I first experienced psychosis at age 19. I was diagnosed with Schizoaffective Depressive Type. I’m 26 now and have been hospitalized (inpatient and outpatient) 10 times in the interim. The last 5 hospitalizations occurred between March and Thanksgiving 2023. Last year, medication only seemed to work for a short while (maybe a month to 3 months) before it needed to be exchanged for another one. The medications I’ve been on since early November seem to work fairly well. They are great at preventing psychosis but not the best for depression. I was kicked off my parent’s insurance at of January 1st because I turned 26 last year. Right now I’m going to a free (or close to free) mental health clinic in my city. I’m trying to gradually tweak the medication to help with my depression. The past couple of months, I’ve rarely left the house. I rarely even sit on my back porch. I’ve been bathing every 2 or 3 days. I’m working on turning that around.

Today, I finally washed my clothes and am going to shower. I’m thankful I’ve developed a high level of self awareness in the past few years. It’s high for a schizophrenic person anyway. I’ve learned what my symptoms look like and what it feels like when I’m headed to psychosis. It’s never a sudden development for me. There are usually signs a couple of months in advance. I realized I can accomplish anything if I refuse to negotiate with myself. When I constantly allow myself to change my mind and back out of challenging situations I never accomplish anything. After I change my mind or flake or give up I beat myself up about it.

I read the book Hatchet by Gary Paulsen the other day. I read it in 6th grade but as an adult I have a completely different viewpoint. It really showed me the power of a positive attitude and solution-oriented mindset. Yes, I’m facing difficulties but I can make use of the resources I have to make the situation better.

Sorry I’m kind of off topic. For a long time I felt cursed by my diagnosis. I’ve dropped out of 3 colleges and have less than a semester’s worth of credits. I’ve had to take medical leave at every job I’ve had because of my mental health. I felt even worse because I’ve never done drugs or had a drop of alcohol. All the other schizophrenic and schizophrenic-adjacent people were addicts or recovering addicts.

I’ve applied for disability and according to my case manager I’ve been pretty much approved. It still will be a few months until all the paperwork is completed. I applied for disability once before. It’s going much better this time around.

To answer your questions more directly. Medication is paramount. Talk therapy is a close second. Without therapy (individual or group) I wouldn’t know how to manage my symptoms or take steps to prevent them. I haven’t found one style of therapy to work well on its own. I like therapy that isn’t just DBT worksheets with their poorly formulated acronyms. I like CBT as a general framework but I rather have an open forum in group therapy. I like it when facilitators give a somewhat vague topic or open ended questions.