It was his first time in the Psychiatric ER. He wasn’t sure why he was there. At first, neither were we. Other than a reported funny feeling in his jaw from a fight after smoking “bad weed,” it appeared he simply was emotionally distressed by a reasonably upsetting situation. He was 19 and in his first year of college, but how the next few hours unfolded threatened to jeopardize his academic and personal future. He was experiencing the early signs of schizophrenia.
Schizophrenia Spectrum is both one of the most widely known mental illnesses and misunderstood because of the profound dysfunction it can cause. A distinguishing feature of schizophrenia is the presence of psychosis, a mental distortion that separates one from reality. Often the distortions emerge as auditory or visual hallucinations, delusional or bizarre thinking, disorganized speech, or severe emotional and physical withdrawal from others.
Before a diagnosis, a person has to display a pattern of behavior consistent with these symptoms for a minimum of six months and have significant interference with their functioning. Often, symptoms first emerge during late teen years to the early twenties.
These technical definitions become more personally important when the reality of the diagnosis shifts a parent’s expectations for their child’s future and makes planning how to increase support the priority.
Adolescence is a tenuous moment in life where young people are figuring out who they are and rely on the support and guidance of caregivers to provide a sense of emotional and physical safety (whether teens admit it or not). A diagnosis of schizophrenia can unsettle both the caregiver and the teen’s sense of stability. Often, both parent and teen do their best to explain why the disorder has impacted their family and figure out how to best position the teen to have a healthy and productive life.
Recent science has revealed that schizophrenia is generally a biologically-based disorder with genetic and neurological origins that manifest when individuals with a predisposition are exposed to environmental stressors. Damage can be substantially lessened with early interventions. This is particularly important for parents of color, as ethnic minorities are disproportionately diagnosed.
While a host of psychotherapeutic and psychopharmacological treatments, such as group therapy and proper medication dosing, can be effective at managing symptoms, a parent can have a tremendous impact by helping to organize a teen’s life. A stressor that can exacerbate symptoms is disorganization in the child’s life that creates unreasonable demands and interpersonal conflict. Having a routine for a teen’s day and communicating expectations in a manner that helps the teen independently maintain a healthy routine tremendously enhances the impact of treatment.
A psychotic break is a very scary experience for a teen and research shows that individuals with schizophrenia are more likely to be the victim of violence than perpetrators of it, contrary to popular perception. When parents can show they understand how difficult managing schizophrenia is for their children by ensuring healthy communication is integrated into a daily routine, then successfully navigating the teen years with schizophrenia becomes less of a fantasy and shifts to a solid reality.
Dr. Isaiah Pickens is a clinical psychologist who trains health professionals and teens on psychological trauma and suicide prevention. He is the founder of iOpening Enterprises, a multimedia company specializing in developing entertaining and educational stories for teens, young adults, and the adults who work with them. Follow Dr. Isaiah Pickens @PickensPoints.