blues” after childbirth, which commonly include mood swings, crying spells, anxiety and difficulty sleeping. Baby blues typically begin within the first two to three days after delivery, and may last for up to two weeks.

But some new moms experience a more severe, long-lasting form of depression known as postpartum depression. Rarely, an extreme mood disorder called postpartum psychosis also may develop after childbirth.

Postpartum depression isn’t a character flaw or a weakness. Sometimes it’s simply a complication of giving birth. If you have postpartum depression, prompt treatment can help you manage your symptoms and help you bond with your baby.

Symptoms

Signs and symptoms of depression after childbirth vary, and they can range from mild to severe.

Baby blues symptoms

Signs and symptoms of baby blues — which last only a few days to a week or two after your baby is born — may include:

• Mood swings

• Anxiety

• Sadness

• Irritability

• Feeling overwhelmed

• Crying

• Reduced concentration

• Appetite problems

• Trouble sleeping

Postpartum depression symptoms

Postpartum depression may be mistaken for baby blues at first — but the signs and symptoms are more intense and last longer, and may eventually interfere with your ability to care for your baby and handle other daily tasks. Symptoms usually develop within the first few weeks after giving birth, but may begin earlier ― during pregnancy ― or later — up to a year after birth.

Postpartum depression signs and symptoms may include:

• Depressed mood or severe mood swings

• Excessive crying

• Difficulty bonding with your baby

• Withdrawing from family and friends

• Loss of appetite or eating much more than usual

• Inability to sleep (insomnia) or sleeping too much

• Overwhelming fatigue or loss of energy

• Reduced interest and pleasure in activities you used to enjoy

• Intense irritability and anger

• Fear that you’re not a good mother

• Hopelessness

• Feelings of worthlessness, shame, guilt or inadequacy

• Diminished ability to think clearly, concentrate or make decisions

• Restlessness

• Severe anxiety and panic attacks

• Thoughts of harming yourself or your baby

• Recurrent thoughts of death or suicide

Untreated, postpartum depression may last for many months or longer.

Postpartum psychosis

With postpartum psychosis — a rare condition that typically develops within the first week after delivery — the signs and symptoms are severe. Signs and symptoms may include:

• Confusion and disorientation

• Obsessive thoughts about your baby

• Hallucinations and delusions

• Sleep disturbances

• Excessive energy and agitation

• Paranoia

• Attempts to harm yourself or your baby

Postpartum psychosis may lead to life-threatening thoughts or behaviors and requires immediate treatment.

Postpartum depression in new fathers

New fathers can experience postpartum depression, too. They may feel sad or fatigued, be overwhelmed, experience anxiety, or have changes in their usual eating and sleeping patterns ― the same symptoms mothers with postpartum depression experience.

Fathers who are young, have a history of depression, experience relationship problems or are struggling financially are most at risk of postpartum depression. Postpartum depression in fathers ― sometimes called paternal postpartum depression ― can have the same negative effect on partner relationships and child development as postpartum depression in mothers can.

If you’re a new father and are experiencing symptoms of depression or anxiety during your partner’s pregnancy or in the first year after your child’s birth, talk to your health care professional. Similar treatments and supports provided to mothers with postpartum depression can be beneficial in treating postpartum depression in fathers.

Causes

There’s no single cause of postpartum depression, but physical and emotional issues may play a role.

• Physical changes. After childbirth, a dramatic drop in hormones (estrogen and progesterone) in your body may contribute to postpartum depression. Other hormones produced by your thyroid gland also may drop sharply — which can leave you feeling tired, sluggish and depressed.

• Emotional issues. When you’re sleep deprived and overwhelmed, you may have trouble handling even minor problems. You may be anxious about your ability to care for a newborn. You may feel less attractive, struggle with your sense of identity or feel that you’ve lost control over your life. Any of these issues can contribute to postpartum depression.

Risk factors

Any new mom can experience postpartum depression and it can develop after the birth of any child, not just the first. However, your risk increases if:

• You have a history of depression, either during pregnancy or at other times

• You have bipolar disorder

• You had postpartum depression after a previous pregnancy

• You have family members who’ve had depression or other mood disorders

• You’ve experienced stressful events during the past year, such as pregnancy complications, illness or job loss

• Your baby has health problems or other special needs

• You have twins, triplets or other multiple births

• You have difficulty breast-feeding

• You’re having problems in your relationship with your spouse or significant other

• You have a weak support system

• You have financial problems

• The pregnancy was unplanned or unwanted

Complications

Left untreated, postpartum depression can interfere with mother-child bonding and cause family problems.

• For mothers. Untreated postpartum depression can last for months or longer, sometimes becoming a chronic depressive disorder. Even when treated, postpartum depression increases a woman’s risk of future episodes of major depression.

• For fathers. Postpartum depression can have a ripple effect, causing emotional strain for everyone close to a new baby. When a new mother is depressed, the risk of depression in the baby’s father may also increase. And new dads are already at increased risk of depression, whether or not their partner is affected.

• For children. Children of mothers who have untreated postpartum depression are more likely to have emotional and behavioral problems, such as sleeping and eating difficulties, excessive crying, and delays in language development.

Prevention

If you have a history of depression — especially postpartum depression — tell your doctor if you’re planning on becoming pregnant or as soon as you find out you’re pregnant.

During pregnancy, your doctor can monitor you closely for signs and symptoms of depression. He or she may have you complete a depression-screening questionnaire during your pregnancy and after delivery. Sometimes mild depression can be managed with support groups, counseling or other therapies. In other cases, antidepressants may be recommended — even during pregnancy.

After your baby is born, your doctor may recommend an early postpartum checkup to screen for signs and symptoms of postpartum depression. The earlier it’s detected, the earlier treatment can begin. If you have a history of postpartum depression, your doctor may recommend antidepressant treatment or psychotherapy immediately after delivery.

Age 16, 1988

Age 16, 1988

For me my mental illness came crashing into my life in full force when I was sixteen.

That was the year I first started hearing voices,

started to believe people could read my mind and insert thoughts into my head,

was the first time I was truly suicidal,

was the year I started to self harm,

dragging a razor blade across my left arm and watching my blood flow,

the first time I was dissociative,

when the world became vague, dreamlike, less real,

as I observed events as if from outside my body like a movie in slow motion,

the year the panic attacks began.

This was also the year I suffered as a survivor of sexual assault,

the most difficult event of my life as a biker held a knife to my throat and raped me,

beating me severely.

From then on I carried a knife in case I am in a similar situation,

not so I could defend myself, but so I could slit my wrists.

To this day the sound of a Harley Davidson makes me physically cringe.

That was when the night terrors began reliving my trauma every time I closed my eyes.

That was the year the negative coping mechanisms developed: cutting, isolating, alcohol, drugs.

That was when the abyss of depression swallowed me up whole,

and I wanted to die or crawl in a hole forever,

because I was worthless, pathetic, weak, and most importantly,

I was to blame for being raped,

I should have been able to stop it as a sixteen year old boy.

This is not how it should be at sixteen.

A Day In My Life: My Most Common Delusions

A Day In My Life: My Most Common Delusions

Having delusions is one of the most feared and fear mongered symptoms of Schizophrenia and Schizoaffective Disorder. Some people believe God is speaking to them directly or through a TV or through the radio. Some people believe they have supernatural powers or is a chosen one to lead a religious or secular special mission. There is an incredible variety in the delusions which may afflict people. When properly medicated many people have these delusions completely disappear and then there are some that don’t.

I am one of those that always has my delusions in varying degree no matter what medication cocktail I have tried. Thankfully when medicated I know they are delusions and not part of reality, although everything around me, my feelings, my thoughts tell me they are true. Sometimes it’s a vicious fight between the part of me grounded in reality and the part that isn’t. The level of stress and anxiety I am going through largely determines which part of me will win the fight.

Thankfully I rarely have delusions like those I previously referenced. My delusions can be summed up as thought broadcasting and thought insertion which drives my paranoia. Thought broadcasting is when I believe that other people can hear or read my thoughts. Whereas thought insertion is when I have thoughts that feel foreign to me and seem as if they have been inserted by an outside person. I rarely have both at the same time, but when I do it is crippling. Having either of these delusions can lead me to isolating from society, my support structure, my friends and family, and even the people I believe are controlling or spying on my thoughts. It’s not often, but the more I am unable to separate reality from what I’m feeling the more paranoid I become.

As much as my medication cocktail helps me survive everyday life and be a functioning member of society it never fully eradicates either my delusions or auditory hallucinations. I find myself reality testing when I’m dealing with thought broadcasting by thinking nod your head if you can read my thoughts. Of course nobody ever does which only feeds my paranoia that they don’t want me to know. When my meds aren’t working I’ve narrowly escaped going inpatient in a mental hospital on multiple occasions. I have had several partial hospitalizations though where I spend my days at the hospital, but am allowed to sleep at home.

My Voices, My Dear

When you are gone

I shudder in the corner of my existence

They point at me

I stand strong to the accusations

Then they laugh

I wilt into the corner

Through the walls and through the floors

Alone

Alone without them

Without you.

Crisscrossing

The crisscrossing clash of tiny dishes fall about my feet

As an echo bounces off the walls of my own sweating intolerance

My palms have become cold

While the heat of my frustrations boils to the surface

I repress the tears rolling down my face

Pulling them back inside me if I only had the patience

The slam of the door silences your exit

And I slouch into the floorboards alone

Alone at last.