parenting a young adult with mental health challenges

My daughter is a sophomore with an excellent academic record. She started showing symptoms of loneliness during the lockdown and, when we tried to talk with her about it and she had an unexpected anxiety attack. She was happy to go back to college and after a few weeks we noticed that she is hiding something. She is leaving alone. After sharing our concerns, she disclosed that she is not well and she is seeking counseling but we are afraid she is telling us what we want to hear: counseling. We know she is not drinking etc.
Should we ask about school work at all or pretend it doesn't matter? Should we ask details about her counseling sessions, not the actual topics discussed but how often they meet, whether or not she feels better etc?
We used to be very close to her but this year we noticed how she distanced herself from us. We do not want to invade her privacy but, in the same time, we do not want her to be alone during these trying times.
Any reading recommendations would be much appreciated. Thank you very much.

Hello coronalight: I'm not the best member, here on PC, to be replying to your post. But I noticed this is your first post so I thought I would at least welcome you to Psych Central.

My personal thinking, with regard to what you wrote, is that the best you may be able to do is to make sure your daughter knows you're available to talk if-&-when she decides she wants to. Anything beyond that may be viewed, by her, as being nosy & intrusive. Perhaps other PC members will have more insightful suggestions. I hope you find PC to be of benefit.

Hi Skeezyks,

Thank you for your reply. I keep browsing around and I came across a somehow similar thread.

My daughter gave us a lot of details about what she experienced in the past couple of months (scary episodes, to say the least). We did not inquire about what might have caused this, however she did hint at peer pressure, social media, lockdown, bleak future, over-burnt etc so I am not surprised.

I also tried to keep the advice at minimum but it is hard to say nothing and I don't know what to say. I am trying to learn how to encourage her to break the vicious cycle that, in my humble opinion, makes things worse: sleeping during the day and binge watching at night, rarely leaving her student accommodation, giving up college assignments completely, avoiding friends etc I do understand that lack of energy and motivation causes this attitude but I would really like to know how she can slowly regain control without medication.

I am still very interested to hear from other people, until then I will try to find answers in other posts, PC is so enlightening.

Hi coronalight. Welcome to Psych Central. Sorry your daughter is struggling.

Professional help or counselor may help if she is open to getting help.

Setting boundaries is something that has worked in my experience. When the grades come out this semester, ask to see them if you are paying for this college experience. In my life, having people support a person in school was not helping them and so having a break of a semester or two was a big reality check. I think setting boundaries can be a tough love but in the end a kind thing to do because it puts an end to a situation which potentially is making things worse.

These may be of interest
Coping With What You Can't Control

Parental Strategies When Adult Children Have Problems

Angry Kids: Tips to Cope with an Out of Control Child

Hope you get the support you are looking for. @CANDC

Hi CANDC,

Thank you for your reply, I welcome your advice and I will definitely try to apply what I learn from the links you posted.

My daughter is overwhelmed by feelings of guilt because she cannot study as she used to due to low energy, lack of motivation, inability to focus etc which created a downward spiral. The good news is that she has found a therapist, so I hope my daughter will start healing slowly and regaining her motivation before it is too late to rescue the academic year. However, we are getting used to the idea that she may have to take the rest of the year off (even though we are paying most of it). Fingers crossed we don't get there!

PC is a valuable resource and I am grateful for all the people that post and reply so others can learn from their experiences.Thank you again.

I would just try to be available for her to talk to when she wants to. As a sophomore in college she is an adult. But you are still her parent and you always will be. Just try not to be too intrusive. Just be available.


Like, "honey, I know you are struggling right now. If there is anything I can do to help, let me know. If you want to talk, let me know." You might have to do this several times because sometimes people when they are struggling feel like they are a burden to others.


If grades are slipping, could be that more is going on then just loneliness. Could have a mental health disorder. A lot tends to show up at that age. Young adult.


I'm schizoaffective and while I got through my Bachelor program okay, I found that when it came to my Master program I could only reasonably take one class at a time (I was working full time as well--it was a lot!). It took me 4 years, but I graduated. Maybe she is taking too many classes?

Depression can sometimes come across as laziness, low energy, lack of motivation.


Maybe your daughter needs to take a gap year?


Hope she feels better soon and that you can know how best to help her soon. -- Kit

Hi Kit,


Thank you so much for your reply and for pointing out that her condition could be more serious than it seems. You are right, my daughter does refer to her mental health issue as depression, after reading a lot on the internet about it. She does not have a formal diagnosis yet and she trusts her therapist for now.

It does help a lot to hear from people that are familiar with this scenario: continuing your studies while battling mental illness. It is even harder to focus on your studies while suffering from depression during the covid-19 lockdowns: alone in your room, expected to watch pre-recorded lectures, with no human interaction beyond a chat with tens of people you never met, not allowed to visit your family or to have guests etc

My daughter is at home now and she acts "OK" but I know she isn't. We used to be close and now I am making an effort to respect her privacy and ask no questions beyond what she willingly shares. I am slowly getting an idea about what type of memories overwhelmed her during the lockdown and it seems that it all stems from burnout during high school. Looking back, I can see now some red flags that I missed at the time out of ignorance.

The marks did drop significantly during this term and, even after a few appointments with the therapist, there is no progress on the motivation front. My daughter has a slightly better schedule at home because she makes an effort to join some of the family activities. We are trying to focus on being calm and supportive but we would like to know what is a realistic timeline for her treatment: should we just decide now to take a gap year and focus on the therapy, to avoid further frustration and guilt or we should just wait and see what happens in a few months, after more therapy and... more lockdowns? Obviously there are a lot of factors that determine the length of the treatment but I have no idea if we are looking at min 3 months of therapy or min 6 months before we should expect a significant change in her outlook on life in general.

I did not raise these questions with my daughter since she is optimistic about the success of therapy and I do not want to give her another reason to worry even more than she does right now about her future.

Thank you Kit and all PC contributors for your invaluable advice.

I would say expect longer with the therapy than shorter.


I've been in therapy around 15 years total (including from when I was an adolescent). But the majority of that was stabilization. I've experienced the most growth (and stability) in the past year, and most of that framework that has been successful for me this past year was with my Pastor who is a licensed Marriage Family Therapist. I don't see him anymore but this growth that I've been having is attributed to him, not my current therapist.


I'm not saying your daughter needs 15 years of therapy. I have a pretty difficult condition to manage and I wasn't on the right medications for a long time. Once I was on the right antipsychotic that really made a difference. Before I was just on anti depressants and they helped but not enough.

Medication is another thing to consider. Your daughter can start with a GP but I would strongly consider a psychiatrist. They are doctors who have special training for the brain meds. In fact the one I see is a neurologist psychiatrist. So he's been helpful with my migraines too.


There are pros and cons to a gap year. One thing is routine. School and school work does provide structure and routine. But if the grades are going to go down so far as to jeopardize further graduate level studies a gap year may be the best thing.


There's a thread right now on the psychotherapy forum that is asking about things instead of therapy. This might be helpful to look at for in addition to therapy for your daughter. For a while I had a case manager and she managed my care among all my providers. She also encouraged me to go to support groups and exercise and stuff like that. The "whole body/whole spirit" approach.


It's a good sign that your daughter is optimistic about therapy. It's hard to find a good therapist that one "clicks" with. So if she has, that's great. Because rapport means more often than the degree the therapist has. There's a saying in therapy which is, these problems didn't develop overnight and they aren't going to go away overnight. So give her time to work through stuff.


PM me anytime.

Best wishes--Kit

When it comes to young adults and adolecents and mental health I am of the belief that early, strong intervention is best even if its uncomfortable at first. Your daughter might not be a danger to herself yet but IMO you have the right to insist she see a therapist and get diagnosed by a psychiatrist. If these things happen and she doesnt improve you have professionals to rely on should she need something more intensive or inpatient.

Hi Kit,

Thank you for sharing your personal experience, I understand now that most likely we are not going to see right away an improvement in my daughter's overall motivation etc.

You mentioned that school work provides structure and routine to the day. My question is how do I help my daughter get back in any routine? My daughter sleeps a lot one day and at all the next day, does not get out of the house but joins us for dinner, movies etc. She also had a hard time completing a school assignment this week. and this is unusual for her. Since she is sleep deprived, should we wake her up or let her sleep?

We are trying to understand how much we should rely on the therapist in this regard: will the therapist give her advice on how to get back into a sleep/study routine and follow up on the progress my daughter is making on that front? If the common wisdom is that the therapist is not concerned with this aspect of the problem and my daughter is in charge of maintaining a healthy schedule, then we will discuss this at home. Right now, since she just got home, we are walking on eggshells around her and try to show as much support as possible. Unfortunately the therapy sessions paused for the holidays so I feel like we cannot do nothing for the next three weeks.

Most likely having a relatively normal sleep schedule and some healthy routine does not solve the original problem but I am afraid that a lack of both sleep schedule and daily routine might make matters worse.

Thank you again.

Hi Sarahsweets,

Thank you for your reply, I am definitely going to make sure my daughter attends her therapy sessions and a psychiatric assessment. Unfortunately, I will only know what my daughter shares with me. since she found the therapist herself.

I wonder whether or not I should contact the therapist directly regarding my daughter's progress? I understand that the specifics of the conversations they are having are strictly private and I fully respect that.

Thank you again

My answer to this would be no--in most cases. The therapist cannot even confirm your daughter is a client and even if your daughter gives permission for the therapist to talk to you, in most instances they won't. There's a few exceptions in cases of if your daughter is planning to harm you there is a warning they have to give.


The only reason I would contact your daughter's therapist would be if there were any concerning things that could be dangerous to your daughter. I.E. your daughter hurting herself. Your daughter planning on hurting herself. Your daughter having hallucinations or paranoia. And really in those cases, even with COVID, I'd say get her to a hospital ASAP and contact the therapist later. The hospital can do an assessment and decide whether IP (inpatient) is needed. Ideally take her to a hospital that has mental health services. Any ER can help you but the standard of care is variable. Like where I live none of the hospitals have a psych unit. The closest ones who do are an hour and 15 minutes away or an hour and 30 minutes away but it really is better for me to go there than to go to just any ER and then have to get transferred.

In my opinion and with my experience with my own mental illness having a routine has been very helpful in getting me and keeping me stable.


I suggest making a routine with your daughter's help. I understand that she is so depressed that she cannot get out of bed. This is very real and do not discount it. In which case, a gap year is probably a good idea. If that is the case her schedule will need to be really simple so she can follow it.


But let's say you have a routine where she will go to bed by midnight and get up by 12 PM (That's 12 hours sleep). From 12 to 2 she does hygiene, eat, shower, wake up, whatever. From 2 to 6 she does school work. With breaks built in. From 6 to 8 family time. From 8 to 12 AM personal time. You know, something like that. But you need to get her to BUY IN. You should probably not be like, this is the law and this is how it is going to be. She needs to have a say in what will work for her.


If that type of schedule is too complex for your daughter right now then do a list kind where each day she will get a shower. She will do 2-2 hour segments of homework. She will eat one meal with the family. Etc. And check off the list.


Your daughter's therapist may or may not be addressing this in therapy. It depends what your daughter is bringing up. If your daughter does not seem to think it is a problem then the therapist will not view it as a problem. If you daughter does not think sleeping all day is a problem the therapist will not either (likely).


Might be good idea to discuss with your daughter what her priorities are right now. If it is not school and it is her mental health then just get the term finished, talk to the school, get a leave of absence and consider time off. If you are using student loans, this may trigger you to have to start paying on them which is a consideration.


But your daughter needs to set the priorities. Because she knows what she is capable of right now.


For example my schedule:
4 AM to 7 AM: wake up, hygiene, play with pets, personal time, commute.

7 AM to 3:30 PM: Work M-F
3:30PM-5PM: Personal time (which I can use to nap, watch TV, shop, bank, whatever)
5PM -6PM: Dinner with parents, Bible Study with Parents
6PM-7PM: TV

7PM-4AM: Sleep

My schedule Saturday Sunday
5AM-9AM: Wake up, hygiene, play with pets, personal time
9 AM-11 AM: Church/Bible Studies, Worship etc
11 AM-12PM every other Saturday Therapy
11 AM-4PM: Personal time, napping, laundry, shopping, errands, etc
4PM-6PM: Dinner with parents, Bible Study
6PM-7PM: TV
7PM-5AM: Sleep

But this schedule is "bought into" by me. Like my parents couldn't dictate it. They do make recommendations that I have dinner with them. That I do worship. Etc. And I follow them. And work dictates 8 hours of my life M-F (although as you can see I'm at work and on the internet. I'm lucky enough to have a job with some down time in it).


Feel free to PM me anytime. Kit

Hi Kit,

Your replies are clear, useful, and very much appreciated. If I understand correctly, the therapist will address the problems that my daughter brings into the conversations, she may or may not advise on how to break the vicious circle and build a healthy schedule but not necessarily follow up on these aspects, unless my daughter sees these as obstacles to her healing .

Based on snippets of conversations, my daughter understands that her therapist will help her overcome the problems from the past but also expects that she is a life coach helping her set goals for her future, without the bias inherent in a family. My daughter has really high expectations from her therapist and her life seems on hold until she starts seeing her therapist after the holidays. She seems powerless to set even small goals every day but she is trying to correct her sleep schedule and I think this is a promising start. I will give her time to see if she gets this part under control and then make suggestions if necessary, like you said.


I will keep in mind the advice regarding on reasons to contact the therapist directly and hopefully it does not get to that.




Thank you again.

Hey @coronalight: I saw that you were in Buffalo and decided to look some stuff up. I do not know if these are all hospitals and some offer day outpatients services like IOP and PHP. I wanted to let you know that you do not have to wait for a therapist or Psyche doctor to refer you to any programs or services you can do it yourself. And trust your gut. One of the links is for NAMI one of the best mental health resources available.
Mental Health Care & Addiction Treatment | BryLin
CPEP (Psychiatric Emergency) - Behavioral Health Services | ECMC Hospital | Buffalo, NY
Outpatient Behavioral Health Services - ECMC Hospital | Buffalo, NY
Buffalo Psychiatric Center
Buffalo Psychiatric Center
https://www.bestselfwny.org/
https://www.ehsny.org/
https://www.namibuffalony.org/contact/

Hi Sarahsweets,

I will definitely explore the resources you suggested, thank you so much for following up. The more I read, the more I learn and, without the help of you and other Psych Central contributors, it would be so much more difficult for us to educate ourselves. It is painful to watch a child struggle and not knowing what to say and when to say it in way that does not make things worse, and this is one more reason I am grateful I found this website and that people are trying to help.

I was wondering how your holidays went and if your daughter's sleep schedule has gotten better? Of course it can be very hard right now because of the holidays and routines tend to get messed up during the holidays and with New Years coming up that can be difficult too. Please be patient with your daughter--as it sounds like you are doing. It can be difficult when one wants to see results sooner rather than later. However, growth will come on her own schedule. It sounds like she is waiting until after the holidays to start working on stuff, when she can see her therapist again, is that correct? I know she is an adult so it can be difficult to know how much to ask or whether to just wait for your daughter to tell you. Certainly remind your daughter that you are there for her if she wants to talk.


Do you happen to know what kind of therapist your daughter is seeing? It could be social worker, MFT, PhD or a whole bunch of other things. I am just concerned because you said something like she expects that she is a life coach. Life coaches are very different from therapists and you don't necessarily have to be licensed to be a life coach whereas to be a therapist you do. (You can be a counselor without being licensed, I think, but you cannot be a therapist without being licensed.) Some people get a lot of benefit out of life coaches...I've always been wary of them due to the severity of my problems.


I hope your holidays went well and I'm sorry I didn't get back to you sooner. I wasn't online much over the holiday. I hope your daughter's sleep is getting straightened out. That can take a long time. Also watch for dips in moods in January and February. Sometimes, not all the time, people who did well over the holiday may experience difficulty in mood in the January and February months. Most people think that most suicides occur during the holidays but I think that is misleading. I'll try to find the reference. Holiday Suicides: Fact or Myth|Suicide|Violence Prevention|Injury Center|CDC this one is from the cdc which is a government website that says that it is a myth and actually it peaks in the spring and fall. So just be aware the moods change over time. Getting through the holidays is a good thing but don't stop being vigilant. Ironically, I learned when I studied for a short time to be a social worker (switched my major to business) that if a person starts feeling better it can actually be a sign that they have decided to commit suicide. Just watch for other signs like giving things away, tiding up personal belongings etc. Not to scare you, just to let you know. As someone who has attempted twice, both of mine were in the fall and I didn't really give much warning, I was rather impulsive. My parents were blindsided both times.


Wishing you the best of luck and hoping for health for your daughter. I'll pray if that is okay with you. Kit

Kit, my daughter has been making an effort to wake up mid-morning every day, out of her own will, and she seems OK most of the time. We talked about some of her thoughts&worries but I am quite afraid to ask more questions so I do not cross boundaries. I think she is vulnerable and she is better off talking with her therapist before she shares more. Despite our best efforts to look calm and supporting, the atmosphere in our home is quite tense because we are afraid we could trigger a bad reaction/episode. The good news is that have a kitten that takes the edge off.


I read your reply above, the part with feeling better as a sign of deciding to commit suicide, and I am scared and concerned but grateful you mentioned it. She made it clear to us that she is not suicidal and I do hope her therapist is better equipped to assess this risk. When school resumes, my daughter wants to go back to her university accommodation, where she lives alone, and she could meet her therapist in person instead of zoom sessions from home. She reluctantly accepted to stay home for now and this made her sad.


I have no idea if the benefits of in-person therapy sessions outweigh the risks of living alone during lockdowns, when you are depressed.


Her therapist worked for top colleges as a counselor for over ten years; she worked as well in private practice, with teenagers and young adults, so she seems qualified. She has a bachelor's degree in the field and additional related training, she is not a social worker.


I mentioned life couching as in advice on making a schedule, setting goals, etc besides helping her heal and slowly build up hope and motivation.


Kit, thank you for your prayers and for the time you take to give me much needed advice.

Hello again. Sorry for my late reply as I was not online much over the holiday weekend. I'm usually not online much on the weekends anyway.


I am glad your daughter has been able to get up mid-morning on her own accord. That, to me is a sign that the depression is not all encompassing and also that she has some motivation. These are good signs. I think you are doing the right thing to not ask too many questions. Try not to feel like you are walking on eggshells. She will probably notice that. Try to just be as normal as possible. What is your kitten's name? I have two cats: Esther--a Russian Blue mix rescue, and Amelia--a Snowshoe mix rescue. Both of them are very good for my mental health. Amelia laid on my lap this morning and Esther slept in my bed last night. Plus taking care of them reminds me to take care of myself and also helps me feel like I have purpose.


Some therapists will do a risk assessment each time they meet with a client for self harm, suicide, etc. Others do not and rely on various other cues to let them know how their client is doing. I have had both types of therapists. They look at stuff like cleanliness, affect, appropriately dressed for the weather, general mood. Stuff like that. Others are more explicit such as "Have you had any thoughts of harming yourself or others since we last spoke?" My regular doctor PCP is like that. She just flat out asks me every time I go to see her. My therapist that I have now asks about every session. The one I had previously relied on her own judgement. One suicide attempt was under her care and one was under the care of the therapist I have now.


It sounds like her therapist is very qualified. That's good. It is most important that they "click" and have a good relationship as the relationship heals more than the degree does if that makes sense.


Just take it a day at a time and try to not worry excessively. I don't know if in person therapy will outweigh the risks of living alone but I'm sure your daughter misses some of her independence. Both of my suicide attempts took place when I was living at home (I have always lived at home) so I don't know that much about living alone.


Try to stay hopeful and positive if you can. Not fake positive but just normal positive. It's always easier to go to someone if they are hopeful and positive and not like, "Ack the ceilings coming down!" My parents have gotten easier to talk to over time. But it took me being hospitalized before that really changed. Now they seem to understand the seriousness of it all and they are showing me that they are hopeful for me and positive for me. This makes it easier to go to them when I am struggling. They remind me that I can come to them too. I don't find it annoying. I find it reassuring.


Your post seemed pretty positive. It sounds like your daughter wants to continue with her studies right now and everything. This is good. Might be an increase in motivation. I wish the best for your daughter and for you and your family. PM me anytime. HUGS and prayers Kit

One month later, my daughter made some progress as in she is a little bit more comfortable talking to us and she continues her weekly sessions with her therapist. The sleeping schedule is not ideal, as she watches tv at night and sleeps until lunch, but the good news is that she has dinner with us, plays piano, reads on the internet about depression/anxiety, goes for walks, does basic chores. Her mood is "ok" most of the days (with periodic full days in bed) but she does not do any school work and this increases her anxiety regarding her transcript, her future etc. Any attempt to discuss this matter ends with "I cannot focus/I have no motivation" and another full day in bed.


For this reason we do not know where to draw the line between giving her more time to work with her therapist and pressuring her to contact the school to find out what options she has going forward. I wonder if it is possible to take the term off on mental health grounds assuming that a letter from her therapist is enough to attest her inability to complete the school work. I am not even sure if the therapist would write such a letter or if my daughter would have to seek a formal diagnostic from a psychiatrist for this reason. Her therapist has not recommended that my daughter goes to see a psychiatrist until now and I am assuming that she would say something if she notices anything worth exploring further.


Does anyone know if a therapist alone can diagnose depression or anxiety or a related mental health condition? Would a letter from a therapist be enough for the college to approve a medical leave of absence for this term? I am trying to find info online on the college website but the only advice I see is to contact the school. At this point we trust that therapy will help her overcome this episode of depression, but we are worried that she may end up in a worse academic situation than she should be in, just because she postpones talking to her school.

Any advice is very much appreciated, thank you all.