What is a prodrome?

ˈprōˌdrōm/ noun:  an early symptom indicating the onset of a disease or illness

In psychiatry, the word prodrome is often used to describe a period of time during which an individual begins to display symptoms of a mental illness, typically accompanied by some type of disturbance in functioning, but before the disorder fully presents itself.  Classically it has often been used to describe a period of time of social isolation, change in mood or behavior, and change in functioning who go on to develop schizophrenia, but often people who go on to receive a diagnosis of bipolar disorder have a prodrome as well. 

Unfortunately, sometimes the prodrome is best identified in hindsight.  After a teen or adolescent develops a major depressive episode or a manic episode, parents and family look back and say “oh yeah … he WAS moody and irritable, he DID stop hanging out with friends, he DID seem a bit restless and agitated, he WAS very distractable, his grades DID drop significantly”.  Often in the moment, symptoms seem like normal adolescent behavior or “just a phase”, or often can be related to other issues going on, such as peer problems, academic problems, or other life stressors. That is because the symptoms don’t tend to be severe, may not happen all together, and are often non-specific - meaning that they could be seen in a variety of disorders, such as depression, anxiety, attentional disorders, drug and alcohol disorders, etc.

Bipolar disorder often cannot be clearly diagnosed during this period, unless there are symptoms that are specific to the disorder.  However, any changes in an adolescent’s mood or behavior that affects their relationships and their function at school, with peers, and at home, is worth evaluation by a child and adolescent mental health specialist.  This person can help you monitor changes in symptoms and response to treatment so that whatever may be brewing beneath the surface can be caught early and treated appropriately.

-Dr. Buchanan-