Help me "fix" my daughter who sleeps all day

[JanisMoplin]

I have a complex mental health situation- or some other situation with my DD, and am looking for help.

DD is 20 and at uni in another country, near a family member. Yes, this is not ideal. This decision happened before the pandemic. On the upside, she has good private health care and therapy available, maybe better than with the NHS? I do not know.

Anyway symptoms: she developed severe anxiety and depression in the lockdown, which got worse when her uni went back to in person. She sleeps all day because she is depressed, and is up all night with raging insomnia. She has chest pains due to anxiety. She says her brain is broken and finds it hard to even write a couple of paras.
Before the lockdown, she was outgoing, cheery and on course for a 2:1. She has had to take a whole semester off uni and maybe more.

Anyway medical treatment wise: She was on escalitopram last year. It worked ok for a while without any major side effects but when uni went back to in person, it wasnt enough. Two different docs prescribed paroexetine. I know this is a terrible drug but we had to try it for 6 weeks because they insisted. Gave her horrible wooziness and disorientation. She slept even more. Both doctors refused to give her Sertraline saying it might affect fertility ( I know from googling this is not true). I should point out that doctors in this country are quite authoritarian. I want DD to try Sertraline but she is just sick of meds and their side effects. Starting her on therapy but she needs to be awake for that.

Thyroid and vitamins all normal. Getting a sleep test done for narcolepsy. Doctors think the sleepiness is depression. Could it be chronic fatigue syndrome? Sorry to go on like this but just wondered if any of you recognised these symptoms.

Please, please don't say she is an adult and I should back off and let her sort it out. I don't want to do that. She also feels hopeless, suicidal and with no energy to continue her education.

Oh that sounds really tricky, it must be awful feeling so far away from her :(

As the healthcare system there is quicker by the sound of it, could you see if she could get assessed for ADHD? Obviously it’s a leap from your short post but it is hugely underdiagnosed in women especially, as there doesn’t have to be obvious hyperactivity at all, and can present as depression especially trying to cope with situations that require organising yourself, like uni. It sounds like she could be burnt out/in shutdown mode so it’s worth looking at - ADHD medication has transformed my life.

In all honesty though if she’s struggling so much and isn’t doing well anyway I’d be wanting to bring her home. How long has she got left of the degree? Is it possible to transfer her course to the U.K.? Or defer a whole year and look at moving back there after?

I think pp is right, bring her home. She needs support and to get her MH sorted. She can go back to uni at a later date.

She sleeps all day because she is depressed, and is up all night with raging insomnia

Shes not got insomnia though if she's sleeping all day, she's just turned night into day & vice versa. If she sleeps all day then naturally she's not going to be tired at night.

Sounds like she'd benefit from being home to get proper help & tlc

Both doctors didn't think she had ADHD. But of course it is often overlooked. She reads very long books on her phone; currently reading Anna Karenina. Is that typical of ADHD people?

I forgot to say that we are thinking of transferring her back to the UK but she just entered her third year. And can only transfer in 2nd year so she will lose a year. We may still do it and are applying in UCAS by January. I don't know why I said 20. She is now 21.

I second the screen for ADHD. It might not be the issue but may be worth ruling it out. Young people with ADHD have particularly found lockdowns and restrictions difficult - lack of interest, motivation, insufficient variety to keep an interest-based brain motivated and focused. Lack of social connection has affected them particularly. I have heard a lot of the “broken brain” stuff from the diagnosed young people I see at work, including those who were diagnosed way before Covid.

If it is ADHD it’s one of the most easily alleviated issues, but if not at least you’ve ruled it out. And I advise strongly against Sertraline unless she can be closely monitored by a MH professional as it can exacerbate suicidal ideation in young people. Sertraline may also exacerbate impulsivity in young people with ADHD and some other SSRIs can exacerbate lethargy and disrupt executive functioning. I’m a psychologist and am diagnosed myself, I had a horrible time with SSRIs.

People with ADHD can focus on things they have interest in, so reading long books wouldn’t preclude it.

Absolutely - books can be a hyperfocus and if she’s depressed too it’s a way to escape.

Thank you for all the kind replies. I know MH is not a one size fits all thing. I am getting her to see a specialist ADHD doctor.

@PineappleMojito I was thinking about it and I too feel like I have a broken brain. I am a very social person and now I have been told to WFH for ever. DD too is social, extroverted, and was very keen on debates, public speaking, MUNS etc before the lockdown. Now she wants to sit in her room all day and says she can't talk to her roomies ( who are perfectly nice).

I am also wary of SSRIs esp as DD is very, very skinny and reacts badly to most. But not sure what else to do.

She doesn't want to come home really, but am going to persuade her. She has couple of friends she is still seeing there. And UK winters make her depressed!

@SingToTheSleigh

Absolutely - books can be a hyperfocus and if she’s depressed too it’s a way to escape.

And when they're on her phone, a perfect way to ensure that she stays awake all night.

@Redglitter

I think pp is right, bring her home. She needs support and to get her MH sorted. She can go back to uni at a later date.

She sleeps all day because she is depressed, and is up all night with raging insomnia

Shes not got insomnia though if she's sleeping all day, she's just turned night into day & vice versa. If she sleeps all day then naturally she's not going to be tired at night.

Sounds like she'd benefit from being home to get proper help & tlc

I agree with this. It sounds like she needs to start at the very basics like forcing herself to stay awake during the day so she moves back normal time but she might need help in doing this.

Yes, when you’re already depressed it’s so hard to do the right things like getting up early and staying off screens which might help her sleep. When you feel that rubbish it really doesn’t matter that you know what to do - it doesn’t make it one single bit easier to actually do it. I’ve been there so many times. 💐

@SingToTheSleigh How have you emerged from that state? I think we all feel terribly denotivated now but I get out of bed because I have to.

Also wondering if I should investigate chronic fatigue syndrome. But that is a rabbithole.

I was diagnosed with CFS (and fibromyalgia) before the ADHD. There are a many people with both! It is definitely a rabbit hole. And it’s always worth looking for more answers - have they checked the more detailed thyroid levels not just basic, have they done a lot of different vitamin and mineral tests?

How does she feel about finishing uni?

In terms of breaking the cycle of sleeping all day what she needs to do is stay up all night plus the following day so that when she does go to bed it will be 36 hours plus awake then she should at least get some sleep that night.

I suspect I have ADD (youngest is diagnosed) and by ability to not sleep is just unbelievable at times even when I want to. I was in hospital and 42 hours later still awake so they gave me a hypnotic in the end just so I could have a break from being consciously awake!

for you and your DD what a horrible situation.