Schizoaffective or Bipolar? Does it matter???

My Psychiatrist is a Latvian fellow aged about 45. He surprised me last visit by saying "your bipolar or schizoaffective features...etc etc", as if it were a toss up betwen the two as to what diagnosis I had. Bizarrely, I felt affronted: I have always identified as Schizoaffective, especially after my worst hospital admission in 2003, whe I was 33. The chief Psychiatrist at that hospital said in my discharge meeting (with the registrar, my contact nurse and parents present) that I had a "Schizoaffective Psychosis" at that time. I was in that hospital as an involuntary patient for 7 weeks; 2 weeks in high dependancy ("the fishbowl" looks over you 24/7). So I always thought that schizoaffective was my diagnosis. So to have my present Psych (of the past 3 years) say in his Ruski-style accent that I might be Bipolar took me by surprise.

I looked up the ever-reliable (???) Wikipedia and gleaned that to be deemed schizoaffective, one must have either (a), (b), (c), or (d) features (look it up if it piques your interest) PLUS have disorganised or chaotic thoughts for four weeks or more. That's been true for me three times; each hospitalisation I've been convinced my parents are evil or that conspiracy theories abound. At my sickest I not only heard voices but hallucinated; thankfully that's only happened once (2003, aged 33). I know I've had it easy compared with some schizoaffective people.

Why does it matter what my label is? I guess I attribute a certain level of gruesome torment to psychosis (which I'm aware Bipolar people can be afflicted with too). It probably doesn't help that psychosis, or schizophrenia, has been misunderstood (eg: media reports of police shooting a psychotic person waving samurai swords) or misinterpreted (movies like "A Beautiful Mind" get some elements rights but either gloss over or get other things dreadfully wrong).

Maybe its the type of mystique that psychosis has? That people who only read or hear about it can't begin to imagine? Why do I want to be known as Schizoaffective instead of BiPolar?

Depression is almost starting to become understood (although it has a long way to go) by the wider community. BiPolar is almost nudging its way into mainstream consciousness thanks to movies and people with Bipolar who manage to contribute brilliant things to society. I said almost.....acceptance has unfortunately a long way to go yet.

However the psychotic illnesses remain cold, as far as I see. I think it freaks a lot of people out; they get scared; they imagine axes swinging and all sorts of violence and unpredictability. I know, I know.....BiPolar people endure psychosis...very real, stark and horrific/hospital involuntary stay-type of psychosis. Please don't think I am minimising what anyone with Bipolar in distress goes through; it's horrific, I've seen it in people I've been in hospital with.

Anyway look at the end of the day a label is a label. I've seen people make careers out of their label (as public speakers, authors etc). So why the fuck shouldn't I take ownership and pride in mine?