Recognizing Psychosis In Children: Early Signs And Symptoms
Children and teenagers often move through complex emotions and behaviors as they develop. It can be hard for parents and caregivers to distinguish between temporary phases and potential signs of mental illness.
Psychosis can be a concerning mental state. It usually involves changes in how a child sees, hears, and comprehends the world around them. Early identification and help can offer the best possibilities for supporting a child experiencing psychosis.
Even subtle changes in a child can indicate deeper concerns. It can be understandable to want to shield a child from any type of distress. However, if you suspect a mental health condition like psychosis is developing, waiting to take action can make things harder. Understanding the early indicators can empower you to put your child on the path to diagnosis and support. Speaking with a therapist can help you work through your thoughts and feelings about the situation.
What is psychosis?
There are many potential causes of psychotic symptoms, including mental illnesses like bipolar disorder and schizophrenia. Psychosis could also be a temporary reaction to certain medications, substance use, or medical problems.
Symptoms of psychosis in children and adolescents
Children and adolescents experiencing psychosis may have some common symptoms:
- Hallucinations: These can refer to seeing, hearing, smelling, tasting, or feeling things that aren't there. Hearing voices can be a common example.
- Delusions: Delusions can be defined as false beliefs that a child strongly holds, even when there is clear evidence to the contrary. They may experience paranoia or believe someone is out to get them.
Psychosis can be a serious condition, but that doesn't mean there's no hope. The sooner the cause is explored, the better the chances of getting appropriate support may be.
Warning signs of psychosis in children
Sometimes, the signs of psychosis in children and teens emerge gradually. Other cases involve a more sudden onset. These early signs aren't necessarily specific to psychosis; they could indicate other mental health disorders. A mental health professional can assess symptoms and patient history to provide an accurate diagnosis.
Behavioral and social changes brought by psychosis in children
- Declining school performance: Grades may drop significantly, or a child previously invested in school may show disinterest.
- Trouble concentrating: Focusing on tasks or conversations may become harder.
- Sleep disturbances: Falling asleep, staying asleep, and oversleeping can all be potential problems.
- Emotional changes: Your child might seem emotionally flat or demonstrate outbursts of anger and irritability that are out of character.
- Social withdrawal: Previously outgoing children may lose interest in friends and activities.
- Suspicion or mistrust: Your child may express fearfulness or seem watchful, as though guarding themselves against a threat that you can't see.
Other changes that psychosis disorder can bring to your child
As psychosis progresses, the symptoms typically become more noticeable. Along with the early signs, be mindful of these additional changes:
- Disorganized speech: Responses to questions may not make logical sense or may be fragmented and hard to follow.
- Strange beliefs: A child might express unusual and insistent ideas that seem far-fetched, such as believing they possess special powers.
- Inappropriate expressions of emotion: Laughter or crying at inappropriate times are possible indicators.
- Neglecting personal hygiene: Bathing, dressing neatly, and other self-care tasks may be ignored.
Psychosis doesn't manifest the same way in everyone. Some children might display subtler signs that can be overlooked or misunderstood.
- Changes in sensitivity: Your child may become highly sensitive to light, sound, or touch.
- Odd motor behaviors: Your child might hold an inappropriate or bizarre posture, display abnormal motor behavior like repetitive, useless, and excessive movement, or seem rigid and unresponsive.
- Expressions of confusion: Your child may ask questions indicating they're struggling to understand what's happening around them or in their own mind.
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It can be difficult to see your child experiencing something you don't understand. Every child is different, and that also applies to the ways in which mental health challenges might present. Consulting with a doctor can help you find an appropriate way to move forward.
Negative symptoms of psychosis in a child
Most discussions of psychosis center on dramatic symptoms like hallucinations and delusions. Yet, there's another category of potential symptoms to consider called "negative symptoms." These can describe decreases or absences in typical behaviors and responses.
A child with negative symptoms might exhibit:
- Limited speech or a tendency to speak very little
- A lack of emotionality or a flat facial expression
- A lack of motivation or a sense of apathy
- Social withdrawal and decreased enjoyment of activities
It may be hard to know what to do when you're worried about your child's mental well-being. Getting a thorough assessment is often a good place to start. Pinpointing the cause of these symptoms can be tricky, so seeking expert input can provide an accurate diagnosis.
The sooner a child with significant symptoms of a psychotic illness receives appropriate support, the better their outlook is likely to be. Research shows that early psychosis treatment programs often have encouraging results in helping children and young people manage their symptoms. The right therapeutic approach and, in some cases, antipsychotic medications, can improve a child's function. Early support may also decrease the risk of a child experiencing a full-blown psychotic episode in early adulthood, when the symptoms are often more severe.
Support strategies for parents and caregivers of children with psychosis disorder
Learning your child is experiencing psychosis can be incredibly difficult. You're likely experiencing a mix of worry, fear, and uncertainty. However, there's support available for you and your child. Here are some strategies to help you navigate the situation.
- Seek information: The more you understand, the better you may be able to advocate for your child. You can learn more about psychosis from reputable sources like the National Alliance on Mental Illness (NAMI).
- Connect with support groups: Finding other parents and families going through similar experiences may allow you to exchange stories, concerns, and advice.
- Focus on communication: Talking openly with your child in age-appropriate ways can reassure them that they aren't at fault.
- Maintain a nurturing environment: Children and adolescents usually need stability and structure more than ever during times of mental health challenges.
- Prioritize self-care: Parenting a child with mental illness can be stressful, but you shouldn't ignore your own needs. Self-care can help you stay strong and resilient.
Things might seem uncertain right now, but there are steps you can take to regain control. Knowing more about the condition can empower you to be your child's strongest advocate.
Navigating school and the role of family
Psychosis can cause significant disruption in many parts of a child's life. Collaborating with the school system may be a step to consider. You can talk to administrators about accommodations like extra time for assignments, a quiet testing space, or help transitioning between classes. Many schools offer mental health resources and support on campus. Navigating the school environment successfully can reduce stress for your child.
You shouldn't feel like you must handle this on your own. There are organizations specializing in helping kids with serious mental health needs. Exploring these community programs could be beneficial for your child and the entire family.
When a child experiences psychosis, it can also affect everyone around them. Siblings may have a range of reactions – concern, confusion, anger, and embarrassment are just a few. Open communication with all family members may be helpful. Explaining the situation in age-appropriate ways and answering any questions can help siblings feel less fearful and more supportive. A therapist can also guide you in having conversations with your child's siblings to help them understand and cope with the changes they see.
You play a role in helping your child through this experience. While psychosis can be challenging, kids can recover and go on to live fulfilling lives — especially with the right treatment and your unwavering support. The road ahead may seem unpredictable, but getting help can be a positive step forward.
Treatment for mental health problems such as psychosis
Online therapy can make things easier by helping you connect with a therapist who can offer parenting advice and guidance in navigating your child’s psychotic symptoms. You can schedule appointments at times that work for you, even outside of typical office hours, and attend them via video conference, phone call, or online chat.
According to a 2020 study, remote therapy for caregivers of individuals with psychosis typically resulted in decreased stress levels and a sense of being empowered to turn mental health knowledge into action. This may be particularly helpful for parents navigating their child’s experience of psychosis.
Every child is unique, and their treatment journey likely will be, too. Assessing psychotic illness in children usually requires specialized skills, experience, and knowledge. Through collaborative efforts between parents, professionals, and the support of family and community programs, children with psychosis can get the help they need and deserve.
Takeaway
Frequently asked questions
Is psychosis a mental illness?
Psychosis isn’t listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition as a diagnosable condition on its own. Rather, it is a syndrome - a collection of symptoms - that can appear in several other medical and mental disorders. Schizophrenia, schizoaffective disorder, delusional disorder, and other psychotic disorders can all cause psychotic symptoms. Other mental health conditions, such as bipolar disorder or severe depression, can also cause psychosis. Addressing psychotic symptoms of a serious mental illness generally relies on treating the underlying disorder.
What are the symptoms of psychosis in children?
The symptoms of psychosis in children are generally similar to the symptoms seen in adults. However, even typically developing children sometimes struggle to distinguish fantasy from reality. Imaginary play is an important part of human development, and it is unlikely most people would consider younger children delusional if they repeatedly insisted they were superheroes. Because of this, it can often be challenging to recognize unusual beliefs associated with psychosis when assessing a child.
Childhood-onset psychosis is extremely rare, further complicating diagnosis and definitions of symptoms. Most children who experience psychosis or are on the schizophrenia spectrum also exhibit language delays or abnormal brain development, which are sometimes used to refine a diagnosis. While research is still ongoing, a young person with psychosis might exhibit these warning signs:
- Insisting they can’t think normally or their “brain is not working.”
- Feeling like their mind or eyes are playing tricks.
- Seeing or hearing things others cannot.
- Disordered thinking and disorganized speech, also known as “word salad.”
- Unusual fearfulness, suspicion, and paranoia.
- Social isolation and withdrawal from friends and family.
- Difficulty managing simple tasks.
- Intense emotions or the absence of emotional expression (flat affect).
What mental health treatment is best for children with psychosis
Medical treatment of psychotic symptoms typically requires substantial evaluation following the first psychotic episode. Psychosis is rare in adults, but pediatric patients experience psychotic episodes even less frequently, which can complicate diagnosis. An evaluation often includes a thorough investigation of medical, social, and family history, neuropsychological assessment, neuroimaging studies, laboratory tests, and other tools to determine how to best treat the possible psychosis.
A young patient might also work alongside pediatric or adolescent psychiatry experts for ongoing treatment. Unless an underlying medical condition is found that explains why the psychotic episode occurred, the psychosis is typically treated as though it is part of a psychiatric condition. Typical treatments include antipsychotic drugs, training for parents, counseling for the patient, and psychosocial interventions to help the patient navigate school and social relationships.
What forms of mental illness include psychosis?
While mental health conditions are closely associated with psychosis, the National Institute of Mental Health indicates that a person can experience psychosis and never be diagnosed with a mental disorder. The mental health conditions most often associated with psychosis include schizophrenia, bipolar disorder, and severe depression. Other disorders, such as obsessive-compulsive disorder or autism spectrum disorder, sometimes appear to have features of psychosis, such as delusions, but a different syndrome causes the symptoms.
What does psychosis look like in a child?
Psychosis has many of the same features in children as it does in adults. However, young children do not have a solid concept of reality, and some symptoms, such as delusions, might be difficult to identify. More apparent symptoms include disorganized speech, social withdrawal, and complaining that their brain or senses aren’t working correctly or are “playing tricks on them.” Other symptoms might include limited facial expressions - evidence of a flattened affect - or unusual suspicion and paranoia. Early-onset psychosis might also lead to more severe symptoms, such as self-harm or suicide attempts, especially in older children and adolescents.
What are the warning signs of psychosis?
The early phases of a psychotic episode typically include warning signs that a full episode is imminent. Called prodromal symptoms, these signs are similar to what someone experiences during an acute psychotic episode but are less severe. Common prodromal signs include irritability, confusion, a decline in self-care, increased paranoia, and sleep disturbances. Prodromal symptoms often develop gradually and may allow the person experiencing them to receive treatment or take proactive steps to prevent the impaired functioning associated with a psychotic episode.
What are the five key symptoms of a psychotic disorder?
Five symptoms commonly associated with psychosis include:
- Hallucinations. Hallucinations are disruptions in sense perceptions. They most commonly involve hearing things others cannot hear or seeing things others cannot see.
- Delusions. Delusions are false beliefs that are often unusual, such as someone believing they are telekinetic or the rule of the entire world.
- Disorganized thinking and speech. A person experiencing psychotic symptoms might say nonsensical or unintelligible things. They might also find it challenging to stay focused.
- Strange or unusual behavior. Psychosis changes how a person relates to reality and evaluates decisions, which often leads to behavior substantially different from how they usually act. In rare cases, psychosis can induce dangerous behaviors like self-harm or a suicide attempt.
- Negative symptoms. Negative symptoms refer to the absence of things ordinarily present, such as motivation to participate in activities the person normally enjoys, a lack of emotional expression, and social withdrawal.
Symptoms can vary based on the underlying condition, its severity, and whether the person is currently receiving treatment. Environmental factors might also change how a person displays symptoms. It is typically helpful to guide someone experiencing psychosis toward medical care.
Does psychosis ever go away?
Psychosis is rare in the general population, and most people who experience a psychotic episode will never experience another one. Whether or not psychosis will resolve permanently typically depends on the underlying condition causing it. Those diagnosed with psychotic spectrum disorders, such as schizophrenia, typically require lifelong treatment to manage their condition. With treatment, it is often possible to prevent the onset of a psychotic episode or reduce its severity. Many people are diagnosed as young adults and develop robust coping skills to help them manage the condition.
Transient factors, such as drug use or severe sleep deprivation, can also cause psychosis. Psychotic symptoms due to sleep deprivation typically resolve completely after the person gets enough sleep. In many cases, psychosis due to substance use resolves once the person abstains from the substance, but in some cases, the drug use may lead to permanent changes in the brain. Later-onset psychosis, typically caused by dementia, typically requires treatment with medication to resolve.
How can you tell if a child is psychotic?
The only way to tell if a child is psychotic is by having them evaluated by qualified medical and mental health professionals. Psychosis can be dangerous in any age group, but childhood psychosis is extremely rare and may indicate a serious underlying problem. If you believe your child has displayed psychotic symptoms or may be at risk of psychosis, strongly consider reaching out to a medical or mental health practitioner. If symptoms are severe, the emergency department at a local hospital can likely provide immediate stabilization to ensure the child’s safety.
What are the early warning signs of psychosis?
The early warning signs of psychosis, commonly called “prodromal symptoms,” are present in the early stages of a psychotic episode. They typically mean that, without intervention, the symptoms will increase in severity until the person enters an acute psychotic episode. Common symptoms include irritability, confusion, sleep disturbances, disorganized thoughts, and confused speech. A person who is diagnosed with a psychotic spectrum disorder and has received treatment for psychosis may be able to recognize that they are experiencing prodrome symptoms, but most people experiencing their first psychotic episode will not make the connection.
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