SCARBOROUGH – Several recent tragic suicides of young people in our area call attention to one of the major contributing factors often responsible the onset of a major mental illness such as schizophrenia, bipolar disorder or major depression.

It is an unfortunate and malignant biologic reality that these brain-based illnesses often begin during teenage years (as if this developmental period didn’t already pose enough changes and challenges for young people!).

Any of these — not only schizophrenia — can be characterized by a relatively rapid appearance of psychotic level symptoms such as hallucinations, bizarre and irrational delusional beliefs or marked changes in behavior. These quickly become apparent to family members, friends, teachers and others.

But just as often, severe mental illness can begin with gradual, much less dramatic and obvious changes in a young person’s thinking and the way they perceive the world.

Clinicians in “Early Intervention” programs are trained to routinely ask referred young people “if their eyes and ears are beginning to play tricks,” or if there are other subtle changes in thinking and behavior, as their potentially ominous significance may not be recognized.

Parents, teachers, and classmates, as well as the young person him or herself, may feel a growing but frustratingly vague uneasiness that “something is not quite right” over a period of weeks, months or even years.

Prior to the eventual emergence of the more typical and frightening symptoms mentioned above, (the hallmarks of “psychosis,” or what is often described as “being out of touch with reality”), observers can mistakenly conclude that illness “just came out of the blue.”

Unfortunately, whether such illnesses announce their presence rapidly or gradually over time, suicide risk increases as unsettling and unfamiliar mental and behavioral changes progress.

Sometimes a young person literally dreads the possibility he or she is losing any possibility of having a normal future, as mental illness relentlessly erodes and compromises usual abilities to easily manage school and family responsibilities, enjoy social relationships, and cope readily with day-to-day events and challenges.

Hope of prevention, or at least attenuation or arrest of the most serious and costly mental illnesses (comparable in cost, mortality and disability to cardiovascular disease and cancer) has emerged only in the past several decades.

Cutting-edge clinical research and treatment programs around the world share the goal of early detection and ever more effective treatment of serious mental illness.

Early intervention efforts focus on accurately determining just which young people are truly at high risk for a first psychotic episode.

Clinicians and researchers use sophisticated neuropsychological testing to probe for characteristic areas of weakness, high-tech imaging to search for telltale anatomic abnormalities in the brain’s structure and neurochemistry, and nuanced screening interviews looking for even the most evasive early symptoms.

The challenge for all who do this work is to discover “red flags” which can give reliable early warning of an impending first psychotic episode.

We can intervene now more than ever before thought possible, to change and improve the course of developing mental illness

As with most all human diseases, the sooner characteristic symptoms are recognized and treated, the greater the odds of a successful outcome. But sadly this not always the case.

Whether or not early intervention programs exist in a community, some tragic loss of promising young lives happens despite the best efforts of well-trained professionals.

It can occur, as well, despite the deep love and caring of family members for a young person in the grip of a serious psychiatric disorder.

Even when detected and treated early, some mental illnesses can be as inexorably progressive, and as deadly, as the most invasive and metastatic cancers.

Nevertheless, far more widespread public understanding and recognition of the more ominous early symptoms of a possible impending first psychotic episode is badly needed.

A pamphlet entitled “Warning Signs of Major Mental Illnesses” can be downloaded from the American Psychiatric Association’s website,

Armed with such information, guidance counselors, teachers, coaches, parents or fellow students may play a crucial and potentially lifesaving role in assuring early treatment that can sometimes stop mental illness in its tracks.

– Special to the Press Herald