SWITCHING FROM SELF-CRITICIZING TO SELF-CARE

Switching From Self-Criticizing to Self-Care

Every year, at the High Holidays, I feel the most Jewish guilt I feel all year.

I feel guilty for not looking forward to the holidays so many people cherish. I feel guilty for not going to services more during the year. I especially feel guilty for the fact that I can’t fast on Yom Kippur for medical reasons, although in recent years, I’ve started volunteering during the day, doing more physical tasks that people who are fasting might be unable to do.

But this year, that idea has to be thrown out the window, along with any other ideas of a traditional High Holiday service. I was starting to feel overwhelmed at the thought of spending Rosh Hashanah and Yom Kippur alone because it would be even more alone than in the past - instead of going to synagogue, I’ll be in my apartment, attending services on Zoom.

As I spent more time puzzling over what to do and untangling my feelings, I learned about a local (virtual) session for young people living alone about how to deal with the changes of this year. I signed up and attended the session earlier this week.

At the session, I was expecting to hear a lot about what to do, but I wasn’t expecting to have so much space for everyone to share what they were feeling. On a virtual whiteboard, all of us shared our favorite parts of past High Holidays, things we’re afraid we’ll miss, questions about religious or other matters related to the days, and more.

It was such a relief to see I wasn’t the only one feeling confused about what to do in terms of services, food, and listening to the shofar. Other people were concerned about where they were going to find community and how to make online services feel like in-person ones. The major question that kept coming up was how to keep the meaning of the holidays intact when so much else has changed and is still changing by the day.

As someone who struggles greatly with change, and who has also spent a lot of my life feeling like I’m the only one who has these sorts of difficulties, I was encouraged by the fact that many people were asking questions and seemed so relieved to get advice. People were sharing far more than I expected, and in the breakout rooms (a feature of Zoom I’ve never explored before), I enjoyed having one-on-one conversations with strangers who had similar concerns.

One of the takeaways that stuck out to me was self-care. As the High Holidays are a time when I feel a lot of guilt and confusion, I’m not used to being kind to myself then. And lately, I’ve been having a hard time being kind to myself at all. Especially in the wake of falling for a puppy scam, I’ve been feeling unprepared and immature, ill-equipped for the world at hand, and have been calling myself a variety of cruel names.

But this panel inspired me to try to break out of the negative thought patterns I find it so easy to get stuck in. Even at a time of year I’ve come to associate with ruminating over everything I’ve done wrong - a process I’ve done every year since I first heard of apologizing to friends and family for wronging them over the last year in order to get into the Book of Life - I can try to be kind to myself. And I’ve already started.

Today is two weeks since I sent payments for a puppy I never received, and in those two weeks, I’ve cried a lot and berated myself even more, but I also went through old collectibles and games and sold enough on eBay to make up the difference. I know it’s not the same, but it’s a way for me to take charge over a situation I had very little control over and reduce my anxiety significantly.

I’ve been doing things like that as much as I can during the pandemic, and the High Holidays are no exception. I know there are some things I can’t change - I’m going to be alone in my apartment no matter what I do - but I can take advice from the session and remember that there are other people out there in Chicago and beyond trying to be kind to themselves this holiday season.

I’m going to set up a special space in my apartment for the High Holidays, and even if my preparations are simple, I can move my computer away from my desk and feel like I’m in a different place. I’m going to try to challenge my fears about not having a “normal” High Holiday experience and not being a “good Jew” by not going to in-person services or fasting on Yom Kippur.

During the pandemic, I’ve thought a lot about pikuach nefesh (saving a life), one of the most important good deeds a person can do. Ever since the panel, I’ve seen a new application for this mitzvah - by being kind to oneself, it’s easier to be kind to others and available for them, and you never know who truly needs that kindness.

Wishing all my readers a happy and healthy new year and opportunities to heal, learn, and grow at this tough time!Ellie, a writer new to the Chicago area, was diagnosed with OCD at age 3. She hopes to educate others about her condition and end the stigma against mental illness.

Ellie, a writer new to the Chicago area, was diagnosed with OCD at age 3. She hopes to educate others about her condition and end the stigma against mental illness.

LUCY IN PEORIA WITH HEARTBREAK

Lucy In Peoria With Heartbreak

I woke up on my tenth day of quarantine to wonderful news - my COVID test was negative, meaning that many of my friends would feel comfortable seeing me, albeit from a distance. But even better than that, I was going to get a puppy that day.

The moment I knew I would be going back to Chicago, a little over a month ago, I decided to get a dog. It was the perfect time since I’m going to be working remotely the next few months, and the biggest thing that scared me about heading back was the loneliness I believed was inevitable. I was also afraid of being bored, and the challenge of raising a dog would be perfect to fill both holes in my life.

I started looking at various local shelters, aware that I would need to do things in advance since there are so many people hoping to adopt pets during the pandemic. I applied at several shelters, checked out breeders, and wrote to my landlord to get the specifics of what kinds of dogs are allowed in my apartment.

The first day after I arrived in Chicago, I found the first dog I was interested in - a Hug (Husky/Pug mix) from a local shelter who got adopted out to someone else. I loved his face because he looked like one of my favorite dog breeds and the one I’d want most, a French bulldog. Over the next week, I applied for half a dozen dogs I’d be okay with before I came to the conclusion that if I was going to be spending a good deal of time and money on a dog, I should go for one I really, truly wanted - and that’s when I got taken for a fool.

I connected with a man from Peoria named Javier (the first real name I’ve used in this blog, as I hope to warn anyone else who he might be scamming), who said that he had a puppy available. She was a grayish Frenchie with bright blue eyes like the sky on a sunny day, a funny little soul patch and a white tummy, and in the videos he sent me, she seemed to be playful, kind, and curious about the world - definitely my kind of dog. And, as he told me after I sent him the first payment, her name was Lucy.

Since my pseudonym is partially inspired by my favorite Beatles song since childhood, “Eleanor Rigby” (a song that felt like both a call to the loneliness endemic to my school life and the possibility for change if either of the lonely people in the song had reached out to each other), I loved that the puppy’s name was Lucy. It reminded me of the way I apparently learned to sing “Lucy In The Sky With Diamonds” along with nursery rhymes, and loved to entertain adults around me by singing it as best as I could.

It struck me a few minutes later, as I enthusiastically showed off the puppy’s picture to several of my friends, that there was an easy solution to the fact that I always wanted a dog with a nerdy name. Lucy would be a great nickname for Luthien, the most beautiful elf maiden in The Silmarillion - and she was one of the most beautiful puppies I’ve ever seen. I could already picture her dog tag in my head: Luthien on the top line of the heart, followed by Lucy in quotation marks to show that that’s her nickname, and finally my phone number. I pictured myself dressing her up in a little costume to match my elf dress, carrying her around on Halloween, showing up to Pokemon Go raids with her in a baby carrier so I could hold her and play at the same time.

Javier was supposed to show up the next morning, and I was so excited that I couldn’t sleep. My Fitbit recorded sporadic rest interspersed with pacing and reading and picking the perfect outfit to meet my puppy. I cleaned my apartment after crawling on the floor to make sure there were no small objects at a puppy’s eye level. I did as much work as I possibly could, hoping to spend Friday afternoon getting that cute dog tag and other supplies I’d need to make her comfortable.

I heard from him in the morning, which made me feel more confident, but my hopes were shattered when hours passed after the second payment and I never heard from him. I tried to text and call the number that had always worked before, hoping against the odds that he was just caught in traffic and would bring my puppy to me like he said he would.

By the time 1:00 rolled around, I knew I had been scammed, and the thing I’d feared since leaving my parents’ house started to happen: I started to breathe so fast I couldn’t catch my breath, my heart was pounding, and all I could do was rock back and forth in my comfy chair as every emotion I was terrified of poured over me all at once, in addition to the loss of a (to me) significant amount of money.

I called my bank immediately, sobbing, and was told that I’d need to wait 5-10 business days to see what they could do. I filed a report with the FTC and the police, but the odds are still slim I’ll be able to get the money back except by the one strategy I’ve come up with: finding old video games, Pokemon cards, and other valuables that matter to me but not too much, that I would be okay with selling.

My friends and family helped me get out of the initial near-panic attack (only calling it a near miss because I was able to dispel it over an hour instead of several days), but I am still horribly ashamed to look at the texts with Javier, full of red flags I can see now that I’m not looking at the situation with rose-colored glasses.

My friends and family are trying to encourage me to see this as a learning experience, but a consequence of the way my head works is that I beat myself up about mistakes and failures for years to come. I still feel a pit in my stomach when I think about the college honor I didn’t get, the messages I sent while in the throes of depression, and many other moments throughout my life that I can never seem to forgive myself for. And my dog-less apartment is a reminder to me every day that I failed once again, and this time, in a very costly way.

It’s been a few days since the incident. I haven’t looked at her picture, because I know the bright blue eyes won’t be following me around my apartment. I know the love I thought I would get from her will come to me eventually from another dog, but for the foreseeable future, I’m going to be living in my apartment alone, bored except for the entertainment I come up with for myself.

Instead of learning the lesson my family has told me to focus on - how to avoid scams - I’ve learned something else: I’m very used to my tendency to fall into the easy territory of my favorite stories when I’m frightened by something in real life. However, I never had the opportunity to realize that I can retreat into these stories even before I know if things are going to be hard, that I can be so deep in denial that I ignore obvious signs. I trapped myself in a vicious cycle of repeating my mistakes in my head, thinking over every sign that I should have seen and everything I should have known.

There are two silver linings to the situation - my newfound openness about my search for a dog with my friends and family, and the way I was able to stop a burgeoning panic attack from completely derailing me. And as of the time I’m writing this, I’ve made back 1/7 of the money I lost to Javier. It might be a long journey, and in the meantime, I’ll need to find new ways to cope instead of making up a story of myself, happy, with a dog that doesn’t exist.

One day, I will have a puppy - hopefully a French bulldog or a dog that looks like one - with bright eyes that will stare at me like my family’s dog stares up at my mom, like she hung the moon and every star just for him. In the meantime, however, I have decided on a new goal: to reflect on my past mistakes and try to see them as learning opportunities instead of simply criticizing myself in an endless loop of negative feedback. It’ll certainly be hard, but now that I don’t have a new puppy to raise, I’ve got the time and energy to invest in my mental well-being. It’s time to break the cycle of negativity my OCD has trapped me in about my past mistakes while turning my puppy dream into reality.

For now, I’ll be looking up at the sky. My thoughts of Lucy will hopefully diminish, and by the time I am able to find a puppy to love, I hope to have forgiven myself for this mistake (among others) and approach dog ownership with a full heart.

Ellie, a writer new to the Chicago area, was diagnosed with OCD at age 3. She hopes to educate others about her condition and end the stigma against mental illness.

THIS IS NOW

This Is Now

Early in the evening of my sixth day of quarantine after returning to Chicago, I finished reading a book.

It’s not at all an unusual circumstance for me, and I have a pile of books waiting for me on the lowest shelf of my bookshelf (two shelves below my Tolkien shelf sagging from the weight of everything I’ve piled on there). I found six books I’d bought used on eBay before I even heard the word “coronavirus,” and I’d forgotten what all of them were about.

Two were classic fantasy fare, one was sci-fi, another humor. One was based on a TV show some of my friends told me was funny, and the last one was a collection of short stories I suddenly remembered being very excited about.

I briefly wondered why I hadn’t taken it home when I remembered the premise of the book: it deals with themes of death. I remembered packing to return home, holding the book in my hands before returning it to the shelf. I was panicked enough, I thought. I didn’t need something to remind me of some of my worst obsessive fears or trigger horribly upsetting memories.

But as I held the book on the sixth day of quarantine - which, like the blood test I got shortly before returning to Chicago, went far more smoothly than I expected - I found that I wasn’t upset. Even as part of me tried to convince myself to read one of the fantasy books or even the humorous one, I wanted to read this one. It had an intriguing premise, and short stories are a great fit for the way I’m running my life in quarantine: lots of activities, working out as much as I can in the confines of my apartment, and keeping ahead of all my chores.

The thoughts I had in my head at that moment reminded me of something I’ve been telling myself, that I hadn’t connected to my deeper fears of the past: that was then, this is now.

Ever since I got back to Chicago and had an easier transition than I expected, I’ve had to tell myself that phrase many times in a day. Every time I expect to break down crying or revert to old, bad habits, I need to remind myself that just because I thought or behaved a certain way in the past doesn’t mean I am guaranteed to do so again.

Applied to the situation of choosing a new book, I’m not guaranteed to resurrect old obsessions or negative thoughts merely because I see the word “death” on a book cover or read a book with death as a major theme. And this principle can apply to so many things - I was able to try a new food (kale noodles) this week by telling myself that just because I had reacted with extreme fear to trying new foods in the past didn’t mean I needed to do so again, and I was also able to take a surprisingly optimistic take on my COVID swab test earlier in the day.

I had been afraid, even though I knew there would be no blood involved, because I knew there would be a lot of people and things triggering my fear of all things abnormal in medicine. But on the walk over, I told myself that just because I had been afraid of these things in the past didn’t mean I was about to panic. I could wait and see how I felt, and hopefully, things would be all right.

Sure enough, when I got there, I was more than a little nervous, but I used the same distraction techniques I use in hospitals and at the hematologist’s office to keep myself from fixating on the things that scare me. And I used my new mantra at every step of the way, starting when the nurse came over to get my vitals and I put my finger in the same pulse ox machine I had to wear in the hospital.

This is now, I thought as the numbers took a little too long to calibrate for my liking, but the numbers were totally fine. Before I knew it, I was taking the test, the swab going so far inside my nose I could practically feel it tickling my brain.

This is now, I thought when I spent the next hour watching doctors and nurses go over to people one by one. I was outside in the sunshine. I could stand. I was wearing my Lord of the Rings mask. Things had definitely improved since back then.

This is now, I thought when I was finally able to walk home, knowing I was breathing the last fresh air I’d have for the next eight days, but even though I knew I’d be back at my apartment soon, I could still enjoy my brief time outside.

I can’t even begin to say how many times I’ve told myself in the last six days that “that was then, this is now.” It’s becoming the mantra of my quarantine, something to remind me that every day has the possibility to be something new. Even though I’m trapped in certain routines and unable to do many of the things I enjoy right now, I can still create new experiences for myself. Hopefully, over time, these will push out my scarier memories and leave me with both a more positive outlook and the ability to try new things with less fear.

Ellie, a writer new to the Chicago area, was diagnosed with OCD at age 3. She hopes to educate others about her condition and end the stigma against mental illness.

EXPOSURE THERAPY IN THE MOMENT

Exposure Therapy In The Moment

I’m writing this from the passenger seat of the car, as Dad drives closer to the Tennessee-Kentucky border. I’m on my way back to Chicago, something that has scared me for a long time. Sure, I’ve been looking forward to certain things back in Chicago, but considering that two of my biggest triggers of negative thoughts are boredom and loneliness, I can’t deny that I spent the majority of the night last night tossing and turning.

The article I read – and blogged about – last week gave me the idea of trying to do exposure therapy on myself about going back, but I quickly found a question I couldn’t answer: how is it possible to reduce anxiety in situations where it’s impossible to prepare by simulating the experience?

For some situations, like the beginning of the pandemic, I couldn’t predict that it would happen or what it would look like. But for a situation like this, it was all too easy to picture myself being bored and lonely, pacing around my apartment and being too afraid to leave, or at any time in the first two weeks when I won’t be able to leave at all as I’m coming from a state where there are a lot of cases.

Even though I could picture many specific moments along the way – waking up far too early in the morning, watching the garage door close with me on the outside, sitting in the car and thinking just like I am now – there was no way to do an exposure like I would do for a more concrete fear.

Even when I was working with a psychiatrist to learn how exposure therapy worked in the first place, I couldn’t do proper exposures for the things that made me the most anxious, like inpatient hospital stays. I could do things like listen to the sounds I’d hear in the hospital, lay in bed, and write vividly imagined stories of what it would be like, but deep inside, I would know it wasn’t real, so I’d never feel that primal fear or have a chance to overcome it.

Right now, I’m pleased to say that I’m feeling okay. I haven’t cried yet, and it’s been fun talking with my dad about a variety of video games. I have plenty of entertainment in the car, including my Switch with Animal Crossing booted up, stories loaded onto my phone, and a new cross-stitching pattern of hobbit meal times to adorn my kitchen. But that doesn’t mean I’ll feel okay forever, or that I won’t break down crying the minute Dad leaves me in the apartment by myself.

My reaction to the drive so far, however, is showing me that I don’t necessarily need to expose myself to every potential experience ahead of time to feel okay. I haven’t done a drive this long before, nor have I figured out a concrete plan to be alone during a pandemic. But so far, I’m fine. I don’t need to tiptoe around this situation, because so far, I’ve been more afraid of being afraid than of the situation itself.

And even though I couldn’t do exposure therapy to prepare me for today or the days and weeks to come, I was able to take several steps towards making my life in Chicago easier. I have a hold on an exciting new book from the library, a box of new miniatures to paint, and three new cross-stitching patterns to fight boredom. I reached out to local friends to set up a support system for any times when I’m not feeling fine. And I’ve dealt with as many chores and practical matters as I could to give myself more time for self-care measures like working out, eating healthy, and spending time on my favorite hobbies.

For situations like these, this seems to be the best way to go. Before, when I’m worrying about the different feelings I may have, I may not be able to replicate the experience, but I can take as many steps as I can to make the actual day easier. During, I can practice self-care and mindfulness, being aware of how I feel and the types of thoughts in my head. And after, once I’m settled in my apartment, I can look back at this process and see what worked and what didn’t for next time.

I’ve gotten into the point where, even though I’m terribly afraid of hospitals, I can pack a hospital bag and get myself there without focusing too much on what will happen once I arrive. I hope that this time, I’ll learn even more about my reactions in different scenarios, and I’ll be able to go into the next occasion like this more prepared. I won’t be able to go up the pyramid chart like I did with my psychiatrist, but I can prepare myself to make the day’s exposure easier, hopefully achieving similar results to what I would have gotten from proper exposure therapy.

Ellie, a writer new to the Chicago area, was diagnosed with OCD at age 3. She hopes to educate others about her condition and end the stigma against mental illness.

Guest Blogger: Schizophrenia and Schizoaffective Disorder – How they’re alike, how they’re different, and what it felt like to get each diagnosis

During my mental health journey, I originally received a schizophrenia diagnosis

It sounds strange, but I was a little excited when I received the schizophrenia diagnosis.  Not because I wanted to have schizophrenia, but because now I had a reason for why these things were happening to me. I had documented treatment methods. And it was something I could research and learn more about. That was something that was very important for me. Possessing knowledge about it made me feel like I had more control at a time when my world was spinning out of control.

The diagnosis also crushed me. At that point, all I really knew was the stereotype and the story of my uncle with schizophrenia who is unable to live independently. I feared that I would never be able to even come close to living the life I had always expected to live. Part of me gave up on myself immediately. Another part of me fell into denial. But the remaining part of me refused to give up hope. That was the part that kept me going. It was my sole motivation to follow my treatment regimen and keep living.

Right when I was starting to accept my diagnosis, it changed

My family and I bought books about living with schizophrenia. We researched the disorder. And then the diagnosis changed without warning: schizoaffective disorder. I felt a little deflated. Here I had hyped myself up preparing for life with schizophrenia, and now it’s something different? And it was something that I’ve never heard of before. I turned to the books we had bought. But I found nothing but short mentions and basic descriptions of the diagnoses and the debate surrounding it. I turned to the internet and came up with not much more than that. It left me feeling profoundly lost. I almost felt dirty or dismissed, like I wasn’t good enough for a diagnosis of schizophrenia. 

The schizophrenia diagnosis gave me a sense of security because I knew what it was, how it was treated, and heard stories from those who lived with it. I didn’t have any of that with schizoaffective disorder. We didn’t know what kind of outcome there might be, and I couldn’t find anyone who shared the diagnosis. I felt so isolated. Logically, I knew that I was not the only person in the world with schizoaffective disorder, but it truly felt that way sometimes. I desperately wanted to know that there was someone else out there who could understand what I was going through with this disorder. And those that I found were people living with schizophrenia. 

Are schizoaffective disorder and schizophrenia the same?

You may have seen myself and other advocates using “schizophrenia” and “schizoaffective disorder” together and sometimes interchangeably. Why is that? Are these two separate disorders or not? The answer, right now, is yes.

The controversy

The fate of schizoaffective disorder as a unique disorder has been a hotly contested issue for many years, and still is. Until 1980 the the most widely used diagnostic manual in the United States, the Diagnostic and Statistical Manual, actually listed schizoaffective disorder as a subset of schizophrenia. Schizoaffective disorder is often put on a spectrum between bipolar disorder and schizophrenia, with researchers and clinicians debating whether it belongs on one end or the other or as a standalone disorder in the middle as it is now.

When I first learned of the controversy, I remember thinking that if it ceased to be a diagnosis, what would that mean for me? For me, having a diagnosis made the disease tangible and manageable. It made it real. Would I have to start from scratch again?

How are they alike?

People with schizophrenia and schizoaffective disorder both experience symptoms of psychosis like delusions and hallucinations. Both depression and bipolar disorder can also come with symptoms of psychosis referred to as psychotic features.

Along with sharing the symptoms of psychosis, there is also evidence to suggest that schizophrenia and schizoaffective disorder also share physical changes and abnormalities in the brain. In the case of both disorders, both good and poor outcomes are possible. This means that some people will be able to manage symptoms and function highly, while others may have more difficulty managing symptoms and functioning in daily life. 

So what’s the difference?

What sets schizoaffective disorder apart from mood disorders with psychotic features and schizophrenia is the timeline and which symptoms play a larger role. While the mood symptoms must be around for the majority of the time, symptoms of psychosis like those of schizophrenia also need to continue for at least two weeks in the absence of mood symptoms. 

In comparison, any mood symptoms experienced by someone with schizophrenia won’t play as big of a role in their disorder. In the case of depression and bipolar disorder with psychotic features, the psychosis symptoms happen almost exclusively with mood symptoms. For those disorders the mood symptoms also must be the most prominent symptoms. Schizoaffective disorder is also more rare than schizophrenia. Only 0.3% of people are affected by schizoaffective disorder. For schizophrenia, about one in 100 people are affected.

Some say that schizoaffective disorder has a better prognosis than that of someone with schizophrenia. However, that’s not true in all cases. Many view prognosis as very individual. There are so many factors that come into play whether it’s schizophrenia or schizoaffective disorder. This includes things like age of onset, severity at onset, and how quickly someone received treatment. It doesn’t necessarily mean those with more positive outcomes haven’t suffered though.

Why do so many of us with schizophrenia use the terms together or interchangeably?

For both schizophrenia and schizoaffective disorder, the symptoms of psychosis are the same. Those of us with schizoaffective disorder often explain the diagnosis to others as a combination of schizophrenia and a mood disorder. This can be a helpful way to explain it because the majority of people have never heard of schizoaffective disorder or understand psychosis, though most have at least a basic knowledge of schizophrenia. Sharing so many symptoms also means that people with schizoaffective disorder and schizophrenia go through similar experiences. Both disorders also face a great deal of stigma in part because of these shared symptoms of psychosis. These shared experiences make it easy for us to relate to each other.

Coming together

It took time, but I have become comfortable with my my schizoaffective diagnosis. Having a name for what I was going through was helpful. But over the years, I’ve learned to focus more on my experiences and less on the word. Connecting with people with schizophrenia and hearing stories of others who live with that diagnosis was crucial to me accepting my diagnosis. The differences in the diagnoses didn’t matter to us. For many with either diagnosis, the symptoms of psychosis are by far and away the most difficult to understand and live with. It made me feel less alone to know that I wasn’t the only one who struggled with such stigmatized symptoms. It gave me hope. 

Those of us with schizophrenia and schizoaffective disorder have formed a community of sorts surrounding shared experiences with psychosis, fighting stigma, and spreading hope. Whether you have schizoaffective disorder, schizophrenia, or a loved one with one of these diagnoses, what the psychosis community wants you to know is that you should never give up hope.

Katie Sanford is a mental health advocate based out of the Chicago area who lives with multiple mental health disorders including schizoaffective disorder. Katie uses her story to break down the stigma surrounding mental illnesses like schizoaffective disorder and offer hope to those with diagnoses and their loved ones. She does this through speaking, writing, and her blog Not Like The Others.

Sources

American Psychiatric Association. “Schizophrenia Spectrum and Other Psychotic Disorders.” DSM Library, American Psychiatric Association, 2020, dsm.psychiatryonline.org/doi/full/10.1176/appi.books.9780890425596.dsm02.

Firman, Guillermo. “MedicalCRITERIA.com.” Medicalcriteria.com, 31 Mar. 2020, medicalcriteria.com/web/schizophrenia/.

Kanahara, Nobuhisa et al. “Onset Pattern and Long-Term Prognosis in Schizophrenia: 10-Year Longitudinal Follow-Up Study.” PloS one vol. 8,6 e67273. 26 Jun. 2013, doi:10.1371/journal.pone.0067273

Miller, Rachel, and Susan E. Mason. Diagnosis: Schizophrenia: a Comprehensive Resource for Patients, Families, and Helping Professionals. Columbia University Press, 2002.

Parker, Gordon. “How Well Does the DSM-5 Capture Schizoaffective Disorder?.” Canadian journal of psychiatry. Revue canadienne de psychiatrie vol. 64,9 (2019): 607-610. doi:10.1177/0706743719856845

“Schizoaffective Disorders F25-.” ICD-10-CM, ICD10Data.Com, 2020, www.icd10data.com/ICD10CM/Codes/F01-F99/F20-F29/F25-.

Torrey, E. Fuller. Surviving Schizophrenia: a Manual for Families, Patients, and Providers. Harper, 2001.

Wy TJP, Saadabadi A. Schizoaffective Disorder. [Updated 2020 Apr 15]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK541012/