16 year old daughter in crisis

[Needhelpforthis]

I don't know what to do any more about my daughter.

She is on setraline, 50mg a day and while that helps with her panic attacks, it's not helping with her feeling of 'sadness'. I put that in inverted commas not because I don't believe her, but because I don't know if that's the right word for it. She says she has a heavy feeling in her chest and that she always feels bad and the only thing that helps her is self-harming. She has been self-harming for a few years but we only found out in the past 18 months.
She is under CAHMS but they don't seem to be able to help and she doesn't want to engage with them anyway. It was a CAHMS Dr who prescribed setraline.
I asked the doctor if my DD could be depressed but they think not, but what can this feeling be that she has? It sounds to me like depression; the sadness, the apathy, the feelings of desperation.
She has been referred for testing for ASD and I think it's likely that she is on the spectrum but there is a long waiting list.

Does anyone have any insight/experience with this? I would appreciate ang help.

As I write this, she us upstairs in her room shouting 'help, help' my husband is with her trying to calm her down. This has been happening on and off today and last night. We took her to A and E on Monday night as she self-harmed quite badly, but I am at a loss as to what we can do long-term.

I can't explain all the ins and outs of the situation but I will try to reply later.

Apols for garbled message. I am going to take over from my husband now.

You are doing all the right things. You are good parents. I am lost for words really. It sounds like hell. I hope you get some more constructive advice but hand hold from me for now.

The weight on the chest, relieved by self harm sounds like anxiety. That's how mine feels.

Therapy helps me with that but if she won't engage, probably not much point

Oh dear, that sounds awful. Is she able to say what causes her to feel sad? Are there any triggers? Does she socialise with friends? How is she at school?

50mg is quite a low dose for depression, she might need to increase it a bit. Was it CAMHS psychiatrist who prescribed? Get back to them and ask if you can increase it, but do it slowly, by 25mg increments. Sadly, depression and anxiety is very common in teens with ASD.
If you use Facebook join the private group 'Parenting Mental Health' it's a godsend.

We had this when dd was 15/17. She had a good life, secure home, friends, great school so it was an internal problem rather than a less than good life in any way.

We got zero support from CAMHS.
A private adolescent psychiatrist was a great help; relate counselling was much better than camhs but I would caveat that with the fact that ime counsellors are a bit like shoes - you have to try on a lot before you find ones that fit.
GP was happy to prescribe once the psychiatrist was in place.

If you have no alternatives but camhs, may I suggest that you confirm with them in writing what has been agreed at every appointment or interaction. We found they were very good at double speak and moving goalposts.

Eventually after self harm including od's and restricting food dd was diagnosed with ADHD - so many things fell in place - CAMHS laughed when I told them that. Once diagnosed and medicated dd turned the corner.

It's really hard op. I hope someone is looking after you too.

Could have written your post - tis almost exactly the
same here.
Can't help you and don't know where to turn ourselves.
We are almost broken.

Is she managing school? Have you asked for a EHC needs assessment from the Local Authority? My daughter had an autism diagnosis at two and fell apart at 14. CAMHS were never much help, had a support worker who didn't understamd autism, then because dd wasn't improving she proposed to discharge her. I complained, they offered more of the same so I complained again, got a psychiatrist, mediction, new support worker and three sessions with a psychologist from LD CAMHS even though dd has no LD they just knew I was going to be trouble. They taught me positive behavioural support strategies which was really helpful for dd.
At the same time I fought to have her placed in independent specialist school and CAMHS wrote the necessary supporting letter (probably glad to get rid of me tbh) This was key, a school with all therapies on site so she has OT, Art and Music therapy, Counselling, they have their own psychologist and hugely supportive teachers and support staff.
She's always going to have autism and the anxiety that runs alongside, she takes sertraline daily, she too talks of feeling sad and I think it's because she is very sensitive to any dip in mood so where you and I might sigh and get on with it dd feels deep sadness. I encourage her to do the things she likes such as crafts or playing piano because if she can distract herself the sadness eases until next time.