A combination of factors—not your fault.
There is no single cause of schizoaffective disorder. Most researchers agree it’s a complex mix of biology, environment, and experience. Understanding the possible causes won’t fix the illness—but it can reduce shame and help you make sense of what happened.
🔬 Biological Factors
Genetics: SZA tends to run in families. If a parent or sibling has a related disorder, your risk is higher. But genes are only part of the story.
Brain structure and chemistry: Imaging studies show changes in brain regions related to emotion, thinking, and perception. Many people with SZA also have irregularities in dopamine and serotonin signaling.
😔 Trauma and Stress
Childhood trauma, abuse, and neglect are strongly linked to the development of psychosis-spectrum disorders.
Chronic stress, especially without support, can contribute to symptom onset.
Life instability, marginalization, and oppression can all act as environmental risk factors.
☠️ Substance Use
Substances like cannabis, amphetamines, hallucinogens, and alcohol can trigger symptoms in vulnerable people.
In some cases, drug use reveals an underlying condition that might have otherwise remained dormant.
In others, it contributes directly to psychosis or mania.
Substance use doesn’t mean you “caused your illness.” It just complicates it—and makes treatment more difficult if it’s ongoing.
🔄 It’s Usually a Combination
Most people with SZA have more than one contributing factor: genetics, trauma, stress, substances, and life events all overlapping. It’s rarely simple, and it’s never your fault.
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Brain & Behavior Research Foundation – Schizoaffective Disorder
➤ Includes info on brain structure and chemical imbalances in SZA.Schizophrenia & Psychosis Action Alliance: Understanding Substance Use and Psychosis
➤ Plain-language fact sheets covering drug-induced psychosis and co-occurring SMI.