Please help - Scared for my daughter

[Bepis]

My daughter is 18 years old but she has special needs so is a lot younger in her mind. She has suffered with anxiety for the past 5 years or so, to the point where it stopped her attending school and she had to be under CAMHS. Her anxiety was mainly around people she didn't know and new situations.

The past couple of weeks have become so difficult and I just don't know what to do or where to turn.

I noticed her hearing things and she would say to me that her stepbrother swore, or I swore etc when that never happened. That went on for a while but now she is panicking if her sister is on the phone. Her sister will talk to her boyfriend in the evening in her room (they have separate rooms) but my eldest daughter is just flat out panicking about it and refuses to go upstairs. When I finally get her into her bedroom, she will not get in bed but just sits on her bed until 7/8 in the morning.

I tried laying with her this morning so she would get some sleep and she managed an hour or 2.

She's also started putting her fingers in her ears whenever someone talks. Not in a rude way but it's become a reaction. This is within the last couple of days.

She says she can hear her sister talking on the phone at 5/6/7 in the morning despite her sister being fast asleep.

She is also zoned out (I can't think of a better way to describe it). Like when I talk, it's like she doesn't understand me. She's also started whispering instead of using her real voice and is even starting to become non-verbal.

I'm so scared, I don't know what's wrong with her and I don't understand.

I took her to the doctors today and they prescribed Sertraline. She had her first tablet tonight. This seems like more than just anxiety though.

Has anyone else experienced this? Im scared and in tears.

I have got the number for the 24 hour mental health service so I'm going to call them shortly. She has made no references to wanting to harm herself or others, no acts of aggression or violence thankfully.

Are you absolutely sure that having to meet his girlfriend and him 'punishing' her (younger?) sister are the only things that happened to her whilst she was there? It makes me think that maybe there was far worse happening and she's reacting to that.

Oh good grief, I didn't even think if anything worse happened 😭. I know he grabbed her by her arm and told her to stay out of it but he didn't hurt her. My thoughts are that it might have triggered emotions from past events, such as witnessing me get assaulted by their dad; the arguments etc.

You sound like a wonderful, caring mum OP. I hope your dd gets the help that she needs.

Thank you, that is so kind of you. I feel very helpless right now, I just want her to feel better. Breaks my heart seeing her like this.

I wonder if you look at it thinking along the lines of her witnessing/experiencing trauma rather than as 'a mental illness' or something that's come from inside of her, does it make more sense how she's reacting?

Not speaking/panicking about phone calls - not being able to say anything whilst he attacked somebody? Told not to say anything or he'd come and punish her?

Not eating - whatever happened started at mealtime/over food or she was ordered to sit down and eat whilst an attack went on?

Not sleeping - because of fear he would come to your home and do the same to you if she said anything?

Almost paralysis - the not moving, not saying anything, 'keeping out of it'?

Fingers in ears - fear of the noises and shouting/screaming?

Not getting into bed - I don't even want to think about that.

I am very concerned that she witnessed or experienced something so traumatic that this is a PTSD/trauma response entirely separate to her diagnoses in all but her response being more akin to a far younger child witnessing/experiencing them and the 'hearing things' is her having flashbacks, rather than hallucinating or imagining them.

I'm not sure how you would deal with that, but I don't think that treating it as psychosis and medicating for anxiety/depression would be the approach they would take with a child who has been a victim or witness of violent crime. I think that the MH crisis team might be worth contacting for you to tell them that you suspect this; they may not be helpful, but it's a start, rather than leaving you for several days without anything.

That was something I experienced as well. And for someone who has no problem ever eating, I could barely eat food during my week long breakdown.

That sounds reasonable as an explanation.
It's quite complicated with mental health.

We can only go on our experiences and advice but ultimately the medical professionals will need to see her and assess her fully.
I just hope she feels better and I really feel for her.

A side effect of sertraline can be nausea and complete lack of appetite. Coincidentally I was talking to someone yesterday who was prescribed it a few weeks ago. She said that she ate nothing at all during the first week on it, then suddenly her appetite appeared again. So try to hang in there with her, and maybe just keep a written record of how she is each day. It might be difficult to separate her MH issues and the side effects (nausea, lack of appetite, insomnia) initially. But if it helps, the person I was talking to said that once she got through that first 7-10 days, the side effects disappeared completely.

Antidepressants meds can take upto 2-4 weeks to kick in, But as she’s so young it could be quicker (no expert) also as said
if she’s got extreme anxiety her appetite/sleep will be suppressed this is quite normal with anxiety/depression (so don’t worry, make she is drinking enough)
don’t let it carry on the way she is for too long before getting other help.
as said, write the things down that she’s doing/saying out of the ordinary for her.

just a question, no offence
why are you letting the girls go to their dad’s when he’s treating them like this?
don’t make them go, their old enough to make their own minds up

I think it my be ptsd brought to a head

If she is genuinely not sleeping she will descend into a psychotic episode. We cannot function with no sleep and people seriously ill won’t sleep just because they are tired. It doesn’t sound like she is quite that bad at the moment but should be referred to a psychiatrist now before it gets too bad. If she does get worse take her to A&E and ask to see the on call psychiatrist.

You told the GP she was hearing voices and suspicious that things that aren't happening are happening? You told them everything you told you us in your first post? Because I'm very very surprised the GP hasn't referred you to a specialist mental health team. I would call back, ask for an emergency appointment and ask for a referral to the Early Intervention in psychosis team. They are specialists in this and have to see her within 2 weeks of referral.
Have you also told them she's getting no sleep? Lack of sleep will make her mental health difficulties worse.
I'm disappointed with your GP, you shouldn't be having to figure this out yourself.

How’s dd doing today

@SugarplumFairyyy She has been through a lot, I agree with you. She managed to get 4 hours sleep last night but I had to stay next to her all night and keep reassuring her. She eventually dropped off. She's not as detached today and she appears to be smiling a bit more but she is still exhausted. My plan was to keep her away from her dad as awful as that may sound. He just does not understand what she needs and I think he put far too much pressure on her.

@kiwiiem I am sorry to hear you have also been through something similar, it must have been so scary for you. You mentioned sleeping tablets in your post, I did ask the GP for these when I took my daughter the other day. The GP said that they don't like to prescribe them anymore. I spoke to the mental health crisis team last night though and they mentioned about getting sleeping tablets so that my daughter could 'reset' herself. They suggested to phone 111 to get an out of hours GP appointment for sleeping tablets but this is not something I wanted to do last night as I would have caused my daughter more distress as she was exhausted. I might see how she goes with her sleep and get her into the regular GP if it doesn't improve. I took your advice about making her feel included in things and casual chatting. We did that last night when I slept in her bed and we watched the New Year on TV and started to watch a film together. Thank you for your advice and your kind words.

@Swimswam I am going to push for a referral to a psychologist or psychiatrist as that will also give me the best strategies on how to help her get better.

@NeverDropYourMooncup These are excellent points and something I did not consider. After reading your post, I researched more about trauma and responses to it. It is a very plausible explanation and could very easily be the case. The fingers in the ears stood out to me, where you said that it could be the fear of noises and shouting. She has always been sensitive to loud noises anyway. She doesn't seem to be doing it as much today though so I am hoping the Sertraline is starting to work.

@saraclara I like your idea about keeping a log of how she is each day as that will also give any doctors or mental health professionals a clear idea on what they are dealing with. I am on Sertraline too but I have been on it so long that I cannot remember the side effects of them.

@Seasider2017 Their dad has actually been fairly ok for a long time and there has been no issues. At their ages, I always said it was up to them if they wanted to go and visit him (both daughters being 18 and 16). They wanted to spend Christmas with him, so at the time, I had no reason to not let them do that. Unfortunately, the way he behaved was appalling and he showed zero understanding or consideration for our daughters needs, just his need of wanting to see his girlfriend. I don't like to say what my children can or cannot do at their age but considering this has happened with her mental health, I don't think I will be letting her go for a while. I messaged her dad to let him know that she was unwell and had been put on Sertraline but he has ignored me so he cannot be that concerned.

@nowwhherredowestay Yes I told the GP everything, that she had been hearing her sister talking in her bedroom, even though she was not talking. I told the GP everything that I wrote in the first post. I was hoping she would be referred to specialists but the GP prescribed medication and gave me a phone number for CBT. CBT is not good for my daughter though as she will not even talk to me about how she feels because she just does not understand how she feels. She needs more specialist treatment in my opinion, such as the higher up professionals, like psychologists and psychiatrists etc. I told the GP that she hasn't slept in 3 nights and I asked for sleeping tablets but she would not prescribe them.

Please please go back and demand a second opinion. The treatment you're being offered really isn't what she's likely to need.

www.nice.org.uk/guidance/qs80/resources/implementing-the-early-intervention-in-psychosis-access-and-waiting-time-standard-guidance-2487749725

She slept for 1 hour last night

I wonder if hearing what happened to my DD would help? Might be interesting for some of the posters talking about a "specialist mental health team" etc.

My DD started to become ill in almost exactly the same way you describe OP, when she was nearly 15 it was April. I took her to a private psychologist who told her that there was nothing wrong, and the week after that she went into her bedroom and didn't come out for about 6 months. She was hearing and seeing things, completely delusional, sometimes awake round the clock, sat in complete darkness for most of that time, rarely ate, told us she wanted to "go away" (which means suicide). The GP was disinterested, but finally agreed she could go to CAMHS. She was assessed there - triaged - within a month and put on a waiting list to be seen by a psychologist. About 7 months after the initial referral she saw the CAMHS psychologist who also said there wasn't really much wrong with her. I made a formal complaint and she eventually saw a psychiatrist in December and was put on fluoxetine (Prozac).

Every time she saw this psychiatrist she was told she was getting better, nothing wrong with her etc. Eventually I got her diagnosed again having to pay privately and she has severe OCD and body dysmorphia. She's been under a specialist hospital for a year. She'll be 20 soon. Lost her entire late teenage years and all the time the main driver for CAMHS was to get her off the books. I was lucky, I suspected her diagnosis and joined a support group who helped me to get her assessed - we had to apply to the Clinical Commissioning Group for funds for the assessment.

So 5 years like this, and no end in sight. The reason I am telling you all this is not to make you think that your DD will suffer in the same way but to try to bring home that for you this is a terrible crisis, and quite right it is, this is the prime time to help your DD - however, for all the mental health professionals, this isn't really urgent or serious. Although the things she's doing now might look like "psychosis" its just she's completely overwhelmed by her own mind, the thoughts and feelings. Posters have said to let the sertraline do its job and even if you had a specialist team on tap now, they'd say the same. I do agree about getting an assessment, but if your DD is now considered the age for adult services they will want counselling first. Keep saying your DD is too unwell. My DD was unable to speak for months and because of that adult services discharged her - she was too ill to talk, so could not object and that was a complete gift for them. You'll become expert in spotting people who have no idea what they are doing and don't have your DD's interests at heart. Like your Ex for example, definitely keep him away from her and tell him exactly why - you say that he "only" grabbed her arm. Try doing that to the cashier in the supermarket tomorrow and see how far you get. Its not ok under ANY circumstances.

In order to bypass the tier 3 services (that means local) you will need to show a trial of sertraline, possibly even another drug to augment it, but just keep on like a broken record in the meantime. What your DD will be offered depends on what you have locally - we had nothing of any real use and so my DD waited years and despite my constant complaints was overlooked and ignored. However I know of others in my support group who got help quickly in other parts of the country.

Its just when I say "quickly" I mean within a few months, not a few days. The next time you speak to the GP he/she will likely say you have to wait for the sertraline to work, give it another month etc. In the meantime do your homework, find out what is available locally - is it just IAPT? Talking therapies? If your DD was referred to adult services for NHS assessment how long would that take? If she can't speak then will they discharge her? They normally prefer parents not to be involved (means they can get the young person to say whatever they want to get them discharged).

There's a great resource - a charity called Young Minds who have a parents helpline. I know they will be overwhelmed next week but try the week after. Have a look through their website and see if you can get your DD to look at the young people's bit too. You might find she rallies a bit, and you might find yourself on the long road, I hope its the former:

www.youngminds.org.uk/parent/parents-helpline-and-webchat/

Just wanted to say as well that what @nowwhherredowestay points out is helpful in that although your DD may not have psychosis, quoting NICE guidelines for assessment could be a game changer; as @nowwhherredowestay says what's being offered "locally" is probably not helpful and might actually be harmful. The prize if you like is a proper assessment, that's what you need. Keep your eyes on that.

When my children were small I knew if I got 5 hours sleep or more on average then I could cope. Less than than on an ongoing basis is just not enough for good mental health.
I would go back and see a different gp (see if any of them specialise in mental health) and ask for sleep help. They can and do give a fortnights worth of zopiclone. This can help with sleep but is not enough to knock someone out if they are ruminating. If it doesn’t work you go back and ask for something stronger like diazepam or an antipsychotic. Make it clear that she needs this help, ideally from a psychiatrist.
If you can afford to pay for her to be assessed see if there is a priory hospital locally. They also do zoom appointments and costs about £300 for an initial assessment.

What SN does she have OP? Does she have a diagnosis? The anxiety, aversion to noise, getting over whelmed and not wanting to meet new people could be due to ASD for example. People with ASD are also more likely to suffer from comorbid psychotic illnesses.

Whatever the case it sounds like she needs you so much right now, I'm so glad you're there for her.

Thank you to everyone for posting and helping me through this, I am so grateful. I will be able to answer individual posts a little bit later on today.

So my daughter has today just been sat all day staring at the floor but she has done a little bit of colouring. She ate half a sandwich but that's all she could manage. I've had to encourage her to keep taking sips of her drink.

I took her upstairs to her bedroom around 6:00 pm as she looked so tired. I just laid there with her and ended up falling to sleep myself until around 9:00. When I woke up my daughter was still awake and watching tv but then she settled down. Thankfully she fell to sleep at 9:00 and has been asleep ever since, so she's had 8 full hours so far tonight. I'm so happy because she needed it so much.

I'm still awake and laying next to her.

She needs a rapid referral to a psychiatrist! As others have suggested, possible first episode of psychosis. I wonder if she is developing paranoid schizophrenia. Either way she needs proper assessment and treatment.

I think you need to push for an urgent referral to mental health services or go to A+E to access the mental health team. She is very ill.

Sounds so much like autistic burnout.
She’s coped and masked and managed for so long, the recent events have pushed her beyond what she can manage.
sounds like the approach of calm acceptance of who she is and her boundaries, alongside gentle reassurance is helpful.
as she improves, maybe exploring autism, and in particular sensory differences, might help her understand why she might find things more tricky, and accept that it is not her fault that things can be difficult.

@Guavafish1 do you have experience of the rapid referral you mention, or accessing MH services via A&E?

Yes I have long standing mental health issues (bipolar)... I've previously been to A&e when i have bad episodes.. I see a mebtal health nurse and I'm also under consultant care.