Onika L. Dainty

A Diagnosis I Didn’t See Coming

It was January 2025 when I started a group trauma informed treatment program at Ontario Shores Centre for Mental Health Sciences. For the first time in the history of my mental illness, I was given access to my personal medical records from my stay at the psychiatric hospital. I was curious about what the medical staff, social workers, psychotherapists, and psychiatrist had observed while I was deeply unwell during my three month residency in 2024. When I began exploring the daily, detailed reports about my behaviour and activity on the unit, nothing seemed out of the ordinary. It all appeared to fit my experience of mania and how I remembered behaving.

Then I opened a Psychosocial Assessment dated February 2, 2024, and something shifted inside me. It felt like the identity of my illness had changed, and with it, the way I had understood myself for over 20 years. The report read:

Ms. Onika Dainty is a 41 year old woman with a diagnosis of schizoaffective disorder, bipolar type, with noted borderline traits.

The ground beneath my feet shook. I knew it was not a medical error. I felt confused and betrayed, but also like I had just been handed another piece of the puzzle that makes up my complex mind. I knew very little about this diagnosis, yet I was determined to face it head on.

Being newly diagnosed with schizoaffective disorder can feel overwhelming, isolating, and hard to explain, even to yourself. This blog explores what schizoaffective disorder is, how it overlaps with diagnoses like bipolar disorder, and what it can mean to live with a layered mental health condition.

What Is Schizoaffective Disorder? A Blended Symptom Profile

What is Schizoaffective Disorder?

Schizoaffective disorder is a complex mental illness that blends symptoms of schizophrenia, such as hallucinations, delusions, and disorganized thinking, with symptoms of a mood disorder, such as depression or mania. This combination can disrupt thoughts, emotions, and daily functioning. There are two main types: bipolar type and depressive type. It is often misdiagnosed early because the symptom profile overlaps with both schizophrenia and mood disorders like Bipolar disorder.

Schizoaffective vs Bipolar vs Schizophrenia

Schizoaffective disorder is a hybrid condition with a blended symptom profile. Schizophrenia and Bipolar disorder have distinct clinical categories, with schizophrenia typically defined by psychosis and Bipolar disorder defined by episodic mood shifts. The overlap becomes especially confusing when someone experiences manic psychosis and continues to have psychotic symptoms after the mood episode begins to stabilize. In other words, the mood may calm down, but hallucinations, delusions, or disorganized thinking can linger beyond the manic phase.

The Emotional Weight of a Complex Diagnosis: A Formally Bipolar Woman’s New Blended Reality

The biggest challenge I faced with my new diagnosis of Schizoaffective disorder-bipolar type, was the feeling of being misled by my medical team. I was almost a year out of hospital when I discovered it. If I had not been curious enough to read my medical reports, I would have continued living under a label that no longer fit the full picture of my mental health.

I was angry, ashamed, and afraid. The moment I read Schizoaffective disorder in my file, I felt like I had lost my identity. I felt like I had walked down the wrong path on my journey to wellness and that I was too far in to turn back and start over.

And yet, there was also relief. I had always felt pieces of my mental health puzzle were missing. When I am in psychosis, I have experienced auditory delusions, visual hallucinations, and extreme disorganized thinking. My Bipolar disorder framework could not fully explain those symptoms, so I told myself they were simply part of my manic episodes. After being in and out of psychosis for almost a year, unable to manage on my own, admitted and discharged from units whose main mandate was to stabilize me, I eventually became a resident of a mental health hospital with the time and resources to observe me properly.

When I saw the new diagnosis, I thought I should feel gratitude, but instead I mourned. I mourned the woman who had fought for almost 20 years against stigma, discrimination, and misunderstanding related to Bipolar disorder. I became an advocate, a peer support specialist, and a woman who learned the language of mental health so I could move through a world that often saw me as broken. How would I keep moving forward if I did not even know what I had? If my care team was not being transparent with me?

That evening I called my cousin in tears, and he asked me a profound question: Are you a different person than you were yesterday? Are you still the woman who has the tools to manage your mental illness, regardless of what it is called?

The answer was a resounding yes. My diagnosis had changed, but I had not. I was still Onika. I was still determined. My goal has always been healing, emotional stability, and a full, joyous, robust life. Nothing changed except that I now had a more complete picture of my symptom profile. I had to let go of the person I thought I was, close the door on the diagnosis I believed was mine, and make space to learn and grow within this new blended reality.

Learning to Manage the Dual Sides of the Diagnosis

Once I moved through the initial shock of my Schizoaffective disorder diagnosis and began educating myself, I was able to take my power back and rebuild a management strategy that spoke to all parts of my mental health. I started by looking at treatment options and realized they were similar to what I already knew. A combination of antipsychotics, mood stabilizers, and psychotherapy was recommended by my mental health care team.

Since my discharge from Ontario Shores Centre for Mental Health Sciences in 2024, I have not experienced psychotic symptoms, but I have noticed longer mood shifts. I track these mini episodes in my daily planner because structure and self awareness help me stay grounded.

Managing Schizoaffective disorder has its challenges, but I prioritize routine, healthy habits, and stability as a form of protection. Sleep hygiene has become a primary pillar of my care plan. I am still a 5 a.m. person, but now I take my medication earlier so I can get eight to ten hours of sleep consistently. My second pillar is stress management. I use meditation, breathwork, and daily movement to reduce anxiety and support emotional regulation. My third pillar is medication adherence and transparency with my healthcare team. I take my medication as prescribed and check in monthly, or sooner if I feel a crisis on the horizon. The final pillar is self care, self compassion, and grace.

I feel brand new in this diagnosis, so I keep reminding myself that once upon a time I was new to Bipolar disorder too. I felt helpless and alone then. Over time, I learned to advocate for myself. I learned to lean on my support team. I learned that healing is a process, and that psychoeducation, routine, and community can hold you steady when your mind feels loud.

Final Thoughts

It’s Okay to Be in the Process

With this new diagnosis, I have had to accept a few hard truths. First, it is okay to be in the process, as long as I am an active part of the process. This diagnosis is part of my reality, but it is words on a page in the next chapter of my life, not the entire book and not how my story ends.

I have also learned to stop chasing the “right” label and start listening to my lived experience. Schizoaffective disorder is simply terminology for a cluster of symptoms I have always carried. In many ways, it is not a detour. It is a more accurate map for the journey I have already been on.

Whether it is Bipolar disorder, anxiety, PTSD, ADHD, or Schizoaffective disorder, I have always fought for a better life while living with mental illness. None of these labels define me. They guide me toward understanding the unique, and often beautiful, trappings of a complex mind.

To my readers: If a diagnosis could be a doorway instead of a definition, what kind of understanding might you find on the other side?

I Thought It Was Just Anxiety, Then Came ADHD

For years, I blamed my forgetfulness, restlessness, and impulsivity on anxiety or mood swings. Then came the ADHD diagnosis, and suddenly the pieces clicked into place.

Since childhood, I lived with a relentless internal dialogue. The noise in my head only quieted when I shook it hard, almost violently, as if resetting my brain. That internal monologue followed me into adulthood. When I was diagnosed with Bipolar I disorder, I explained the noise as part of bipolar symptoms that intensified during episodes and lingered during anxiety or stress, even in remission.

Although I was prescribed medication to stabilize my mood, manage psychosis, and treat anxiety and PTSD, the constant mental chatter never fully stopped. It was not until my hospitalization in 2023 that a hospital pharmacist raised the possibility of co-occurring Attention Deficit Hyperactivity Disorder (ADHD). He explained how ADHD often goes undiagnosed in people with Bipolar disorder because stabilizing severe mood symptoms takes priority. He encouraged me to pursue testing.

When I finally spoke to my psychiatrist, he agreed. The results were clear. I was diagnosed with ADHD alongside Bipolar I disorder.

Living with ADHD alongside Bipolar disorder, anxiety, or PTSD adds complexity, but it also brings clarity when understood in context. This blog explores how ADHD shows up in people with multiple diagnoses, how to distinguish overlapping symptoms, and how to manage them with compassion, structure, and self awareness.

What ADHD Really Looks Like, Especially in Adults with Other Diagnoses

ADHD in adults often presents as chronic inattention, disorganization, difficulty with focus, time management challenges, missed deadlines, and losing items. Hyperactivity may look like restlessness, constant motion, or feeling unable to slow down. Impulsivity can show up as interrupting, impatience, impulsive decisions, mood shifts, or emotional outbursts. These symptoms affect work, relationships, and daily functioning, and they are often rooted in childhood experiences or trauma.

ADHD, Bipolar disorder, and Anxiety disorder share overlapping symptoms including impulsivity, irritability, distractibility, restlessness, and sleep disruption. This overlap can make diagnosis challenging. ADHD symptoms tend to be persistent and consistent, while bipolar symptoms are episodic, cycling between mania and depression. Anxiety is characterized by excessive worry, but all three conditions share emotional dysregulation and focus difficulties.

Because Bipolar disorder is severe and volatile, its symptoms are often treated first, which can delay ADHD diagnosis. ADHD is a neurodevelopment disorder that affects executive function, emotional regulation, self control, and attention. Anxiety disorders exist as a separate category but frequently co-occur with both Bipolar disorder and ADHD, creating symptom masking that complicates diagnosis.

Historically, Black women, neurodivergent adults, and trauma survivors have experienced delayed or missed diagnoses. Ongoing self monitoring and transparent communication with mental health providers are essential for accurate diagnosis and effective treatment.

Untangling the Threads: ADHD in a Multi Diagnosis Life

Living with multiple mental health diagnoses requires understanding how each condition shows up in your body and mind. When I received my ADHD diagnosis in 2024, I felt both overwhelmed and relieved. I have a research oriented mind, so I immersed myself in psychoeducation, peer support, and medication information. Over time, I gained clarity about how ADHD fits into my symptom profile.

For years, I attributed my impulsivity solely to manic episodes. While mania intensifies impulsive behaviour, I learned that ADHD driven impulsivity is chronic and rooted in executive function challenges. Manic impulsivity is episodic and driven by mood disturbance. Recognizing this distinction helped me manage one of my most difficult symptoms with greater self compassion.

Understanding this difference allowed me to build routines, structure, and healthy habits that prepare me for both ADHD related impulsivity and bipolar mood shifts. I learned to check in with myself and my support team, remain transparent with my healthcare providers, and ask for help early.

I also learned to distinguish between depressive episodes and ADHD related executive dysfunction. There are times when my body shuts down completely. I feel no sadness, just profound exhaustion and mental blankness. Rest and sleep regulation are the only remedies. Other times, emotional overwhelm and depressive inertia take hold. During those periods, I lean on my support system and remind myself that bipolar depression will pass with effort, care, and time.

Identifying whether a challenge stems from ADHD or Bipolar disorder helps me respond with the right tools and protects my overall mental health.

Strategies That Work for ADHD, Even When You’re Managing Other Disorders

Managing ADHD alongside other diagnoses requires an integrated and personalized treatment plan. In my experience, the most effective approach combines medication management, psychotherapy such as Cognitive Behavioural Therapy (CBT), and lifestyle strategies centred on structure, routine, and healthy habits.

Working collaboratively with psychiatrists and therapists ensures comprehensive care. Treating the most impairing condition first often reduces symptoms across diagnoses. The tools I developed to manage Bipolar I disorder became invaluable when ADHD entered the picture.

Daily structure supports my stability. I rely on planners, to do lists, timers, medication reminders, and consistent sleep hygiene. I break tasks into small steps, schedule rest intentionally, and use energy peaks wisely. Digital tools like Todoist, Focusmate, or Habitica offer ADHD specific support. Peer support groups can also be helpful when they align with your individual needs.

Final Thought

Receiving an ADHD diagnosis required me to rethink how this condition fits into my mental health story. Transitioning from a single diagnosis to a multi diagnosis life was overwhelming at times, but it also brought freedom.

The little girl who once shook her head to quiet the noise can rest now. I am in the driver’s seat. ADHD is part of my story, not the whole book.

Though there are more letters attached to my diagnosis profile, I am no longer afraid. I am informed, supported, and equipped with tools that align with how my mind actually works. There will always be challenges, noise, and unpredictability, but I face them with clarity, hope, and faith rather than fear.

To my readers:

What would shift for you if you stopped seeing ADHD as a failure to focus and started seeing it as a call to design a life that truly fits you?