LARGO — Questions about John Jonchuck's sanity have dogged his criminal case since the day he was first accused of tossing his 5-year-old daughter, Phoebe, from the Dick Misener Bridge in St. Petersburg.
He has previously received treatment in a state hospital after being declared incompetent to stand trial.
This week, Jonchuck himself put a name to his condition.
Standing in court on the first day of what is expected to be a month-long murder trial, Jonchuck told Pinellas-Pasco Circuit Judge Chris Helinger that he is being treated for schizoaffective disorder.
"Essentially, you can think of it as a combination of a mood disorder and schizophrenia," said Jeffrey Danziger, a forensic psychiatrist based in Orlando who is not involved in Jonchuck's case.
Like schizophrenia, the illness is marked by hallucinations, delusions, and disordered thoughts. But unlike schizophrenia, it also carries traits of an underlying depression and mania.
It has no cure. But the symptoms can dissipate with medication.
FULL COVERAGE: Everything you need to know about the John Jonchuck trial.
Lawyers and the judge are counting on that to ensure that Jonchuck stays lucid throughout his trial.
In court, he said he takes six different medications. They include Seroquel and Haldol, both common antipsychotics, which are designed to reduce the schizophrenic symptoms.
He likely takes massive doses of them, according to psychiatric experts questioned by the Tampa Bay Times.
Haldol, an older drug used frequently with schizophrenia patients, was recently administered to Jonchuck via an injection. His regimen also includes a daily oral dose of the medication, but injections are meant to ensure the patient doesn't regress. Doctors use a needle to saturate a deep muscle with the drug, making its effects last several weeks.
"It sort of sits there for a month and slowly releases," said Danziger.
That could make the difference in ensuring Jonchuck stays compliant with his medication while in jail. That hasn't always been the case.
After being treated at a state hospital in 2016, Jonchuck returned to the Pinellas County Jail, where he began refusing his oral medication. He also turned down meals, a visit from a psychiatrist and recreation time. What followed was another declaration of incompetence and a return to the hospital.
PREVIOUS COVERAGE: The trial of John Jonchuck comes down to one question: Evil or insane?
In the four days he has appeared in court this week, Jonchuck has been calm, neatly dressed in shirts and ties provided by his lawyers. On Tuesday, he seemed subdued, his mouth often hanging open. On Wednesday, he appeared upbeat, smiling and sharing a laugh with one of his lawyers.
Can we make anything of his courtroom behavior so far?
"I wouldn't try to read the tea leaves too much," said Danziger. "I don't think you can make too much of that unless it's grossly inappropriate behavior."
The four other medications Jonchuck takes include drugs for anxiety, depression. They are:
• Gabapentin, an anti-seizure medicine, which is sometimes used to treat anxiety.
• Cogentin, a medicine used to counteract side effects — like involuntary movements and muscle stiffness — which commonly result from anti-psychotic drugs.
• Klonopin, a sedative, which reduces anxiety.
• Wellbutrin, an antidepressant.
One noticeable difference from his past court appearances has been Jonchuck's apparent weight loss. Records indicate he has lost about 40 pounds.
That is unusual, said Bella Schanzer, a psychiatrist with the Baylor University College of Medicine, who is also not involved in Jonchuck's case.
"That's a miracle if he's lost weight on these medications," Schanzer said. "Most psychiatric medications tend to make people gain weight."
Jail records indicate that Jonchuck has thus far accepted meals each day. He has also received his regular doses of medication. The trial is moving forward.
Despite all the drugs and Jonchuck's self-reported diagnosis, the nature of his mental problems is expected to be a point of contention between prosecutors and the defense. That battle is one that will be waged through the testimony of experts who have examined the defendant. They include two prosecution witnesses, who are expected to testify that Jonchuck exhibits the traits of being a psychopath.
There could be other explanations for Jonchcuk's behavior. People who knew him have said that he was known to abuse drugs, including methamphetamine and synthetic marijuana. Those substances could exacerbate the symptoms of a mental illness.
IN DEPTH: The Long Fall of Phoebe Jonchuck
But even if he is mentally ill, defense attorneys face a monumental challenge in proving that he was insane at the time of the crime.
"There is a difference between being psychotic and being unaware of your behavior," said Eric Storch, a psychologist at Baylor University.
Times staff writer Josh Solomon contributed to this report. Contact Dan Sullivan at firstname.lastname@example.org or (813) 226-3386. Follow @TimesDan.