Chemical Imbalance and Schizoaffective Disorder

My brother (16 y.o.) was being treated for ADHD for about a few months. He actually seemed pretty normal, except that he always worried about if his classmates liked him. We thought that it was just a normal phase of a teenager -- wanting to belong, etc, especially since he was quite a shy boy. He claims to have been seeing things -- ghosts, monsters, etc. since he was little, but we did not think too much of it as it does not really seem to affect his everyday life that much.

Then exam week came, and having been put into a lot of pressure in those days, he started claiming that he was the Savior and that God is talking to him. He had a whole other world for him and his minions. He also had an unhealthy obsession with a female star, whom he things is his destined life partner.

Long story short, after a few months of evaluation, he was diagnosed with schizoaffective disorder brought about by a chemical imbalance in the brain -- he was lacking Lithium. He is getting better now, but I am just curious if this could have been prevented? Is it possible to detect a chemical imbalance (i.e. a lack of lithium) even when he was still in the ADHD stage, or even earlier?

Cabernet,
Thats a good question. I doubt it, but please let me know if you hear otherwise. Sorry about your brothers illness, but good he was diagnosed. Tell him he needs to be sure to drink alot of water while taking Lithium. Several severe side effects can occur if dehydrated like uncontrollable muscle spasms, and twitching, toxicity.

Thank you for your reply, Ruffy. He did drink a lot of water when he was taking Lithium even without prodding, so that was good.

As far as I know, no "chemical imbalance" has ever been proved to cause any mental illness, and there is no test for any such thing. I think at best "chemical imbalance" is a shorthand oversimplification for whatever may be true. Neurotransmitters are chemicals that neurons in the brain emit, which then travel across "synapses" (spaces between neurons) to other neurons. Psychopharmacology concentrates these days on these neurotransmitters. But if imbalances are present in neurotransmitter chemicals or in their transmission from one neuron to another, does that "cause" mental illness, or is it something that is found when the illness is already developed? If there is an imbalance, why? What causes the imbalance? Why does it develop? Is it a matter of genetics, or is it due to experience modifying neuron pathways, or is it something that we do not know about? Or combinations of all those? Those who claim "chemical imbalances" cause mental illness have a lot to explain. I suspect no really educated researcher would use the term except as a simplified shortcut. And those shortcuts can lead to misunderstandings.

off.

My son just turned 21 and he had a busy life... college, work, girlfriend. Then five days ago his world and his mind broke. The Dr.'s tell me he's schizophrenic.
He was supposed to work the day his break happened and to let his demons/bad thoughts out he had to do something so he lit two fires to release them. When I found him he was cut up and flat/no emotion just walking.
Now I am just so scared for him and I am just looking for someone who can let me know what to expect and so I can hopefully get my son back(my baby)and help him and get the best care. Sorry for the rambling I am just so afraid for him and Love him so much. Thank You.

Was there any indication of trouble before this day on which things happened?

JarsMom: My son just turned 21 and he had a busy life... college, work, girlfriend. Then five days ago his world and his mind broke. The Dr.'s tell me he's schizophrenic.

Hello JarsMom,
My sympathies on your family's predicament. A parent can't help but feel concerned for their child in that kind of circumstance and overwhelmed by the world they have been thrust into as a result. When I'm concerned and overwhelmed I tend to gather information -- it helps return a measure of power to me. So, in the hopes of helping you do the same, here's some information that I hope will prove helpful.

#1: As best I understand it, a diagnosis of schizophrenia requires a minimum of six months of symptomatic behavior. At least one month of that time must be comprised of positive symptoms (i.e. hallucinations), the remaining time can be comprised of negative symptoms (i.e. withdrawal). In other words, your son's doctor cannot make a diagnosis of schizophrenia as based on five days of behavior, no matter how unusual it is. It's worth mentioning at this time that many people recover from schizophrenia.

#2: It's possible your son is experiencing psychosis. This is considered one of the positive symptoms of schizophrenia but it is not the same thing as schizophrenia. Psychosis can be produced by a number of factors -- stress, trauma, drug reactions or illicit drug use. No doubt you are trying to figure out what caused all this in your life. I suggest you try to trace it back to a cause and share that information with your doctor. It's worth mentioning that even more people recover from psychosis than recover from schizophrenia. In fact, there is a diagnosis known as "Brief Reactive Psychosis" which is considered to be psychosis that lasts less than one month. Most doctors expect that people will recover from Brief Reactive Psychosis however, if you go a day past a month, they call it schizophrenia instead and all too frequently, predict a dismal option of recovery.

#3: I assume your son is currently in a hospital and likely being given treatment in the form of anti-psychotic medications. He might also be receiving anti-depressants, anti-convulsants (mood stabilizers) anti-anxiety medications and possibly, additional medications to help counteract the potential side effects of the aforementioned. The issue of medications is a very complex subject but one that's worth investigating. Here are some initial resources that might help you and your son better understand the medication he may have been given (and expected to take):

As a cautionary note, when my own child was hospitalized and given anti-psychotic medication, it produced a very rapid and profound decline in function. Unfortunately, this was interpreted as a form of "negative symptoms" and doctors continued to medicate them. When our child was finally taken off the medication, they rapidly improved. Psychiatric drugs can be very powerful medications that have the power to help and the power to harm. You would be well advised to get the names of the medications your son has been given and make note of the potential benefits as well as the side-effects so you can alert his doctors to the fact if you see any evidence of the same. It is very likely that if your son complains about his medications, he will not be listened to so he may need you to advocate on his behalf.

That's just a bit of information to help get you started JarsMom. If you'd like some more, feel free to ask.

Best to you, your son and your family. I can appreciate this is a difficult time for all of you.

~ Namaste

Thank you for all your responses.

@Jarsmom -- feel free to message me if you want someone to talk to. It is not easy when a family member goes through this illness, especially during the early stages.

Just an update, to those who may be interested.

I mentioned that he was getting better, and he is, in terms of how he interacts with people. His old sense of humor is almost back to normal and his responses and movements are quicker (as compared to before, when he was quite "robotic").

Still, his delusions persist. Lately, he says he's being haunted by ghosts. He's also a bit more active in wanting to "spread the word". He is manageable, but it can be quite taxing to do so.

As we have been treating him for half a year, the doctor suggests that we perform ECT -- particularly because his progress is a bit slower than the ideal and it may be difficult to "bring him back" to normal if we go on at this rate. Despite some of the misgiving that I have about this treatment, we are becoming inclined to try it out, if this would give him a fair chance of living a normal life.

Any thoughts would be welcome. Thank you.

Fire the doctor.

sharaz--" he was lacking Lithium"
look further into this--noone lacks lithium.
sounds like a clear diagnosis isn't complete. i'd wait on the shock therapy till that's clear.
you are a good bro indeed.

If your brother is still delusional then I would suggest first adjusting his medication before giving the go ahead for ECT. Either titrate it up or switch to a different one (assuming he is on an antipsychotic).

Well, they decided to observe him more before going on ahead with the ECT. That is, in the psychiatry unit so that they can see how he interacts with the other patients, etc. So far, so good. He has improved a lot from the change in the environment. Hope it goes well and we won't need to resort to ECT.

@tim999 - thank you, I will look into that. Maybe my understanding was still lacking in that department. He was said to have a chemical imbalance and was given Lithium for a while to "balance" it. So I assumed.

@cybermember - yeah, we were thinking that as well. Although he was switched to Abilify plus Lexapro (he had some depressive tendencies) from Seroquel. He is also on Risperdal Consta, injected to him every two weeks.

dIFFERENCE BETWEEN SCHIZOAFFECTIVE & UNIPOLAR WITH AUDITORY HALLUCINATIONS~TRYING TO FIGURE WHAT MY SISTER HAS & SHE`S RESPONDED DRMATICALLY TO rISPARIDIL.(MY DAD WHAT SHE HAS & i HAVE bIPOLAR i WITH PSYCHOTIC FEATURES(MAINLY DELUSIONAL & A BIT PARANOID;ON MEDICINES)

DOES ANYONE KNOW THE DIFFERENCE BETWEEN SCHIZOAFFECTIVE & BIPOLAR i WITH PSYCHOTIC FEATURES?