Welcome to Back from the Abyss. I'm Dr. Craig Hecock.

Go into doctors' offices in America, and you generally see a preponderance of older patients,

with only the rare scattering of adolescents and young adults.

And this is because most serious medical illnesses don't occur until later in life.

Most doctors spend the majority of their time with people over age 40.

Psychiatry is a huge exception to this rule. Serious psychiatric illness almost always

appears during adolescence or early adulthood. The first break of psychosis or mania, the first

crippling depressive episode. These classically occur right when kids are finishing up high school

and heading off to college or work or the military.

The cruel reality of severe psychiatric illness is that it typically derails young people just when they are starting to find their way in life,

when they're leaving the nest and setting goals and developing into independent adults.

One of the more common things I see in my practice is exactly this,

a young adult leaving home for the first time,

sometimes with early warning signs of impending doom,

but other times with no signs at all.

And then within a few months, or maybe a year or two,

the psychiatric breakdown begins, and the parents are left in a horrific position.

For another quality of severe psychiatric illness is that more often than not, as people get more and more ill, they lose their insight and judgment.

They either don't realize that there's something

desperately wrong, or they become increasingly convinced that there's nothing that can be done

for them. It's unimaginable that someone would have, say, 104 degree fever or vomit blood or

have a debilitating headache or see their cracked femur poking out of their skin

...