How to help younger siblings?

I have a son in his 20s with Schizophrenia, he is stable on Clozaril for 2 years now after many hospitalisations, but not able to study or work. We had many years of extremely difficult times with him between the ages of 16 and 21, before he was put on this medication. My concern is my youngest son, who is now 16. I know that he has increased risk of Schizophrenia due to his brother (and other family history). However I worry about it a lot, especially as he is now at the age where it all started with my oldest son. I don’t want to ‘put things on him’ especially my anxiety, but I guess that is probably what I am doing. He is not showing any of the same symptoms exactly. My oldest had ‘classic’ paranoia and hearing voices. But my youngest has changed. How do I know if it is in the normal range for a teenager or if is early signs? I am not sure if I could bear if if a second son was also having to deal with this. He has not been out of the house at all during the whole ‘lockdown’ (that’s 4 months). He is on his room with curtains closed on his computer all the time. He does the minimum school work and is antisocial. I know a lot of this is probably normal teenager, but it is a big change in his character. I have tried not create a lot of friction/arguments, so the result of this is that we let him get on with it a lot of the time and don’t push him too hard. So getting round to my question, what can I do to create the best environment for him so that he has the best chance of not also developing schizophrenia despite the family history?

You aren’t specific about how your younger son changed, so it’s hard to comment. A certain degree of reticence and withdrawal is normal in adolescence. Prodromal behavior can be difficult to pinpoint as no one thing is a tip-off, it’s more of an overall pattern. I would look for signs of difficulty concentrating, distractions or self-medicating drug use. Skipping school and declining grades can be tells. Signs of sleepless nights or oversleeping, and a decline of contact with friends. Spacing out and staring into space could be an indicator too.

Things I would consider:

Have discussions about stress and how to manage it. As well as discussions about mental health resources and how to access them. If you attend NAMI sessions ask if your younger son would like to attend or have friends and family training. Be aware when you have a sibling with a SMI, other siblings may be confused or jealous of the extra attention they receive. They may also be fearful of ending up like their sibling and brush off or deny prodromal or active symptoms.

In my experience, while initially I did a lot of denying and covering up of my symptoms, my older brother served as an example of what not to do for a successful recovery. There was a degree of wanting to hide and spare my parents the burden of another symptomatic child, but once I accepted responsibility for my illness and asked for the support of my parents to that goal, they were much better prepared and informed on how to navigate the system and how to speak with their children about their illnesses.

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Thank you that is good advice. I’m not very specific because it is nothing specific, just a general unease I guess.

I have a similar issue. My son was diagnosed with SZ a couple years ago. He is being treated successfully (good and bad days) but his behavior in high school/college is seared in my mind. It was subtle at first, before his first obvious break. Then my daughter started to struggle with depression at the start of high school. Her depression has been rather hard to treat. She’s had episodes of cutting, got caught shoplifting and did dangerous stuff online going into forums talking to strangers for “fun”. She is very social with her friends, but anti social with us—which is typical teenager behavior, I guess. The psychiatrist has not identified any psychosis symptoms and believes the trend in cutting with young girls is usually attributed to poor coping skills. She does have trouble concentrating and that can be bc of depression. Dr. is interested in trying ADHD meds for inattentive ADHD, since she struggles with concentration and is very fidgety. (also, her sister has ADHD) Like you, I am TERRIFIED. Like Maggotbrain said, she sleeps too much. Is sometimes spacey, has insomnia and sleeps a lot. Her brother lost all his friends in HS, but she has very close friendships and has made new friends. I read into every single behavior. Covid has made everything so much harder for kids—especially those with mental illness.

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Im sorry but I didnt read the other replays… but get him into a GOOD Dr ASAP and CPT thearpy before he is out of your hands and on the street. These children get lost if parents dont take charge and get the paper work done with HIPAA as soon as possible.

I don’t want being terrified to affect him! It’s hard isn’t it? It’s good she has friends - always a positive sign.