12-12-14 FROM MY FILES FRIDAY ; On April 4, 2011, I wrote about warnings that might suggest someone you love is showing signs of an emerging mental disorder. Here’s a slightly edited version of “What Were the First Warning Signs.” Please share on my Facebook page helpful information from your own personal experiences that might help others.
“Did you see any warning signs that should have tipped you off about your son’s mental illness?”
It’s a question I am asked whenever I speak in public.
Like other parents, I have spent hours thinking about my son’s past, wondering if there were behaviors that I missed which should have been red flags. If so, what were they? When did his mental illness first begin revealing itself?
My son always marched to the beat of a different drummer as a youngster. As a parent, I was proud of many of the quirks that made him unique. He was different in a good way. But after his illness surfaced, I wondered if some of these differences had been warning signs.
One reason why it can be difficult to recognize symptoms of an emerging mental illness is because many of them surface when an individual is in his/her early 20s. Often, this is when young people are becoming more independent. Is excess alcohol consumption a warning sign or simply what young men and women do when they attend a college, join the military or move out on their own?
This is also an age when individuals often feel under tremendous stress, which can trigger a break.
So what sort of signs should a parent watch for if they believe their son/daughter may be exhibiting behavior that suggests an emerging mental disorder?
My son was attending the Pratt Institute in Brooklyn when I first realized something was amiss. We talked each Sunday afternoon on the telephone and he told me that he was having difficult eating. Food had lost its flavor. Even worse, many of the dishes that he’d once enjoyed now made him physically ill.
Because my son always had been a picky-eater, I was not immediately alarmed. (I also remembered that meals at my college weren’t the greatest!) But a week after our first conversation about food, my son stopped eating because he’d been vomiting all week. He also told me that he was having difficulty recognizing when he was dreaming and awake. I immediately drove to New York to check on him.
When I saw the condition of his dorm room, I became alarmed. It was a mess. Clothing, papers, books — everything that he owned appeared to be dumped on the floor. I found little yellow notes scattered everywhere. Few of them made sense to me. When I asked, my son downplayed their significance, claiming they were bits-and-pieces of lyrics that he was composing for a rap song.
At the urging of my wife, Patti, I decided to call a psychiatrist, who my son willingly went to see him. I will never forget what that psychiatrist said. “If you are lucky, your son is using illegal drugs. If you are not, he has a mental illness.”
I couldn’t imagine anything worse than my son using drugs. I was naive about the devastating impact that a mental illness can cause. The doctor prescribed a mood stabilizer and anti-psychotic and my son took them. He immediately got better so I believed the problem had been solved and all of us could simply go on with our lives.
I was wrong.
My son was busy with classes, didn’t like how he felt on medication, and soon had stopped taking his pills. If you’ve read my book, then you know what happened next. My son ended up being psychotic and when I took him to an emergency room, we were turned away because he was not considered dangerous enough to be treated. He ended up breaking into an unoccupied house to take a bubble bath and was arrested.
So what do I tell parents who ask me about early warning signs?
Three things.
First, don’t be ignorant like I was. Be aware of the symptoms of emerging mental illnesses. We need to do a better job educating doctors, teachers, and parents about those signals. Common ones include insomnia, extreme changes in energy levels and appetite, periods of distinctly depressed or elated moods that persist for longer than several days at a time, withdrawal from normal activities and friends, hearing voices and irrational beliefs and fixations.
Second, know your own family’s medical history. Mental illnesses, such as bipolar disorder and schizophrenia, are thought to have a genetic component. It’s important to learn if there is a history of mental illness in your family. Because of shame and stigma, my family’s history was hidden. No one talked about a cousin who was discharged from the military after he became withdrawn and paranoid, nor the uncle who was an alcoholic and considered suicide. You would not hide the fact that your family has a history of heart problems. But people hide mental illnesses. Being open and honest about mental illnesses in one’s own family also sends a message that it’s okay to seek help.
Third, make certain you see a good psychiatrist who is going to take sufficient time to investigate what really is happening. The brain is complex and determining why a person is exhibiting troubling signs can be tricky. There could be other reasons, besides a mental illness, that might be causing a sudden change in personality. Make certain that a doctor checks every possibility before issuing a mental health diagnosis. And then make certain that a psychiatrist has sufficient information to correctly diagnose what form of mental disorder is emerging. Different doctors have diagnosed my son with: bipolar disorder, early onset schizophrenia and schizo-affective disorder. That’s why it is often helpful to get more than one opinion — if you are lucky enough to see a psychiatrist before a crisis.
Perhaps the best advice that I’ve heard was offered during a recent Diane Rehm show on NPR that I participated in after the tragic shootings in Tucson. Kenneth Duckworth, the medical director at the National Alliance on Mental Illness, was asked by a listener about warning signs in adolescents.
Dr. Duckworth said that if a parent is waking up in the morning extremely anxious about their child’s erratic behavior, then that parent should consult with a psychiatrist. He explained that parents routinely check with doctors when they spot symptoms of a possible physical ailment. Why should concerns about a potential mental illness be treated differently?
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