Help, 16-year-old DD have a nervous breakdown

[Untenable]

I need to know how I can get through the weekend with DD who really is having a complete MH crisis.

DD has always been very anxious, she has had two lots of therapy with Camhs and a few sessions with private therapists which have been pretty useless. In brief, she is a total perfectionist, full of self hatred,. With ridiculously high standards for herself academically. Over the summer she seemed to be getting a bit better once GCSEs had finished, went on holiday with friends then family and had fun. Went to a couple of festivals and danced away. Then she came back and started sixth form. And it almost immediately went to pot. Day one: She was complaining about one A-level she was doing and that she didn’t think she was up to the task. (she got straight nines in her GCSEs). Day 2 complaints that she thought her teachers for another subject Weren’t good enough. Day 3 decided the third subject, she was doing, was not right for her she needed to drop it and sfundvsomething else.… Fast forward another weekend and every day she has been coming home from school and crying hysterically all evening saying can’t cope..

The school has been amazingly supportive, the head of Lower Sixth and her deputy have met with me and her dad twice this week, and with her once to try to help and are emailing constantly , she has been sitting in various A-level classes to try and find the third a level, but we’re beyond caring about that now – she simply seems to be disintegrating in front of our eyes, she somehow get through the day, and then gets home and has a meltdown. It can’t go on like this I pulled every strung in the book to get her an appointment with a really good psychologist, who I thought might actually help, sessions were meant to start on Monday. I’ve just had an email saying they have been postponed until Thursday. I’m not sure how she will cope until then, but again the psychologist may not be able to help.

She also has an appointment with our GP who I think they have to give her antidepressants, but that is not until the end of the month

really I need advice on how to get through the weekend with her. She is in absolutely no state to see a friend. All I can think of is dragging her out to things with me and making her sit in the cinema, go shopping, go for a meal et cetera, even if she is utterly miserable because she can’t just stay home and cry.. all she wants to do is work, if the school haven’t set anything, she will invent a task and sit at her computer, looking miserable and crying

It’s a devastating situation.

She’s not a Virgo!

And despite having seen about 5 million mental health professionals, mostly paid for by me, no one has diagnosed her with ASD but who knows

Thanks for sharing, I'm going to remember this if ever needed.
Hope this is all in the past for you.

My dd saw her therapist for over a year and I even questioned asd to her.

She said she hadn't seen signs

My dd is an expert masker

She wanted a diagnosis herself as she struggled with different things. Learning about herself was key.

It's all so clear now

This sounds like textbook autism.

It's interesting that you refuse to engage with posters suggesting this, OP.

Is there a reason why an ASD diagnosis is not something you're willing to entertain?

Girls are brilliant at masking and so autism in girls is often misdiagnosed as anxiety disorder or depression.

Going from GCSEs into sixth form is a huge change. Learning styles are different, schedules are different, the structure of the day is different, and teachers are different. Suddenly there's a whole lot of autonomy required and unstructured periods of the day where students are expected to manage their own time rather than having it managed for them. Moreover, the first week of sixth form is full of teachers explaining the exam requirements and the content of their courses, which naturally feels overwhelming and stressful. It's no wonder this has caused a meltdown - all of this change would be hugely triggering for someone with ASD.

As a teacher who has over a decade of experience of working with teenagers with autism, I would strongly recommend you seeking an assessment for ASD.

I'd recommend you ask for an assessment here The NAS Lorna Wing Centre for Autism

OP, this is so important to understand.

Even amongst professionals, understanding of how autism presents differently in girls is still not very well understood. The textbook signs of autism commonly don't apply to girls and yet still the stereotype exists.

Girls with autism can ape normative social behaviours brilliantly. As such, they can seem neurotypical, even to professionals. Their autistic traits are commonly dismissed as 'just' anxiety. However, chronic anxiety is probably THE most common trait of autism in girls, in my experience. Any girl presenting with high levels of anxiety should have autism ruled out before pursuing any other diagnosis.

Longer term can you both start a hobby together so she can get used to being bad at something and still enjoying it? Paint and wine evenings (you can have her wine) or doing beginners tennis lessons together?

As a relatively smart + very very anxious person - I have found DBT more helpful than CBT. Quite transformative in managing my feelings

I had a break down nearly 2 years ago. Still recovering now.
I need someone to completely take control of me. Everything was just too overwhelming. I couldn’t make any decisions as it was just too much pressure. I couldn’t work, in fact I couldn’t do anything.
I think she needs time away from college and for you to tell her that you will sort that for her. Act now before she has a full breakdown.

Sending sympathies 💐 for your DD but you too as its very hard on worried parents to witness such high levels of distress.

sorry forgot to I’ve been seeing a psychiatrist for about 18 months and that’s helped massively.
CBT didn’t work for me it required too much effort when I felt completely broken

Back to basics with little or no pressure.

If she will go out on a walk, great. If not, no worries. If she sits in her room, go in with some ice cream or a drink and chill out with her.

Why don't you both just chill out? Go to the shops, buy some nice things for a weekend in and spend it in your pyjamas with her.

If she is moping, or crying, just give her a hug but try and keep some centre and don't be too dramatic. Just zen.

Just tell her that this weekend everything is on hold, Decisions, A levels, it can all wait. At the end of it, if she's looking more grounded, then maybe chat about options. Show her she has options, including not doing A levels, and the sky will not fall in if she chooses that option. Life will go on, things will be fine.

I came very close to a mental health breakdown a few years back, and ive had struggles with anxiety since i was a teen
It's hard to describe how a breakdown feels, and everyones experience is different of course. For me everything felt raw and loud and bright and hard and I felt like I would break, I was so brittle. I had a constant mental churn going of all the things I needed to do and say and remember and fix and how I couldn't do any of it and I was going to screw it up and it was all so out of control Even the smallest decision was overwhelmingly hard, it felt like every choice I made was life or death stuff. I couldn't stand to have people around me, people who I adore like my lovely SIL, the only people I could cope with were my dh and my mum. It felt like the emotional equivalent of having raw skin all over my body, the slightest touch would be excruciating. Feeling that way was exhausting and I had no way to turn it off.

I got better, it took time and medication, sertraline worked for me, and a combination of huge reserves of patience and kind firmness from both dh and my mum foe me to get the help I needed.

Things that helped outside of medication, were taking care of my physical health. I got bloods done and found my iron levels weren't great, so I took a supplement. Getting outside, moving, walking, sleeping a lot, talking to someone, exercise and air. Also giving myself permission to focus on only one thing,by literally scheduling in my calendar when I was going to deal with some of the stuff whirling through my brain, stopped some of the mental churning, some of the time.

You sound like you're a wonderful loving mum, and I'm sorry you're having to go through this, and I'm sorry that your daughter is too.

I hope she gets the help she needs really soon.

What @cherryassam said, and take her out of school.

She needs to be in work, education or training but that does not mean school or college.

'Home ed' can take many forms including 'unschooling'.

Dd is autistic dx age two she is also very intelligent IQ 162 and really anxious. When with her friends nobody would be able to differentiate her from the others certainly the autism specialist teaching service needed to ask her teacher to point her out she really is so adept at masking. I think that masking so as to appear NT is incredibly common amongst intelligent autistic girls but it comes at a high price and burnout is also sadly common as well.

I am NOT refusing to engage with autism suggestions, I will look into it but we need to get through the weekend first. Being reprimanded is not what I need tonight.

practical suggestions are what’s needed now, the rest can happen on Monday . Thanks for those suggestiong them

Autism burnout looks very similar to depression but needs a different recovery approach.

With depression, you are encouraged to get up and do something each day, that going for walks and achieving small things will help.

With autism burnout, it's the opposite. Take away all demands, decisions, expectations. Let the person hibernate. Bring food and drinks.

I inadvertently made things worse for my daughter by not knowing she was autistic until she was in full crisis mode. If there is any possibility, then tread gently until you can get professional help.

I was just about to respond saying this and you got there before me. Great post.

I wasn’t reprimanding you, OP. Sorry if it came across that way.

I just wanted to flag how important it is to consider autism as people with depression and people with autism need very different approaches to help them when they’re struggling, as @WhatsitWiggle has already explained. Considering autism as a possibility to explain your daughter’s behaviour may help you help her more effectively this weekend by giving you some different strategies to try.

Is there any way you can get her to eat more. When you say hardly eating what does that actually mean?

What about energy shakes or something.

@FusionChefGeoff
Get her out and into nature. Walking / canoeing / stand up paddle boarding / walking along a beach / hiking...
^^^^^

My first thoughts.
As soon as she gets home get her off on a walk to get rid of all that adrenaline!!!!!!!

I have seen a million therapists/gps over the years. Took me 30 years to get diagnosed with CPTSD and OCD. I’m now pushing for a BPD diagnosis. Things aren’t just magically noticed. My DP has only just got a diagnosis for autism and a few extra things and that’s after years of being under the crisis team and their professionals for his burnt outs. It takes the right questions and also arm yourself with as much information about autism/ASD etc and make notes on why symptoms your DD has.

I appreciate the advice on autism and will look into it. However, it’s hard to hear conflicting advice for the weekend - take her out a lot vs let her veg. If she stays here she just ruminates. We have a hm professional in the family she is going to talk to him today. Private gp on Monday. She says she doesn’t see how she can carry on at school , I’ve said if that’s the case she can have a break. The school is amazing and will pull. Out all the stops

Sounds really really tough.

Lots of good suggestions here but depending where you live, I'd jump in the car with the dog and take them to the beach.

It's a lovely day and beaches have a way of putting things into perspective!

Failing that, a forest.

@HeBeaverandSheBeaver

I think we must have twins. I also think all these crashes would have happened much earlier if it wasn’t for lockdown. Dd was able to recharge during lockdown initially, but the had immense trouble returning to school.

Make sure you apply for PIP. Mine went from 9 GCSE to full Pip in less than a year. We also tried for an EHCP. We didn’t get it, but the LEA are putting in place a multi agency support team. They are also applying pressure on school for home tutoring.

The usual time for ASd burnout is 14/15.