At a loss on how to help my adult daughter

[Merrydance]

Out of the blue over 2 years ago, my young adult daughter had a mental health crisis, needing to be admitted to hospital.
Since then she has been under the care of a Psychiatrist and has a key worker. She is on medication, that has made a difference, but has declined to increase it to the recommended dose. She has been offered therapy, but has declined it. She does not want to talk to us or anyone about her illness
At home on a daily basis, you would not know she is ill. Anything she does outside the home, leads to anxiety symptoms both physically and mentally although she tries not to let this stop her, which I do admire but is hard to watch
Her Psychiatrist has again asked her to reconsider therapy, as he is worried the physical symptoms of her anxiety will become ingrained as part of her coping strategy
Until now, I had felt she had been making slow but steady progress to recovery, but this week I have noticed some of the old symptoms reappear (hearing voices), that had not been noticeable for many months. If you attempt to talk to her, she changes the subject, she does not want to acknowledge or discuss the nature of her illness
I feel helpless to support her, except with day to day practical things. I am struggling to see a future when she will be well enough to live a more independent life and do the things in life she has hoped to do
It makes me feel incredibly sad that she has to endure this cruel illness and completely useless in trying to help her recovery. It has left me with a sense of constant sadness
Selfishly, I can't see a time when I will be able enjoy my life and be more free of caring responsibilities.
I have tried counselling for support 3 times since her illness, but not pursued it. I have been signposted to Carers Groups. The only thing that will help me is her recovery
I am not sure why I am posting this, but feel a need to offload. If anyone has had to deal with something similar it would be good to hear their experiences
There appears to be support groups/forums aimed at teenagers and others for adults but not much that suits a young adult, if anyone knows of anything

Id say she needs a medication review with the psychiatrist if she is having psychotic breakthroughs (hearing voices again). I see she isn’t keen on increasing dosage- there is probably good reason for that as the side effects of anti-psychotics can be quite debilitating. But there may be a different medication she can be switched to that would work better and have fewer or less irksome side effects. So I’d suggest that to her. As her carer, you can call the psychiatrist office and request a medication review as well. Then they will contact her to try and arrange one.

She has been offered therapy, but has declined it.

I have tried counselling for support 3 times since her illness, but not pursued it

The two of you seem very alike in avoiding therapy/counselling. Why is this? Do you think your avoiding therapy/counselling might be influencing her decision to decline therapy too? If you went, and had a counsellor who was helpful, would that perhaps tempt her to try it too? Just food for thought.

Hi I would recommend the charity Young Minds. They have helpful advice for parents on how to support and there's a helpline too.

Thank you Onnabugeisha for your prompt reply. She saw the Psychaistrist 2 days ago and no discussion about increasing medicafion, they have tried so many times to encourafe this, they are concerned if they push her too much, she will not want to engage with them. She has previously been on 2 different medications that did not see a significant change, her current one has worked but would be more effective at a more therapeutic dose. I think the conversation the Psychaitrist had with her 2 days ago, has increased her symptoms, as she found it stressful. He wanted to refer her to another hospital for outpatient services, but said they would not accept his referral as she has not tried therapy
She does not kow I tried therapy, as I did not tell her. One of the reason for me stopping is I have little time away from her, it has been by phone and I do not have the privacy to talk about her.
Her Dad has had therapy and been open with her about this
I think it is something for that is too painful to face
I am just struggling to see a way forward for her

Thanks HotPenguin, I will take another look at Young Minds

Sorry OP.
No advice but good luck xx
Any forums / organisations specific to her illness that can advise?
You would not be selfish to care for yourself and your needs? You can be honest that caring is taking its toll. She must try every avenue to get help. You cannot sacrifice yourself for her because she refuses treatment.

That’s really tough OP. Can the psychiatrist try and refer her anyway?
Is there an inpatient option that might work for her?

The only thing that will help me is her recovery

I say this kindly OP, because as a mental health professional I know it’s really hard to support someone who won’t accept their illness or seek support. But your health and life cannot be dependent on whether or not she recovers. That’s not healthy for either of you. It’s a lot of pressure for someone who is dealing with a life changing mental health crisis. It’s also really not uncommon for people with this kind of illness to not accept they are unwell. That’s part of the nature of it.

It might be worth looking up the Hearing Voices network. They have groups that focus on peer support, resources and support for carers, and they have also some understanding within that network about managing voice hearing without medication or low medication, if that is the route your daughter wants to go down. Maastricht Interviewing can help with getting to know and understand the voices. The work of psychologist Rufus May might be worth a look as he works in this area. The best thing carers can do is provide that practical support and get as much understanding for yourself about the condition as you can. Knowledge can be helpful. And definitely network with other carers so you don’t feel so alone with it all, and they might be able to connect you with other sources of support such as respite, finding her a support worker who could do some of the practical things and provide social support to get out and do things. There are lots of things that can help people that aren’t therapy - and I say this as a trained therapist! Therapy isn’t the only answer, but making sure you are not isolated and unsupported absolutely is essential, especially as recovery is rarely a linear process and there can be setbacks along the way.

Thanks ChristmasChair. It is just so difficult when she does not want to talk about it. She just walks away or changes the conversation
She is not difficult and is pleasant company, but acting as if nothing has happened hoping it will magicaly go away
I have been part of a carers forum but for me that did not help or give me a sense of optimism for the future
I am generally an optomistic positive person, but I am struggling with this
I think the prospect of family Christmas visits has also increased her symptoms, she very much wants to join in, but the anxiety around doing them, is making her stressed

Thanks Ravenclaws, that is really helpful
I found meeting with other carers depressing, their relatives appeared to have been struggling more and doing far less than my daughter.
I will take another look at Hearing Voices, but my daughter has not wanted to look at anything like this
She is definitely not isolating herself, she loves being with her friends and this is when she feels at her best. However they are working and have limited availability. The support workers in her mini team have all left and there appears to be just her care co-ordinator left, who is part time. She does not want support to go places and is motivated to do things, but doing them is causing her big difficulties with physical and mental symptoms of anxiety
I know I need to learn to live with her illness and do things for myself, which I do, but seeing her struggles is heart breaking
I don't know how to get her to understand that accepting help could make things easier for her to help manage this illness
Thanks for the support

I have thought of trying to ask them myself if they would accept her anyway. The psychiatrist felt if he referred and it was rejected, he would not be able to re-refer
She would not accept any option that required her to be an inpatient
It will be challenging enough to persuade her to go there as an outpatient

Could psychiatrist do an informal query to see if they could make an exception if he referred her? There has to be a colleague he could call or email?

Are there any day centres? Would she be willing to go do something like that where there’s group therapy type activities where you can just participate without saying anything about yourself and what’s going on with you.

Thank you for taking the time to reply. I think further conversation with her Psychiatrist about referral would be good, hopefully she would agree to it.
She did do a drama group with a local mental health charity, enjoyed it but had really bad physical anxiety symptoms
Some of groups may be worth looking into, that is good advice, thanks