My schizophrenia (or, more accurately, schizoaffective disorder) revealed itself to me in the form of a psychotic episode around this time of year. It happened 17 years ago, when I was a sophomore at the Rhode Island School of Design. Having your first schizophrenic or schizoaffective psychotic episode in college is pretty typical. But if it happened so long ago, why does it still matter?

Schizophrenia and obsessive thinking, which is a symptom of obsessive-compulsive disorder (OCD), rarely present together (although there is a noticeable comorbidity between schizophrenia and OCD). However, I do not have OCD and my schizophrenia symptoms never included obsessive thoughts. At least not until I was put on an antipsychotic medication with a rare side effect of causing obsessive thoughts. Then, not only did I have to deal with symptoms like hearing voices, but my generalized anxiety disorder morphed into a deep well of obsessive thinking with no bottom. Schizophrenia and obsessive thinking is a tough pair to deal with.

People with schizophrenia and schizoaffective disorder are no strangers to medication changes (Mental Health Medication Changes Require a Doctor's Input). Maybe the medicinal cocktail prescribed isn’t relieving symptoms or the medication is causing too much weight gain. Or maybe you’re getting headaches all the time. Medication changes are a big part of having schizophrenia or schizoaffective disorder.

As if dating isn't already tough enough, schizoaffective hypomania makes dating and love even harder. Those of us with schizophrenia and schizoaffective disorder have a lot to deal with when dating. For example, there’s the stress of being on a first date and wondering when would be a good time to tell your prospective partner you have one of the most stigmatized mental disorders. But perils extend beyond that point and include schizoaffective hypomania triggered by the excitement of a first date. Which begs the question, how, exactly, does someone with schizoaffective disorder differentiate between hypomania and the perfectly normal things one feels when falling in love?

Developing schizoaffective disorder is not thought to be an effect of sexism. But for me, the depression that would turn into my bipolar disorder that would turn into my schizoaffective disorder was fueled by sexism. I felt ugly and alone--and some have said that loneliness is the seed that grows into mental illnesses like schizophrenia and schizoaffective disorder.

People with schizophrenia and schizoaffective disorder are particularly susceptible to suicide, and I am no exception. But I have people in my life to live for, especially my husband and family. I make ways to remind myself of what I have to live for to get me through hard moments. With suicide, one hard moment can be all it takes to end a life. And 10% of people with schizophrenia and another 10% of people with schizoaffective disorder die of suicide.

People with schizophrenia and schizoaffective disorder are no strangers to taking medication. Often, they take multiple medications, like me. I take so much medication I have trouble keeping track of it. But I take medication for my schizoaffective disorder, because it’s part of my treatment plan and it means I can live a full life.

Schizophrenia and schizoaffective disorder are scary words to a lot of people but knowing that psychotic episode is like might help alleviate that.. They assume that those of us who have these illnesses are violent and that the voices we hear tell us to kill people. This isn’t the case as my own experience with psychosis will show you. People do not need to fear people with schizophrenia or schizoaffective disorder or their psychotic episodes.

People with schizophrenia and schizoaffective disorder deal with stigma every day, but they have to deal with ableism as well. Ableism assumes that everyone functions at the normative capacity; and that’s just not true, including for people with a mental illness. For example, a facility without a ramp for people who are in wheelchairs would be a place of ableism. Ableism can also mean teasing someone with schizophrenia about leaving a party early. But self-inflicted ableism and schizophrenia and schizoaffective disorder can be the worst stigma of all.

Anxiety can bring about schizoaffective and schizophrenic voices, as I've written before. And I've written about how much they scare me, even though I know they’re not real. When I say “voices,” I literally mean hearing voices-- actually hearing them-- even though they aren’t there. It is one of the hallmark symptoms of schizophrenia and schizoaffective disorder, and for me it’s triggered by anxiety.