If your child spends more time in their room, stops meeting friends, and their grades and self-management also collapse, it is difficult to dismiss this as merely a change of puberty. Whether interpersonal relationships, emotional expression, academics, and lifestyle habits have changed simultaneously across multiple areas, rather than just distancing from parents You need to examine it.
Before the onset of schizophrenia, social withdrawal, loss of motivation, and emotional changes may appear first, rather than distinct symptoms such as hallucinations or delusions. In this article, I will organize the criteria for distinguishing it from puberty, lifestyle changes to observe, and methods for talking to the child in order.
The key point to look at first is whether the relationship with friends, not just parents, has diminished.
During puberty, conversations with parents may decrease and time spent alone may increase. However, if the child frequently meets friends or engages in peer activities, mental health issues are not judged solely based on distancing from parents.
Conversely, if a child who originally got along well with friends avoids appointments, does not participate in school activities, and even cuts off communication with family for several months, the scope of change has widened. Social isolation that distances one from not only parents but also friendsIt needs to be examined along with other lifestyle changes.
The UK National Institute for Health and Clinical Excellence explains that these changes can occur during the prodromal phase of psychosis, which can last for up to approximately one year. However, since the prodromal phase does not necessarily mean that it leads to schizophrenia, parents should not diagnose the condition themselves but refer it for a professional evaluation.
The key is to examine the flow where relationships, studies, and self-management collapse together, rather than focusing on a single behavior.
Changes in emotions and motivation that differ from puberty
| Areas to examine | Common changes in puberty | Changes to watch carefully |
|---|---|---|
| interpersonal relationships | Maintaining friendships while keeping distance from parents | drifting away from both friends and family |
| Emotional expression | Emotions are strongly expressed, such as irritation or defiance | Reduced facial expressions and speech, or reacting inappropriately to the situation |
| Living functions | Temporary disruption of daily routine | Occurrence of absenteeism, decline in grades, and decreased self-management such as washing appear together |
The irritability and rebellion of adolescence are akin to the intense expression of emotions. Even if they get angry at their parents or argue, their emotional range and interests often remain consistent, such as by talking with friends or enjoying favorite activities.
During the prodromal phase of psychosis, facial expressions and speech may actually decrease, the individual may fail to react to activities previously enjoyed, and emotional expressions inappropriate to the situation may appear. It is also necessary to observe whether basic self-care, such as washing, dressing, and eating, becomes disorganized beyond the level of procrastination on homework.
A decline in motivation also affects academic performance. If changes such as decreased concentration in class, lower grades, or increased tardiness and absenteeism are accompanied by social withdrawal, it is safer to view this as a decline in daily functioning rather than simply attributing it to laziness.
Do not take lightly the remark that your thoughts and senses have changed.
If your child repeatedly says, “I feel like my friends are laughing at me” or “People look at me strangely,” listen to when these thoughts started. Their relational thinking, which involves interpreting the actions of those around them in connection with themselves, may be manifesting differently than before.
In the early stages of psychosis, distinct auditory hallucinations or delusions may not be visible from the start. Instead, wavering perceptions may appear first, such as feeling like someone is calling your name, perceiving a shadow behind a curtain as a person, or mistaking the sound of wind for speech.
Hallucinations refer to the experience of sounds or images that do not actually exist, while delusions refer to a state of firmly maintaining beliefs that differ from reality. However, one cannot conclude that it is schizophrenia based on a single misunderstanding or strange feeling; what is important is whether such experiences are accompanied by social withdrawal and a decline in academic and daily functioning.
Recording changes allows you to explain the situation better during counseling.
It is better for parents to record observations based on specific behaviors rather than the impression that "something is strange lately." Recording the periods when the child did not meet friends, the number of absences, changes in grades, sleep and diet, and self-care habits such as washing or tidying the room, along with the dates, makes the flow of change clearer.
In particular, check if the following changes overlap.
- The time spent in the room suddenly increased
- Conversations and meetings with family and friends have decreased.
- School attendance and grades dropped together
- Decreased motivation and emotional expression regarding favorite activities
- Weakening of self-care, such as washing and changing clothes
- He repeatedly says that people around him mock him or look at him strangely.
Social withdrawal, difficulty concentrating, and mood swings can also occur in depression or social anxiety disorder. Therefore, rather than parents naming the symptoms themselves, it is necessary to organize their observations and proceed with a professional evaluation by a psychiatrist.
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Acknowledge the child's emotions, but do not blindly agree with their thoughts.
When a child says, “My friends are deliberately avoiding me,” if you cut them off immediately by saying, “That’s just your imagination,” the child may hide their anxiety. Conversely, it is also inappropriate to accept the belief as fact by saying, “You’re right, everyone seems to look at you strangely.”.
“Please acknowledge their feelings and discomfort first, such as by saying, ”If you feel that way, going to school must have been very uncomfortable.“ Then, calmly ask ”when did you start feeling that way?“ and ”what happened at that time,” and focus on understanding the changes in their life and the difficulties they are facing, rather than refuting what they say.
Empathy is not agreeing with the child's interpretation, but an attitude of taking the anxiety and pain the child feels seriously.If relationship breakdown, absenteeism, poor self-care, and strange thoughts occur together, the next step is to undergo a psychiatric evaluation to examine the current condition rather than trying to resolve it among family members.