Fr  wiki pedia:

Schizoaffective disorder is a psychiatric diagnosis that describes a mental disorder characterized by recurring episodes of elevated or depressed mood, or of simultaneously elevated and depressed mood, that alternate with, or occur together with, distortions in perception. 

My 400 lb. friend Riz is getting better every day, I think.  I may be wrong. I am no professional on mental illness, just a very savvy sufferer of it.

He has been better ever  since he finally convinced his doctor to put him on an antidepressant. They were reluctant to do so, for he is what they call ‘schizo-affective’, a b.s. term meant to neatly diagnose ( ie label) a living soul with mood problems which occasionally push this soul/mind/body  into delusion . Loss of touch with ‘reality’, whatever that may be.

Here is the logic:  to  give an antidepressant to someone of Riz’s ‘condition’ may make him   ‘manic’. Mania may lead to delusion. Delusion may include paranoia, which produces ‘homicidal’ and/or ‘suicidal’ ideations. A no-no. Professional Psyciatry still maintains the laughable illusion that …

for example…tis a 'no no' to think about killing, or at least torturing

  that fucker who cut you off in traffic,

or the one who is well dressed and arrogant and cuts in line at the supermarket help-desk to report a problem with his 3 ft long receipt (he spent 210 bucks ), while you are waiting to retrieve some laundry detergent you forgot , or the bagger forgot, to  put in your cart..

or that motherfucker who made your childhood a living hell, now on Facebook pretending to be a good church-going Christian. Saying Jesus is  the entepeneur to follow for success…

 Fleeting thoughts.Clouds , let us hope...

Riz carefully monitors himself for  such homicidal tendencies.

 If he senses them creeping into his consciousness, he calls the Help Line. Tells them he is homicidal.

They send a Help Team to help him call 911 & have his big ass hauled off to a facility for a short vacation of bed rest and biochemical tinkering with his meds. And arts& crafts & group therapy and tv watching..

  This happened to Riz  this summer. Caught me by surprise, gotta admit, and me a trained mental health expert who also suffers a mental disorder, Bipolar!  I actually thought he was doing well around the time of his surprise exit from the scene. His mom called   me out of the blue and said, “Riz went into the hospital! He called 911 on himself!”

………………………………………………………………………………………………

He called me up the other day with one of his self-described “epiphanies”.

He  said: “Yo, bro. How are you?” He is not only 400 lbs, but Italian. If he were in the “Sopranos” he would be Tony’s kooky nephew. Tony would take a shine to him. Tony would commit homicide without much deliberating, in order to save him…..

 Tony was panic-disordered,too, remember….

“Hanging in. What’s up?” I was probably on OS when he called. He knows I write about him. He wants me to make him famous, to springboard his (imagined) career as an “inspirational speaker’’ once he loses a pesky 200 pounds or so. He feels his life story is worthy of publication, if and only if he can get better.

“I had a thought about what  God requires of us,” he said.

He gets the God bug quite  a lot. In the past, he’s become a member of maybe a dozen churches, mostly to meet girls & appropriate male role models and of course  cultivate friends who will help him out,  in a pinch…like bringing him food when he calls them & tells them  his fridge is bare. Riz admits he is a bit of a manipulator.

“What? “

“God wants us to be serene in ourselves, accepting of our sins, and from there, anything can happen.”

Jesus Christ. How do you respond to this kind of stuff? Luckily I am trained. I said, “sounds just right. But how do we get serene? “ 

“Cultivating an interest, and sticking to it. Like me, with my weight loss program. Two walks a day, I take. I feel better afterwards, and I am looking forward to the next walk. That is the reward, right? I did it and now I want to do it more.” He was booming through the phone lines.

“Well, sounds good, but what’s this sin you are accepting?”

“Sloth!”

Sloth.  One of the seven deadly ones, that’s for sure, next to gluttony, ha.

“What about gluttony?” I inquired playfully.

“That too. It springs from sloth.”

“an addiction, food, right?”

“Absolutely. Excuse me.”  He lumbered off to the bathroom for a tinkle & came back.

“Sorry,” he said.  “Addiction and sloth and just defeating it by finding something to care about. Like my program of weight loss, and this new book my pastor sent me.”

Shit. “What , who, what pastor?”

“My boy David. You met him. He helped me move the old couch out, and got me that new one from his church.”

“yeah, a clean cut character. “

“I’ve known him for 5 years. Ever since I went to his church for awhile.”

“Why don’t you go anymore?”

“I told you this already. I was going, regularly, then I told a girl I am a schizophrenic who , yknow, is also a sexual  addict.”

“Then they kicked you out.”

“They didn’t kick me out, they asked me to not come back.”

“oh, I see,” I said.  I’d lost track of the flow of the conversation, as usual, which is my fault as much as any interlocutor I may have. I am associative,  mentally. Things come at me and I make a million connections to other things. Bipolar.

Short term memory loss is a symptom.

Like when you smoke pot. You get into the moment with religious zeal. Turns out,  the really religious folks, say that is What It is All About, the Eternal Now. I was glad to read that in my studies…

“So God is what, now, “ I said.

“Serenity!  Weren’t you listening to me?” he exclaimed.

I played the memory-card. “You know the meds, mad, can’t concentrate”

“yeah, me too. But lately I can concentrate on things, little things, like my daily walk or my calorie consumption. Or my Tiger Woods video. Or whatever. Concentration may be the key…”

My memory had kicked back in. I was jovial:  “Not serenity?”

“What?”

“You said serenity was the key earlier, now it is concentration…” Teasing him.

“Oh. Well, serenity..that..well..didn’t I also say something about sloth? And the need to..to..focus?”

“Concentration, fuckwad.”

“Shit! You’re right! Hey , we should write this shit down..hey..gotta go…the pizza guy is here.”

"Yeah ok. Listen, truthfully....what do you think about my new hat?" i valued his opinion. He was, once upon a time, a 'model scout'. For 4 months.

"I like it. It's you!"

Well ok. My sister says she likes it too. It is how i tackle the town, now, under a hat...