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What Does It Mean That My Teen Has Prodromal Symptoms of Psychosis?

Written by Evolve's Behavioral Health Content Team​:

Alyson Orcena, LMFT, Melissa Vallas, MD, Shikha Verma, MD, Ellen Bloch, LCSW, Lianne Tendler, LMFT, Megan Johnston, LMFT Meet The Team >

If your teen has been acting strangely over the past few days and weeks, you might have taken them to a mental health professional, who stated that your child could be in the prodromal stages of psychosis. What does it mean if your teen is prodromal?

This means that your teen is showing the introductory signs of psychosis that indicate he or she could end up developing full-blown psychosis in the near future. Psychosis is marked by strange, unusual perceptual experiences involving hallucinations, delusions, and/or paranoia. If your teen is prodromal, that means they are still in touch with reality, but they are starting to see, hear or believe things that are not real.

How Do I Know If My Teen Is Prodromal?

Psychosis usually progresses slowly. Unless your teen has drug-induced psychosis (meaning, they entered into a psychotic state by abusing substances), this mental health issue does not develop overnight.

To get a better sense of what’s going on with your teen, try to think back and see whether you’ve been witnessing any types of changes in your teen over the past few weeks. Try to create a timeline and mark down any unusual statements your adolescent has made, or any strange situations you’ve noticed.

Prodromal symptoms of psychosis:

Difference Between Prodromal Psychosis and Psychosis

Prodromal psychosis doesn’t always lead to full-blown psychosis. Adolescents in the prodromal stage are still in touch with reality, but are starting to experience perceptual changes. For example, they could start seeing hallucinatory visions or shadows, but think their mind is playing tricks on them. They could start having delusions, but then not be sure if it’s all real. In the same vein, one could be having paranoid thoughts, but simultaneously questioning whether these thoughts actually make sense.

On the other hand, a teen experiencing full-blown psychosis is not questioning their take on reality. They’re not asking others (or Google) whether what they’re thinking is real or not. Because to them, it’s as clear as day.

Teens experiencing psychosis fully believe that what they’re experiencing is true: Their hallucinations. Their delusions. Their paranoia. It’s all real life.

That’s why a teen who is still not sure whether what he or she is experiencing is real or not is usually in the prodromal stages of psychosis. So if your teen is starting to entertain strange notions (some common examples include that there’s somebody spying on him or out to harm him), or is mentioning seeing slight shadows or lights that you don’t see, or hearing murmurs of voices you can’t hear, you might want to consider whether they could be in the prodromes of psychosis.

Does Prodromal Psychosis Always Lead to Full-Blown Psychosis?

Prodromal psychosis can lead to full-blown psychosis. But not always. Experts estimate that a third of teens who experience prodromal symptoms eventually go on to experience psychosis and develop a mental health disorder like schizophrenia. However, early intervention and treatment can prevent the progression. Receiving professional mental health treatment at a teen rehab center specializing in psychosis—whether it’s residential treatment (RTC), partial hospitalization programs (PHP), or intensive outpatient programs (IOP) – increases the chances of recovery and prevention of conversion to full-blown psychosis. These teen treatment programs also implement vital lifestyle changes such as stress reduction practices, early bedtimes, and management of co-occurring mental health symptoms that often go hand-in-hand with psychosis (such as depression and anxiety).

Treatment for Teen Prodromal Psychosis and Psychosis

Treatment for full-blown psychosis usually necessitates inpatient hospitalization at a mental health hospital or at a residential treatment center for stabilization. However, if your teen is just experiencing the prodromal signs of psychosis, start by taking them for a clinical assessment at a mental health professional. Even if the results of the assessment indicate your teen does not yet have clinical psychosis, they might still benefit from a partial hospitalization program (PHP) or intensive outpatient program (IOP) that specializes in treating psychosis and co-occurring issues like depression or anxiety. As mentioned earlier, early intervention and treatment could reduce the chances of your teen’s symptoms converting to a mental health disorder.

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