Typical Teen Behavior or Warning Sign? Recognizing an Overlooked Mental Health Epidemic

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 more common than you'd think, and it's becoming more common every year.

What most parents don't understand

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 as many as 271,000 young people in California will experience first-episode psychosis next year. Yet many families have never heard of it.

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. 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.

"We're seeing more and more teens come into care with psychosis that's been triggered or worsened by cannabis use. And often, neither they nor their parents have any idea there's a connection." — Adrian Marroquín, LCSW, Co-Founder & Clinical Director, California OnTrack

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 hospitalization.

But there's good news: with early treatment, people with psychosis can learn skills to manage new symptoms, scary thoughts, unusual beliefs, and changes in brain functioning. Teens can recover, stay in school, and reconnect with friends.

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.

• 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

You are not overreacting. Psychosis is common, treatable, and — most importantly — doesn't have to define your child's future. What matters most is that you act early.