Subtle Psychosis Signs in Children

On a visit to her pediatrician, an 11-year-old's demeanor quickly turns from typically amicable to red in the face, growling and grabbing the doctor's wrist tightly, fighting her off as if her life depended on it.

Key takeaways:
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    Before psychosis, behavior can look like regular growing pains or typical teen rebellion.
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    If you notice several sudden or gradual changes in a child's behavior, consult with the child's pediatrician for a referral to a child psychiatrist or psychologist. Don't wait.
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    A thorough evaluation from a pediatric psychiatrist or psychologist will rule out what it is not, such as substance abuse, medical condition, or trauma.
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    The better you understand the disease, the less intimidating it can be.

The doctor looks at mom over the top of her slipping glasses, clenched jaw, and squeals. "She needs to see a psychiatrist!" But to the mother, this was just one more tantrum she had expected from her emotionally unstable child, so she replied, "No."

Possible signs before a psychosis

Psychosis is a misplaced sense of reality, including hallucinations (seeing or hearing things that don't exist) and delusions (beliefs that are not true). Conditions like bipolar or schizophrenia are two conditions that exhibit psychosis as a symptom. Before psychosis, early warnings might appear subtle and gradual, such as:

  • A warm and friendly child greeting friends and family is now being sensitive and keeping apart, almost hiding away as if wanting to be invisible.
  • Disposition may change from contributing to conversations with peers to hardly participating.
  • The child might go from liking looking groomed to looking unkempt and disordered.

In the beginning, parents might view the behavior as the child being shy or lazy about participating in daily interactions and activities. However, if the behavior continues and is noticeable enough to recognize as not usual, question, "What is going on?"

Not easily detected in children

Psychosis before 12 is not as common as the onset in adults. Mental Health America, a community-based nonprofit, states that it is less than 1/16th (one-sixteenth) as common as the adult-onset type. Early onset of childhood psychosis may have vague warning signs that mask the expected growing pains of development. There may be altered personality characteristics as a mental health condition is coming on. In a child, a tantrum may look like attention-seeking behavior. More noticeable, they may be behind in speech or other milestones. In teens, it can be a drop in school grades, strange manners, or disengagement with activities and friends. They may show fewer emotions and expressions or display dramatic mood swings.

What causes mental illness?

Several reasons could be behind the change in behavior, including hormonal changes in teenagers to experiencing an extreme life-changing event. Some possible causes may stem from the following:

  • Genetics
  • Trauma
  • Substance abuse
  • Physical illness or injury
  • Mental health condition

The thought that your child could have a mental illness is scary, and identifying the disease and narrowing down the possible cause can lead to the beginning of the best approach to treatment. Familiarizing the patient and family with what to expect might calm some uncertainty they might initially experience at hearing the assessment results. Offering to answer questions and concerns about what's to come might help alleviate the alarming news.

Beginning treatment

The parent may consult the child's pediatric physician regarding their recent behavior. Identifying the condition and moving forward is vital to the success of treatment and management of a possible life-long illness. Typically, a pediatrician will refer the patient to a child and adolescent psychologist or psychiatrist specializing in evaluating, diagnosing, and treating mental health disorders. The usual treatment for early psychosis may involve therapies focused on educating and coping with the mental illness. There will be evaluations and assessments to rule out what it is not, such as medical diseases, substance abuse, or trauma. If mental illness is the cause of the symptoms, the work begins by determining the best possible prognosis.

After completing evaluations and assessments, parents may feel heartache and fear for their child's future if the results show the likelihood of a mental disorder. The truth is the stigma of a mental illness comes with many struggles, especially if it is a long chronic condition.

One of the first steps is for the parents and their child to familiarize themselves with coping skills and to understand the diagnosis — consistency, and adherence to the therapies and prescribed medications are essential. Caregivers may see improvement in their child's disposition and appearance with time because the treatment is helping.

The other nonmedical approaches are to take every opportunity to remind the child they are loved and safe. Show patience and understanding, especially during an episode. Together, the parent, child, psychiatrist, psychologist, and other supporters will face snags throughout the disease and push through whatever impedes progress.