Stubbornness and Schizophrenia

As many parents do, I remember having moments of frustration with a stubborn child which I characterized as misbehavior. These moments would be brief and then end. How then does one distinguish a normal stubbornness from that which occurs in the prodromal stage of schizophrenia?

In the prodrome, the period of time before the first break, the stubbornness was different. It was totally obsessive. The mind of our son was locked on a certain idea and could not be moved over a long period of time. For example, our son would talk over and over and over again about the same issues he had with his roommate. Nothing my husband said could help him resolve his problem and move on. He seemed stuck. We saw this pattern play out many times over the course of the prodrome. When I think back on this time, I remember many conversations with Jay in which I tried to get him to entertain different approaches to his future after he dropped out of college. He was unable to act on any of them. He would not visit other colleges or think about different courses of study. Yet he seemed a bit desperate, excessively worried about his future and began pacing a lot in the house.

At that time, none of us understood that Jay’s mind was becoming sick. Today, I understand that the perceived stubbornness, inability to complete tasks, and what appeared as willful misbehavior were all early symptoms of a developing mental illness.

Reprint only with written permission of the author.

Voices of the Illness – Schizophrenia

Like many parents we were caught off guard by our son’s descent into mental illness.  To say that we were blindsided by his car accident, arrest and hospitalization would be an understatement. It took awhile for us to overcome the shock and begin to process the meaning of what had happened to our son and our whole family. 

We were soon advised of our son’s suspected diagnosis, schizophrenia, and urged to read available literature.  I reached for the National Institute of Mental Health’s booklet on schizophrenia which defines the positive and negative symptoms of the illness as follows:

Positive symptoms refer to a distortion of a person’s normal thinking and functioning.  They are “psychotic” behaviors.  People with these symptoms are sometimes unable to tell what’s real from what is imagined.  Positive symptoms include: hallucinations, delusions, thought disorders and movement disorders

Negative symptoms refer to difficulty showing emotions or functioning normally.  When a person with schizophrenia has negative symptoms, it may look like depression.  People with negative symptoms may: talk in a dull voice, show no facial expression, like a smile or frown, have trouble having fun, have trouble planning and sticking to an activity, talk very little to other people even when they need to.

The positive and negative symptoms are very evident when the illness is full-blown and psychosis sets in.  One cannot miss the decrease in functioning, the tendency to isolate, the change in thinking, the pacing, the alteration of the senses.  In our son’s case, there were earlier signs that we missed or misinterpreted as normal teenage behavior.  It is these symptoms I want to share as they could be helpful to other parents struggling as we did to understand the difference between normal teenage behavior and behavior signaling a developing mental illness. 

EXCESSIVE NEED FOR SLEEP: Jay always slept a lot sometimes 13-14 hours a day but wasn’t that what teenage boys do? Today, I would say that Jay’s frequent tardiness to his first high school class, his difficulty completing his assignments and constant need to sleep a lot was a sign that he was slowly falling behind in his ability to keep up with his siblings and classmates.  By many standards though he did well in school and sports but his success was much more of a struggle for him.

DIFFICULTY MAKING DECISIONS: We noticed that Jay wanted to go to college but could not make a decision about where to apply.  My husband finally drew a circle on the map with a 60 mile radius from home and asked Jay to select colleges within that framework. 

DIFFICULTY HANDLING DEATH: Jay fell apart when his pet bunny died and walked our neighborhood with me for a long time before he regained his composure.  He did the same when our dog was put to sleep.

EXCESSIVE LEVEL OF ANGER: Jay’s reactions to things that upset him were at times extreme in the level of anger and hostility he showed. 

Hindsight brings clarity, but my husband and I do wonder if we had recognized these symptoms earlier if we could have taken steps that would have prevented Jay’s illness from becoming as severe as it is. 

Voices

Having a child with an incurable mental illness is every parent’s worst nightmare and -even more terrifying when that illness is schizophrenia, the physical manifestations of which often include angry, disturbed, even violent words and actions. Our son’s mind was hurting and trapped inside itself. We often asked ourselves what we could have done to prevent it and what we could now do to help our son?

There were so many voices to consider on this fourteen year-long journey. There are the voices that are the symptoms of the illness, my voice as a mother, the voices of other family members, the voices of the doctors and other health care professionals, the voices of the lawyers and criminal justice system, the voices in the media, voices of research and for our family the voices of the military bureaucracy and VA mental health system.

Over the next months I plan to share how we navigated these voices in the best interests of our son and helped him return to a productive life.

Roadmap to Recovery-Building a Life with Schizophrenia

My name is Margo Nielson and I want to welcome you to Margo’s Blog.

Fourteen years ago our family life changed forever when our middle child became ill with a severe mental illness.   It took years to arrive at a correct diagnosis and along this journey I had much to learn.  At the suggestion of my son’s psychiatrist when he was most ill, I am opening this blog to share what I learned in the hope that it will help others to find at least a partial roadmap on this most difficult journey. In addition to sharing what we did as a family, I will be posting articles that offer insight into advances in the field of mental illness particularly schizophrenia.