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

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

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.

When healthy, have them sign agreement that they can access medical records and even better to have medical power of attorney.

She's 19. No one can "have" her sign anything.

No kidding, But they can ask her to and the best time to do it is when they’re in a good mental headspace. I know that from experience. No need to be nasty on this thread.

Agree. With the exception of one poster early in the thread, most people have been compassionate as well as offering helpful insights and experiences.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote: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.

Late teens and 20s are a common time for schizophrenia diagnosis. I am not sure what state your family member is in but some states have increasingly focused on creating supports specific to "first episode psychosis" because it is thought that psychosis causes some damage to the brain that "kindles" further episodes. Early treatment is key.

Here is an example in Maryland of a "First Episode" Clinic -

https://www.mprc.umaryland.edu/Clinical-Care/First-Episode-Clinic/

You might want to have your family member ask about this kind of resource in their state.

Also, I don't know the age of the niece, but if she is in school, the IEP or 504 process can be used to help her while she is recovering and finding proper treatment.

If you want to know more about schizophrenia, Ellyn Saks has written a good memoir about her experience of the illness.

TY!

I see you mentioned she is 19 - so I want to adjust what I wrote - IEP and 504 processes only apply to public schools up to 12 th grade. BUT, private schools at any grade or colleges and universities must accommodate (under the ADA) serious illnesses like schizophrenia, which are considered long term disabilities even when well-treated because sudden relapse is possible.

If your niece is in college, her family can contact the Office of Disabilities and ask to meet with someone who can help explain what the process is for notifying professors she is ill, providing information about how to and by what dates request to withdraw, request incompletes or extensions on work. Schools (like Yale and some other Ivies) sometimes have unfair, discriminatory policies about re-admitting students

If the family bought "tuition insurance", they need to read the plan carefully and see if new onset mental illness is covered (it is on our university's plan).

I know it seems like it might create pressure to refer to school, but IME, kids really feel like this kind of mental health crisis is destroying their perception of what their life could be, which is a huge stressor. Parents can also be under financial pressure because losing a semester's worth of tuition can be a huge financial burden.

Finally, even without a signed healthcare form or school release form, you can sometimes navigate "consent" issues. Consent doesn't have to be a particular signed form (although that's helpful). A good healthcare worker can often frame an oral question to the patient in a way that encourages them to provide oral consent. Schools have to tell you about process even if they can't tell you about a particular child. School websites for the disability and registrar's office often have a lot of good information about these policies.

I know it's not the point of this post, but Yale finally caved to alumni pressure & now kids who voluntarily withdraw for mental health reasons have automatic readmission rights!

That's so terrible that it took Yale so long when many top schools have readmit rights if student able to demonstrate, in concert with mental health professionals, a plan for return.

I think most of the mental health community has very little understanding of chronic, severe mental health issues. The patient may say they’re ok, and todays too agreeable therapists will follow the patients wishes. But some bipolar and schizophrenic students will never return to the original mental state. Current drugs don’t cure mental illnesses, only cover up a few of the symptoms. I think a long break is needed for severe cases.

DP - ironically, Yale has some of the top researchers in psychiatry/mental illness of any who are out there. Experts in schizophrenia, bipolar disorder, addiction, etc. They have far more understanding than most about SMI. I mean, better late than never, Yale, but I was SMDH over here.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote: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.

Late teens and 20s are a common time for schizophrenia diagnosis. I am not sure what state your family member is in but some states have increasingly focused on creating supports specific to "first episode psychosis" because it is thought that psychosis causes some damage to the brain that "kindles" further episodes. Early treatment is key.

Here is an example in Maryland of a "First Episode" Clinic -

https://www.mprc.umaryland.edu/Clinical-Care/First-Episode-Clinic/

You might want to have your family member ask about this kind of resource in their state.

Also, I don't know the age of the niece, but if she is in school, the IEP or 504 process can be used to help her while she is recovering and finding proper treatment.

If you want to know more about schizophrenia, Ellyn Saks has written a good memoir about her experience of the illness.

TY!

I see you mentioned she is 19 - so I want to adjust what I wrote - IEP and 504 processes only apply to public schools up to 12 th grade. BUT, private schools at any grade or colleges and universities must accommodate (under the ADA) serious illnesses like schizophrenia, which are considered long term disabilities even when well-treated because sudden relapse is possible.

If your niece is in college, her family can contact the Office of Disabilities and ask to meet with someone who can help explain what the process is for notifying professors she is ill, providing information about how to and by what dates request to withdraw, request incompletes or extensions on work. Schools (like Yale and some other Ivies) sometimes have unfair, discriminatory policies about re-admitting students

If the family bought "tuition insurance", they need to read the plan carefully and see if new onset mental illness is covered (it is on our university's plan).

I know it seems like it might create pressure to refer to school, but IME, kids really feel like this kind of mental health crisis is destroying their perception of what their life could be, which is a huge stressor. Parents can also be under financial pressure because losing a semester's worth of tuition can be a huge financial burden.

Finally, even without a signed healthcare form or school release form, you can sometimes navigate "consent" issues. Consent doesn't have to be a particular signed form (although that's helpful). A good healthcare worker can often frame an oral question to the patient in a way that encourages them to provide oral consent. Schools have to tell you about process even if they can't tell you about a particular child. School websites for the disability and registrar's office often have a lot of good information about these policies.

I know it's not the point of this post, but Yale finally caved to alumni pressure & now kids who voluntarily withdraw for mental health reasons have automatic readmission rights!

That's so terrible that it took Yale so long when many top schools have readmit rights if student able to demonstrate, in concert with mental health professionals, a plan for return.

I think most of the mental health community has very little understanding of chronic, severe mental health issues. The patient may say they’re ok, and todays too agreeable therapists will follow the patients wishes. But some bipolar and schizophrenic students will never return to the original mental state. Current drugs don’t cure mental illnesses, only cover up a few of the symptoms. I think a long break is needed for severe cases.

DP - ironically, Yale has some of the top researchers in psychiatry/mental illness of any who are out there. Experts in schizophrenia, bipolar disorder, addiction, etc. They have far more understanding than most about SMI. I mean, better late than never, Yale, but I was SMDH over here.

Agree. Real disconnect there.

BTW, does SMI = severe mental illness?

[Anonymous]

Anonymous wrote:

Anonymous wrote:TY to (nearly) everyone who weighed in here - really appreciate your insights, questions, and suggestions as does my cousin.

The last few days have seen some improvement and we are all praying for continued progress.

PP directly above you - you’re welcome and good luck. I was thinking about your niece and wanted to check back in. I’m glad there’s been some improvement. We know a lot now about how to support people with serious mental illness (if that’s what it is), so there’s reason to hope. Sending good wishes for the best possible outcome!

FYI, niece has been making great improvement. According to cousin, even the nurses are taken aback by the swing to a positive direction.

Is there any chance this could be a one-time occurrence?

Please continue to send good wishes and thanks to all who posted with helpful info and personal stories.

[Anonymous]

Op, so glad niece is making progress!

I don't know what to say about "one time occurrence". I think that very much depends on the underlying mechanism for the psychosis (schizophrenia? bipolar? an infection? drugs?).

I only have familiarity with bipolar with psychosis. On the right meds, the mania and psychosis can recede very quickly, and things can come back to "normal". But, over the long term it is very common for the person with bipolar to start to feel well enough that they come to doubt the further utility of meds and go off, and then the cycle begins again. The early phase of mania feels so good that some people mistake that for their "normal" and think the meds are unnecessarily depressing them. TBH, my now ExH has never in 20 years accepted his diagnosis and stayed on medication. Part of it was missing the hypomania, and part of it was not accepting that he had a serious MI. He did not tell his new wife, for example, that he had bipolar, rather just anxiety and depression. As a result, I don't think he's very well medicated, and he continues to struggle in ways.

If I had any advice, it would be to make sure the Niece has ongoing regular appointments with a psychiatrist and therapist, even when she's feeling good. And, while she's feeling well and competent, to have her sign any necessary paperwork (if she is over 18) to give her parents access to medical advice, healthcare decision-making if she becomes non-competent again as well as access to finances and bills and school.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote: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.

Late teens and 20s are a common time for schizophrenia diagnosis. I am not sure what state your family member is in but some states have increasingly focused on creating supports specific to "first episode psychosis" because it is thought that psychosis causes some damage to the brain that "kindles" further episodes. Early treatment is key.

Here is an example in Maryland of a "First Episode" Clinic -

https://www.mprc.umaryland.edu/Clinical-Care/First-Episode-Clinic/

You might want to have your family member ask about this kind of resource in their state.

Also, I don't know the age of the niece, but if she is in school, the IEP or 504 process can be used to help her while she is recovering and finding proper treatment.

If you want to know more about schizophrenia, Ellyn Saks has written a good memoir about her experience of the illness.

TY!

I see you mentioned she is 19 - so I want to adjust what I wrote - IEP and 504 processes only apply to public schools up to 12 th grade. BUT, private schools at any grade or colleges and universities must accommodate (under the ADA) serious illnesses like schizophrenia, which are considered long term disabilities even when well-treated because sudden relapse is possible.

If your niece is in college, her family can contact the Office of Disabilities and ask to meet with someone who can help explain what the process is for notifying professors she is ill, providing information about how to and by what dates request to withdraw, request incompletes or extensions on work. Schools (like Yale and some other Ivies) sometimes have unfair, discriminatory policies about re-admitting students

If the family bought "tuition insurance", they need to read the plan carefully and see if new onset mental illness is covered (it is on our university's plan).

I know it seems like it might create pressure to refer to school, but IME, kids really feel like this kind of mental health crisis is destroying their perception of what their life could be, which is a huge stressor. Parents can also be under financial pressure because losing a semester's worth of tuition can be a huge financial burden.

Finally, even without a signed healthcare form or school release form, you can sometimes navigate "consent" issues. Consent doesn't have to be a particular signed form (although that's helpful). A good healthcare worker can often frame an oral question to the patient in a way that encourages them to provide oral consent. Schools have to tell you about process even if they can't tell you about a particular child. School websites for the disability and registrar's office often have a lot of good information about these policies.

I know it's not the point of this post, but Yale finally caved to alumni pressure & now kids who voluntarily withdraw for mental health reasons have automatic readmission rights!

That's so terrible that it took Yale so long when many top schools have readmit rights if student able to demonstrate, in concert with mental health professionals, a plan for return.

I think most of the mental health community has very little understanding of chronic, severe mental health issues. The patient may say they’re ok, and todays too agreeable therapists will follow the patients wishes. But some bipolar and schizophrenic students will never return to the original mental state. Current drugs don’t cure mental illnesses, only cover up a few of the symptoms. I think a long break is needed for severe cases.

DP - ironically, Yale has some of the top researchers in psychiatry/mental illness of any who are out there. Experts in schizophrenia, bipolar disorder, addiction, etc. They have far more understanding than most about SMI. I mean, better late than never, Yale, but I was SMDH over here.

Agree. Real disconnect there.

BTW, does SMI = severe mental illness?

Yes, sorry, SMI = serious mental illness. Typically comprises disorders with a psychotic component: schizophrenia/schizoaffective, bipolar disorder, severe depression with psychotic features.

OP, I am so glad to hear about your niece’s continued improvement!! That’s wonderful and I hope bodes well for her future. Her care team should be doing a full work-up to consider alternate causes to something like an initial psychotic break (and later schizophrenia) - other things can cause similar symptoms. If nothing else, such a strong response to meds is a great sign. As a PP noted, medication compliance is a huge issue with psychotic disorders. Understandably, but it’s worth thinking about at this point.

I’m pulling for your niece! Good luck!

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:TY to (nearly) everyone who weighed in here - really appreciate your insights, questions, and suggestions as does my cousin.

The last few days have seen some improvement and we are all praying for continued progress.

PP directly above you - you’re welcome and good luck. I was thinking about your niece and wanted to check back in. I’m glad there’s been some improvement. We know a lot now about how to support people with serious mental illness (if that’s what it is), so there’s reason to hope. Sending good wishes for the best possible outcome!

FYI, niece has been making great improvement. According to cousin, even the nurses are taken aback by the swing to a positive direction.

Is there any chance this could be a one-time occurrence?

Please continue to send good wishes and thanks to all who posted with helpful info and personal stories.

Is it possible it was drug induced?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:TY to (nearly) everyone who weighed in here - really appreciate your insights, questions, and suggestions as does my cousin.

The last few days have seen some improvement and we are all praying for continued progress.

PP directly above you - you’re welcome and good luck. I was thinking about your niece and wanted to check back in. I’m glad there’s been some improvement. We know a lot now about how to support people with serious mental illness (if that’s what it is), so there’s reason to hope. Sending good wishes for the best possible outcome!

FYI, niece has been making great improvement. According to cousin, even the nurses are taken aback by the swing to a positive direction.

Is there any chance this could be a one-time occurrence?

Please continue to send good wishes and thanks to all who posted with helpful info and personal stories.

Is it possible it was drug induced?

Most likely not. Not a habitual pot smoker though has smoked on rare occasions.

[Anonymous]

Chris Palmer, MD a Harvard psychiatrist seems to be very focused on keto for mental health issues. It's worth checking out his research and book.

[Anonymous]

Last day or so not so great for dear niece. Love any suggestions for support. Cousin looking into NAMI, but also open to more, especially articles/orgs that address what feels like could be a long slog for parents.

[Anonymous]

Anonymous wrote:Last day or so not so great for dear niece. Love any suggestions for support. Cousin looking into NAMI, but also open to more, especially articles/orgs that address what feels like could be a long slog for parents.

I’m so sorry she’s not doing well, OP. Where are they located? Glad to look for local resources.

In the meantime: https://nationalepinet.org/resources/clients-and-families/

The larger website has lots of resources and information, but this page might be a good first one to look through. If you or your cousin have any more specific questions/asks, please post back and I’ll try to check this thread at least daily. (I’m a psychologist who has worked inpatient and cared for people during their initial psychotic episodes. If I can help your niece and your family, I’ll do my best to.)