Unsure Of Diagnosis

A MySchizophreniaTeam Visitor asked a question 💭

My 18yo son had first episode psychosis on Dec 23 after watching his grandfather die. It was an expected death and he was on hospice. He was home from his first semester of college at a very competitive university. He had all A’s. He started thinking he was dying and called 911 and said we were keeping him from the hospital. He had not slept good in 7 days before the episode. Extended up in a psychiatric hospital for 6 days and discharged on zyprexa 7.5 and abilify 5. Abilify was stopped 2 months ago and lexapro was started. He is currently on 5 mg zyprexa and 15 lexapro. He’s never had any other delusions or hallucinations. He does have the negative symptoms but no positive. He’s taking 2 online classes and has A’s. He has great insight for the situation. Does this sound like schizophrenia or BP 2 or major depression? He’s an introvert anyway and never had many friends.

March 20
MySchizophreniaTeam2

What could be causing your son's symptoms after his first psychotic episode?

It's understandable to feel uncertain about the diagnosis. Your son's situation has several factors that make it complex to determine whether this points to schizophrenia or another condition.

The timing matters here. His episode happened after Show Full Answer

What could be causing your son's symptoms after his first psychotic episode?

It's understandable to feel uncertain about the diagnosis. Your son's situation has several factors that make it complex to determine whether this points to schizophrenia or another condition.

The timing matters here. His episode happened after significant stress (witnessing his grandfather's death) and severe sleep deprivation (7 days of poor sleep). Both of these can trigger psychotic symptoms even without an underlying chronic condition.

Some key points about schizophrenia:

* Most men are diagnosed between ages 18-25
* Schizophrenia typically involves ongoing positive symptoms (hallucinations, delusions, disorganized thinking)
* Negative symptoms include withdrawal, lack of motivation, and reduced emotional expression
* People often don't recognize their own symptoms, but your son has great insight
* The condition usually causes significant impairment in daily functioning

What's encouraging about your son's situation:

* He's maintaining excellent academic performance (all A's)
* He's had only one psychotic episode with no recurring hallucinations or delusions
* He has strong insight into what happened
* His functioning remains high despite negative symptoms

The fact that he's doing well academically and has good insight is positive. However, negative symptoms alone, especially after just one episode triggered by stress and sleep deprivation, don't necessarily confirm schizophrenia.

His treatment team is best positioned to monitor him over time and adjust the diagnosis as needed. Early symptoms can look similar across different conditions, which is why ongoing observation is important.

March 20
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