Completely failing our teen, can't stop crying

[WeeMadArthur1]

Posted in SN as well but I don't know what to do. DD has always struggled with anxiety, friendships, confidence but it's getting increasingly worse (she's 17 now). She's terrified of talking to people, won't talk to teachers unless she absolutely has to, can't answer the door, can't go on a bus or in a shop, will speak to a couple of friends at college but won't see them outside of that, basically spends all her time in her room when not at college.

We've been to GP three times, she's not old enough for adult mental health services, can't be put on CAMHS waiting list as the GP said she'll turn 18 before anything happens so it's pointless. We were referred to a central access point who said they can't help as she's not an adult but they recommended anti anxiety meds. But GP won't prescribe them as she's not old enough.

She has a lot of the symptoms of ADHD and autism, which is exacerbating her anxiety as she's struggling to concentrate on A levels but scared to talk to the teacher about it. Had an ADHD assessment but she doesn't reach the threshold for diagnosis because the teachers think she's fine (probably because she tries to make herself as inconspicuous as possible and doesn't cause any disruption, also she's done well academically so far, even though all work has been rushed at the last minute).

She really wants to go to uni in September but admits she will only come out of her room for lectures and won't be able to speak to anyone so I've no idea how she'll cope. I think she should take a year out but she can't get a job as she's too scared to talk to anyone, and if she doesn't do anything she'll just stay in her room and get more anxious and depressed.

I feel we've completely failed her, we should have done something different bringing her up to help her confidence, but I don't know what. She's on the waiting list for private counselling but I'm not sure what else we can do.

I'm no expert but I have got a seventeen year old.

I think if this was me I would set small goals and insist in a way - that she achieves them.

Eg. On Saturday we get the bus to wherever together. Then we get the same bus as each other home but we don't talk to one another or sit together. Then on Sunday she does the same journey by herself. Maybe you could get an earlier bus.

I would tell her that it's not OK that she spends all of her time in her room alone and that you want her to enjoy her life and if she isn't going to do that with friends then she need to join in with what is happening at home.

Oh dear I’m very sorry. That sounds stressful and exhausting for you.

I don’t know how helpful I can be but didn’t want to read and run. I would put your foot down about going to university while you’re still her responsible adult. She’s not ready and it would be a disaster and make her anxiety even worse.

She needs to take a gap year to deal with her anxiety, even if she can’t manage a job in that time. Sell it as time to focus on her mental health and seeing all the services that wouldn’t help her when she was below 18. Perhaps she could get an online only part-time job? There’s not much, and they’re pretty thankless, but she could look. Or she could take some online courses to just to keep busy.

Having been anxious and depressed many times the small goals is great.

To start with they should be really small, but a step up from normal eg walk down the street and back, go into corner shop and leave without buying anything.

If she can get the goal done in the morning, even better as mood tends to be worst in the morning, then in the evening you feel better but beat yourself up for having done nothing and set unrealistic goals for the next day. So setting yourself up to fail.

Id at all possible I'd suggest a private ASD/ADHD assessment with a clinic specialising in girls and women. If she is diagnosed this will open doors for support at university (hopefully) A private psychiatrist for medication if it's needed until she is 18 then it becomes much easier on the NHS.
Also, if you use FB join Parenting Mental Health or Autistic Girls Network.

Have a read through this too:

autisticgirlsnetwork.org/wp-content/uploads/2022/11/Keeping-it-all-inside.pdf

You can’t wait for help as it will apparently not be forthcoming. Search the internet and find out everything you can anout ASD for girls, join a support group (for you) snd piggyback off other people’s knowledge and experience. You do not have to do this alone.

I would bet my money her being autistic. Of course she would benefit from a proper assessment but it's ok nowadays to self identify. Many parents of autistic kids think it's something they've done wrong before they get the diagnosis. Many autistic young people also blame themselves before they get the diagnosis. I would advise you both to read up on autism in women as much as possible and put in place appropriate strategies, not least huge amounts of self compassion.

Sounds like me at that age. I was diagnosed AuDHD as an adult. I did get better as I got older and I found people at uni that I felt more comfortable with and started to open up. I still struggle with anxiety but this is the nature of neurodivergence sadly.

Are there any groups for neurodivergent teens that you can take her too. I tend to find that talking to other ND people is less intimidating.

I knew someone like this. She had to drop out of college. What helped her was practising going places where she wouldn't meet anyone she knew. So rather than the local Tesco her mum would drive an hour and they would go in there together. She couldn't talk to anyone for a long time, but gradually got better. She's married with two kids now and lives a normal life.

I also turned out to be ASD as an adult.

The good thing is that it is much much better after puberty is over.

I found CBT, even on line CBT really helpful as I was convinced every one was staring at me. Mind-blowing to discover that people you see on the street are just getting on with their day.

She sounds a lot like my eldest DD who is autistic and waiting on an ADHD assessment. They cope until late teens then the pressure of constantly masking creates unmanageable anxiety. I'm not saying she is autistic but there are a lot of red flags.

My suggestions are:

• read up on autism in girls
• help her advocate for herself. Can you support her in speaking with her teacher? I no longer care if I get labelled "that mum" - my DD needs the support
• try to get her assessed for ASD. This will open up more support especially at uni. Even if they "only" diagnose anxiety support will be offered.

Be kind to yourself. It's hard watching our kids fall apart but you obviously care a lot and you are not "failing her". The advice from other posters about taking small steps is good. Ignore anyone telling you to just force her out of her room - she probably needs this to decompress.

To offer some hope, my DD is at uni and she's ok. She needs a LOT of support and she chooses how social she wants to be which is totally fine. Research unis carefully as some are much better than others for support eg Bath offers a summer stay over for autistic kids to introduce them to uni before the chaos of freshers week (not restricted to students actually going to Bath).

What symptoms of ADHD does she have? this all sounds a lot more like ASD to me and I don't see anything that suggests ADHD. I'd apply for DSA for uni now on the basis that she is probably autistic.

Will she do things with you? Will she go on a bus/in a shop etc with you? If so that's where you start, if not then that's what I'd encourage her to try first. So at least once a week you get the bus together and go shopping together. You might need to do them separately if doing both would be too overwhelming. From there you start getting her to pay with you behind her in case she needs support, you do that till she is confident. Then you wait at the doors to the supermarket and she goes and buys a few things and pays - all baby steps. This is what we have done with autistic ds who is a similar age.

Has she applied to any nearby universities? I think that if she's firmed a uni nearby then that might be helpful. Something I have drummed into ds though is that going to uni is one thing, but getting a job afterwards is quite another. You have to compete - and things like getting involved in societies and helping run them eventually, getting a part time job perhaps with the uni, and working on your social skills are going to be absolutely crucial to that.

You haven't failed her though! She's autistic and just needs loads of support right now with all these huge steps - but if you can break them into baby steps and slowly build her up she'll get there.

Some good ideas already from PPs. It sounds very hard, but don't blame yourself. It does sound like ASD although I've obviously not got enough evidence to say.

If she might have ASD, avoid counselling which is aimed at NT people. It can really backfire (or just be useless). There are some resources for helping anxiety for people with autism which might help.

Be careful about which uni she goes to as student support varies. However, there's no reason that she can't get help there including diagnosis, mentoring (to help her out and about), help socialising or attending things which she's interested in. If she has ASD, the anxiety isn't going to magically go away having taken a year out, although working could help to build her confidence.

Thanks all for your supportive messages. She (and I) thought she might have ADHD because she struggles to concentrate, in lessons she says she'll suddenly realise half the lesson has gone and she hasn't heard any of it, she has never seemed to be able to do homework or revision until the very last minute, she'll spend the whole time worrying about needing to do it but not being able to make herself do it, time blindness, losing things, can't remember conversations she's had, fidgets, doesn't wait her turn in conversations (with us). But her schools have never picked up on any of this, and we'd thought it was just how she was.

The autism possibility makes sense because of the social issues, sensitivity to sounds, and she also has some quite niche special interests. My younger DD has what I thought were more noticeable autism symptoms but she didn't reach the threshold for diagnosis so I assumed DD1 wouldn't.

We try to get her out of her room but she'll always rush back up again, eg as soon as she's eaten her dinner. Doing small steps is a very good idea, although challenging because if she doesn't want to do something she really won't!

It sounds like a mental burnout from masking which is common with girls who are neurodivergent. You haven't failed her. That is part of her struggling to cope with her ADHD no doubt and the key thing is not to put pressure on her to conform to what you think she should be doing as a teenager. Maybe she needs the alone time to recharge after being with people in school all day.

Sounds like my dd , we had a private assessment which confirmed HFA ..

She had anxiety / anorexia / self harm and depression

She goes to uni now and hopefully will pass her 2 nd year exams although I'm not convinced she goes to lectures tbh ..

She has tried 3 anti depressants and seems to be ok on the current ones .

She eats ok now and doesn't self harm anymore but is nervous and sad alot of the time which makes me sad ..

As soon as she is 18 you can start trying any depressants without camhs which I'm not sure if you knew or if you want to but they have helped Dd

Tbh if she's in burnout already then she needs to withdraw to self regulate. It might not be helpful to be pushing her right now depending on how her nervous system is doing overall.

If she's feeling psychologically safe and her nervous system isn't over stressed, gradually building up what she feels confident to do is a good plan. But timing is important.

the school assessments for ADHD and ASD have very high thresholds and really don't pick up young people who mask well and have a chieved reasonably well academically. A proper screening would pick up the subtle issues and open some avenues for ADHD or ASD related coaching or counselling

OP I agree with this poster. My DD is 17 and has an ADHD diagnosis this year privately. The school disagreed and their scores didn't show that she meets the threshold for diagnosis. However our private consultant had other tests QBCheck (please google this) that showed a very high level of inattentiveness. Coupled with anxiety, eating challenges she was a right mess. The diagnosis has helped us all understand her so much better. She has extra time in school for exams and her diagnosis will be taken into consideration for her UCAS score.

It's cost us a lot of time and money, but I believe it's the only way she will be able to get the support she needs to lead a normal life. Girls mask a lot and I'm regretting not pursuing a diagnosis years ago.

@WeeMadArthur1

Op.my youngest wasn't diagnosed asd until 17. Despite sibling with autism and lots of neurodivergence in the family.

It was very difficult. BUT I want to urge you to look after yourself. You cannot help your child if you are made unwell from this situation. Please look after yourself.

@SoftPillowAllNight this was a private assessment. We'd got so frustrated with the GP going round in circles because she's too old for child services, too young for adult services that we decided to pay. We went with Psychiatry UK because the GP said they would accept shared care with them, but maybe it wasn't a good choice. It felt as though the assessment didn't count for anything as they'd already decided they couldn't diagnose because the schools hadn't noticed it.

It's a lot of money to risk trying another provider, and to be honest I'm not sure DD would agree to go through with it again at this stage.

I feel completely exhausted with trying to navigate the various systems and processes, and it's making me doubt myself, maybe it isn't ADHD at all and I'm just looking for reasons rather than blaming myself.

I feel as though the best approach is now to let her try to concentrate on finishing her A levels over the next few weeks (i.e. keep reminding her to do little bits of revision, which she won't do and will then get really upset that she's let herself down). Then spend the summer trying to gently try things like going out, going to a shop, etc. When she gets her exam results we'll then decide whether to defer for a year and concentrate on trying to help her, and maybe trying for another ADHD/ASD assessment when she's not got the exam stress on top.

On top of working full time and trying to help DD2 who also has anxiety!

This. Mental health services are dire right now don't wait for that. Go private if you can and encourage her to take small steps with going out/ speaking to people etc

@WeeMadArthur1 - I see, do you mind saying what tests did Psychiatry UK do? And the school? Did the school fill out a report?

In my DD's case the psychiatrist was convinced of her ADHD based on her history and a 90 min long chat with her. So when the school's form didn't reflect his findings he was aware that girls can mask very well and had other mechanisms to assess. If that had failed too then obviously she wouldn't have got a positive diagnosis. But her score on that was very high, beyond doubt.

Could you consider an Educational Psychologist who can help her navigate the world a bit better? My DD's school have offered her this and the lady has worked with my DD to formulate everyday failure points + coping strategies.

It's difficult to know how much to push when it's an important exam year and the child is neither child nor adult. It's a very tricky age. Just stay close to her and let her know you are there by her side with/without diagnosis.

Regardless of the adhd/autism please contact the schools sendco and discuss her anxiety - they can speak with her teachers on her behalf and try to work out with the two of you strategies to keep her in schools/ lessons.

@SoftPillowAllNight Me and DD had to fill in RCADS forms, me and the school filled in SNAP-IV 26 forms, we all filled in strengths and difficulties forms,, I filled in a CAMHS developmental history form, and the school did a CAMHS report on school functioning.

The assessment mainly involved asking me about her history, milestones, issues at school before age 12 etc. They spoke to me much more than they did to her, but she was very anxious and wouldn't look at the screen (it was online).