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Youth and Psychosis: What Parents Need to Know

Something is wrong with your child. You can’t put your finger on it, but she is acting strangely. Withdrawn and sullen, she won’t get out of bed. She mopes around all day refusing even to take a shower or get dressed; this is really odd considering she used to be so picky about the way she looked. Sometimes she lashes out for no apparent reason, other times she walks around showing no emotion. Your gut is telling you that things are not right but your head refuses to believe this is anything but typical teenage behaviour.

Should you be concerned?

Perhaps. Persistent, ongoing changes in your child’s behaviour, personality or day to day functioning may be an indication of psychosis.

What is psychosis?

Psychosis describes a treatable medical condition that affects the brain and can result in some loss of contact with reality. Early warning signs (the prodromal phase) of psychosis include many of the behavioural changes we described above. Your child may also seem to be extremely anxious, suspicious or disoriented. Where once she was affectionate, she now hates being touched by anyone. She may be extra sensitive to sounds, smells, light, colour and textures.

As time goes on, and if the illness is not treated, more severe (acute) symptoms develop. Your child may experience hallucinations (seeing, hearing, smelling things that are not there), delusions (paranoia or feelings of grandeur), increasing confusion, exaggerated mood swings and other behavioural changes (such as inappropriate laughter or sudden bouts of anger).

Approximately three per cent of the population will experience a psychotic episode at some point in their lives; many will have their first experience in adolescence or early adulthood. For some, the symptoms come on gradually and appear to be the behaviours of a “difficult teen”; in others, the symptoms appear rapidly and are clearly the result of a disorder.

Psychosis is particularly challenging for young people, because this is a critical time in their lives for developing self-esteem, confidence, relationships and a positive outlook on life. A psychotic episode can interrupt healthy development in any one or
all of these areas if not treated early and properly.

What causes psychosis?

Research shows that chemical abnormalities in the brain are present in psychosis, but the reasons behind these imbalances remain a mystery. In
addition, risk factors such as a family history of psychosis, illegal drug use (including cannabis), excessive alcohol use and stress contribute to the onset of a psychotic episode.

Is there a cure?

Psychosis is a chronic disease – in other words, it can be a lifelong illness however, it is treatable and manageable. Early identification, assessment and treatment can minimize the impact of a psychotic episode and decrease the chances that other psychological problems will develop. Full recovery is possible and with the right help, many youth grow up to lead healthy, productive lives. While relapses may occur from time to time, the effects of a psychotic episode are decreased if symptoms are identified within the first six
months of onset.

How is psychosis treated?

Medication and counseling are key elements in the treatment and ongoing management of psychosis, as are family support and education.
We won’t go into detail here (please see “What is Psychosis?” or go to the list of our pamphlets). For now, be assured that help is effective and available for your child and your family.

What can you do?

Be aware of prodromal symptoms:

Make sure you can recognize them, and ensure that your child gets help as quickly as possible if she
shows signs of them. Read “Early Psychotic Intervention” (EPI) for more details on the reasons why early assessment and treatment
are so important.

Don’t ignore the warning signs and do not take a “wait and see” attitude:

Psychosis will not usually go away on its own and if left untreated, can lead to substance abuse, depression, increased risk of suicide and a great deal of family upheaval. Your child may be the one suffering from psychosis but the whole family will be affected by her illness.

Recognize your own fears:

You may be afraid of the discrimination that surrounds mental illness; you may even share some of those prejudices. You would not be alone in this, but consider the facts – if your child is suffering from a psychosis, she will not be able to cure herself. If you want her to get better, you need to face your fears and reach out for help.

Make arrangements for your child to see someone for an initial assessment, particularly if the risk factors we mentioned above are present:

Many young people who develop psychosis for the first time are still living at home. As a parent, you play a vital role in recognizing that “something is not right” and getting your family doctor or mental health professional involved. Other places you can turn to for help include community mental health services, teen health clinics, school counselors, psychologists, social workers, help lines and in the event of crisis,
the emergency department of your local hospital.

Be an advocate:

Youth with a “first time episode” of psychosis are often circulating in the health system, undiagnosed, for a long time. Speak up to ensure that your child sees a mental health professional with experience in EPI.

Be supportive:

This can be very challenging for a family living with a child with psychosis; that’s why family support is important for you as well. Learn how to be non-confrontational and reduce stress in the emotional environment. De-stress yourself in family support groups; it’s healthier for you and your child. Psychosis is not your child’s fault and it is not yours either. No once chooses to be ill.

Be part of the recovery process:

As your child recovers, lifestyle issues play an important role. Encourage her to eat a healthy diet; take up a hobby and exercise; establish positive relationships; set realistic goals around school or work; and minimize her stressors. You, along with her health care team, want to support her in gradually and realistically resuming her life. Just remember it is your child’s process – not yours – you are there to help, not take over.

One last thought: Take care of yourself.

So much attention is paid to the child with psychosis during this process, that parents often neglect themselves. Be aware of your own needs, your own requirements for a healthy lifestyle, and the need to take a break. If you don’t look after your own health, you won’t be able to help your child.

For your child’s sake, take care of yourself too.

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