What were the first signs?

“Did you see any warning signs that should have tipped you off about your son’s mental illness?”

It’s a question I get 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 were red flags.  If so, what were they? When did his mental illness first begin revealing itself?

My son, Mike, marched to the beat of a different drummer as a youngster. As a parent, I was proud 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 signs.

One reason why it can be difficult for parents to recognize symptons of an emerging  mental illness is because many of them surface when an adolescent is in his/her early 20s. Often, this is when young people are breaking away from their parents. Whether they are in college, as mine was, or join the military or simply move out on their own for the first time, it can be a time of experimentation and risky behavior. Is excess alcohol consumption a warning sign or simply what young men who join fraternities love to do on weekends?

This is the age when adolescents feel under tremendous stress too, which can trigger a break.

So what sort of signs should a parent watch for if they believe their son/daughter may be developing a mental disorder?

Mike was attending a New York City college when I first realized something was amiss. We talked each Sunday afternoon on the telephone and he told me that food had lost its flavor. Even worse, many of the dishes  that he’d once enjoyed now made him physically ill.

Because Mike 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, Mike said that he was starving because he’d been vomiting all week. 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 looked as if it had been dumped on the floor. It was a disorganized mess.  I found little yellow notes scattered everywhere.  Few of them made any sense to me. When I asked, Mike downplayed them, claiming they were bits-and-pieces of  lyrics that he was composing.

My wife, Patti, and I were concerned enough to call a psychiatrist and Mike willingly went to see him. I will never forget what that doctor said. “If you are lucky,” he told me, “your son is using illegal drugs. If you are not, he has a mental illness.”

I was stumped. At the time, I couldn’t imagine anything worse than Mike using drugs. I was naive about the devastating impact that mental disorders have on a person and their loved ones.

The doctor prescribed various pills and Mike took them. He immediately got better. I figured the problem had been solved and went on with my life. Mike did too and after a few weeks, he was so busy with his classes that he stopped seeing the doctor and taking the pills. Because he was not complaining about food, I thought we had resolved the problem.

And then Mike became so psychotic that his friends called me and we found ourselves racing down a road that led to him being arrested, forced into a hospital, and tasered by the police. 

What do I tell parents who ask me about early warning signs?

Two things.

First, don’t be ignorant like I was. Know the symptoms of mental illnesses. 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 really important to let your child know if there’s a family history of mental illness. You would not hide the fact that your family has a history of heart problems. Don’t hide mental illnesses either. Not only will this help your adolescent recognize the symptoms sooner if they begin developing them, but by being open and honest about mental illnesses, you send the message that it’s okay to seek help.

Perhaps the best common sense 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 replied that if a parent is waking up in the morning extremely anxious about their child’s erractic 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?

What do you think? 

One way to learn is by sharing information. If you are a parent, please tell me what warning signs you first noticed when your son/daughter became ill. If you are a person with a mental disorder, please share with us what were the first signs that you noticed?

Share your story please.

About the author:

Pete Earley is the bestselling author of such books as The Hot House and Crazy. When he is not spending time with his family, he tours the globe advocating for mental health reform.

Learn more about Pete.


  1. My son was diagnosed at a very early age. One of his first warning signs was that he could not sense danger, i.e. breaking loose and darting into traffic was a major problem. That was twenty years ago and I actually had to keep him on a leash (for which I received a lot of dirty looks out in public). What they didn’t know was – I was keeping him safe. Now he’s 23 and I find myself still trying to ensure his safety while he attempts to live independently in the community and it’s not easy.

  2. My sister was so angry as a child. She would overreact to situations and make our family miserable as she lashed out at us and had temper tantrums that lasted hours. It was exhausting for all of us. As a teen she was bulimic and we admitted her to a psychiatric hospital. Between the eating disorder and her anger, we were at a loss as to how to help her. Her anger is a frightening thing to this day, and although I know it’s her illness speaking, it’s hard to be close to her, and for this we feel guilty. That first time she was admitted we went to weekly family therapy with her. We’d say, “We love you,” and she’d say, “I hate you!” How many times can you hear that and not feel hurt? How can you not want to protect yourself from someone’s irrational anger? She has schizoaffective disorder and has no insight into her disease. I wish we had received better help from the medical community when she was young and we had a better chance of treating her disease, but this was in the mid-eighties and I don’t think bipolar disease in children was thought to be common then.

  3. My son was 16 and athletic, handsome, intelligent, well liked, social young man. He had depressed days here and there, which we did attribute to his “maturing”. Then he went to a party and took illegal drugs…we took him to the hospital because of the way he was acting and they told us he was “coming off the drugs…” A day later, I knew that wasn’t the answer as he was locking us in his bedroom as “the government” was going to get us all….we “had to build a shelter” to save us….it took me a few hours to realize something is really wrong here. So, this time we took him to the hospital and, as his Mom, I demanded a psychiatrist look at him. That was his first diagnosis of bipolar. He is now 21 and has been in the hospital 5 times due to “getting better, and I don’t need my medicines”. He is now is his recovery process again, on meds, and doing well at home.
    Each time he “became sick” it was something different. One time it was the government was sending “rays” down to the earth the control people, one time while in his first semester of college, the RA”s and other kids on his floor were after him…I know the warning signs of his paranoia now. The biggest sign, however, is him not taking his medication.
    I really enjoy your blog….and cannot push myself, as a parent, the main thing I can do is be my son’s advocate…he cannot and sometimes the medical community doesn’t do enough. I have educated myself and make that known to his doctors until he is able to take care of himself longterm.
    Thanks for listening.

  4. This article tugs at my heart more then any other that Pete has penned. My son is this article, just 1 month in college he blew. Sixteen hospilizations later, 6 years in with his MI diagonis from BP1 to sizoaffective, MI is now his life and ours. I don’t want to beat myself up no more in regards in what we could of done to stop this or how we missed it. But I do know that in 2nd grade he was diagnosed with ADHD, all through elementary school he was a straight A student, All through Middle School straight A student and High School came, 28 ACT, early acceptance to a top college, he worked his entire life to be a brain surgeon. Not one month away from home in college, he was removed from college by the campus police, taken to the hospital, he was in his 1st full blown pysotic episode, 15 more to follow to date. We sat down recently and talked to him about when things changed in his mind, he stated, freshman year in college, fully depressed, sophomore and junior and senior year of college fully hypomanic, one month in college MI reared its ugly head. What I would like to share about this, is, that we knew something was different for him very early on, the isolation, didn’t need friends, very peculiar, only could focus on one thing at a time, always took it to the top, trouble sleeping, could not handle crowds. I only wish I knew earlier and could of help him and not subjected him to so much pain to be like everyone else and only wish I knew what I knew now, if he could not take care of himself in high school how could he of ever handle a large college. If you are wondering if you child is sick, then seek help, there is no normal to live by and I only wish, I never sent him to a large college in hopes of him being able to handle it, when I knew he could not take care of himself in high school. He is doing well today, on SSI, taking medications to keep him stabile, has great family support and great medical support, I just only wish, I knew about MI sooner and he and we our family would of not had to endure such uncessary pain and would of seeked help earlier for him. The signs were there, he isolated all through high school and I only wish I didn’t think he would of been able to handle that crowd.

    • Concerned Mom says

      Your story is similar to mine. Our son is now 26 years old. When he went to college, he started feeling depressed and my husband and I just attributed it at first to adjustment problems. By that first December 2003, he was experiencing deep depression and when he came home on winter break, I got him to as doctor who prescribed an SSRI. IN the Spring, things got better and he had been diagnosed with seasonal affective disorder.
      The following winter, depression reared its ugly head again but by spring he became hypomanic but was still functioning.
      To make a long story short, after 7 years, with last winter being the worst depression ever, 5 months, this spring he became manic, went on shopping sprees, stopped going to work, suddenly broke up with his GF and was acting extremely bizarre. My husband and I both called his psychiatrist. Well, after 7 years, we got the correct diagnosis, Bipolar I. My husband were thinking back to behavior when he was growing up, and he did have an anger management issue and seemed to overreact very easily. He has always been an achiever, honor roll, leadership, but now we are putting the pieces of the puzzle together and it is making sense. He has already been picked up by police 3 times, he was driving recklessly and has been psychotic. It is frightening. He has been hospitalized twice in 2 weeks. He had not been taking Lithium but we hope that now he realizes that it is crucial for him to stay on his medication as normal as breathing air. We all realize that his life and ultimately ours will never be the same! I have read 6 books on Bipolar Disorder in the past month and hasve just started reading Crazy and already see parallels between Mike and what we are now going through. It is hell on earth!
      I hope that our son will continue to take his meds outside of the hospital. He lives in another state so we cannot monitor that. The worst part was his belligerence and anger towards us. IT is like another person has inhabited his body and mind. We know that there will not always be smooth sailing but as our friends tgell us, just take it one day at a time! That is my new mantra!

  5. Mullligan from Colorado. I am so honored to be by sons caregiver and rep payee and I am so blessed to tell him everyday that my life would not be whole without you in it and you are a gift from God. He is the joy of my life and I tell him that everyday.