Schizophrenia is an often-misunderstood illness. Even those who have it do not totally understand the nature of their condition, so it can be a confusing, terrifying experience. Add to that the normal stress of teenage life, and you have captured the essence of teenage schizophrenia: a world of fear, confusion and helplessness where no one else can join you – a world of your own.
The disorder is physically, emotionally and mentally draining for the families of those afflicted. Schizophrenic teens often have difficulty functioning normally in society and may need financial assistance, emotional support and daily help for tasks such as taking medication.
As the symptoms normally progress slowly over time, in most cases, teachers and peers will be the first to notice the early signs.
"My daughter was 13 years old when diagnosed with schizophrenia," says Shirley Good of Altoona, Pa. "She had a history of running away as early as age 7 and began having problems with extreme arachnophobia – fear of spiders – at age 8. She also had problems with vomiting when she rode in the family car, especially on her way to and from ballet classes."
Her daughter's symptoms progressed until around age 11, when she intensified her running away tactics and became highly uncooperative in school. "One day her father showed up with bleeding arms and face saying our daughter had attacked him," Good says. "I went to her room and found her banging her head against a window frame, drawing blood. She was forcibly restrained and taken to the hospital where she was treated for injuries, then admitted to the psychiatric unit for diagnosis and treatment. This was the first of many admissions and diagnoses of schizophrenia."
Schizophrenia affects 1 percent of the nation's general population, according to the National Alliance for Research on Schizophrenia and Depression (NARSAD), a nonprofit organization in Great Neck, NY. Although males and females are equally affected by schizophrenia, symptoms of the condition most normally appear earlier in males. In some instances the signs and symptoms of schizophrenia will appear before the age of 12 or 13, but these cases are rare.
"The typical age of onset for schizophrenia is in the late teens or early adulthood," says Russell Scheffer, a clinical psychologist at Southwestern University Medical Center in Dallas, Texas. "The onset of clear psychosis is typically in the teens or early adult years. It can occur before the onset of puberty. Prior to the onset of clear-cut psychosis there is often a period of decline in functioning in social situations and school. These negative symptoms, including social withdrawal, are often the most difficult symptoms to treat."
What Is Schizophrenia?
According to the National Alliance for Research on Schizophrenia and Depression (NARSAD), schizophrenia is a "serious brain disorder that makes it difficult for a person to tell the difference between real and unreal experiences, to think logically, to have normal emotional responses to others and to behave normally in social situations and may also have difficulty in remembering, talking and behaving appropriately."
Schizophrenia is not a condition of "split personality," depression, laziness, the influence of inappropriate upbringing or insufficient or uncaring parents. Schizophrenia, like any other disease or illness, has signs, symptoms and means for diagnosis and treatment.
Its cause, however, is still unknown. "There are a variety of theories about the cause of schizophrenia," Scheffer says. "These include a neurodevelopmental model that states that brain abnormalities are present at birth and become expressed at a later date due to maturational or environmental factors. A second hypothesis states that a person would have an underlying genetic vulnerability but would require an environmental stressor such as birth trauma, psychological stressors or head trauma to fully express the illness. There are many other theories about the cause of schizophrenia, and many of these focus on (the brain chemicals) dopamine, serotonin and glutamate."
Heredity May Play a Role
Teens who have a family member with schizophrenia are 30 percent more likely to develop the disorder themselves, NARSAD reports. If both parents have the disorder or a history of the disorder, the teen is then 40 percent more likely to develop schizophrenia.
"My brother struggled with what took us years to diagnose – paranoid schizophrenia," says Tammie McElligott of Berrien Springs, Mich. "Before becoming ill, he was a friendly boy who loved to play, laugh and be with people. As the illness began to show itself, he seldom joined the rest of the family."
During her brother's junior high years, teachers reported that the boy seemed distracted. By age 22, he left the house with a gun, walked down the street and fatally shot himself.
"It is amazing to my family how this particular illness has been making headlines more and more with boys in their teenage years and early 20s," McElligott says. "There are concerns as to the possibilities of either my sister or myself having the illness – and what about our children?"
Different Symptoms Than Adults
The disorder expresses itself differently in teens. It is often difficult to recognize it in the early stages unless evaluated by an adolescent psychiatrist who specializes in teenage schizophrenia. Yet the American Academy of Child and Adolescent Psychiatry offers the following warning signs, which may indicate the onset of teenage schizophrenia:
- Difficulty telling dreams from reality
- Delusions and hearing voices that are not real
- Confused or very displaced thinking
- Vivid and bizarre thoughts and ideas
- Extreme moodiness
- Behaving in ways normally associated with much younger children
- Severe anxiety and fearfulness
- Confusing television life or situation with own reality
- Severe problems in making and keeping friends
Teens with schizophrenia may exhibit behavior changes slowly, over time. Children who were once active in sports, socially active with friends or with family may begin to withdraw and become shy or secluded. Often teens will begin discussing strange situations they feel they were a part of, but that never really occurred, or they may regress into childish behaviors and become dependent upon their parents. They may be "clingy" or fearful of people, animals or objects.
Teens who exhibit the early warning signs should be evaluated so an individualized treatment plan can be developed – which may include individual therapy, family therapy, social skill training, psychiatric medication and monitoring. Parents who feel their child fits the screening criteria, or who have a family history of schizophrenia, should discuss the possibility and request a referral to a child and adolescent psychiatrist who is trained and specializes in evaluating, diagnosing and treating teens with schizophrenia.
The timing and method of treatment can largely influence the response and outcome. "Early treatment appears to be the best indicator of treatment response," Scheffer says. "The longer someone is psychotic – hallucinating, paranoid, delusional, disorganized in thoughts, speech or behavior or having negative symptoms such as social withdrawal – the harder the psychosis is to treat and the longer it takes for them to get better. Early medical attention often leads to a better outcome."
While there is no cure, those afflicted with schizophrenia can – with proper care – gain control over their symptoms.