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Does My Teen Have 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
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The NIMH has some startling statistics about psychosis. Every year in America, about 100,000 teens and young adults experience their first psychotic break. Three out of 100 people will experience psychosis at least once in their lives. And the most common time for someone to experience a psychotic break is during the teenage and college years.

But what is psychosis, actually?

Early Warning Signs of Psychosis: Prodromal Symptoms

Psychosis usually involves hallucinations and delusions. Before we get into the full-fledged symptoms of psychosis, though, it’s important to talk about the early warning signs of psychosis. These are called prodromal symptoms. While prodromal symptoms vary from teen to teen, and there’s a wide spectrum of behaviors, some of the most common include:

  • Withdrawal from others
  • Change in eating and sleeping patterns
  • Decline in personal hygiene
  • Loss of interest in once pleasurable activities
  • Loss of motivation
  • Decline in academic performance
  • Difficulty concentrating, keeping up a conversation
  • Becoming wary of others
  • Worrisome moods
  • Other changes in personality
  • Starting to see or hear things that others may not see or hear
  • Extrasensory experiences or changes in perception

If you’re reading this list, you might be thinking that these symptoms sound a lot like depression. And you know what? You’re right.

“In teenagers, prodromal symptoms are often mistaken for depression, or normal teenage angst or anxiety,” says Lauren Cona, LCSW, Clinical Program Director at Evolve Treatment Centers for Teens in Woodland Hills, Los Angeles. Cona, who has years of experience working with adolescents with psychosis and prodromal symptoms, says that this can make prodromal symptoms “hard to catch.”

“It can be challenging to figure out where these symptoms are coming from. Parents may chalk it up to typical teenage moodiness. The way to determine whether it’s something more serious is to ask whether the teen has been experiencing a change in circumstance, or a change in thought or speech. Are they developing thoughts or behaviors that seem unusual? Are they, out of nowhere, getting suspicious of others or becoming anxious about certain things? If you have a child who normally cares about school, friends and personal hygiene, and very suddenly seems uninterested in those things, that may be a good time to consult with a mental health professional.”

Psychosis in Teens

If teens are experiencing these aforementioned prodromal symptoms, or these symptoms are increasing in acuity, they might be on their way to developing psychosis.

A teen’s first psychotic break can be scary. Hallucinations and delusions can increase to the point where your teen is fully convinced that what they’re seeing or hearing is real. They can then start acting upon these hallucinations or delusions in unsafe ways.

What’s important to reiterate here is that teens experiencing psychosis fully believe that what they’re experiencing is true. To them, it’s as true as day. Trying to convince them otherwise is a futile effort and one that may even rile them up further.

Help! My Teen is Experiencing Psychosis

Understandably enough, psychosis can be frightening. Especially for the parents and family members of a teen with psychosis.

During a psychotic episode, the best thing to do is call 911. If your teen is actually experiencing psychosis to the point where they are unsafe to themselves or others, they may require hospitalization, where they will receive 24/hour monitoring. Usually, teens stay in the hospital for about 72 hours, but they can stay longer (up to a few weeks) if staff determine that your adolescent isn’t safe enough to go home.

Treatment for Teen Psychosis

If your teen is hospitalized with a psychotic episode, they may need additional mental health care upon discharge. Residential treatment centers (RTCs) or outpatient programs, such as IOPs and PHPs, may be appropriate based on your child’s clinical needs.

An adolescent residential treatment center, like a stay at the psychiatric hospital, offers round-the-clock care and supervision. Licensed therapists and clinicians, psychiatrists, residential counselors, and medical support staff will treat your teen. Contrary to a psychiatric hospital, though, at a residential treatment center teens live in a comfortable, home-like setting. There, your teen will get the necessary treatment they need to manage their symptoms.

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