Is my friend schizophrenic?

I've been worried for the past few months that my friend Kathryn might be showing the first signs of schizophrenia. I've known her for a few years now and when I first met her at the age of twelve, she was bubbly, a little bizarre, incredibly brilliant, and attractive. I thought she had the potential to do anything she wanted. I was even a little jealous. She's now fourteen years old.

Sometime earlier this year (circa January or February), I noticed her personality changes. She refused to take any medications (she had been prescribed some for migranes and depression) because she felt that the government was getting her addicted (she had never taken illicit drugs, either). She seemed to get more and more enwrapped in different religions and cultures she identified with, almost as if she was creating worlds for herself. She was becoming more and more self-absorbed, even once thanking me for not talking to her about my suicidal tendencies.

Kathryn always enjoyed giving hugs and being friendly to people when we were younger. Lately, though, it seems she's been getting more and more antisocial. At parties, I would notice that she would talk to me and only me, unless I was in a conversation with a mutual friend. However, if there was a social gathering I couldn't attend, she would gush to me about how much she was talking to people and how everyone liked her. Now, I'll often see her at parties merely standing alone in the middle of all of the socialization, hardly talking to anybody.

Kathryn has lately been expressing a good amount of discontent towards me. She berated me for transferring to a different high school and would lecture me when I drank. She's always been stubborn, but nowadays, any attempt at all to talk about her problems will lead to an eruption on her part. This doesn't stop her from endlessly lecturing me about my problems.

For some reason, though, I seem to be carrying the weight for all of my choices, good and bad, even if other friends of her's make the same ones. For example, several of her good friends attended the high school I currently attend, yet I'm bearing most of the negativity. Most of our friends will get drunk and yet I'm constantly being told that I'm making stupid choices. I don't know why it is she's taking all of this out on me.

Recently, Kathryn had a disagreement over another life choice I made. She found out, got into an eruption, and stopped talking to me. While she was berating me, I could honestly say that I feared for my physical safety. She didn't speak to me for three days, and when she did, she merely told me that I was doing what I did for other people and not for myself, and that she didn't want to be friends with me.

I've searched her symptoms on Web MD countless times, but today, I did a bit more research. I found that a lot of people who develop early-onset schizophrenia go through what she's going through. Her age, her behaviors, her social skills, everything seemed to match. A few of her family members are also schizophrenics. I'm really concerned for her, because she's a brilliant young woman but if she's too detached from reality, she won't be able to make something of her life.

I'm now 100% sure that there's -something- inherently wrong with Kathryn. I'm really worried about her, but no matter what, she won't listen to me or admit that she has a problem. On the rare occasions she does admit to having an issue, she merely returns to her religious/cultural worlds. My question is: what's wrong with my friend?

Well, given how much trouble shrinks have about coming to a final, workable diagnosis, you shouldn't feel bad that you can't. Any doc's probably going to say that one of your pieces of evidence raises real concerns: "A few of her family members are also schizophrenics." I'm pretty sure that's a big risk factor.

But here's a thought: don't worry about coming up with a diagnosis.

Instead: see about getting her some help. Find out what resources are available in your area. Things to consider:

Is there a mental health clinic in your area?
Is there a chapter of NAMI ? www.nami.org (largely for family/friends of patients)
Are there any members of her family who are fairly balanced and could be asked if she's getting any help.
(I'm assuming that she's likely to blow you off if you make too direct a suggestion -- she being leery of meds and all.)
If her family is not concerned, not taking an interest, there may still be some way to marshall some help via school/social services.

I'm glad she has you as a friend and concerned ally.

Good luck...
—LQ