These are the words of distress that behavioral health professionals hear form families when a son or daughter has their first breakdown. What we used to term, “nervous breakdown” is now more commonly referred to as the initial signs of mental illness. This experience for families is always a time of grief, however; with proper support, the family and the struggling young person can learn to live with and even thrive with their condition. Though it is most typical for the first signs of mental illness to occur in late teens or early 20’s, clinicians have seen initial symptoms in much younger children and sometimes much later in middle age.
My older brother, Dave, first experienced symptoms at age 21. He was working part time, enrolled in college, and had been out to training camp with the Baltimore Orioles. He looked like our local hero on the outside. Out of seemingly nowhere, he began experiencing paranoid delusions, hearing voices and behaving in a bizarre manner. He was admitted to a state hospital where he was diagnosed with Paranoid Schizophrenia. Fortunately, our family was open to learning about mental illness, educated and had always been nurturing of one another. Dave got the help he needed and was eventually able to live independently, hold a job, have a car, and participate socially with family and friends. Families have often asked me what they should look for and I have included a few domains here as a guide.
Physical signs of Schizophrenia, Bipolar, and other serious mental illness
- A blank, vacant facial expression
- Overly acute senses – lights are too bright, sounds are too loud
- Staring, while in deep thought, with infrequent blinking
- Clumsy, inexact motor skills
- Sleep disturbances- insomnia or excessive sleeping
- An awkward gait (how you walk)
- Unusual gestures or postures
- The inability to experience joy or pleasure from activities
- Feeling indifferent to important events
- Feeling detached from your own body
- Hypersensitivity to criticism, insults, or hurt feelings
- Sudden irritability, anger, hostility, suspiciousness, resentment
- Suicidal thoughts or suicidal ideation
- Rapidly changing mood- from happy to sad to angry for no apparent reason
- Severe Anxiety
Changes in Behavior
- Dropping out of activities and life in general
- Social isolation- few close friends if any. Little interaction outside of immediate family.
- Neglect in self-care- i.e. hygiene, clothing, or appearance
- Replaying or rehearsing conversations out loud- i.e. talking to yourself
- Inappropriate responses- laughing or smiling when talking of a sad event
- Drug or alcohol abuse
- Thoughts that go around and round your head but get you nowhere
- Becoming incoherent or stringing unrelated words together (word salad)
- Racing thoughts
- Overpowering, intense feeling that people are talking about you, looking at you
- Hearing Voices
To learn more about what an individual experiences when s/he is having initial symptoms of mental illness, read the book, “Eden Express: A Memoir of Insanity” the true story of Mark Vonnegut (yes, son of Kurt). Though Mark is not quite the writer his dad was, his descriptions of symptoms are exquisite. Mark did struggle, but eventually after following Dr. and Therapist recommendations, he went to Medical School, and has been a practicing Pediatrician since the late 70’s.
We invite readers to comment or question on any or all parts of this blog.
Sam (ask the doc)