That gut feeling about your teen isn’t paranoia — it could save their life

Ari Blechner, LCSW

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You know your child better than anyone. So when something feels “off” — when the teenager who used to text friends constantly now isolates in their room, when the young adult who was thriving in college suddenly fears professors, when your parental gut is telling you this isn’t just “normal” stress or teen moodiness — listen to that instinct.

That nagging feeling you can’t shake, the one that keeps you awake at 2 a.m. wondering if you’re overreacting, isn’t paranoid parenting. It’s often the first and most important alarm system for detecting serious mental health concerns like first episode psychosis.

As a counselor who has supported hundreds of families through these frightening experiences, I can tell you that the parents who trust their instincts and seek help early are the ones whose children have the best outcomes. Your intuition isn't just valid, it could be life-changing.

First episode psychosis refers to someone experiencing a psychotic episode for the first time. While it affects 3 out of every 100 young people aged 15 to 25 and causes significant impact on families, educational resources specifically designed for parents remain scarce. Because it can look like depression, it can be hard to identify.

Although symptoms vary from person to person, common warning signs of first episode psychosis include:

• Strong beliefs about things that don’t seem real to others
• Hearing voices or seeing things no one else notices
• Extreme suspiciousness or feeling constantly watched
• Acting like a completely different person
• Dramatic changes in sleep patterns
• Pulling away from people they used to enjoy being around

While brain development is the underlying factor, stress can act as a trigger that pushes a vulnerable system over the edge. Young adulthood is naturally full of big changes — making new friends, leaving home for the first time, college pressures, new relationships and figuring out independence.

For a young person whose brain chemistry is already predisposed to psychosis, these normal life stresses can become the tipping point where the brain starts misinterpreting what it sees and hears (causing hallucinations) or develops strong beliefs about things that aren’t actually true (delusions). It’s not that stress alone causes psychosis, but rather that it can activate an underlying vulnerability.

But here’s the encouraging part: when caught early, young people often respond well to early treatment. Programs that specialize in treating adolescents aged 15 to 25 have found that comprehensive early treatment — combining medication, therapy, family education and peer support — can help young adults achieve significant improvement when intervention happens quickly. It can actually help their brain systems and prevent bigger problems down the road.

Young adults are just gearing up to do life and mental health issues can slow or even stop that momentum, but the sooner we seek help, the sooner they can get back on track.

When we talk about catching this first episode psychosis at the “first sign,” we’re not just being cautious. We’re talking about dramatically changing a young person’s future. Research shows significantly better outcomes with early intervention; when families and counselors act quickly to get help, young adults see significant improvement and go on to live full, successful lives.

It is like a physical injury. If you treat a sprained ankle immediately with rest and care, it heals properly, but if you ignore it and keep walking on it, you might end up with a permanent limp or other damage that’s much harder and takes more time to fix.

The same principle applies to mental health. During those early weeks and months when symptoms first appear, treatments that can include counseling, medications and family support can make things drastically better, rather than causing long-term issues that may follow a person throughout their life.

Things can get significantly better after a first episode. Young people can often return to school, maintain relationships and pursue their goals with the right support. But when psychosis goes untreated, it can disrupt education, damage relationships and make recovery much more challenging. The message for parents and counselors is clear: trust your instincts when you notice changes, and don’t wait to see if things get better on their own.

Getting help early isn’t overreacting, it’s helping your loved one get back on track with the life they’ve been building.

Editor’s note: Ari Blechner is a recovery coach with Valleywise Health, which provides mental health services for teens and young adults in Avondale, Chandler, Mesa, Laveen, Peoria and Phoenix. Please submit comments at yourvalley.net/letters or email them to AzOpinions@iniusa.org. We are committed to publishing a wide variety of reader opinions, as long as they meet our Civility Guidelines.