When a child or teen first starts exhibiting signs of mental illness, it’s not always clear what the diagnosis should be. And when it comes to mental illnesses like schizophrenia, parents and loved ones may feel even more uncertain whether the symptoms they’re observing fit the diagnosis.
An estimated 2.4 million Americans live with schizophrenia, a chronic mental illness that affects a person’s ability to think clearly, manage emotions and relate to others, according to the National Alliance on Mental Illness (NAMI). It can also include symptoms like delusions, hallucinations and lack of motivation.
Schizophrenia most frequently begins in the late teens to early 30s (typically earlier in life for men than women), and the prevalence in children under age 13 is about 1 in 40,000. For kids and teens, that means their parents, guardians, teachers or loved ones may be the first to spot the signs.
Jessica Dubron, a psychologist in private practice in Los Angeles, told The Mighty in an email interview that adolescents often behave in ways that leave their parents puzzled or concerned, so it is easy to mislabel the onset of schizophrenia as typical teenage behavior.
“For example, teenagers sometimes isolate themselves or have periods in which they struggle in school,” Dubron said. “Also, teens may experiment with substances which can also lead them to exhibit [schizophrenia-like] symptoms.”
But it’s important to seek out the correct diagnosis, so you can get your loved one treatment and support. We asked Dubron and our Mighty community to share some of the signs they noticed that they or a loved one was experiencing schizophrenia. Find out what they had to say, plus Dubron’s advice for parents who think their child may have schizophrenia, below.
1. Being Disengaged and Isolated
Your loved one might not have goals, or appear to be uninterested in things happening in their life and the world around them. Mighty contributor Malena Missy explained in an essay on The Mighty that her daughter stopped showing an interest in her friends.
“She became secluded. She withdrew from the family a bit. She would just stay in her room, didn’t want to eat, talk, watch TV or anything,” Missy wrote.
2. Strange Ideas and Delusions
A delusion is a belief in something that is false, but the person experiencing believes it is real despite widely-accepted evidence to the contrary. A person with schizophrenia might have ideas and theories that seem strange and untrue. For example, this could mean confusing a movie with reality, or thinking you can read minds or predict the future.
“My family member started having religious visions, good and bad,” Christine S. said.
3. Paranoid Thoughts That Don’t Make Sense
They might think they are being watched, or that someone is trying to poison them or bugging their home. Loss of insight, or not realizing that you have a mental illness, is also a common symptom of schizophrenia.
“I have schizoaffective disorder and the first symptom I noticed was being paranoid, although obviously I didn’t view it as a symptom, due to loss of insight,” Stephen C. said.
4. Poor Performance in School
They might have trouble concentrating, keeping grades up or being interested and invested in school. Other symptoms might make it difficult to concentrate, as Mighty contributor Michelle Hammer explained in her essay on The Mighty.
“Imagine you’re sitting in a classroom, and the teacher is speaking. But instead of listening to the teacher, you’re listening to the voices in your head. I didn’t know they were voices at the time. I thought I just had vivid thoughts and daydreams,” Hammer wrote.
5. “Blunting” of Their Personality and Affect
A person with schizophrenia might have a “blunted” affect, which means they don’t express their emotions on their face or with their voice, or may seem unresponsive. Dubron described this symptom as a blank stare or vacant expression.
6. Hearing Voices
Hearing voices and other auditory hallucinations is the most well-known symptom of schizophrenia, and young people could certainly experience this.
“I started hearing voices when I was 16. It started out with voices that sounded like I was in a busy crowded restaurant and over the years those voices developed into four distinguishable men’s voices,” Amanda D. said.
“[My loved one] told me that when he got really depressed he could hear what people really thought about him in his head. And then he turned to me and said, ‘That happens to you, right?’” Alena M. said.
7. Talking to Themselves
If your loved one is hearing voices, they may start talking back to them, which to an observer may appear like they are talking to themselves. In a video for WebMD, Hammer described what’s going on in her head when she appears to talk to herself.
“Living in the city and having schizophrenia is interesting, just because I do hear voices as I’m walking down the street. So in my head I’m thinking of the person talking to me. But then, I start talking back to the person. And then, maybe I’ll snap out of it, look around, and like five people are staring at me,” Hammer said.
If you are noticing these signs in your teenager, Dubron urged loved ones not to jump to conclusions. These signs might indicate other mental health issues such as depression or anxiety — or may even just be a sign your teen is going through the emotional rollercoaster of high school. It’s a good idea to check in with people they regularly interact with, for example teachers, coaches or close friends.
“What’s important to evaluate is whether or not the symptoms they are experiencing are causing impairment in their functioning — meaning that the symptoms are affecting areas of their life (socially, academically, in the home) in a significant way,” Dubron said.
If your child is experiencing psychotic symptoms, you should speak to their pediatrician or primary care doctor, so he or she can potentially rule out other medical issues. Then, it’s important to get evaluated by a psychiatrist and find a therapist who specializes in psychotic disorders.
Parents should approach their children from a place of love, compassion and patience, Dubron recommended, as parent and family involvement can have a significant impact on the success of treatment. Educate yourself about your child’s triggers, and don’t forget to take care of yourself and reach out for support.
“Stability and routine are key to managing symptoms of schizophrenia for individuals affected at any age. Teaching children good self-care and health habits is advisable because the incidence of diabetes, heart disease and unhealthy lifestyle choices (cigarette smoking, lack of exercise, not going to the doctor) is more common in individuals with schizophrenia,” Dubron said.
For more insight on schizophrenia, check out these stories by our Mighty community: