Major mental illnesses such as schizophrenia or bipolardisorder rarely appear “out of the blue.” Most often family, friends, teachers, or individuals themselves recognize that “something is not quite right” about their thinking, feelings, or behavior before one of these illnesses appears in its fullblown form.
Being informed about developing symptoms, or early warning signs, can lead to intervention that can help reduce the severity of an illness. It may even be possible to delay or prevent a major mental illness altogether.
What are the Signs and Symptoms to Be Concerned About?
If several of the following are occurring, a serious condition may be developing.
- Recent social withdrawal and loss of interest in others.
- An unusual drop in functioning, especially at school or work, such as quitting sports, failing in school, or difficulty performing familiar tasks.
- Problems with concentration, memory, or logical thought and speech that are hard to explain.
- Heightened sensitivity to sights, sounds, smells or touch; avoidance of over-stimulating situations.
- Loss of initiative or desire to participate in any activity; apathy.
- A vague feeling of being disconnected from oneself or one’s surroundings; a sense of unreality.
- Unusual or exaggerated beliefs about personal powers to understand meanings or influence events; illogical or “magical” thinking typical of childhood in an adult.
- Fear or suspiciousness of others or a strong nervous feeling.
- Uncharacteristic, peculiar behavior.
- Dramatic sleep and appetite changes or deterioration in personal hygiene.
- Rapid or dramatic shifts in feelings or “mood swings.”
One or two of these symptoms can’t predict a mental illness. But a person experiencing several together that are causing serious problems in his or her ability to study, work, or relate to others should be seen by a mental health professional. Guidance counselors, teachers or classmates are often the first to notice symptoms.
Suicidal thoughts or attempts and bizarrely violent or homicidal thoughts require immediate attention.
Untreated, these early symptoms may progress to a psychotic episode.That is, the individual may develop irrational beliefs (delusions), serious disturbances in perception (hallucinations), and disordered thought and speech, or become otherwise out of touch with reality. A psychotic episode can develop very gradually and may go untreated for extended periods of time.
Shame, fear, denial, and other factors often prevent individuals or their families from seeking help, even though the emergence of these symptoms as early as the teenage years is not caused by bad parenting. But help is available and treatments for major mental illnesses are more effective than ever before.
When Should Treatment Begin?
Over a decade of research at centers around the world has shown that early intervention can often prevent a first psychotic episode and a hospitalization. Even if a person does not yet show clear signs of a diagnosable mental illness, these “red flag” early warning symptoms can be frightening and disruptive.
The minimal risk of starting treatment even before a mental illness appears in its full-blown, diagnosable form is outweighed by the degree of distress a person and their family may already be experiencing by the time they are referred for mental health screening.
At the very least, the affected person should:
have a diagnostic evaluation by a trained professional;
- be educated about mental illness and signs and symptoms to watch for;
- receive supportive counseling about daily life and strategies for stress management; and
- be monitored closely for conditions requiring more intensive care.
Family members are valued partners and should be involved in treatment whenever possible. Ongoing family involvement may be essential when a person has not yet accepted the need for treatment.
Each individual’s situation must be assessed carefully and treatment should be individualized. Medication may be useful in reducing some symptoms. Oftentimes, the best treatment involves both medication and some form of talk therapy.
Education about mental illness and what is happening in the brain can help individuals and families understand the significance of symptoms, how an illness might develop, and what can be done to help. For example, families can learn the harmful role that stress can play in accelerating symptoms, and ways to reduce it.
Ongoing individual and family counseling, vocational and educational support, participation in a multi-family problem-solving group, and medication when appropriate, can all be powerful elements of comprehensive treatment to prevent early symptoms from evolving into serious illness.
Just as with other medical illnesses, early intervention can make a crucial difference in preventing what could become a lifelong and potentially disabling psychiatric disorder.