Understanding First Episode Psychosis (FEP)

Psychosis affects about 3 in every 100 adults, with typical onset in late adolescence or early adulthood (16– 22 years old). Early psychosis, also known as first-episode psychosis (FEP), is often frightening, confusing and distressing for the person experiencing it and difficult for his or her family to understand.

Early psychosis, or a first episode, is the most important time to connect with the right treatment. Doing so can be life-changing and radically alter a person’s future. So, while it can be difficult to tell the difference between the early warning signs of psychosis and typical teen or young adult behavior, if you are concerned, don’t delay in getting help.

Psychosis involves loss of contact with reality, such as hallucinations (seeing or hearing things that others do not) or delusions (beliefs that are not based in reality). Symptoms of psychosis can also include speech that does not make sense, difficulty thinking clearly, lack of self-care, withdrawal and odd or inappropriate behavior.

The Prodromal Period

Early psychosis rarely appears spontaneously or with rapid onset. Usually, a person has gradual, non-specific changes in thoughts and perceptions, but is unable to identify what is occurring. This period is called the “prodromal period” — when signs of a problem are apparent, though the illness itself has yet to emerge. Early warning signs can be difficult to notice or to distinguish from typical teen or young adult behavior, and include the following:

• An unexplained drop in grades or job performance
• Changes in cognition such as difficulty thinking clearly or concentrating
• Suspiciousness or uneasiness with others
• A decline in self-care or personal hygiene
• Isolating, loss of contact with friends
• Strong, inappropriate emotions or having no feelings at all
• An increased use of marijuana, alcohol, and other substances.

Signs of early or first-episode psychosis

Determining exactly when the first episode of psychosis begins can be hard, but these signs and symptoms strongly indicate an episode of psychosis:

• Hearing, seeing, tasting or believing things that others don’t
• Persistent, unusual thoughts or beliefs that can’t be set aside regardless of what others believe
• A sense of confusion, difficulty expressing thoughts and ideas in a coherent manner
• Strong and inappropriate emotions or no emotions at all
• Withdrawing from family or friends
• A sudden decline in self-care
• Trouble thinking clearly or concentrating
  

If something about your child's behavior 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.