If you’re reading this, maybe something about your teen has shifted. Perhaps they’ve pulled away from friends, stopped showing up to school, or started saying things that don’t quite make sense. Maybe they just seem... different. And not in a typical "teenager" kind of way.
You might be hoping it’s stress, burnout, or anxiety. Anything but something serious.
But here’s a reality that almost no one is talking about: Psychosis in young people is not rare; it’s actually more common than you would think. And, most importantly, it’s becoming more common every year.
What most parents don’t understand is this:
We’re in the middle of a public health crisis when it comes to youth psychosis—but we don’t recognize it as one. And because we don’t recognize it, families are missing critical windows to intervene.
The epidemic we don’t see
In recent years, the mental health crisis among teens has become impossible to ignore. Rates of anxiety, depression, and suicide have all surged, but what’s getting less attention is the quiet rise in early psychosis. It’s showing up more often, in younger kids, and in ways that many parents, and even professionals, don’t recognize until things escalate.
Psychosis affects roughly 3 in every 100 people at some point in their lives, and for most, it begins in adolescence or early adulthood. Some estimates suggest that as many as 271,000 young people in California will experience first-episode psychosis next year.
And yet… many families have never heard of it. They don’t know the signs and they assume psychosis looks like something out of the movies, clearly dramatic or extreme.
In reality, it often starts small and quiet.
The subtle progression toward psychosis
Psychosis isn’t a diagnosis; it’s a symptom. It means a person is having trouble telling what’s real from what’s not. Among other things, that might look like strange or false beliefs that are strongly held, hearing things, suspiciousness, visual or tactile hallucinations, or disorganized thinking. But in teens, the earliest signs are much easier to miss.
There’s often a "prodromal" period—a stretch of time when something seems off, but not obviously alarming.
Common early signs include:
- Pulling away from friends or isolating
- Struggling to concentrate or organize thoughts
- Losing interest in school, sports, or hobbies
- Becoming paranoid or unusually suspicious
- Reacting emotionally in ways that seem disconnected from the moment
- Saying or believing things that seem odd
And one of the most under-recognized factors? Cannabis.
Especially high-THC cannabis, which has been shown in numerous studies to increase the risk of psychosis, particularly in teens with genetic or environmental vulnerability.
Also read: Understanding First Episode Psychosis
"We’re seeing more and more teens come into care with psychosis that’s been triggered or worsened by cannabis use," says Adrian Marroquín, LCSW, Co-Founder and Clinical Director of California OnTrack, a program of Pand Health. "And often, neither they nor their parents have any idea there’s a connection."
Why early action matters
Psychosis isn’t something you wait out. The longer it goes untreated, the more likely it is to progress and the harder it is to get back to baseline. Every week and every day that a teen remains untreated can increase the risk of long-term disability, school disruption, or even hospitalization.
But there’s good news, too.
With early treatment, people with psychosis can be taught to use new skills to manage these new symptoms, scary thoughts, unusual beliefs, and changes in brain functioning. Teens can recover, stay in school, and reconnect with friends. They can get their lives back on track.
"The earlier we catch it, the better the outcomes," says Marroquin. "It’s that simple."
What to do if you're unsure
You don’t need to know for sure. You don’t need a diagnosis; you just need to pay attention and reach out.
Here’s where to start:
- Keep notes on what you’re observing: changes in mood, behavior, or thinking
- Talk to your teen. Be curious, not confrontational.
- Contact someone who specializes in early psychosis in adolescents
Unfortunately, psychosis maintains a significant amount of stigma and not every therapist or pediatrician has a strong grasp on the symptoms and how to treat it. In many cases, this vulnerable population falls under the exclusionary criteria for treatment programs and outpatient providers. That’s why California OnTrack exists—we’re one of the only programs in the country that can treat teens aged 14–17 who are experiencing early psychosis.
Also read: Understanding Thought Disorders
You are not overreacting. Psychosis is common, treatable, and most importantly, it doesn’t have to define your child’s future.
What matters most is that you act early. Even if you’re unsure, scared, or hoping it’s something else. That first step could make all the difference.
If something about the behavior of your teen or young adult child has you concerned, even if you’re not sure what it means, you don’t have to figure it out alone. Reach out to California OnTrack at Pand Health to connect with a clinician who understands early psychosis in teens and young adults. Whether you’re looking for answers, want to ask questions, or are ready to schedule a confidential evaluation, we’re here to help.
