From a young woman in the U.S.: My boyfriend has schizoaffective disorder and has known for a while. He still struggles with accepting it and has gone to many doctors and therapists. He is currently on medicine and sees a therapist every week. However, I notice that he seems a little withdrawn.

He doesn’t talk to me very much anymore (maybe 15 minutes max, sometimes not at all) and when I asked, he said it was because he was dealing with his condition. We’re long distance so it’s hard to see what’s going on but I want to be there for him. Should I just give him space? Is there anything I could do for him? Is this considered a norm?

Schizoaffective Disorder is a serious, chronic, and severe mental illness. Symptoms are a combination of symptoms of schizophrenia, including hallucinations, delusions, and disorganized thinking and symptoms of a mood disorder, such as mania and depression.

There are two types: Bipolar type where there has been a manic episode. Depressive episodes can also be seen. The Depressive type is when there is no mania, but depression is part of the picture.

Often a person who suffers from Schizoaffective Disorder has periods of severe symptoms and periods where they seem to improve. The disorder causes difficulties in social and occupational and academic functioning. Often the patient goes into periods of isolation and/or periods of high anxiety. This leads to problems in relationships with family, friends, and partners. Frequent unemployment or dropping out of school is common.

I’m very glad your guy is getting treatment. A combination of medication, therapy, and training in coping skills and social skills often leads to improvement that can be maintained with proper support.

I suggest you look for the local chapter of NAMI (National Alliance on Mental Illness). NAMI support groups provide information, practical advice and emotional support for family members, partners, and friends of people suffering from chronic mental illness. Depending on the city, groups meet weekly or every other week. Your boyfriend would probably also benefit from attending a NAMI Connection support group for those who are managing a mental illness. The NAMI website also offers a great deal of helpful information.

I’m concerned that you are trying to deal with this in the context of a long distance relationship. You didn’t indicate whether you have ever met this guy in person. If not, your ability to read his symptoms and provide support will be very limited.

It’s important that you understand that although some patients manage it fairly well, there is no cure for this disorder. Being in relationship with him means you will always also be in relationship with his disorder. Such couples can be successful but it’s not easy. Only you can decide if you have the inner strength and commitment to manage the ups and downs that are inevitable.

I wish you well.
Dr. Marie