Is my DD psychotic or just highly strung?

[oneofthegiantsisme]

This is a bit convoluted, so please bear with me while I try to explain!

We had a stressful bedtime with my DD last night - she took a bit too long getting ready for bed so didn't have time to listen to music as she wanted to (she's nearly 11). We had tears & tantrums, but she calmed down, brushed her teeth & headed for bed.

Just before lights out, she realised that she had missed a lock of hair out of her plaits (hair is v. long, so plaits keep it from getting too tangled at night). She got very upset about that (being already fragile from previous tantrum), but I told her it didn't matter, that little bit wouldn't get tangled, it would be fine, etc. I also said she didn't need to cut the lock off (which is what she did a previous time that the same thing happened); she agreed, and said "anyway the scissors are downstairs". So, I said goodnight & retreated downstairs.

Ten minutes or so later, we could hear sobbing coming from her room, so I went to see what was up. She was beside herself, but eventually managed to explain that "I had to pull the hair out, and now I wish I hadn't done it". She had pulled out the offending lock of hair at the roots (well, most of it, anyway). I was shocked, and horrified, partly by what she'd done (didn't it hurt???), but mostly by the thought process that led her to do it ("I had to..").

I'm afraid I didn't react very well, and said (and I quote) "God, child, you're not right!" (yes, I know, absolute no-no, label the behaviour not the child, mea culpa - but as I said, I was shocked). My husband realised things were not going well & came and took over with DD while I went downstairs & wept for a while!

DH & I discussed it when he came back down; she's very self-critical, highly strung, and things have to be just right. He says he's got the T-shirt, so understands all too well. I understand, too, but I don't know what to do about it.

I went back up to check on her later, and she was not asleep, so I cuddled up for a chat & she admitted she'd been lying there trying to think of ways to punish herself for what she'd done. I told her she didn't need to do that, mummy & daddy would be sad, and all she needs to do is make sure she doesn't do it again. I left her happier & she went to sleep, but she did ask me this morning if I was still cross with her.

I guess my question is this - is she just a normal, highly-strung child, or does she need help? I'm extremely wary of medicalising normal childhood behaviour, and I think, at the moment, industrial quantities of self-esteem boosting are the way to go; but on the other hand, how do I know if she needs professional help? If she broke her arm, I wouldn't just give her Calpol! My fear is that this will escalate as she gets into teenage years, and that in a year or two we'll be dealing with self-harming and suicide bids.

At the heart of it, I'm terrified that my beloved daughter will kill herself before she's twenty if I don't do the right thing. Somebody please tell me I'm being hysterical & over-reacting!

I think there might be a midway between permanently medicalising her and doing nothing.

Dd has had a fair few anxiety issues and we have found that CBT training helps. Recognising what problem patterns of thought are and learning techniques for dealing with them.

It is not the case that the world is divided into two kinds of people: the mentally ill and the mentally healthy. It's a spectrum, but there are definitely behaviours and ways of being that are not healthy or that need help, long before you get to the sectioning stage.

I would first have a guided chat with your dd where you lead to her to realise that she has certain ways of working herself up that are not good for her. Then try to see if she can help herself recognise when a bad train of thoughts starts and stop it. I find it helps me to visualise it very clearly as a crossroads, with one road leading further and further into negative thought, and telling myself "no, you don't have to go down that way, that's closed today".

Also tell her that if it is too difficult for her to handle this all on her own, there are people who are specially trained to help her. Assure her that she doesn't have to live with bad thoughts, that it's something lots of people go through, but that it can be stopped. It might also help to point out that bad thoughts typically start when you are overtired.

If she needs help, then your GP will be able to refer her to CAHMS (Children's Mental Health Services). They may even have a community team, so she doesn't have to go to formal hospital appointments.

Is there a school counsellor? They have a lot of experience with this sort of thing.

The guided chat sounds a good idea - where do I find out more on how to do this?

No, there's no school counsellor, by the way.

Guided chat is not a technical term, it was something I made up .

What I mean is, you have a gentle talk where you let her express herself, but gently and gradually lead her in the direction you want to go, in this case of realising that she has times when she gets started on a train of thought and can't stop herself and that it would be better if she could.

But ime you don't have to be afraid of asking for outside help: it's not like they're going to stick a label to her forehead forever if she does need some CAHMS involvement, it is confidential and the school doesn't need to know about it.

Thanks for that.

I think my reluctance to ask for help is partly to do with logistics - if I have to take her out of school for appointments, she'll have to say something when everyone asks "where are you going" and I don't like encouraging her to lie - but telling the truth doesn't seem like a great idea given the way children are!

Dd just says medical appointment, no need to go into details.

And tbh, you may have unnecessarily negative ideas of what children are, not of course that I know the children in your school, but at dc's schools there are plenty of children with all sorts of problems and very little judging or prejudice.

It may be that your dd doesn't actually need any outside intervention. But if she does, I wouldn't let any thoughts of what others might think stop me. Or for that matter any feelings that you yourself may have about mental health issues. The important thing is that your dd is happy.

That is, of course, the important thing. The worry with the other children was based on the fact that she's had a bit of trouble with a couple of kids already (which new teacher is aware of & keeping an eye on, so I think it's OK now).

I'll try some constructive conversations with her & see if we can make progress that way, but thanks for helping me understand what options there are if we can't sort it out ourselves (and helping me realise I'm not just being hysterical - I think!).