Schizophrenia has a bad reputation. It’s an illness that typically frightens people and can lead to distance, emotional pain, and conflict in relationships. However, it’s important to know that many of those with schizophrenia can go on to lead normal and meaningful lives. Yes, schizophrenia is a challenging illness, but it’s nothing to be frightened of. Instead, schizophrenia is an illness that simply needs to be managed and cared for. This article will explore how a schizophrenia diagnosis may affect teens and what parents can do to help.
Psychosis and Teen Schizophrenia
Schizophrenia rarely affects someone under the age of 18. However, it can happen. But in most cases, the illness will begin to appear in late adolescence. One clear sign that a schizophrenia diagnosis is a possibility for a teen is the experience of psychosis. Essentially, psychosis is a break in reality; it’s when a teen might experience hallucinations, delusions, or other unusual experiences. The experience of psychosis can be brought on by drugs, extreme stress, or a medical condition.
It’s important to know that just because psychosis is a characterizing symptom of schizophrenia, not all teens who experience psychosis will have the lifelong illness of schizophrenia. Psychosis for some teens can be a one-time event, and in others it can be the first sign of the illness of schizophrenia.
The Illness of Schizophrenia
Schizophrenia is a mental illness that affects the ways that a person thinks, feels, and behaves. The symptoms of this illness include the following:
Symptoms that a person develops as a result of the illness. These are known as positive symptoms. They include disturbances in thought, delusions, hallucinations, certain erratic feelings, changes in movement, and unusual behavior. Psychosis (described above) makes up a major part of the positive symptoms. A teen with schizophrenia might experience certain sensations, beliefs, and behaviors as a result of the illness.
Certain abilities that a person loses because of the illness. These are known as negative symptoms. These can include low energy, low motivation, poor social skills, little facial movements, and less than lively physical movement. Although these might seem less significant than those listed above, a loss of energy and motivation can have a significant impact on a teen’s life, particularly at this stage in life.
The way the illness affects the mind. These are known as cognitive symptoms. They refer to difficulty with concentration and memory, such as disorganized thinking, slow thinking, difficulty understanding, poor concentration, poor memory, difficulty expressing thoughts, and having a hard time integrating thoughts with feelings and behavior.
These three categories (positive, negative, and cognitive) are the primary groups of symptoms commonly seen in schizophrenia. As a parent, you might use these symptoms as a guide if you’re already concerned about your teen. Additional signs to watch out for include:
- drop in grades or job performance
- trouble thinking clearly or concentrating
- paranoia or suspiciousness
- uneasiness with others
- decline in self-care or personal hygiene
- spending a lot more time alone than usual
- increased sensitivity to sights or sounds
- mistaking noises for voices
- having unusual ideas
- having strange feelings or having no feelings at all
Even if you are seeing these symptoms in your teen, keep in mind that in order for a teen to received a schizophrenia diagnosis, symptoms must last longer than six months.
After a Schizophrenia Diagnosis, Treatment is Key
As mentioned above, even if your teen has a schizophrenia diagnosis, treatment can make a big difference in the quality of your teen’s life. Fortunately, there are treatment modalities that can help ease an adolescent’s struggle with the illness. In fact, many who are diagnosed with schizophrenia can go on to live normal lives, as long they continue to engage in treatment. Many families quickly learn that without treatment, their loved one does not do well.
However, before considering treatment, it’s important that your teen is appropriately assessed by a mental health professional. Here are a few steps to consider as you think about how to support your teen’s mental health:
- Have your teen evaluated. If you’d like to have a diagnosis for your teen, the best thing you can do is to schedule a comprehensive diagnostic evaluation from a board certified psychiatrist. As you are obtaining a diagnosis, be patient. Getting an accurate diagnosis is an evolution of sorting through information that changes as your teenager develop. For instance, if your teen has had only one experience of psychosis, then it may take some time to determine whether it was a symptom of schizophrenia or a one-time event. In other words, your teen’s mental health provider might have an idea of your teen’s diagnosis but may need more time to gather information. However, in some cases, mental health providers can provide you with a diagnosis within a week, depending upon the circumstances.
- Discuss treatment options. After a schizophrenia diagnosis, you’ll want to discuss your treatment options. Schizophrenia will require medication. The type, strength, and duration of medication treatment will depend upon the symptoms your teen is experiencing. Keep in mind that often finding the right medication combination is a process. Depending upon the medication your teen is taking, the following side effects can appear:
- blurred vision
- increased heartbeat
- loss of sexual drive
- skin rashes
- weight gain
- changes in metabolism
- a higher risk of getting diabetes
- menstrual problems for women
Different people respond differently to different medications. For this reason, it’s important that you, your spouse, and your teen sit down with the psychiatrist and have an honest conversation about medication options and their side effects. In fact, in this conversation, it’s important to ask the following questions:
- How much experience do you have in treating schizophrenia?
- Is it difficult to get an appointment with you?
- Can I contact you during a crisis?
- What is my teen’s schizophrenia diagnosis and how did you obtain it?
- What is the treatment plan?
- When can my teen expect to feel better?
- How will my teen know that he or she is getting better?
- What if my teen begins to feel worse?
- What side effects should my teen expect?
- Will you work with my teen’s other providers?
- Stick with treatment. One of the most challenging facets of schizophrenia is treatment. In many cases, a teen doesn’t want to take the medication or continue with therapy. If your teen is hearing voices, for example, those voices may be directing them to stop taking medication. Or your teen may feel that medication is stifling their freedom. And having to face the side effects of medication can make it difficult to stick with treatment. However, most families find that if a person is willing to stay with the treatment (medication, therapy, support groups, etc.), they can go on to live normal lives. They will be able function in their daily life, including having a job and having meaningful relationships. It can be difficult for some people to accept that they have an illness or be okay with their medications’ side effects. After a period of time, which often includes grieving, your teen may be ready to accept the diagnosis as well as the medications they need to take to stay well.
- Let your teen go through a process of acceptance. As you can imagine, it will be difficult for someone to go from having a “healthy” mind to not being able to think clearly or make decisions for yourself. Schizophrenia can be an experience of loss for many teens. They may lose friends and family who don’t know how to relate to them. They may lose the familiarity of school and their neighborhood if your teen ends up going to a residential treatment center. And as just mentioned, they lose the clarity and functioning of their own mind. But eventually, your teen will accept their new life. One that can still include loving relationships, good times, and a career. But having a “normal” life is a result of participating in ongoing treatment and support. And your teen is going to have to choose that new life for themselves.
- Parents, you may need to go through an acceptance process too. It can be challenging to know your teen in one way, and then have to get to know them in another way. It may be challenging to at first prepare your teen to be an independent adult and then instead have to take care of them in ways you didn’t expect. As parents of a teen with schizophrenia, your role will change too, as well as your lifestyle and the relationship you have with your teen. This too will require some acceptance and willingness to change.
If it turns out your teen does receive a schizophrenia diagnosis, the whole family may have to go through a process of acceptance. But once you and your teen have found a treatment option that doesn’t cause too many side effects and is manageable, then everyone can move on with their lives. And schizophrenia doesn’t have to be the center of your teen’s existence
Dr. Nalin is a Licensed Clinical Psychologist, and Founder and Executive Director of Paradigm Treatment Centers, who has been a respected leader in the field of adolescent mental health for more than 20 years. He received his undergraduate degree from the University of Southern California, his Master’s degree from Loyola Marymount University, his Doctoral degree from Pacific University’s APA approved Clinical Psychology program, and completed his training at the University of California, San Diego’s APA approved psychology internship program.
Dr. Nalin has provided training and mentoring to students entering the field of psychology at institutions of learning including Pepperdine University’s Graduate School of Education and Psychology, UCSD, Pacific University, and Santa Monica College. He was also instrumental in the development of the treatment component of Los Angeles County’s first Juvenile Drug Court, which now serves as a national model.
Dr. Nalin has appeared as an expert on shows ranging from CBS News and Larry King, to CNN, The Today Show and MTV. He was also featured in an Anti-Drug Campaign for the Office of National Drug Control Policy (ONDCP).
Dr. Nalin is a Diplomate of the National Institute of Sports Professionals and a Certified Sports Psychologist as well as a Certified Chemical Dependency Intervention Specialist. He lectures and conducts workshops nationally on the issues of teen mental health, substance abuse prevention, and innovative adolescence treatment.
In 2017 Dr. Nalin was awarded The Sigmund Freud Foundation and Sigmund Freud University’s Distinguished Achievement Award in recognition of his work with youth in the field of mental health over the course of his career.