ISO info on psychosis in late teens/early 20s.

[Anonymous]

Cousin just called and told us that her DD/our niece has been admitted to a psych ER - has been there for a few days. While the diagnosis is not conclusive, cousin is sharing that the doctors on duty are talking about psychotic disorder, schizophrenia, etc. We are close - more like siblings - and she is asking me to find out anything I can. Have come to this forum for other questions as folks here tend to be more gentle as well as helpful. I would appreciate any information people can share. Cousin told me they are doing tests, but sounds like they do not think this is a drug-induced psychosis as of now.

TIA.

[Anonymous]

It sounds strange to say, but the prospects for someone with a first episode are currently better than ever. So many big strides were made in the last few years on early intervention.

https://store.samhsa.gov/sites/default/files/d7/priv/sma16-5005.pdf
https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2015.15050632
https://health.ucsd.edu/care/behavioral-mental-health/first-episode-psychosis-program/

[Anonymous]

I don't know what kinds of tests they would be doing. It's more of a history taking of episodes and mood swings.

My son has been diagnosed with schizoaffective disorder. A combination of schizophrenia and bipolar. His psychosis has been very limited, but he definitely has manic and depressive episodes. Medication, therapy and a firm schedule have helped.

I strongly suggest your sister join NAMI and take Family to Family course online (8 week class).

[Anonymous]

I don't know what she thinks you'd be able to find out what with you not being a psychologist, not being her daughter's psychologist, you not having access to any of the test results being run on her daughter, and you not being a professional psychiatric disorder researcher. Your posting on a message board to get opinions from CPA's and stay at home moms with English degrees is not going to be helpful.

Why not do what you can to encourage her to be patient and listen to the actual doctors treating her daughter and then do what they suggest? That would actually be helpful to her.

[Anonymous]

Anonymous wrote:I don't know what she thinks you'd be able to find out what with you not being a psychologist, not being her daughter's psychologist, you not having access to any of the test results being run on her daughter, and you not being a professional psychiatric disorder researcher. Your posting on a message board to get opinions from CPA's and stay at home moms with English degrees is not going to be helpful.

Why not do what you can to encourage her to be patient and listen to the actual doctors treating her daughter and then do what they suggest? That would actually be helpful to her.

Seriously? That's what you came here to say when I ended my post that folks in this forum tend to be gentle and helpful.

FWIW, CPAs and WAHMs with English degrees may have mental illnesses or know someone who does.

The next time perhaps you should type this out, reread the original comment, then delete because you realize you have nothing to offer.

[Anonymous]

Anonymous wrote:I don't know what kinds of tests they would be doing. It's more of a history taking of episodes and mood swings.

My son has been diagnosed with schizoaffective disorder. A combination of schizophrenia and bipolar. His psychosis has been very limited, but he definitely has manic and depressive episodes. Medication, therapy and a firm schedule have helped.

I strongly suggest your sister join NAMI and take Family to Family course online (8 week class).

Thanks for responding. How did your son end up with this diagnosis? Was there a triggering event where your son ended up in an ER/pysch unit?

Appreciate your observations/suggestions and all best to your son and family.

[Anonymous]

Anonymous wrote:I don't know what kinds of tests they would be doing. It's more of a history taking of episodes and mood swings.

My son has been diagnosed with schizoaffective disorder. A combination of schizophrenia and bipolar. His psychosis has been very limited, but he definitely has manic and depressive episodes. Medication, therapy and a firm schedule have helped.

I strongly suggest your sister join NAMI and take Family to Family course online (8 week class).

I also really recommend NAMI Family to Family course (or Basic for parents of kids under 18)

One thing to consider with psychosis is that it is now well-established that some psychotic episodes are wrongly mistaken as schizophrenia when it is really autoimmune illness.

Admittedly this is a small proportion of schizophrenia cases, so I don't want to give false hope, but definitely should be asked about. https://www.washingtonpost.com/wellness/2023/06/01/schizophrenia-autoimmune-lupus-psychiatry/

A larger proportion of schizophrenia cases are thought go have a genetic basis. Here is one example. https://www.nih.gov/news-events/news-releases/schizophrenias-strongest-known-genetic-risk-deconstructed

[Anonymous]

We went through/are going through this with my brother. Unfortunately our experience is not good as my parents missed the signs when he was a teen... so my perspective is biased.

She needs to get on meds before she is 18. Preferably, the kind that is an injection (monthly) as opposed to a pill to take everyday. Many people will start to feel better and refuse to take meds. You can imagine what happens then. After 18, your sibling cannot make any decisions for their child. It is incredibly difficult to get them any help if they refuse after 18. It's not an easy road if they are not on meds. Hard to keep a job, and it is very very stressful on the family.

[Anonymous]

Anonymous wrote:We went through/are going through this with my brother. Unfortunately our experience is not good as my parents missed the signs when he was a teen... so my perspective is biased.

She needs to get on meds before she is 18. Preferably, the kind that is an injection (monthly) as opposed to a pill to take everyday. Many people will start to feel better and refuse to take meds. You can imagine what happens then. After 18, your sibling cannot make any decisions for their child. It is incredibly difficult to get them any help if they refuse after 18. It's not an easy road if they are not on meds. Hard to keep a job, and it is very very stressful on the family.

sorry your cousin, not sibling.

[Anonymous]

It is often hard for people with schizophrenia and related disorders to keep taking their medications because either they don't believe they are ill, or they stop once they feel better. The side effects can be significant too. So I would recommend that your relative talk to the doctors about a long term plan for sticking with the meds and whether long lasting shots would be an option, which they are for some meds.

Finding a good care team for when she leaves the hospital and dealing with insurance may be difficult on top of everything.

[Anonymous]

1)She should try to find a first break psychosis clinic (probably at a teaching clinic or associated facility.) the treatment in the first weeks and months of a psychotic illness is incredibly important for the course of the illness.

2)She should ask his physician about the possibility of anti-nmda receptor encephalitis. It’s not highly likely, but it turns out it’s the cause of some cases of psychosis and treatment is different.

3)Once stabilized and home absolutely no weed.

Good luck and I hope he does well!

[Anonymous]

I’m very sorry your family is having to deal with this. They will probably want to do a full neuropsych test to help with a diagnosis. Generally, I think the earlier they catch these disorders, the better the prognosis - you might look up first time psychosis programs. If she needs to go to residential treatment you might want to Google around to find which ones around here have the best reputation. ERs often have to just send teens to wherever there is an empty bed - try to see if you can get her in to a good one. It’s good your cousin can talk to you, these situations can be so isolating. You’re doing great helping her out by researching for her.

[Anonymous]

Anonymous wrote:I don't know what she thinks you'd be able to find out what with you not being a psychologist, not being her daughter's psychologist, you not having access to any of the test results being run on her daughter, and you not being a professional psychiatric disorder researcher. Your posting on a message board to get opinions from CPA's and stay at home moms with English degrees is not going to be helpful.

Why not do what you can to encourage her to be patient and listen to the actual doctors treating her daughter and then do what they suggest? That would actually be helpful to her.

Shame on you, PP. One of the best ways patients and parents actually learn about mental illness is from peers who have been through it before.

Just this weekend, I asked other DCUMers about breast cancer and no one admonished me in the way you have. It is perfectly normal to seek others who are coping with similar health issues. You are behaving in a discriminatory way against people with mental illness, and given that mental illness carries a huge stigma that creates silence and isolation, your shaming is just contributing to the problem.

Families coping with mental illness are not sheep to be herded by some authoritarian doctor or medical system. We know a lot about out family members and their issues and are capable of learning a lot about medical diagnosis and treatment and have a right to participate collaboratively in shared-decision making with medical providers.

Misdiagnosis is very common with mental illness, and is usually questioned by family members. My ex-husband was mis-diagnosed as depressed, then mis-diagnosed as having a sexual addiction and then, several years later finally diagnosed correctly as a person with bipolar depression experiencing hyper sexuality in mania. Because of his initial misdiagnosis he was actually given a kind of medication which made him worse - a medication that never would have been given if had had an initial, proper diagnosis. Did you know that people with bipolar go an average of 7 years between symptom onset to final, accurate diagnosis?

I have two other family members who also suffered misdiagnosis. Both of them only came to the right diagnosis by a lot of observation and research by family members and collaboration with their doctors.

Shame on you PP! Your perspective is SO wrong.

[Anonymous]

Anonymous wrote:1)She should try to find a first break psychosis clinic (probably at a teaching clinic or associated facility.) the treatment in the first weeks and months of a psychotic illness is incredibly important for the course of the illness.

2)She should ask his physician about the possibility of anti-nmda receptor encephalitis. It’s not highly likely, but it turns out it’s the cause of some cases of psychosis and treatment is different.

3)Once stabilized and home absolutely no weed.

Good luck and I hope he does well!

Number two should be teaching hospital.

[Anonymous]

Anonymous wrote:We went through/are going through this with my brother. Unfortunately our experience is not good as my parents missed the signs when he was a teen... so my perspective is biased.

She needs to get on meds before she is 18. Preferably, the kind that is an injection (monthly) as opposed to a pill to take everyday. Many people will start to feel better and refuse to take meds. You can imagine what happens then. After 18, your sibling cannot make any decisions for their child. It is incredibly difficult to get them any help if they refuse after 18. It's not an easy road if they are not on meds. Hard to keep a job, and it is very very stressful on the family.

Alas, her child just turned 19.