Study Suggests Schizophrenia May Be Detectable Years Before Its Onset

“Problems abound in defining schizophrenia,” wrote the late Colorado Recovery founder Richard Warner in his book The Environment of Schizophrenia. Symptoms can vary in type and severity over time, with periods of worsening and remission of symptoms. It’s frequently difficult to distinguish between symptoms of bipolar disorder for schizophrenia. 

The cause of the illness is  also unknown. “There is no single organic defect or infectious agent which causes schizophrenia, but a variety of factors increase the illness—among them genetics and obstetric complications,” wrote Dr. Warner. Then there is the onset mystery of why schizophrenia “normally begins in adolescence when important risk factors, such as genetic loading and neonatal brain damage, are present from birth or sooner.” 

New research is now suggesting that the risk of schizophrenia and bipolar disorder may be detectable years before the illnesses begin. A University College Dublin-led study funded by the Health Research Board found that 50 percent of people who developed these mental health disorders had attended specialist child and adolescent mental health services (CAMHS) in childhood.

Published in the journal World Psychiatry, the findings suggest the possibility of earlier intervention and even prevention, co-author Professor Ian Kelleher from the UCD School of Medicine told Neuroscience. The study was carried out in conjunction with the Finnish Institute for Health and Welfare (THL).

“In a total population study of all individuals born in Finland in 1987 and followed up to 28 years, half of all psychosis and bipolar diagnoses occurred in individuals who had attended CAMHS during childhood or adolescence,” wrote study authors Kelleher, Lång, Ramsay, Yates, et al. 

The authors felt that there was a significant window of opportunity for intervention in terms of the time from initial CAMHS attendance to a diagnosis of psychosis or bipolar disorder.

“These findings highlight an enormous, untapped potential for the prediction of psychosis and bipolar disorder within already existing structures providing specialist pediatric mental health care. They support a new focus for psychosis and bipolar disorder prediction efforts on specialist community and inpatient CAMHS and present exciting new opportunities for psychosis and bipolar disorder prevention research.”

They wrote that “a key finding of our study was that in contrast to the small proportion of psychosis cases identified by current high-risk strategies, at least half of all individuals diagnosed with psychosis or bipolar disorder by age 28 years had, at some point in their childhood or adolescence, attended specialist CAMHS.”

Furthermore, the researchers found that their findings “also highlight the importance of the transition between adolescent and adult mental health services. The reasons for presenting to CAMHS differ from those for presenting to adult mental health services, and only a small minority of CAMHS patients are subsequently referred to the latter services.”

Stressing the importance of early intervention, Professor Kelleher told Neuroscience: “We know it’s crucial to intervene as early as possible to prevent some of the worst effects of these illnesses. But ideally, we would like to be able to intervene even before the onset of illness, to prevent it altogether.”

Colorado Recovery opened as an independent treatment center in Boulder in 2006 to create a non-hospital treatment center for people with serious mental illness that employed the most effective diagnostic and treatment methods and focused on respectful, compassionate, and optimistic care.

Our treatment facility provides the services needed to address schizophrenia, bipolar disorder, and other serious mental illnesses which are specific to each individual. About half of our clients are under 35 years of age and we expect good outcomes regardless of the duration of the disorder. Clients of any age will feel comfortable in our program. Call us at 720-218-4068 to discuss treatment options for you or the person you would like to help.

 

Colorado Recovery Launches Partnership With Therapeutic Riding Center

Colorado Recovery has teamed up with the Colorado Therapeutic Riding Center (CTRC) in Longmont, CO to expand services for their clients. The Colorado Therapeutic Riding Center is the oldest therapeutic riding center in the Centennial State and has been operating since 1980. 
 
Equine-assisted therapy incorporates horses into the therapeutic process. People engage in activities such as riding, grooming, feeding, and leading a horse while being supervised by a mental health professional.
 
The goals of this experiential form of therapy include helping people develop skills such as emotional regulation, self-confidence, and responsibility. Mature horses typically weigh between 900 and 2,000 pounds and it can sometimes feel a little bit intimidating to have such a large, majestic creature participate in therapy sessions.
 
However, because of its demonstrable benefits, equine-assisted therapy has grown in popularity. Horses are keen observers and are vigilant and sensitive to movement and emotion. They often mirror a client’s behavior and feelings, conveying understanding and connection that allows the client to feel safe.
 
Potential benefits of equine therapy include distress tolerance, emotional awareness, impulse control, self-esteem, social awareness, and improved social relationships.
 
Michele Bruhn is the executive director at Colorado Therapeutic Riding Center. “Our mission is to change the lives of people with disabilities and mental health issues by promoting their physical, psychological, and social well-being through equine-assisted activities and therapies,” she says. “CTRC maintains a herd of more than 25 magnificent therapeutic riding horses. Each member of our herd is a treasure in a way that is unique to them, each with their own tale to tell.” 
 
On its 39-acre campus, CTRC offers therapeutic horsemanship, equine-assisted therapies, and equine-assisted mental health services. “The horses are really the modality of treatment,” says Bruhn. Clients are not necessarily learning how to ride a horse as our therapists work on different goals for each individual client. We evaluate our clients’ affect and body structure and then match the right type of horse with that person.” 
 
All CTRC instructors are certified through Path International. The first Colorado Recovery patients started equine therapy in mid-September.  
 
Colorado Recovery
 
The treatment program at Colorado Recovery aims to empower adults with mental illness, and those who support them, with an unrelenting optimism for recovery, purposeful involvement in the community, and an enhanced sense of meaning in life.
 
Our treatment facility provides the services needed to address schizophrenia, bipolar disorder, and other serious mental illnesses which are specific to each individual. Call us at 720-218-4068 to discuss treatment options for you or the person you would like to help.

Psychiatrist Nauman H. Taj Joins Colorado Recovery as Medical Director

Nauman Hanif Taj, MD, is the new medical director at Colorado Recovery. Dr. Taj has a long, impressive track record as a board-certified adult psychiatrist. 

Following his medical training at Tufts University in Massachusetts, Dr. Taj was awarded a fellowship at the Boston Psychoanalytic Society and Institute, the third oldest psychoanalytic institute in the United States. Dr. Taj has worked as a psychiatrist in various settings including inpatient and outpatient.

After working in a Nebraska hospital for several years, Dr. Taj moved to the Ft. Collins area in Colorado to practice as a psychiatrist. Recently, he was approached by Colorado Recovery to help take its immensely successful Warner treatment model to the next level. 

“Colorado Recovery is different because it brings clients out into the community as part of their psychiatric rehab,” says Dr. Taj. Community integration and social engagement are at the heart of the treatment philosophy, setting the course for a life of engagement, purpose, and connection. 

Another Colorado Recovery advantage is the careful re-evaluation of each individual diagnosis. “We always do a comprehensive, fresh evaluation. Many clients have had the same diagnosis for years, which is sometimes wrong and symptoms can always change. You really need to know the patient, their social life, and their support system. I also ask them what they don’t like about seeing a doctor and that often opens up an interesting perspective.”

Dr. Taj emphasizes that you always have to see the whole person. “You can’t separate the patient and the patient’s symptoms from the human being you’re interacting with. That person could be a husband, a dad, or a mom. That person could be working two jobs just to keep a roof over their head. You have to see that patient as an important part of society.” 

Colorado Recovery

The treatment program at Colorado Recovery aims to empower adults with mental illness, and those who support them, with an unrelenting optimism for recovery, purposeful involvement in the community, and an enhanced sense of meaning in life.

Our treatment facility provides the services needed to address schizophrenia, bipolar disorder, and other serious mental illnesses which are specific to each individual. Call us at 720-218-4068 to discuss treatment options for you or the person you would like to help.

American Alternative to Psychiatric Hospitalization Revived in Israel

Traditional approaches to treating psychosis and other serious mental health conditions frequently involve hospitalization and the prescription of powerful medications. Critics argue they are often ineffective and involve the risk of serious adverse effects.

The Soteria model was meant to be an effective alternative to psychiatric hospitalization, preserving patients’ personal power, social networks, and communal responsibilities. The original project was founded by psychiatrist Loren Mosher in San Jose, California, in 1971.

A second Soteria facility opened in 1974 near San Francisco. Mosher was influenced by the philosophy of moral treatment, previous experimental therapeutic communities, and Freudian psychoanalysis. The name Soteria is derived from the Greek word for “salvation” or “deliverance.” Soteria or Soteria-based houses are currently run in the United States, Sweden, Germany, Switzerland, and other countries.

The Soteria concept recently received an upgrade in Israel. In an article for Psychology Today, John Read reported on the successes and challenges of three new Soteria-style houses in Jerusalem and Tel Aviv.

Read was delighted to be invited himself to the opening of the first of the three Soteria-Israel houses in 2016 in Jerusalem. “The warm, relaxed atmosphere in the house was such that it took some time before I could tell who were residents and who were staff,” he remembered. “Not being a religious person I had mixed feelings about the presence of a rabbi until it was explained to me that the person in question was not a rabbi but a resident who sometimes liked to be a rabbi, which seemed to bother nobody.”

Friedlander, Tzur-Bitan, and Lichtenberg evaluated the Israeli Soteria homes. While “crucial components of the original model were preserved … others had to be altered,” they reported in “The Soteria model: implementing an alternative to acute psychiatric hospitalization in Israel.”

The researchers presented eight basic principles for the functioning of Soteria: “care is given in a home, not an institution; groups are small, eight or less; communication is open; activities are client-centered; treatment is consensual; medication is de-emphasized; staff learns to ‘be with’ the resident empathically and non-judgmentally, and the group is the central therapeutic instrument.”

“The heart of the staff remained the ‘companions’, usually students or individuals with personal experience of acute emotional crises,” Friedlander, Tzur-Bitan, and Lichtenberg explained. “These companions were instructed, as in the original Soteria, to cultivate a therapeutic community, with a warm and non-hierarchical atmosphere, blurring the differences between staff and residents.“

Participation and empowerment of patients are key ingredients of the model. “Medication was not considered the first line of treatment, and when used, was understood to be mainly symptomatic treatment—drug-centered and not disease-centered. Its use was not forbidden (contrary to the original Soteria during the first six weeks of the stay), nor was it mandatory, except in exceptional cases where there was a concern for the safety of the residents or their environment. As with all treatment decisions, considerations pro and con were discussed candidly with the resident.”

As Read pointed out in Psychology Today, “the Soteria model is by no means the only alternative to the traditional ‘medical model’ approach of label (diagnose), medicate and, when that fails, hospitalize.”

A similar treatment alternative to psychiatric hospitalization is available at Colorado Recovery. Our Warner Model emphasizes empowerment, integration, and self-actualization. The late Dr. Richard Warner was internationally known for his groundbreaking approach to mental health treatment and for the new model of treatment he created, based on a warmer and more familial setting, comprehensive levels of care that result in a path of self-reliance, and community engagement for connection and a feeling of contribution.

The Treehouse at Colorado Recovery is a social-vocational center run by and for our clients. The program helps prepare them for success in relationships, volunteer work, education and training, internships, and job placements.

At Colorado Recovery it is our mission to help adults with serious mental health issues stabilize their illness, minimize symptoms, improve functioning and enhance each person’s social inclusion, quality of life, and sense of meaning in life.

If you have questions about our recovery model or our services to treat schizophrenia, bipolar disorder, and similar mental illnesses, call us at 720-218-4068 to discuss treatment options for you or the person you would like to help.

The Power of Groups

Last year, Colorado Recovery expanded services outside the signature continuum of care, and started admitting directly into our intensive outpatient program (IOP) clients who may be ready to begin their recovery at the IOP level of care, or for those in the process of stepping down from another program. 

Community integration and social engagement continue to be at the heart of our approach, setting the course for a life of engagement, purpose, and connection. This non-institutional approach created by the late Colorado Recovery founder Richard Warner is key to outcomes associated with independence and self-respect. 

Dr. Warner considered schizophrenia and similar conditions bio-psycho-social disorders significantly affected by the environment surrounding the client on multiple levels. The Warner method harnesses the benefits of client empowerment to increase skills and work preparedness and assist them with social integration. 

Our groups are an integral part of that treatment approach. “We have all sorts of different groups: a hiking group, a musical group, art therapy, a movement group, motivational therapy, the ACT therapy group (acceptance and commitment) therapy group—all different kinds of groups, all different kinds of approaches for clients to progress in their recovery,” says admissions coordinator Julie Owen, MA.

Every IOP patient is assigned a therapist who participates in the weekly treatment planning meeting with the team’s psychiatrists and other treatment staff. Groups include dialectical behavioral therapy (DBT), cognitive behavioral therapy (CBT), co-existing disorders group for psychiatric illness and substance misuse issues, the breakfast group, an art therapy group, the movement therapy group, the creative writing group, and a garden group as well as various activity groups.

One of the groups available at the IOP level is movement therapy. Dance/movement therapy (DMT) is defined by the American Dance Therapy Association  as “the psychotherapeutic use of movement to promote emotional, social, cognitive, and physical integration of the individual, for the purpose of improving health and well-being.”

“The basic tenet is that emotions live in the body,” says Colorado Recovery’s movement therapist Elise Alvarez. “It’s about creating awareness around clients, and then movement to process those emotions. In case of anger management issues, we could ask ‘Is there a specific part of your body that you feel anger in?’ Anxiety might manifest as feeling a weight in the chest.” 

By expanding the awareness of such feelings, people are better able to recognize what’s happening in each present moment and then make more informed decisions about their feelings instead of simply reacting to them impulsively.

Meaningful employment is an important aspect of the treatment model originated by Dr. Warner. Clinical research shows that employment can improve outcomes of mental health treatment. “Several studies have shown that patients discharged from psychiatric hospital who have a job are much less likely to be readmitted to hospital than those who are unemployed, regardless of the patient’s level of pathology,” Dr. Warner wrote in The Environment of Schizophrenia

“Finding suitable employment for clients as part of their treatment plan is the task of the employment group,” explains vocational rehabilitation counselor Dalma Farkas. “Clients learn and practice social skills which are essential for job searches and placements. Participants receive continued support, assistance, and encouragement—from each other as well—to successfully get back into the labor market.”

Employment support includes helping clients find a job, go back to school, or find volunteer work in the community. The group covers a lot of territory: how to write a stellar resume, how to prepare for a job interview, and how to keep a job.

Farkas usually gets things rolling with a thorough career assessment. “I ask them what they would like to do, what’s their dream job? I inquire about their job record and also find out what didn’t work for them to avoid bad experiences in the future.”

Another offering available at the IOP level is our Treehouse group. It’s “a safe space to take a break and just hang out,” says Treehouse community organizer Elise Alvarez. “At the same time, it’s a great opportunity to build more comfortable relationships.” The Treehouse group highlights the value of social integration, “many people have found roommates and best friends here,” says Alvarez. “Treehouse gives a population that doesn’t have too much opportunity to socialize the chance to do just that.”

It’s important to give clients some measure of control, to let them work out the budget and create the space the way they want it to be. “We typically start with me making announcements, and then open the floor to things they want to talk about,” explains Alvarez. “We’ve had discussions about terminology: should it be mental illness or biopsychosocial disease? Other times, we plan out dinners or days at the beach.”

Our groups help prepare our clients for success in relationships, volunteer work, education and training, internships, and job placements.

For more information about direct admission to our intensive outpatient program or our other services, connect with a specialist who can answer your questions at (720) 218-4068.

Sleep Disturbances in Patients with Bipolar Disorder

Sleep problems are common among people living with bipolar disorder (BD). “Sleep disturbances in bipolar disorder are present during all stages of the condition and exert a negative impact on overall course, quality of life, and treatment outcomes,” wrote Alexandra Gold and Louisa Sylvia in their 2016 study about the role of sleep in bipolar disorder. 

Disruption of anybody’s sleep schedule can impact their quality of life and daily functioning, as we all well know, but healthy sleep patterns are especially important for people with mental health conditions such as major depression, schizophrenia, and bipolar disorder.  

“Mental health is affected by sleep in several ways,” wrote Short, Bartel, and Carskadon in Sleep and Health. “Overall, insufficient and poor-quality sleep is associated with worse mood and emotion regulation, as well as increased likelihood of developing a mood or anxiety disorder, and heightened risk of suicidal ideation.” 

“Sleep patterns play a significant role in bipolar disorder,” as Geralyn Dexter, LMHC, explained in an article on verywellhealth.com, “Bipolar disorder is a mental health condition characterized by fluctuations in mood. A person with bipolar disorder can experience euphoric highs and devastating lows. In up to 80 percent of cases, bipolar disorder can negatively impact sleep. It may even be triggered by sleep issues in some cases.”

Various sleep problems are associated with BD, including nightmares, trouble falling or staying asleep, sleep apnea (when breathing repeatedly stops and restarts throughout the night), poor quality sleep, and more. “Mania and hypomania are linked to a decreased need for sleep. Lack of sleep can also trigger mania,” wrote Dexter.  

In other words, the impact of sleep disruption can seriously exacerbate BD symptoms, and achieving a healthy sleep pattern can help ease symptoms. 

 

Treatment for bipolar disorder often involves a combination of medication and psychotherapy. A healthcare provider may also prescribe medication and/or behavioral interventions to help patients get better sleep. 

Behavioral interventions may include: establishing and maintaining a set sleep schedule, creating a wind-down routine, and limiting exposure to light, including from screens and other stimulations, close to sleep times.

To avoid sleep disruption before it becomes a problem, it could be useful to make certain lifestyle changes. In her article, Geralyn Dexter provided a few useful tips:

  • Limit your alcohol intake and consume less caffeine.
  • Keep a consistent sleep schedule by getting up at the same time every day.
  • Limit your exposure to light and screen time before bed.
  • Avoid naps, especially closer to bedtime.
  • Get out of bed if you aren’t able to sleep.
  • Gently expose yourself to light during the daytime.

Colorado Recovery provides the services needed to address schizophrenia, bipolar disorder, and other serious mental illnesses which are specific to each individual. Call us at 720-218-4068 to discuss treatment options for you or the person you would like to help.

How to Tackle Seasonal Triggers

Seasonal changes can be tough for people with mental health disorders. Summer days with warm temperatures and long hours of daylight can have an intensifying impact on manic episodes in bipolar disorder. 

People with bipolar disorder may be affected by seasonal changes in multiple different ways. A 2015 study found that most admissions for mania happened in the spring, summer, and midwinter months, bipolar-related depression admissions were most likely in the spring and autumn months, and people were more likely to be admitted to the hospital for mixed features in late spring and winter. 

It helps significantly to be prepared for these seasonal changes instead of being surprised by them. It may be a good idea to seek professional help before symptoms become overwhelming. One way to prepare for possible seasonal symptoms is by joining an intensive outpatient program such as Colorado Recovery.  

“Seasonal patterns in hospitalizations have been observed in various psychiatric disorders,” wrote Hinterbuchinger, König, et al. in a 2020 study on seasonality in schizophrenia. 

“Our study shows that schizophrenia-related hospitalizations follow a seasonal pattern in both men and women. The distribution of peaks might be influenced by photoperiod changes which trigger worsening of symptoms and lead to exacerbations in schizophrenia.”

Seasonal affective disorder or SAD is a well-established mood disorder that is listed as a subtype of major depressive disorder or bipolar disorder in the Diagnostic and Statistical Manual of Mental Disorders. It is characterized by depressive symptoms that occur typically in the fall or winter with full remission at other times. 

Anxiety, too, can get worse in the fall and winter. In a 2019 article for Healthline, Cathy Cassata explained that autumn anxiety is an annual increase in anxiety some people begin to feel during the fall months. “Experts say some causes of this anxiety may be due to beginning a new school year, the looming stress of the holiday season, or possible regret from not having achieved desired goals over the summer.”

In order to tackle any oncoming seasonal symptoms, it is first of all important to be mindful of triggers and symptoms and not just ignore them. Once people with mental health issues realize that their symptoms are worsening, they can utilize acquired coping skills, such as exercise, dietary changes, or reframing their outlook. Or get a therapeutic refresher on how to handle such triggers and symptoms. 

Colorado Recovery is offering the outpatient program component of its signature continuum of care and making it available to all patients, accepting directly at the outpatient level individuals who may be ready to begin their recovery at that level, patients who need a recovery booster, or for those stepping down from another program. Community integration and social engagement continue to be at the heart of the approach, setting the course for a life of purpose and connection.

“We are quite flexible depending on where the person is,” says Peggy Caspari, MA, LPC, RN, Colorado Recovery’s executive director. “This flexibility is really empowering clients which is our core philosophy. We want to do what’s in their best interest and meet them where they are in their recovery.”  

Clients may join the program at the IOP level because it’s the best fit for their needs, and it all starts with a knowledgeable and welcoming admissions department. “The team at Colorado Recovery treats every client as if they were their next of kin, with respect, compassion, and optimism,” says admissions coordinator Julie Owen, MA.

If you have questions about our recovery model or our services to treat schizophrenia, bipolar disorder, and similar mental illnesses, call us at 720-218-4068 to discuss treatment options for you or the person you would like to help.

 

A New Study Explores Why Multiple Diagnoses Are Common With Mental Illness

Much research has been invested in identifying susceptibility genes for schizophrenia and bipolar disorder. Several well-established linkages have emerged in schizophrenia.

“Relatives of people with schizophrenia have a greater risk of developing the illness, the risk being progressively higher among those who are more genetically similar to the person with schizophrenia,” wrote Colorado Recovery founder Richard Warner in his book The Environment of Schizophrenia.

“Evidence accumulated during the 20th century for a substantial genetic contribution to the etiology of both schizophrenia and bipolar disorder, with the genetic influences initially appearing to be largely distinct for each disorder. This reinforced the traditional concept of the Kraepelinian dichotomy, in which the two disorders were viewed as etiologically independent. The picture has now significantly changed to one of partial overlap in genetic influences, although many of the details about what is shared and independent remain to be elucidated. The dichotomy concept has thus been severely weakened but persists in diagnostic classification systems,” wrote Alastair Cardno and Michael Owen in their 2014 study on the genetic relationships between schizophrenia, bipolar disorder, and schizoaffective disorder.

Not only is there an overlap in genetic influences in schizophrenia and bipolar disorder, but more than half of patients diagnosed with one psychiatric disorder will also be diagnosed with a second or third mental illness in their lifetime. About a third have four or more.

A comprehensive new analysis of eleven major psychiatric disorders offers new insight into why comorbidities are the norm, rather than the exception. The study, published in the journal Nature Genetics, found that while there is no particular gene or set of genes driving an underlying risk for all of them, subsets of disorders—including bipolar disorder and schizophrenia; anorexia nervosa and obsessive-compulsive disorder; and major depression and anxiety—do share a common genetic architecture.

“Our findings confirm that high comorbidity across some disorders in part reflects overlapping pathways of genetic risk,” said lead author Andrew Grotzinger, an assistant professor in the Department of Psychology and Neuroscience at the University of Colorado at Boulder.

For the study, Grotzinger and colleagues at the University of Texas at Austin, Vrije Universiteit Amsterdam, and other collaborating institutions analyzed publicly available genome-wide association (GWAS) data from hundreds of thousands of people who submitted genetic material to large-scale datasets, such as the UK Biobank and the Psychiatric Genomics Consortium.

They found that 70 percent of the genetic signal associated with schizophrenia is also associated with bipolar disorder. That finding was surprising as, under current diagnostic guidelines, clinicians typically will not diagnose an individual with both.

The researchers also found that anorexia nervosa and obsessive-compulsive disorder have a strong, shared genetic architecture and that people with a genetic predisposition to have a smaller body type or low body mass index also tend to have a genetic predisposition to these disorders.

The eleven disorders included in the study were schizophrenia, bipolar disorder, major depressive disorder, anxiety disorder, anorexia nervosa, obsessive-compulsive disorder, Tourette syndrome, post-traumatic stress disorder, alcohol misuse, ADHD, and autism.

While more research is necessary to find out what the identified genes do, Grotzinger sees the results of his study as a first step toward developing therapies to address multiple disorders with one treatment.

“People are more likely today to be prescribed multiple medications intended to treat multiple diagnoses and in some instances, those medicines can have side effects,” he said. “By identifying what is shared across these issues, we can hopefully come up with ways to target them in a different way that doesn’t require four separate pills or four separate psychotherapy interventions.”

Colorado Recovery provides services for adults with serious mental illnesses that will stabilize their illness, minimize symptoms, improve functioning and enhance each person’s social inclusion, quality of life, and sense of meaning in life. We provide residential and outpatient treatment options for schizophrenia, bipolar, schizoaffective disorder, and other mental health conditions. Call us at 720-218-4068 to discuss treatment options for you or the person you would like to help.

Signs and Symptoms of Schizoaffective Disorder

Schizoaffective disorder is a mental health disorder that is marked by a combination of schizophrenia symptoms, such as hallucinations or delusions (psychosis), and mood disorder symptoms, such as depression or mania.

As the Mayo Clinic explains, there are two types of schizoaffective disorder: bipolar type, which includes episodes of mania, and sometimes major depression, and depressive type, which includes only major depressive episodes but no mania. 

Because of its hybrid character, schizoaffective disorder is not easy to diagnose correctly. “Many people with schizoaffective disorder are often incorrectly diagnosed at first with bipolar disorder or schizophrenia,” according to the National Alliance on Mental Illness. “Because schizoaffective disorder is less well-studied than the other two conditions, many interventions are borrowed from their treatment approaches.” 

Schizoaffective disorder falls under the schizophrenia spectrum and psychotic disorders category. Bipolar disorder, on the other hand, is a mood disorder. The key difference is that people living with schizoaffective disorder experience symptoms of psychosis independently of any mood episodes. In the case of bipolar disorder, symptoms of psychosis may occur during episodes of mania or depression but not otherwise.

Schizoaffective disorder is relatively rare, with a lifetime prevalence of only 0.3 percent. Sometimes other conditions such as psychotic depression, bipolar disorder I, schizophreniform disorder, or schizophrenia are mistaken for schizoaffective disorder. 

Treatments for schizoaffective disorder, bipolar disorder, and major depression with psychosis are fairly similar. If both manic episodes and depressive episodes are evident, the medications used are likely to include antipsychotic agents and mood stabilizers. If the illness only presents with depressive features and no manic symptoms at any time, then antidepressants are likely to be used.

Mania and depression are usually episodic and can be interspersed with long periods of complete remission of symptoms. If the illness is continuous, with no remission, then the diagnosis may be schizoaffective disorder.

As Nancy Lovering explained in a recent article on PsychCentral about bipolar and schizoaffective disorder, “it’s not possible to have both conditions at the same time. You’d either receive a bipolar disorder with psychotic features diagnosis or a schizoaffective bipolar type diagnosis. The difference would be if you experience mood episodes and psychosis at the same time as in bipolar disorder or if they appear independently at times.”

Colorado Recovery provides services for adults with serious mental illnesses that will stabilize their illness, minimize symptoms, improve functioning and enhance each person’s social inclusion, quality of life, and sense of meaning in life.  We provide residential and outpatient treatment options for schizophrenia, bipolar, schizoaffective disorder, and other mental health conditions. 

The treatment program at Colorado Recovery aims to empower adults with mental illness, and those who support them, with an unrelenting optimism for recovery, purposeful involvement in the community, and an enhanced sense of meaning in life. Call us at 720-218-4068 to discuss treatment options for you or the person you would like to help.

Older Age Bipolar Disorder 

Bipolar disorder (BD) is a mental illness that causes dramatic shifts in a person’s mood, energy, and ability to think clearly. People with bipolar experience high and low moods—known as mania and depression—which differ from the typical ups-and-downs most people experience.

The average age of onset is around 25, but it can also occur in the teenage years, and more uncommonly, in childhood. In some cases, however, people develop the condition much later in life. Bipolar disorder affects men and women equally, about 2.6 percent of the US population has a BD diagnosis, and more than 80 percent of cases are classified as severe.

“About one-quarter of all people with bipolar disorder are 60 years of age or older,” wrote Eleesha Lockett on Healthline. “While the symptoms of bipolar disorder can vary with age, the frequency, severity, and overall impact of the disorder are generally different in older adults versus younger people.”

Changes in the frequency and severity of episodes are among the most obvious changes in bipolar disorder at an older age. A study authored by Arnold, Dehning, et al. suggests that people with older age bipolar disorder (OABD) often experience:

  • more frequent episodes
  • more depressive episodes and less time spent in manic or hypomanic states
  • less severe manic symptoms and fewer psychotic features with mania
  • new symptoms, such as irritability and poor cognition
  • lower risk of suicide, although this may be due to survivorship bias
  • resistance to treatment options, such as certain medications

Arnold, Dehning, et al. note that BD patients over sixty are becoming an increasingly significant cohort. “The elderly represent the fastest-growing group of the population. The share of those >60 years of age has duplicated since 1980. In developed countries, the percentage of those >80 years of age will quadruple by 2050. It is fair to assume that the portion of old age patients suffering from bipolar disorder will grow in a similar manner.”

The authors point out that OABD patients constitute a heterogeneous population. Two major groups have been distinguished: “late-onset” patients (LOBD), and “early-onset” patients (EOBD), elder patients with a long-standing clinical history.

“The dividing line between OABD and adult-age BD seems to be fluctuating, but ≥60 years of age appears to be the consensual cut-off… EOBD and LOBD appear to be distinct forms of BD. LOBD patients have been reported to present more often with bipolar II disorder than EOBD patients. EOBD is associated with a highly positive family history, whereas LOBD is frequently associated with neurological diseases, cognitive decline, or other somatic conditions.”   

In her Healthline article, Lockett adds that according to experts, “bipolar disorder may speed up aging and contribute to cognitive decline. Older studies have found a link between bipolar disorder and cognitive decline, as well as an increased risk of dementia with each bipolar disorder episode.”

So, if you’ve been diagnosed with bipolar disorder, it’s important to seek treatment for the condition, as it can become progressively worse if left untreated. Since it is a complex condition, effective treatment of bipolar disorder requires a holistic approach. 

The late founder of Colorado Recovery, Richard Warner believed that recovery from mental illness should involve much more than getting rid of symptoms and staying out of the hospital. Dr. Warner’s system at Colorado Recovery includes a residential treatment program, a transitional program, an intensive outpatient program, and a “clubhouse” community mental health service model. The Warner model is based on a warmer and more human familial setting, comprehensive levels of care that result in a path of self-reliance, and community engagement for connection and a feeling of contribution.

Our treatment facility provides the services needed to address bipolar disorder, schizophrenia, and other serious mental illnesses which are specific to each individual. Call us at 720-218-4068 to discuss treatment options for you or the person you would like to help.