Schizoaffective disorder is generally treated with an antipsychotic and a mood stabilizer. They are needed for life but they do bring the symptoms into remmission. As a new generation of antipsychotics (which I am in clinical study for) are FDA approved recovery rates should increase. TMS is generally used for treatment refractory depression but it has been used on treatment refractory schizophrenia as before my current recovery (and before TMS was clinically approved) I considered being a participant in that study. Before you would even consider that though you should have your psychiatrist try a combination of all available mood stabilizers and antipsychotics depending what they think is going on. Find out what your exact diagnosis is and what they see wrong and how they intend to treat it.
You say that schizoaffective disorder is "all the time". Does this mean even with medication? Mine lasted for about 3 months before being hospitalized, but no doctor ever told me had that. They always just said "bi-ploar". Maybe I should ask again for clarification. Afterall, I did need ECT's to "cure" it. Also, the TMS's say it is for depression. Does that mean only depression? Or can it be used for psychosis(or schizoaffective disorder), also?
I happened to ask this question to a pdoc, he said in mania you need to be hospitalised, i am not sure of that, i believe both can occur with psychosis. Your question is very relevant and i think like IL said no scale to measure them.
In my modest view, in a full blown mania the pt feels in danger and needs help or his family realises the severity of his symptoms, in hypomania however he feels just high and even i know a person who used to take meds to extend the period because he felt great.
this is an intricate question and involves a lot of yes and no. Both are awful still.
Before my current recovery I had full blown mania and also had psychotic episodes (which need not go with it, I have schizoaffective disorder but there is also bioplar with psychotic features where psychosis only occurs during mood changes, in schizoaffective disorder its all the time). Things were disturbing and extreme and I needed medication as soon as I had my first psychotic break. My mother has cyclothymia (mild bipolar) and perhaps anxiety disorder (again onsite or off I agree only a psychiatrist can make a conclusive diagnosis, her therapist has tentatively agreed to this) and she has gone for over 65 years without medication and I am helping her approach treatment. Other people didn't notice it but I did once I recovered and truthfully life would have been easier for her all these years if she had been in treatment. There is no exact gradation between hypomania and mania and only a psychiatrist could tell but both do need treatment if they impact on a person which they almost always do.
Hypomania is not as intense as mania. For example, you may be pacing, full of energy, talking fast, and racing thoughts, but at the same time you are not a complete ball of energy. Like you may just be much more energetic but not necessarily clean the whole house at 2:00 a.m. You just don't go up as high. I have hypomania and not mania.
Psychosis can happen sort of any time, from what I understand, either in deperssion or mania. I would ask these questions of your doctor, too. We are all different so it is sort of hard to describe. My hypomania will be different than someone elses, for example.