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?

I once signed up for three credit cards in a single day. When they arrived, I rushed to the mall and spent each balance in under three hours. At the time, every purchase felt like a need with purpose but it was hypomania.

Hypomania can feel seductive. It creates the illusion of power, freedom, and the “best version” of yourself. But if left unchecked, it can escalate into mania or even psychosis.

For me, hypomania often ends in manic-psychosis and hospitalization, with my care team working to bring me back to baseline. The truth is, during hypomania, I feel incredible, too incredible. My inhibitions vanish, boundaries dissolve, and everything moves at warp speed. Yet over time, I’ve learned to spot hypomanic episodes, manage symptoms, and stop them before real damage occurs.

This post shares grounded, compassionate strategies for managing hypomania with bipolar disorder and practical tools drawn from lived experience.

First Comes Awareness: Catching Hypomania Early

One of the most important skills in bipolar disorder management is recognizing hypomania symptoms early. This awareness comes from tracking your mood cycles with journals, sleep logs, or apps. Common cues include racing thoughts, decreased sleep, irritability, impulsivity, and excessive optimism.

For me, hypomania sometimes shows up as extreme fatigue rather than excess energy. My baseline is naturally high-energy, which makes early signs harder to detect. After back-to-back trips to the Caribbean and New York City, I unexpectedly crashed, sleeping for days. What looked like exhaustion was actually hypomania.

Even when you know your bipolar cycle, stress, travel, or disrupted sleep can shift how symptoms appear. That’s why reflection before, during, and after episodes is so valuable. Creating a personal “Red Zone Hypomania List”, a set of your own early warning signs that can help you and your support team recognize patterns and intervene sooner.

Grounding Practices That Gently Slow You Down

When hypomania enters your cycle, you can either ride the wave or learn to calm the waters. I used to let it sweep me away, but I’ve since discovered that grounding can slow the spiral.

Some practices that help me include:

• Sensory grounding: submerging my face in cold water, using weighted blankets, or aromatherapy.
  

• Movement and breath: gentle yoga, box breathing, belly breathing, or guided body scans.
  

• Stillness rituals: light therapy, meditation music, or intentional solitude that often leads to restorative sleep.
  

These tools may not erase hypomania, but they create space for rest and regulation.

Structuring Your Day to Reduce Overstimulation

Hypomania often thrives on overstimulation. Building predictable structure and routines can make a significant difference.

• Keep a consistent sleep schedule, even when you feel energized.

• Schedule downtime during busy events like weddings or conferences.
  

• Limit caffeine, reduce screen time, and avoid noisy environments before bed.
  

Structure, routine, and healthy habits are essential to maintaining emotional stability when managing bipolar disorder.

Knowing When and How to Reach Out

Even with the best coping strategies, there are times you need support. Having a trusted network including family, friends, peers, or professionals can be life-saving.

My father often spots pressured speech before I do. My Grama Judie, who helps manage my finances, notices when I hyper-spend. They give me space to self-correct, but step in if needed, following my crisis plan and communicating with my psychiatrist.

Over the years, I’ve built a bipolar crisis plan with questions my support team feels comfortable asking me, such as:

• “When was the last time you slept?”

• “Have you been taking your medication?”
  

These may sound invasive, but with trust, they become vital tools for early intervention.

Protecting Yourself from Hypomanic Impulses

Impulsivity is one of the most challenging parts of bipolar disorder. Protecting yourself means creating safeguards before hypomania hits.

Some strategies I use:

• Safe spending rules: delay big purchases, freeze access to credit, or hand over cards to someone I trust.

• Pause big decisions: whether about relationships, travel, or quitting a job, I place them on a 72-hour hold.
  

• Create a “pause kit”: grounding tools and notes from my baseline self.
  

• The buddy system: an accountability partner who isn’t afraid to tell me the truth.
  

These systems reduce the damage impulsivity can cause and keep me aligned with my long-term healing.

Final Thoughts: You Are Not the Choices You Make in Hypomania

Hypomanic impulses will come, but they don’t define you. Some are minor, others life-altering, yet none erase your worth. Hypomania is a symptom of bipolar disorder, not your identity.

During episodes, energy, creativity, and passion accelerate. It can feel thrilling, but also unstable. Rather than fearing hypomania, I’ve learned to treat it as a signal, an invitation to slow down, set boundaries, and lean on the practices that protect my wellness.

Guilt and shame have no place here. What matters is building awareness, showing yourself compassion, and learning to navigate the highs with wisdom and care.

To my readers: What helps you recognize when hypomania is approaching? What boundaries keep you grounded when the wave begins to rise?

I remember the exact moment my caseworker told me I had 30 days left in my first transitional home. My stomach dropped. Words failed me. I’d only been there six months—though four of those were spent recovering from multiple bipolar episodes, trying to claw my way back to stability.

Questions flooded in:
Was my instability the reason? Did my mental health mean I no longer qualified? Was I headed back to the shelter system?

She explained the whole house was being evicted due to the property’s sale. They were looking for a new space, but with limited options, nothing was guaranteed. I left that conversation with no plan, no income, and no idea where I would be in a month.

Transitional housing is meant to be a bridge—but sometimes that bridge ends before you’ve reached solid ground. For those living with bipolar disorder, the timing can feel especially cruel.

The Illusion of Time: When Transitional Becomes Temporary

Many unhoused individuals hear “you have a place” and think the chaos is over. Relief floods in: no more streets, no more shelter, just rest and recovery.

But transitional housing is always temporary—three months, six months, maybe a year. You trade one uncertainty for another. For me, stability—however fleeting—was still better than the nightmare of being unhoused. I convinced myself the time wouldn’t run out.

But mental health recovery doesn’t fit neatly into housing deadlines. Healing from trauma, bipolar episodes, and instability can take years. The countdown clock only adds pressure, forcing you to “be ready” before you truly are.

The Emotional Fallout of Another Ending

Housing loss has an emotional cost—panic, shame, insecurity, and grief, much like a breakup or death. You wonder if you’re “too slow” or “not good enough,” wishing recovery could happen faster.

I thought paying rent and healing was enough. It wasn’t. I had no control over the sale, no say in my eviction, and no certainty about my future.

Being forced to leave without a plan can reignite old trauma. For those with a recent history of homelessness, like me, the fear is sharper—you know too well what chaos lies beyond that deadline.

In the unknown, hope is replaced by anxiety and darkness. Your future feels hidden, unsettled, and unsafe.

The Search: Scrambling for Stability Before the Exit

After my eviction notice, I scrambled—adding my name to waitlists, contacting rentals I couldn’t afford, facing rejection after rejection. I wasn’t well enough to work, keep up with appointments, search for low-income housing, and manage my bipolar disorder all at once.

In desperation, I even messaged the landlord, pleading to stay. His refusal—steeped in stigma—left me crushed.

The last two weeks were spent in bed, consumed by depression and fear. Would I end up back in the shelter? Hospitalized? On the street?

Days before eviction, my caseworker found another transitional space. Relief came, but so did resentment—being placed last minute made me feel more like a file than a human being.

What Support Should Look Like—And Often Doesn’t

Housing support for mental health recovery should be holistic. Transitional housing should come with wraparound services—therapy, counseling, peer mentorship, and case management.

Too often, systems are disjointed. A shelter case manager may not connect with a transitional housing case manager. Without coordinated care, healing becomes temporary, not transformative.

Trauma from mental illness, addiction, or abuse needs more than a bed. Without the right support, reintegration into the community—the very goal of transitional housing—is rarely achieved.

My success now is due to self-advocacy. Once I realized my healing depended on me, I secured the services I needed during my stay.

Final Thought: Housing Is a Human Right—Not a Privilege

In my new transitional home, I learned that housing stability isn’t simply given—it’s fought for daily. The clock always runs out, and if you’re not prepared, you can fall back into uncertainty.

For months, I lived out of boxes, afraid to unpack. Eventually, I let go of fear, embraced my temporary space, and made it my own—painting walls pink, filling shelves with books, creating comfort where I could.

Housing is a human right. In our current system, it’s too often treated as a privilege, especially for those with mental health challenges. Without safe, stable housing, it’s nearly impossible to achieve emotional stability, financial security, or lasting wellness.

To my readers: Have you ever had to leave before you were ready? What would safety and support look like if it truly supported healing?

Choosing Between Recovery and Rent

I lay strapped to a hospital bed in the Psychiatric Intensive Care Unit (PICU), cut off from the outside world. I didn’t know the day or time until meals arrived, each tray accompanied by a slip of paper telling me my name, location, and menu. Only then did I have any clue what might be happening beyond the cinder-block walls. When psychosis had me in its grip, nothing mattered beyond my next manic thought.

As my mind slowly cleared, I realized life outside had kept moving. Bills still needed paying. Rent was still due. Bipolar disorder demands consistency—structure, routine, and healthy habits can mean the difference between stability and relapse. But when a severe episode leads to long-term hospitalization, maintaining financial consistency becomes nearly impossible.

This is the reality for many living with chronic mental health conditions: the rising cost of housing compounds the struggle to recover. Financial stress and mental health are deeply intertwined.

The Unseen Price Tag of Stability

There’s an invisible cost to stability that many in mental health crises can’t afford. I’ve been fortunate to have the support of family, friends, my mental health mentor Grama Judie, and the income from work during periods of wellness. Others aren’t so lucky.

For many, the choice comes down to paying rent or buying medication. The cost of living—and managing bipolar disorder—rises each year. Private therapy, even on a sliding scale, can be out of reach. Virtual sessions still carry a fee. Add in the cost of transit, gas, and basic necessities, and the expenses pile up.

Living with bipolar disorder often means an inconsistent work history, making income unpredictable. Missed bills, partial payments, or skipped rent become common. The emotional toll—shame, guilt, anxiety—feeds a survivalist mindset where thriving feels impossible. Even when stability returns, another episode may be waiting to unravel it all.

Budgeting While Battling Bipolar

Budgeting with bipolar disorder isn’t just about money—it’s a mental health tool. Cognitive fog during depression can make bill-paying overwhelming. If possible, set up automated payments for essentials like rent, insurance, and utilities before a crisis hits.

For me, mania has led to impulsive spending followed by guilt and anxiety. To counter this, I automate bill payments at the start of the month and move a small “mania spending” budget into a separate account. My mentor acts as my financial accountability partner.

Living on a low income with bipolar disorder is challenging, but not impossible. Create a budget based on guaranteed income, manage supplemental income cautiously, and consider strategies like:

• Separate savings accounts not tied to debit cards
  
  

• “Cash life” budgeting for groceries, gas, and personal spending
  
  

• Early payment of recurring bills
  
  

Survival mode won’t last forever. Structure, routine, and healthy habits around money can lead to both personal and financial growth.

Traditional Homes, Unreachable Dreams

Transitional housing has become a lifeline for many with severe mental illness, especially when hospital discharge is delayed due to homelessness, lack of family support, or loss of income. But the dream of stable, traditional housing often fades in the face of gentrification, rising rents, and strict lease requirements.

Since age 24, I’ve relied briefly on family for housing stability, but have mostly lived in basement apartments, community housing, rent-geared-to-income units, Airbnbs, shelters, and now a transitional home. These weren’t the homes I imagined while working toward my degree in the early 2000s. After my diagnosis, I found myself chasing stability in places where mental health stigma made renting difficult, often trading safety for affordability.

Eventually, transitional housing became the goal—traditional housing, the dream. Even now, in a stable program with potential for permanency, I know the decision to keep me here isn’t mine. By definition, transitional programs are temporary. I could be moved at any time, forced to rebuild the stability I’ve worked years to create.

For many living with bipolar disorder, housing instability is not a temporary setback—it’s a recurring reality.

Final Thoughts — Health vs. Housing: Why Should We Have to Choose?

How do you choose between mental health stability and housing security? There’s no justice in that choice. As the World Health Organization reminds us, “mental health is health.” Without mental stability, even securing a roof over your head becomes nearly impossible.

Safe, stable housing is essential to recovery. It provides space for rest, healing, self-reflection, and planning. Without it, recovery from bipolar disorder, trauma, or addiction becomes far harder—and communities feel the ripple effects. It’s a domino effect of impossible choices and unnecessary sacrifices.

Recovery requires rest. Rest requires security. I’ve lived both realities—housing stability and housing insecurity. Remission isn’t a choice; it’s a necessity. Stability makes it possible, and for too many, it remains out of reach.