Do You Know the Early Signs of Schizophrenia?

Your son may be doing well in school and get along with others, but be a bit withdrawn and have odd likes and dislikes. Then you might notice that his grades are slipping. He might lose interest in playing sports or give up his guitar and stop seeing the friends he used to jam with.

His sleep habits might change—he might be unable to fall asleep or wake too early. Next, he might tell you that for a few hours he heard voices of people who weren’t there, or thought that he was being trailed by a spy.

These strange voices or perceptions may go quickly and never turn into a lasting mental illness. However, these early signs of schizophrenia shouldn’t be ignored. Your son needs a professional evaluation. Look for a psychiatrist who has experience with teens and psychosis. There are steps you can take to delay schizophrenia even if it is bound to come, writes Herbert Meltzer, a psychiatrist and a professor at Northwestern University.

If mental illness runs in the family, consider a candid conversation with all your children: They need to know that experimenting with drugs is more dangerous for them than for other people. Any grandparent, parent, or sibling with schizophrenia or bipolar disorder means that they may have genes that put them at risk of psychosis.

Marijuana may seem like a low-risk drug, but not for them—it could bring on the illness earlier. "Special K" (ketamine), cocaine, and methamphetamine are also dangerous. If your child has been diagnosed with ADHD and is taking Ritalin or amphetamines, the drugs may have brought on the voices and paranoia.

Unusual stress like bullying could also trigger an underlying vulnerability. As a parent, you can work with your child and her school to limit the stress. If your household has become stressful, it might even be better for your child to live somewhere else, Meltzer noted.

During the evaluation, your child’s doctors should rule out contributions from other illnesses.

Now is also the time to gather information from relatives about the course of their illness and treatment. Their history may be clues to what will work best for your child.

The genes for bipolar disorder and schizophrenia overlap. If one sibling has been diagnosed with schizophrenia, other siblings are more likely to develop schizophrenia than bipolar disorder. If one child is showing early symptoms of schizophrenia, it’s reasonable for his siblings to be concerned about themselves and you can help by having them evaluated as well.

If a mother has bipolar disease, a child with early symptoms could develop schizophrenia rather than bipolar disorder.

It is important for anyone diagnosed with schizophrenia to undergo repeated tests of working memory, word memory, and speed of processing information, attention, and social understanding. A steady decline in even one area is a danger sign and treatment drugs can make a difference. The drugs lurasidone, olanzapine, and risperidone may help improve performance. Look for signs of motor side effects for medication. Tardive dyskinesia—involuntary movements of the lip, tongue, and cheek movements—has been linked to cognitive impairment.

It’s easy for people to forget to take medication. Consider long-acting injectable medications that work from two weeks to three months.

Five percent of patients with schizophrenia die of suicide, and many more try. Although clozapine has many side-effects, they can be minimized and the drug lowers suicide risk.

Family and group therapy may be more helpful than individual therapy, Meltzer observed.

The prodromal and early signs of schizophrenia occur earlier in males, usually between the ages of 16 and 25. The average age of onset is 18 in men and 25 in women. The later the onset, the better the chances of a full life and quick action can make all the difference.