Self-harming suicidal DD - me and DH disagreeing how to handle it

[MajesticWhine]

Just need to get this off my chest. DD1 has been self-harming for quite some time, probably 1.5 years, but I only found out about it last term. She doesn't do herself any serious damage, just fairly superficial cuts. She has been seeing a school counsellor for a long time, but this hasn't made much difference. Last term we got a referral to CAMHS. That is not really helping too much either, although on the plus side, she is sometimes going for a couple of weeks without self-harming. She also experiences a lot of suicidal thoughts. She goes into dark moods without any warning or without talking to anyone, when she just doesn't want to be alive. Conversely and confusingly, she doesn't seem obviously depressed and seems cheerful quite a lot of the time.

So recently the therapist she has been seeing at CAMHS has called me up and said she is really worried about her making a suicide attempt and being extra vigilant, locking up medicines etc. She said I must tell school so they can also be vigilant. DD said something to her that made her concerned. So I immediately spoke to my DH about speaking to school, and he didn't want things to be made difficult for DD and her not to be able to take part in the full range of activities that she does. NB this is a boarding school and DD sometimes stays over so the risks and responsibilities of the school are a bit more than if she was just coming home at the end of the school day. DH thinks that the CAMHS therapist is overreacting and is a bit useless.

So he said that when we spoke to school we should water down the message and not mention what the therapist said and just say that we think she needs to be watched a bit as we are worried about her because things have been stressful etc. I could understand that he didn't want to create a fuss, but I felt that her safety was paramount and that school needed to know if she was feeling suicidal. So I basically spoke to school and told them the therapist's concerns and DH is really angry with me for "compromising" her. And of course school are panicking just as you might expect and they are showing signs of not being able to let her stay late or stay over etc. DD is pretty pissed off about the whole thing and doesn't understand what all the fuss is about. And now school want to talk directly to CAMHS. As well as being worried out of my mind, and not sleeping, I also have an angry DH who thinks I am naive and stupid and thinks I have gone against what we agreed and I have made everything worse. Which I did, but my mind was totally scrambled and I just want the best for my daughter. I really didn't feel there was any choice but to pass on the concerns of CAMHS unfiltered.

Sorry this is long and a bit boring. I don't know what I'm asking really. But I am just really struggling to deal with this . Thanks for reading, if you got this far.

[PreAdvent13610]

You have done the right thing.
CAMHS do not break patient confidentiality unless they have to.

[derektheladyhamster]

I work in a boarding school. Of course they need to know what is going on. And if she's showing suicidal tendencies or thoughts, it is absolutely not the right place for her to be staying over night. The staff cannot give her the one to one attention she might require. You did the right thing in informing them, imagine if problems occurred whilst she was there and you hadn't informed them. I'm sure that with the right help your dd will get through this, but sticking heads I n sand won't help her. I hope she gets better soon.

[Haffdonga]

I'm so sorry Majestic. Of course you did the only thing you could have done. How could you possibly not have told the school? I'm sorry to be forthright but you would never have forgiven yourself if your dd had done something at school and you hadn't told them the risks.

Your dh sounds as if he's trying to make it all go away by down-playing it to himself.

[MajesticWhine]

Thanks for the support. It really helps. Yes I think DH is trying to downplay it. I think he wants to think it's all normal teenage angst and he is blaming me because I work in mental health and he thinks I am letting my professional stance cloud my judgement and he is being really quite nasty about it.
Unfortunately we also disagree about medication, because I want DD to take some (if it's offered - it hasn't been yet) and he is set against it.

[Curioushorse]

Hmmm. Sympathy to you. What a horrible time you're going through.

I think you've done the right thing though. I teach in a boarding school and, actually, the children sort of have a lot more freedom than they would at home. They don't, in that they can't leave the site and have limited access to internet/ television/ their phones etc., but it's a big site and they are allowed to go off wandering round the fields and the woods in the way that few children would be (or could be, really) at home. I think lots of boarding schools are like that. The whole area is arranged so that supervision does not need to be constant i.e. there is loads for them to do and very few ways in which they could get hurt........unless there is a problem. We are very good at dealing with students who have less severe mental health issues (stable environment, trained staff etc.), but we couldn't realistically guarantee to prevent somebody from attempting suicide. We just couldn't.

And the CAMHS phonecall? I've dealt with loads of students who have been treated by CAMHS, including several who actually have made suicide attempts. I've never had a phonecall like that. I'm so sorry, but I'd be inclined to treat it seriously.

You did do the right thing.

[EasterRobin]

Yes, you did the right thing. And if it's got this severe, I think it's time you went with your daughter to the doctor to start the conversation about medication. It's a difficult conversation to have, and she should decide whether you go in the room with her and the doctor or not, but you can drive her and wait with her regardless and talk it through with her after.

Your daughter needs to know that death is not the only way out of the mental place she is trapped in.

[MajesticWhine]

We are seeing a psychiatrist this week, so I am hoping this will lead to an offer of medication. The GP won't give it, they just defer to CAMHS.

[PreAdvent13610]

Hopefully the psychiatrist will put together a whole package.
Love your DD unconditionally and accept that this is how she feels now.(much easier said than done)

[lincolnshirelassy]

You absolutely did the right thing. DD's boyfriend was suicidal. His father did not take the repeated warnings seriously, the boyfriend attempted suicide in November which tragically was successful.

Have you any support for yourself? The Young Minds website is good youngminds.org.uk as is Papyrus www.papyrus.org.uk/

Sending hugs.

[MajesticWhine]

thanks lincolnshirelassy. I have had some support from youngminds, but I had not looked at papyrus before. I am so sorry to hear about your DD's boyfriend. So sad.

[BeaufortBelle]

Psychiatrist is definitely the right route. You did nothing wrong.

[MidnightVelvetthe4th]

Is your dh downplaying it because he thinks it somehow reflects badly on him? I'm struggling to see his reasoning really...

I think you did the right thing op and I think you need to be more assertive with your dh.

[MajesticWhine]

There is no reasoning midnightvelvet, he just can't cope with any more stress (work problems) so he is in denial. I am managing him at the moment by just taking control and telling him how it is.

[Mountainwoman37]

Would agree with other posters you did the right thing telling the school. Hope the meeting with the psychiatrist goes well - and your DH able to attend this. After several appointments with an ineffective Camhs therapist ( long story) and when my then 14 year old daughters mental health was deteriorating badly , I demanded in writing a change of therapist and an appointment with a psychiatrist. The psychiatrist diagnosed severe depression and recommended anti- depressants immediately. My DH was very reluctant about the ADs but the psychiatrist bluntly told us of her concerns about the risks of our daughters deteriorating mood and suicidal thoughts - also,that talking theraphy wouldn't work until the ADs kicked in. We're still on the long road to recovery - but We have no doubt thatmy daughter needed and still needs ADs. I hope your daughter gets the help,she needs. Good luck.

[MajesticWhine]

Updating this, just to get it off my chest.

Well 3 months on and DD is not much better, and she is now being started on medication (fluoxetine). I wish they had done that from the start, because now she is taking her GCSEs and she has the uncertainty of getting used to new medication happening at the same time as the exams - not ideal. But anyway, CAMHS have decided that now is the time for meds, so we are going along with it. DH not happy about using meds, but can't really argue with it.

The thing that is really confusing me and making this all so difficult to deal with is that DD is not showing any signs of depression or anxiety when she's at home with us. She seems entirely well; eating normally, chatting with the family, watching tv, laughing and joking around with her sisters. She does the normal staying in her room teenage thing and can be a bit moody, but really nothing beyond what, to my mind, is normal teenage behaviour. But then when she turns up for CAMHS appointments, she turns into a gibbering wreck and tells them she is suicidal and quite understandably, they get really concerned. So the problem seems to be getting worse, but she will not express any of the problems or feelings to us, so we have absolutely no way of monitoring the situation, or knowing what her current level of risk is. There is the mentally ill fragile DD that goes to CAMHS and a completely different one that is at home with us. And her mood changes as quickly as flicking a switch. I just can't understand it.

[leonardthelemming]

I have no practical experience of this, unfortunately, but it is something I have read quite a lot about. No substitute, I know, so my suggestion may be completely off at a tangent and totally irrelevant. But, for what it's worth...

Mood swings are often caused by a hormone imbalance and can affect people of any age but are more common in teenagers because their hormones haven't settled down after puberty. So, in a sense, that bit's normal.

Depression and suicidal thoughts can be linked to low testosterone. Not common in girls/women, but possible (as I understand it).
And I know it to be true because I'm male, and I am on medical treatment which lowers my testosterone level - and I get suicidal thoughts. I don't act on them - but that's perhaps because I understand what's happening.

Of course, your GP has probably already considered this possibility and tested for it. But if not, and the mood swings are as you describe, then it might be worth at least wondering about.
Unfortunately, too much testosterone can have worse effects. It's surprising the hormone system works as well as it does, most of the time.

[Florida41]

hi majesticwhine,
my daughter sound simular to yours , from our point of view you would never guess there was anything wrong , she had been selfharming for about 3/4 months before I saw anything.
close family that have been told are shocked as she is normaly the life and sole of the party.
never thought out of my 3 teenages it would have been my youngest.
she did sometimes seem down but I just put that down to normal teenage hormones. like you. They do seem very good at hiding how they really feel .
I did buy a safe to lock away all the medication in the house when I found out.

been at camhs now for nearly 8 months they were reluctant to put her on medication, and I had to push for medication as I felt we were getting nowhere fast with the talking. still had suicidal thoughts , selfharming ect.
been on 20g fluoxetine now since January with no improvement so they have now upped it 5 weeks ago to 30g .
the last 2 weeks there has been some improvements, not so much time spent in room with curtains closed , talking more openly with me about things , and she said she dose not feel so sad , so that's good.
they are going to see how the next couple of weeks go and then may up medication again to 40g .
my DH is not much use , he works away abit and just puts his head in the sand when home , and when he dose try helping ,he is just actually making matters worse.
I was unsure about medication to start with as you always have it in the back of your mind ,what if it makes things worse.
But hopefully this is now the start of an upward battle . have been waiting over a year to see any improvement and now I hope this is it.
some days it's been really hard but I do feel that I have had to push camhs at times to get anything done .
i hope things improve for you and your daughter, hugs to you both.xx

[prettybird]

I have a teenage relative who has gone through periods of self-harming and working with CAMHS/counsellor.

She always seemed fine with us/her family. She did the harming and angst in private to protect those that love her (the issues aren't related to her close family), so I can understand the two different people that she presents to you and to CAMHS.

[MajesticWhine]

thanks for the replies. I appreciate it.

prettybird - The way you put it, it makes sense that she would protect us from the worst of how she is feeling. She tends to escalate the level of concern of CAMHS by telling them suicide plans, while at the same time telling us everything is ok and she won't do anything. So this is very difficult from the point of view of managing risk and deciding whether she can go on an overnight trip or be left alone. We have literally no idea how bad or good she is feeling at any point in time. I guess we have to just accept that she won't talk to us and just not take it at face value if she tries to reassure us.

Florida41 - It does sound like we have had a similar experience to you. I really hope your DD continues to improve, and I am pinning a lot of hopes on the pills myself, and hoping it changes something. Talking is not doing anything for DD, she says the same, that it's just not helping. Our psychiatrist says she will go to 20mg and then see how things are.

leonardthelemming that is interesting and I don't know much about it. Our GP has certainly not tested for anything, they just referred us straight away to CAMHS.

[HormonalHeap]

My dsd is going through this now and what is helping is regular sessions with an excellent psychologist and anti depressants to get her to the level where she's open to help and improvement. Every week sees an improvement.

[Ticktacktock]

I have the opposite problem almost. My dd uses anxiety and depression as a reason why she can't be made to do something. She does not, definitely does not have this problem. It has been fully explored. She only 'becomes anxious' when homework, chores, jobs, and general participation in real life is mentioned.

For example, dd is unable to use a phone, as it makes her too anxious, cos she is terrified of talking to people. She is not wrong but the reason for this is because she never has phone conversations due to the modern advent of the text and social media. She has been assessed as not suffering from severe anxiety as she claims, but normal anxiety, and a certain amount of anxiety is good, as it gets things done.

A MH specialist mentioned that nationally, anxious teens is a problem, and that schools are having to plough resources into this, providing rooms and staff where they can go when they get anxious. I then discovered that dds school does, indeed, have such a room, and a that it is the in thing at the moment, and is used mainly to get out of lessons.

The specialist did mention that modern life, social media, and the pressure that brings is obviously a factor, as the teen brain isn't mature enough yet to handle it. But for me this isnt a good enough reason to medicate.

[MajesticWhine]

Ticktacktock - yes I saw your posts on another thread. I think schools having a special room for this is a terrible idea, because avoidance makes anxiety worse.