Adult daughter struggling with depression and poor support from mental health services

[TheDarkSidewithSparkles]

Sorry, I don't know whether I want advice or just to vent really..

Trigger for depression, self harm and suicidal ideation

DD in early 20s is bouncing around the system not really being helped - she has been on ADs for 3 years but they are no longer working so she is tapering off them.

She has ASD and is opposed to trying a new AD but I think if she had a consultation with a calm doctor she would probably try other things. (She is very lacking in faith because of terrible CAHMS experiences when younger and a very badly handled inpatient stay in adult psychiatry when she was just 18 and had tried to kill herself)

But all she seems to get are different practitioners who tell her that because she hasn't tried to kill herself recently she is ok and doesn't need any help. They have suggested a yoga group to help emotional regulation - the group is miles away from where we live but services are for the whole county so it's just tough

In desperation I have borrowed money to try for a private psychiatrist appointment but they all have a month long wait.

I know the system is in crisis, was talking to a mental health nurse who basically said sorry its all broken and they feel terrible about it but they can't help people like DD.

It's worse at night and nobody get enough sleep.

I don't know what to do

It is really shocking but I think you are right to not rely on the NHS MH services as they are so under resourced. Have you booked a private assessment yet? A month is a long time when she is struggling so much but hopefully the prospect of some help coming will be enough to sustain her in the meantime. Are you going to be able to fund further psychiatric sessions and therapy sessions when the appropriate treatment has been identified for her?
Good luck, it must be worse to see a loved one suffering than going through it yourself 💐

I am trying to persuade her that we should book something but she is so upset that she can't get help..

Her attitude is "everyone says if you need help you should ask for it.. but there isn't anything so they just want me to die"

I might just book something on her behalf tbh

We won't be able to self fund for long term but can do a consultation and maybe a follow up

I can understand her feeling like that and it might help if she can be made to realise that it isn’t personal and it doesn’t mean that she isn’t seriously unwell and deserving of support. It is a reflection of the dire state of the NHS and not her need for support. There are so many posts on here about desperate suicidal people being turned away by the crisis team and basically told to take a hot bath and have an early night.
It would be worth booking her an appointment as there is a months wait and hopefully persuading her to attend. A private psychiatrist will have the time to review her meds and refer to the appropriate other services such as therapy.

Yes, I think I shall just book stuff and then she has a while to get used to the idea.

The hot bath thing is totally true - go for a walk, do some yoga.. blah blah

Not helpful at all, but especially not at 3am when everything is really dark.

Thank you Lastchancesaloonsurely 🙂

ADs are trial and error, she needs to try a few or a combination of a few to continue. The problem is you need a GP who can show an interest and has some knowledge ( I tend to tell the GP what I need, doseage etc)

Good luck and keep posting here if it helps. There are lots of kind people on the MH board who have been through similar issues can offer support and advice x

They have literally 0 interest in her.. that's one of the reasons she is so disengaged on meds. All her info seems to come from side effect horror stories on reddit

I think the problem with ADs is also that she had the horrific side effect with her first AD of the depression getting worse and she tried to do the unthinkable.

They told us afterwards that its quite a common side effect with teens 😱

Its one of the side effects in general, not just teens. But there are all sorts of different ADs. What was she on? SSRIs? Which one?

Does she spend a lot of time on Reddit? It’s really not a healthy community when it comes to mental health

Citalopram.. then onto ecitalopram which is the one she is tapering off now

It's not healthy for anything!
But she is an adult so I am limited in what I can restrict. We have had some serious conversations about reddit and how it's not the best place to get information.

It’s scandalous that she hasn’t been given ongoing care after that. They obviously recognised that it was a serious attempt if she was hospitalised afterwards. It’s insane to say they won’t provide support unless she has tried again. What a message to give a suicidal person

Also, remind her that people are more likely to post horror stories about ADs than those with positive experiences so online reviews will always be unbalanced.

Was she under a S3?

Could she ask for fluoxetine?

There is a mixture of views about whether ADs do increase suicidal ideation or not, the warnings are still there but not everyone agrees they do. However for those that do think its a slightly higher risk but fluoxetine has a slightly better reputation.

I think she will be better having a psychiatric assessment so the psychiatrist can recommend the appropriate medication rather than asking herself.

She might do. Psychiatry is not an exact science. The most unhinged people I have worked with are psychiatrists. They can have very fixed ideas and not keep up with new research.

what a ridiculous generalisation and comment. Who would be better to assess her than a psychiatrist who is by definition a specialist in the field? You think she would be better off taking recommendations from a random on MN instead?

No, she can do her own research. Its my professional experience of working with psychiatrists that I give, thats all.

I didnt say dont see a psychiatrist. I just challenged the given that only a psychiatrist would be able to give her the 'right' medication.

Quite often they'll just prescribe your bog standard SSRI in any case. Nothing wrong with that necessarily. OPs daughter has already had poor experiences of psychiatry though unfortuantely.

Most of the psychiatrists we work with describe the actions of OP's daughter as 'behavioural'.

From what I understand the Psychiatry services where we live are under huge pressure and are basically broken (a crisis team nurse basically said that they were screwed up)

I do not get it either - monitoring her has to be cheaper than having crisis intervention

Private psychiatrists are completely different in my experience. I have had so much kindness and support from mine and I really hope your daughter will find the aame

From my experience - the drug definitely made it worse. But I agree this is a sample size of one.

She was depressed and anxious and CAHMS said it was all about her autism and told her to read books by Temple Grandin or other inspirational autistic people and she would magically get better.

Then she turned 18, was prescribed AD then soon after attempted suicide. It felt like a massive shift.

I had the same experience of AD - I felt compelled to kill myself and I had to do it immediately. It was a weird feeling and quite different to my other experiences of feeling suicidal.
I didn’t realise there was any dispute over the fact that some AD increased suicidal feelings in teens

Because DD has ASC she always does her research - rest assured!

I have mentioned it might be worth reconsidering her no drugs stance as she is still experiencing the symptoms.

Sorry to drip feed, I am tired but part of her issues with medication is due to tranquillisers being used without her consent when she behaved like a distressed autistic person - like a chemical restraint.

(she had not hurt any member of staff nor had she threatened to do so)

But she has serious trust issues on medication!