To go to GP again about 8yo DD low mood?

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Hi, sorry this is long. And here for traffic.

TLDR: my 8 yo DD doesnt seem to fit any diagnosis for ND but is really sad/ angry a lot of the time and I don't think is 'normal' so not sure how to progress.

Context - me and her dad split 3 years ago but he's 5 mins away from my house, no arguments, she sees us both a lot. Obvs the split is inherently sad as we're not together but honestly the best it could be.

I have 2 DDs 8 and 4. 8yo was a difficult baby (cried for about 6 hours a day) and hard toddler. Kicked off all the time.

8 yo is very bright and can be very lovable. She's a gorgeous girl. Doing very well at school. Got friends at school and externally.

But is very angry and upset all the time. For eg most days she will wake up after 10/11hrs sleep, walk down the stairs and sit on the sofa and pull a rug over her head. Good diet and exercise.

i ask if she's ok - 'no' is the answer. I oh darling I'll make you breakfast, will walk over and give her a kiss over the blanket, while i get on with breakfast etc and she comes around. Could also find herself upset again before school for some reason. Could be it's raining so I want her to wear a jumper (she won't ever wear a coat). Cue another meltdown.

She can be fun and loving as long as I am playing with her. She's never played independently - ever. It's so draining.

But frequently she gets very cross - no matter what we do. It's been so obvious over easter. this weekend we:

• went to a funfair with her mate and she only wants to go on the most daring things which her friend didn't want to and she spends the rest of the time sulking.
• with her sister and dad went play football but she didn't want to be in my team so she sat on the floor not participating.
• got crisps at a pub with a big garden for kids to play in but they didn't have cheese an onion so she was really annoyed and went and sat alone.

Etc Etc. I ignore it and after about 15 mins she comes back fine and we carry on, but it can happen multiple times. So if we are out for 2 hours she can be sulking for nearly all of it.

Plus most at home time she cannot leave me alone or play by herself and gets cross for reasons she doesn't even understand.

it's like the black cloud descends for no reason. I've asked her when she's not so low and she says she doesn't know why she feels like it or behaves like it - like it takes her over. She feels bad about it but can't stop. I do enforce consequences but sometimes it feels painful cos it's coming from her pain rather than being naughty.

I went to the GP for possible ND but the school said she's social so knocked it out and assessment was stopped. I've looked online about the symptoms for Autism and ADHD but she doesn't match most of the symptoms.

Her main issues are difficulty managing emotions. She's just so sad all of the time, and really has been since birth. Very few other symptoms on NHS page for ADHD or Autism. It's a happy house otherwise.

I don't know whether to go to the GP again and to ask for what? I could pay for play therapy but that would be at the expense of other nice things for the family (like holidays) but would do it if it would definitely work (am a single parent). Equally could try and find money for a private assessment but would prevent us doing anything fun/ nice as a family all year.

What would you do?

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Do school do play therapy? They should support children who struggle with their mood if they have it on offer, even if there is no evidence of ND. My DSS is very moody just like you describe and has ADHD. He also has a lot of other symptoms though, he’s quite stereotypical with it. He’s social though, but struggles with maintaining friendships.

Have you spoke to her school about her low mood and what they notice? Depending on where you are many schools are under mental health support teams. They offer low intensity CBT and can either provide intervention directly with your child or with you if they are suitable. This may not be available in your child’s school but many people aren’t aware that this is an option so worth exploring.

Might any of these be useful?

Anger is often a child's go-to emotion when other things are going on for them. It is a bit of a cliche but the saying "All behaviour is communication" is true. What else other than the anger and dissatisfaction she demonstrates could she be trying to tell you? Many young children struggle with emotions and their management so I would say that this behaviour isn't unusual in that age group. There are lots of good resources around for helping children to recognise and manage emotions. Look for the anger iceberg and the anger thermometer, both of these can be helpful.

This is tricky.
my daughter was / is similar - from about 5 years old. She is now 15. I am also split from her dad and he is quite abusive. I did go to the GP / spoke to school / she has some therapy through play via the school etc. I pushed for a referral to CAMHS but she didn’t meet the criteria.
The only things that I have found helpful over the years were :

• I went to see a psychologist myself when she was about 8 years old, which was helpful in understanding how she might have attachment issues and how I could possibly help her (a lot was around “therapeutic parenting”). This cost me about £130 a session and that was 6 years ago.
• she went to see a counsellor herself last year for a bit. She was quite helpful in helping her with coping mechanisms to deal with feelings / her dad etc. This cost me £60 a session.

I always found it was hard to know where to go for support because she didn’t easily fit into a box of having a specific mental health challenge.

Thanks all. She is fine when she's not angry, but she's angry a lot!

I did ask the school about support but I don't think it's on offer without an ND diagnosis. Maybe I should ask again.

I will look up anger iceberg and the anger thermometer.

I'm sure the split between me and her dad has had an impact but she was definitely angry before!

Unfortunately you will find it extremely difficult to get any help on the NHS for a child with these kind of issues.

To some degree they are just normal feelings and may not need "pathologising"

Even when they become quite consuming and extreme, I was told my child didn't meet criteria as they hadn't explicitly expressed wanting to kill or harm themselves....

It is utterly ridiculous that they have to get to that point before they can get any help (and "help" is getting added to a 2 year wait list for camhs)

But by all means ask the GP for advice... Just have very low expectations!!!

Have you considered that she may have ASD / ADHD, but is just masking? I would suggest ADHD much more likely here, it presents very differently in girls, and they are more likely to mask, too. The hyperactivity is less in behaviour and more in mental state - constant racing thoughts, issues with anger that feel out of your control, relating to impulsivity issues and difficulty with emotional regulation. I have ADHD and went undiagnosed until an adult. The way you described your daughter sounded like me as a child.

It may not be ND, but I think you definitely should go back to your GP to say you think something needs to be done to help your DD manage her moods, and to help you manage / cope with them as well. If you think play therapy would help then go for it - better to miss a holiday than to have her and you feeling this way forever.

Does she have any friends? How does she behave with them?

Have you ruled out any physical causes? Could be worth looking into, for example, enlarged tonsils/adenoids causing poor quality sleep and long term sleep deprivation. So no other advice, and sorry you’re going through this, just wanted to flag physical causes.

Hi @CuppaTandBicky i agree the GP and other services may be useless. And tbh not necessary.

@worldshottestmom I've thought both - but then I go online and think she has very few symptoms on the NHS website. She's not impulsive - is hugely responsible and trustworthy.

I've tried to manage my parenting in a way that fits her - telling her in advance she might not get what she wants, trying to manage transitions etc.

Spending time with other kids who kick off only occasionally just make me realise how hard she finds regular things.

Most of our lives are managing her upset over nothing (in my view - I know to her it's all massive and I do try to be sympathetic). My youngest seems to sail through these minor inconveniences which has really brought it to the fore.

What kind of media is she consuming? My son was very emotional and angry when he was spending a lot of time on youtube last summer. Flicking through youtube shorts and i don’t know why or how but it was damaging his brain. Didn’t ever want to do anything but sit in front of a screen. We finally clocked what the problem was, deleted it off all of his devices and had a happy and engaged child again within weeks.

Talk to her school about if they can offer ELSA support for her. If not there may be another agency local to you. It is very helpful with recognising and understanding emotions.
https://www.elsa-support.co.uk/

Agree with @CuppaTandBicky in that those behaviours alone will probably not meet the criteria for a referral. It might be a good idea to start keeping a diary of instances when these behaviours occur for future reference as this might be useful if she is, at some point, put on a waiting list. Some counselling might help her but in my experience, a lot of intervention needs to be done by the parent themselves so educating yourself may be more useful. Are there any drop-in services for young people in your area that offer low level interventions? ( Often run by charities).

This sounds very like my also 8 year old daughter. What helped us was a few months of play therapy. Had it privately, school were no help at all. Things still aren't great but much better than they were. She has serious attachment issues through no obvious reason. I hope you find something that works for you.

@Hallamule she does have friends! and honestly it amazes me sometimes cos she's such hard work with them. She'll want things her own way, get upset, find injustices in lots of things. But then is also generous and funny and gregarious.

I do worry that I am friends with lots of the mums and I do wonder how much of it is my friendships that keeps the socialising going over hers.

If there is no trauma in your dd's past then I would strongly consider autism rather than attachment disorder. They can present very similarly.

@MeinKraft thank you - she would spend all day on a screen if she could but we don't let her (while her sister is happy to play alone, drawing, lego etc), She doesn't fancy much on youtube. will watch some crap american netflix shows when she can like I carly

My sister is autistic and I feel they are so different but aligned. I keep coming back to autism but no real symptoms as on NHS website. She doesn't stim, understands nuance, is very interested in other people's feelings, no special interests, good eye contact etc

It wouldn't surprise me. Both my husband and I definitely have tendancies typical of autism.

Thanks - I think she's physically ok. She takes a while to get off but reliably is asleep by 9pm and then awake at 0730 and never seems tired in the day. She has a very robust constitution and is rarely ill even with a cold.

Have a look at AuDHD symptoms. When a child has autism and ADHD together it isn't just a bit of both - it presents quite differently often. For example at age 8 my AuDHD child didn't really have obvious special interests. But that's because they cycled really quickly between interests due to the ADHD. It's much more apparent now they are on ADHD meds which has slowed down that chopping and changing part.

Also have a look at RSD which is often a symptoms of ADHD. It can often cause low mood. Autism can also lead to black and white views so that things are great or terrible with less in-between. Play therapy rrally helped with this.

Stimming doesn't have to go with autism but bear in mind that it can also be internal. My son has a lot of internal stims e.g. songs or phrases repeating in his head etc. It's become much more external over time. He also has great eye contact and is very interested in other people's feelings (just doesn't always understand/interpret them well).

Her age is also when a big hormonal changes start happening. My youngest DD always struggled emotionally but it ramped up a lot aged 8-12. She has since had ASD and then ADHD diagnosed when she’s extra anxious she monologues or blows up like a volcano, Her cycle for her period also has a big impact on her feelings. I can’t reason with her then but every single time after it’s blown over we talk it through. This has helped to lesson the length and frequency of the angry patches. Plus recognising that trigger stacking is happening. She can cope with lots of things through out the day but when her energy is depleted it can be one small thing that just pushes her over and the default emotion can be anger / sadness when really she just can’t cope with processing one more thing no matter how small as she’s used up all her emotional energy. Modelling how to deal feelings, naming them and apologising if as an adult you get angry too. Some kids do just find it harder to process emotions and they don’t get it instinctively it need do be taught. “The Explosive Child” book is often recommended by Greene.

Can't believe the school said that so dismissively. They should be listening to your concerns. But I get it, both my DC are ND but also both social and academic. DS does struggle with school more. DD holds it together all day and needs huge amounts of downtime to recover from the effort of masking and concentrating all day. Which often results in her being very angry and moody at everything and everyone.

When you say she doesn't stim? Are you sure? DD hair twirls and completely zones out. It's a self soothing thing she's done for years. Both DC also have to constantly fiddle with things. DS was allowed his lump of blue tac at school because the teacher realised if she took it away he'd keep wandering off to find something else. What I'm trying to say is stimming can be really subtle and often we don't realise that's what it is.

It might be that your DD is very emotional and going through some changes but I would say don't rule out ND just because school dismissed it.

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