Mental Health Mental Health Basics

The Real World: Recognizing Mental Illness in Young Adults

There are many stresses associated with young adulthood that might serve as a trigger, such as going to college, living away from home and taking responsibility for oneself.

Can drug and alcohol abuse trigger an episode?
Absolutely. Hallucinogenic drugs, such as marijuana and cocaine, frequently trigger or exacerbate psychotic symptoms associated with schizophrenia and bipolar disorder.

Some people with psychiatric illnesses try to cope with their symptoms by using substances like alcohol, marijuana and cocaine. However, they tend to have more problems. They are less likely to take medication properly and their symptoms are harder to control. Also they might need to be hospitalized more often and are at greater risk of becoming violent. The person might feel better when they are high or intoxicated, but it tends to cause many more problems in the long run.

How is schizophrenia recognized in young adults?
“What we look for is people losing their ability to function,” Hochman says. If, for example, an adolescent was previously doing very well in school and socially, and then he or she regresses, that is concerning. So doctors look for a marked change in social or family functioning or their ability to get good grades or do well at work.

Early symptoms may include experiencing psychotic symptoms such as hallucinations, because certain pathways in their brains are being activated when they shouldn't be. Another worrisome quality is suspiciousness or paranoia. Also, young people might have difficulty expressing themselves verbally, when they didn't previously have trouble organizing their thoughts. Other early problems may include sleep difficulties and anxiety or depressed mood that is not severe enough to meet criteria for a major depressive episode.

There are a couple of ways that schizophrenia can develop. Schizophrenia is a lot easier to recognize when there is a very sudden onset. When, one day, they're doing fine, the next day, they're hallucinating and paranoid, then you know there's something wrong. But schizophrenia can also develop insidiously and slowly.

What are the early signs of bipolar disorder?
Bipolar disorder includes manic episodes and major depressive episodes. Mania is a mood state that is characterized by a dramatic change for at least a one-week period where they tend to be either euphoric or irritable or angry beyond what the situation would normally cause. Other symptoms include a decreased need for sleep, and an increased energy level. They also have an increase in risky behavior, such as excessive shopping or gambling, or being sexually promiscuous.

A depressive episode involves a change in one's mood to sadness or irritability that lasts for at least two weeks and includes changes in sleep and appetite, and low energy.

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