[emom]

This is a cross post from Neuro Talk, but I wanted to see what you think of this. I'm using snippets of my post from there under this same user name, just in case someone notices the duplication, I wanted to put that out there.

These are the most relevant facts at the moment. I called and talked to the admissions coordinator at the local adolescent inpatient psych and she said that if my daughter is asking for this kind of help, I really should consider it, but, part of my trepidation and "unsureness" has to do with the fact that I was hospitalized between the ages of 12 and 15 no less than five or six times and I was not sick, my mom just used it as a disciplinary tool, this was like 1987-89 and honestly only the very last one or two times was I actually a danger to myself, but I LEARNED all about suicide attempts from my previous stays...also learned about drug use from those who were dual diagnosis and I had never been exposed to drugs before that, but still forced to attend N.A. meetings, etc. Just...I was in much worse shape after hospital stays than after, but again, I was not sick. If anything, I had depression that intensive outpatient care could have probably treated.

Anyway, My daughter is 16 and has had an obvious anxiety problem that's been identifiable for at least 5 years. She was put on Zoloft at first and that did seem to help, but at the same time had been diagnosed with ADHD. She was failing all of her classes at the time, she was in 7th grade and by the next quarter of school was passing all of her classes and seemed like a much happier child. She did "ok" the rest of middle school and when she hit high school started having difficulties again.

Background is that my mother has bipolar with rapid cycling which has become worse and worse over the years because she only takes the medications that she wants to take, she won't take the ones that do or that she thinks do cause her to gain weight. She also takes Adderal so that she can continue to lose weight, so you can imagine that she's a mess. She also abuses prescription drugs, which makes things even worse for her.

Given that my mother is that way, you can understand why my daughter has asked with fear in her eyes if SHE could be bipolar "too" like grandma. I have told her that even if it's possible...and it is...that grandma does not take care of herself and IF my daughter has BPD, we will get her the treatment that she needs and if she follows a plan of care, she will be okay.

She was seeing a therapist AND a psychiatrist in the past year and the psych was a child/adolescent psych. I feel like we wasted a lot of time there because he only switched her from Zoloft to Celexa and didn't spend much time talking with me about my concerns or us together and basically said that she was doing poorly in school partially because she doesn't WANT to do the work. He totally dismissed that the reason we were referred to him is that her anxiety level and sensory overload in school just hearing other kids talk in class was to the point where she told the school counselor that she thinks about hurting people and she elaborated to me that she had ideations at that time of even hurting her family. Well, when we talked to her therapist for advice, she did not feel like she needed "immediate" emergency help, but that we needed to tell the psych. She also has rapid mood swings and periods of what I can only describe as mania and will talk a lot, be happier, be productive in things she wants to do like writing stories, drawing, well, anything but school work, but then she'll crash and be depressed, moody, weepy. She is constantly yelling at her brother and me and her dad for making too much noise, certain kinds of noises, etc.

She also had to discontinue her ADHD meds last year because it became apparent that they were causing her anxiety to go through the roof.

She had chronic mono where the worst symptoms lasted for about a year and have been getting better for the past year, but she still has fatigue, sleeps a lot and now her teachers are asking her and us if she has depression, they are worried about her.

Allll of that to ask...would it be appropriate to take her to a good, somewhat local (hour away) psychiatric inpatient adolescent program for evaluation for intake? She approached me this evening and told me that another teacher asked her today if she's depressed, that she has too much anxiety in class and can't stand to be around her friends and is always yelling at them, etc. When I told her that I will see what I can do maybe getting her in with a new psych, also asking if maybe she would be open to going to a hospital for maybe a few days where they could evaluate and get her meds started and correct, she didn't hesitate and immediately said YES, I want to go away for a little bit, I think I need that.

I am concerned that just making appointments with a new psych and starting down that road is just going to be another time waster since it's not as intensive as I think she needs and we need everything evaluated at once to get her on track. She's failing every class and it's affecting her self esteem, but she can't seem to dig out of the hole. For instance, she has an 18% in English, her strongest subject. She cannot go on like this.

I need support. I will disclose that I was hospitalized as a pre-adolescent/adolescent from ages 12-14 at least four times because I was just a behavioral issue and my mom didn;t know how to deal with me, I had so many family problems and I was medicated improperly and I do carry some of that baggage with me, so I admit to being reluctant to just "put her somewhere", but I recognize that that's MY baggage and I am willing to do what it takes to get my girl better.

I could take her out of school, and I know that alone will be hard for her because it was such a big deal for her to get in to this school because it's a visual artsy early college program and she's such a gifted visual artist. The thing is that she will lose that, BUT she's already losing it because she is failing.

I absolutely have asked her what she wants to do because I agree that with her age, she should have a good amount of input and choice in her diagnosis and treatment. She is open to seeing a new psych or short term hospitalization.

I wish she had the motivation and focus to commit to an online school, but unless I hold her hand every step, at THIs time c I don't know if she can/will with her focus issues. But again, she's already doing poorly in school. We are currently about two months, maybe a little less? From the end of the school year and my hope (I realize this sounds selfish, but I assure you it's love) is that if we use the steps the teachers gave us in the parent teacher conference they insisted on this week, maybe she can pull it out and at least finish the semester with SOME credit since she's not going to get ANY for her time the way things are going.

It's really hard, I admit to be mom AND advocate because I really don't know what will help and what will hurt as far as trying to tie up ends.

So...now I have to decide, how will I find a good psych? The ones we've been to over the years have been unable to help in any significant way and they were referrals from current care providers.

Honestly,I'm feeling like these child psychiatrists that we've been dealing with aren't equipped and I just honestly worry we'll just spin our wheels even trying to FiND an outpatient diagnosis and treatment plan.

No, he has not been diagnosed and honestly, given how sick my mom stays from denial of treatment and added drug abuse, I WISH I were off base, but even he seems to be convinced she is bipolar or something very similar.

I have told her not to be afraid, she does NOT have to stay sick "like grandma" if we get her dx and tx early and well.

Anyway, I may try to look at options for outpatient before seriously considering impatient if possible. We really are very close and besides her not feeling well, having her issues, things are good at home and I don't want her to HAVE to be gone if its not necessary.

The harm to others has not come up since we addressed it with the psych and therapist about a year ago and I've asked get about it. If she's being straight up, which she usually is, she's not having those thoughts at this point, but who knows when/if that comes up again??

Sigh. As her mother, I SO want to do what it takes. Where is the parenting manual I was promised?? Especially the one for special needs children???

[Perna]

It sounds like your problems at 16 and your daughter's now are not very similar? If your mother put you in the hospital as a "disciplinary tool" it sounds like you did not choose to go and you and she had obvious differences of opinion about your behavior :-) I know with my stepmother, I was doing anything/everything to resist/"fight back" in our lack of communications war. But, I was more anxious than anything else and think if I had been hospitalized, I would still have been too anxious to "care" about drugs, etc. and to have gotten into them if exposed to them at that time (mid-70's).

I think you have to consider your daughter as herself and talk to her about hospitalization, maybe even tell her some about your experiences there?

Does she have a therapist; are all outpatient resources being used and failing?

[kindachaotic]

Don't give up on finding a new T & pdoc, also new meds they suggest.
Read "everything" you can get your hands on about psych meds for teens, as some of them are the same for adults. Learn everything you can about her previous dx & what you think her symptoms are based on your observations are & what she tells you.
Are there any outpatient (day) programs that have a good reputation in your area? Before she goes inpatient visit first if they will let you. Check their reputation, google, whatever you can find out, what kind of patients they treat?
With this particular school she's in now, if she skipped a year would they let her back in the next year? Since she's failing now, it will affect GPA.
A lot to consider, like you wrote in your post. Sometimes "you" have to make these decisions, 16yr olds are not adults yet no matter how mature they are or seem to be.
I could go on & on I suppose.
Am bioplar myself & raised a bipolar son. Feel free to PM me anytime.

Best wishes for all of you.

[Open Eyes]

((((emom))))

Wow, you really have a lot on your plate and I just want to give you kudos for trying very hard to do the best you can for your daughter. What a challenge to sort this out, with the Mono, her now being in her teens and dealing with hormones, and more of a work load with high school courses. That is a lot to sort through, even for a professional so it is going to take patience from you to sort this all out.

What stood out for me also is the fact that your daughter is also on a new medication so that too could be something that may be contributing to her issues. It seems to me that her idealations of causing harm to others started with the change in medication, and from what I have read some antidepressants can pesent this issue.

I agree with kindachaotic about making efforts to find a new pdoc that can consider the medications she is taking and perhaps see if they can be adjusted. I respect your concern about the hospital perhaps causing more harm than good as well. That is something to consider and I hear you, cant blame you for being concerned.

I am not really sure about a therapist at this point because she may be reacting to the medication and if that is adjusted may improve her outlook and ability to concentrate in school. So I would address the medication first and try to get her stablized.

I can't tell you what to do as I am not a pdoc or specialist, I just wanted to offer my support and thoughts about addressing the medication and see if she can be helped with that first.

Good Luck, I hope you will find your way through this, let us know how you make out.

Open Eyes

[googley]

I see two major differences between your experience and your daughter's experience. Your mom put you in the hospital as punishment. You are thinking about having your daughter go in to get a med adjustment and she says she thinks it would be a good idea. Those are two very different situations.It sounds like your daughter might benefit from intensive observation and med management. The hospital would also be able to help you find a pdoc (psychiatrist) who they know works well with teens. Most youth will not want to go into the hospital. That she thinks it is a good idea means she probably feels very very bad. It sounds like you are working very hard but could use some extra help. I would call ahead and talk to the psych unit to find out what their admissions policy is. Talk to your daughter's therapist about her knowledge about local hospitals and which ones the T would recommend. Good luck.