Friends, Family & Carers Forum

[Father]

Hi,<br>Im not entirely sure this is the right forum but im going to post it here. <br>My 16yo son has developed drug induced psychosis while withdrawing from cannabis, it has been going on for many months now, and while he has started pharmacological treatment, it is worrying. Im not sure whether he has prodromal stage schizophrenia, or not....no one can give me answers. I have a million questions mostly arising from not knowing what i should do, how to talk to him (especially when he talks and behaves unusual, it is often hard to have a legible conversations).<br>It is very painful to see him like this, will it be permanent, will i get my boy back....

[patientpatient]

Hi @Father,

The diagnosis depends on the duration of the symptoms and a diagnosis of schizophrenia requires symptoms to be present for at least 6 months. My son's "working diagnosis" changed several times and I was also confused by the lack of answers but realise now that it takes time to figure out what's happening. Our initial milestone was "two years with no relapse" and he got there, but relapsed shortly afterwards and that was when the Sz diagnosis was confirmed. The other thing to note is that the meds don't provide benefits for many weeks. It took months to find the right medication and many adjustments to get the doses right (while managing some severe side effects).  My son's decision making was impaired so asking lots of questions or talking about choices was something I learned to avoid. We were connected with a local Early Psychosis Team and the case workers were very helpful. Hopefully you are also in regular contact with local case workers and a psychiatrist. My experience was that they couldn't answer questions about the long term.

[Father]

Hi @patientpatient.
Thanks. I understand its going to be a long road ahead, as the diagnosis is in its early stages and looking back there were 'signs' something was quite right....the internet gives alot of scarey and confusing information. If im honest i am racked with guilt, mostly from mulling over the what ifs....im in regional nsw and there isnt alot of specialised support on offer, while they are trying its not making me feel any wiser. Just more concerned.
My greatest concern is his ability to have a somewhat normal life, at the moment it must be hard for him and it pains me.
He can hold legible conversations for a little short while then throw something strange in there, whay do i do with this? I dont know how to respond 99% of the time. For example. Yesterday we were talking about his day after we talked about what he got up to there was a pause in the conversation and he broke the silence and asked me what would be better to make a suit out of (he wants to make a suit) glass or silver.....how do i respond to this sort of interaction?

[patientpatient]

Yes, some of that sounds very familiar. You mentioned 'prodromal stage schizophrenia' in the first post and I wondered if you'd found the term while researching.  As I understand it, the prodromal stage is the build up before FEP (first episode psychosis). In our case, the build up was over many years and FEP was at age 20. For Sz, the length of the build up is one of the predictors of long term outcome, short build up is "good" and a long build up "not so good". But there are many predictors. I searched online, read books and brochures, made a list and ticked all that applied. Your son is much younger and it sounds like the buildup period was much shorter.

I don't think you have to respond to some of the odd thoughts, or just say you don't know because you haven't thought about it.  That's a reasonable reply if the thought or idea is harmless. (A psychologist would repeat it back, "So you'd like to make a suit out of glass or silver?") I ended up going along with some of the odd ideas or sometimes trying to deflect or modify them. If I got seriously concerned, I'd contact the case worker or the psychiatrist.

[Father]

That makes sense. And yes. I did find that term researching. Ive now learnt its pre-psycosis, and he's now fully in one. I believe its been maybe 6-7 months from noticable changes in behaviour to recognisable psychosis symptoms. They had started to developed a week or so after stopping smoking marijuana.

[Lunar]

Hi there @Father

Thank you for sharing your story that sounds incredibly tough dealing with your son's psychosis at the moment, you must be extremely concerned about him, it's great that you are reaching out for ways of coping and talking with him.

It is important to remember that they are still your son. It is very difficult for a person who is acutely ill to be the person they usually are.

There are no set rules; however you may find some of these general guidelines to be helpful:
 
· Be yourself.
· Maintain communication with your loved one. Gain information and understand that the person may be behaving and talking differently due to their delusional beliefs.
· Understand that psychotic symptoms are stressful for everyone and that you may have a range of feelings – shock, fear, sadness, anger, frustration, despair.
· Talking with other people will help you to deal with these feelings. Believe the person will recover – even if it takes some time. Be patient.
· When a person is in the midst of an acute episode they may seem child-like. Sometimes they need to be in a safe, comforting environment and sometimes they need others to help with decisions.
· Try not to take it personally if the person says hurtful words to you when they are unwell.
· Your loved one may seem fixed in their beliefs and ideas. Try to avoid engaging in long disagreements or arguments about their beliefs. As much as possible, try to listen with interest to gain an understanding of your loved one's current reality. This will demonstrate empathy to your loved one. It can also be helpful future reference, so that you can discuss it when they are feeling better.
· Try to validate the feelings associated with the delusion (e.g. feeling scared, hurt or alone) without validating the delusion itself.
· Above all, take care of yourself. It can be tricky to strike a balance between caring for our loved one, whilst still taking the time you need for yourself as well.
 

It sounds like you are alreay doing such a wonderful and supportive job looking out for your son, he is lucky to have you @Father

Lunar 🙂

[Father]

Thank you. That advice is very helpful.

[Former-Member]

Hi @Father

In the "whats new" tab I have posted some links to some YouTube sessions about loss of insight, these are very helpful.

Darcy