Big hugs to you. It sounds like a nightmare. And sounds similar to what I went through with my 21 year old daughter. She is now a true delight, polite, kind, intelligent and we are very close. Mine likes to read too.

My advice and opinion are possibly not going to be popular. But I don't think she needs to be hospitalized. Unless she becomes so violent or manic or depressed there is really no other option. Hospitalizations were traumatic for my kids. They really did not help and I would do anything to go back and change my decisions on that.

What will help in my opinion, a therapist and doctor she trusts, her bond with you. Loads of compassion. Calm her down during fights or stay calm and let her rant. Sincerely asking what can you do to help her in those moments.

And birth control! Open honest discussions. Good luck to you, it is such a nightmare situation.