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Teenagers

teen mental health - am I being horrible?

31 replies

mysterymoniker · 14/01/2009 09:55

I think my friend's daughter (who is 16 and also my daughter's friend) is malingering and that her mother is (unwittingly) enabling her. Then I feel very for being so horrible, but I can't help thinking that to support her the parents (and friends) need to push her to be more active and to help herself rather than to sink into this illness identity thing where she lies around all day being depressed until something nice happens to cheer her up.

I know there is a sort of atypical depression where your mood can and does respond to pleasurable external events in such a way as to appear to switch the depression on and off, but it's a bit marked in this case. I'm sure she does have periods of low mood but I think they've over-pathologised it and by encouraging her to see herself as ill, drop out of school and so on, are not equipping her with the tools she'll need to help herself through life. I think she just wasn't prepared for the amount of work needed for VIth form and this is a convenient way out.

Why am I being such a bitch though?

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cory · 14/01/2009 10:17

Are you sure it is your job to diagnose the extent of this child's mental health problems? Wouldn't that be better left to professionals?

If she is in a state where she is sinking into an illness identity, then just being told to snap out of it is probably not going to be helpful at all. Something like a rehabilitation clinic is more likely to do the job.

I have a dd who has suffered immense emotional damage by being suspected of malingering and being told that we were enabling her. As it so happens, dd has a bona fide genetic physical condition, but the emotional damage has been done regardless. And that damage would have been the same if her condition had been a mental health one. Several years later she is still a very confused and unhappy child who thinks she is a fraud and has brought it all on herself. She knows in her mind that this is not true, but years of living through whispered comments and unthinking remarks from the adults around her and clumsy and amateurish attempts to get her to snap out of it have left a lasting legacy. It has also made me very sensitive about the people around me, because I knew what they have been thinking about me all these years.

Because dd did stay at a rehabilitation clinic for quite some time, I got some insights into how they work, and they really have to be incredibly careful and positive in the way they speak to the children with emotional/psychosomatic problems. They have to recognise that there is a genuine problem first. Even if it's illness identity, that's still a genuine problem. Then they have to train them to deal with and to gradually get back to normal life.

If you want to help these friends, I would suggest that they ask for a referral to a hospital clinic that can deal with anxiety/depression problems. CBT is probably a good idea and some sort of daily life training, perhaps combined with suitable medication. It does sound like she and her family have got to a point where they genuinely cannot do this for themselves.

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plantsitter · 14/01/2009 10:20

you are being horrible.

I wouldn't be 16 again if you paid me a billion pounds, and I'm sure you don't really know what her parents are or are not encouraging her to do.

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mysterymoniker · 14/01/2009 10:26

No it's not my job is it, I don't even know why it's on my mind so much - but definitely don't believe in telling people to 'snap out of it'. That is not quite what I meant by practical support to 'push herself', I mean help to structure her day, help to get outside for a walk each day, to eat well and to maintain regular sleep/wake patterns. None of these are miracle cures but bit by bit, by probably imperceptible degrees, they will play a part in lifting her mood over time.

Sorry for dragging up unpleasant memories cory, hopefully they will get somewhere with CAMHS.

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cory · 14/01/2009 10:35

Yes, I see what you mean, but it is very likely that the family won't be able to do this on their own. For one thing, when you have been struggling with these things for some time, there are so many strong emotions within the family and so many bad memories, so much suspicion going around, that it can be virtually impossible for the teenager to agree to any measures suggested by the family.

When this kind of situation has been going on, it is likely that each family member will on occasion have said things in frustration which makes it difficult for the other family members to trust their good faith. You do. I've been there, I know.

After years of my trying to push dd to do things, some of which were certainly wrong or at least handled wrongly by me, we had got to the state where we needed outside help because she didn't trust me any more on those matters.

CAMHS helped because they were able to take a lot of the responsibility out of my hands and gradually put it into hers. It has worked much better. But she is still damaged.

It may not be for any bad reasons that you care so much: it may well be that you feel frustrated because you do care. But do try not to use the word malingering even in your own thoughts when nobody is listening because it will affect the way you think about her and consequently your chances of doing any good/not doing harm. It is unlikely that the child is doing this for her own pleasure. And it is almost certain that she is not enjoying it.

It is also extremely likely that the whole family will need support. These things damage more than one person.

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gemmiegoatlegs · 14/01/2009 10:38

i know a young girl going through exactly the same thing, and sometimes I think the same - that she is not going to get better by wallowing etc. But again, who am I to judge? Mostly I feel sad cos I think those years are some of the best of your life - grown up enough to be independent but relatively free of responsibilities

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plantsitter · 14/01/2009 10:45

I do actually sympathise a bit MM because my best friend was very similar at that age and it was so difficult not to think she was just attention-seeking or whatever. I have to say that she was so utterly unpleasant to her parents that they must have found it difficult to give her support and there was no way they could have influenced her sleeping patterns or daily activities.

but, as I said, I hated being 16. It is such an odd, in-betweeny, difficult time.

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mysterymoniker · 14/01/2009 10:53

Thanks cory, you've assessed my horribleness very generously - I think you're right, I'm frustrated. I might also be a bit 'triggered' ? by the anniversary factor of when my own daughter was in hospital and remembering the years leading up to it before we could get help and for now when she is supposedly 'all better' (to the rest of the world) but when I know and she knows just how hard it is to maintain even quite a low level of recovery (she has anorexia and depression).

It's difficult to balance it all, being gentle and understanding along with being firm about encouraging them to get up and dressed each day.

I'll try and get that horrible word out of my mind and do something practical myself, see if she wants to come and help me with my horse.

I didn't have a good adolescence either, I need to be a bit more sympathetic.

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cory · 14/01/2009 11:00

No it is very difficult when your own old hurts start resurfacing, and I imagine you also fear for your daughter: is there a risk that this will affect her, surely she needs a calm normal life now?

Am experiencing something a bit similar myself as dd's best friend needs a lot of support (her Mum is dying), but at the same time dd is still struggling with the aftermath of her problems (and will be permanently disabled anyway).

It is very frustrating and scary and difficult- and I don't have any answers, except that we have to hang on in there and try to be as empathetic towards other children's problems as we would hope other people would be to the problems of ours.

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mysterymoniker · 14/01/2009 11:19

Feel better now, more like a normal, fallible human and less like a monster!

Just phoned to see how she is and she is coming to work with me (dog socialisation group) this afternoon and she also asked about helping out at the yard - really really positive stuff. That was a much better use of my energy, and can see how the decision to not finish her A levels has helped her now that immediate pressure is gone.

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morningsun · 14/01/2009 14:43

hi mysterymoniker and cory,could i be really rude and ask for advice on this thread?
it seems you two know a thing or two about teenagers and illness and mental health.
my dd is 15.4,has serious physical illness dxed april2008 when she was extremely ill in hospital,convalescing over months and is a permanent but not terminal disease.
She has always been fiercely strong willed/independent and now i have 2 problems.
The first is she no longer wants me to fuss over her/ask how she is[i don't,just keep an eye]and she does all her own medication~this is fine but its as if she doesn't want me to help at all,wants to go into her appts alone etc.i said ok,the dr can have chat with me after but she thinks that unecessary and ott as "she has friends who get the pill on their own "etc.Also is moody and as if she hates me.
I understand it would drive you mad for your parents to be involved with an embarassing illness but find it hard to get balance right.
At what age are you legally,or medically responsible for yourself?
She is also down cos of what shes been thru and unsupportive bf.
I myself coincidentally had dep and post traumatic stress 12 mos before her illness,was snappy and v down and feel now i am picking up has this affected her and should i apologise or would that just make it worse[mum being weird with mh problem horror!]
I feel guilty for being snappy altho i know i couldn't help it,feel ever so slightly hurt she doesn't need me any more and don't know how to manage with her clinic appts now

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cory · 14/01/2009 15:06

I'm afraid I am not far on enough in this process to answer morningsun: my dd is only 12 so it's still natural for me to be in on her appointments. Another bridge for us to cross eventually. I'd be happy to learn anything you've picked up. I imagine it is particularly difficult for sick/disabled teenagers because their breaking-away process is extra complicated by the demands of their condition and they know it.

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deste · 14/01/2009 22:18

Could it be because she has no control over her condition, by doing the self medication and appointments herself that she has control of that.

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morningsun · 14/01/2009 23:11

thanks for replies
cory,yes it is about breaking away,and it seems a big change from 14to15,perhaps i am starting to process it a bit now.
deste,interesting about control,it is all about control,she wants control in all areas of her life all of a sudden.I think i should be glad she is brave about it all and give her as much control as poss[trouble is it never seems to be enough!]
In a way i hadn't thought about it being about controlling her illness,more aboutwanting her own way and to be in charge,putting it that way is more positive,thanks
I think i'll think of ways to empower her and be more positive,instead of it being a battle,and i think she might back down/relax a little then

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morningsun · 14/01/2009 23:12

cory did you find your dd's condition was a strain on the whole family?

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cory · 14/01/2009 23:39

Yess!! Still is. Not least because diagnosis took a very long time, so we were all left uncertain if she had a genuine physical condition or was having psychosomatic problems (even suspected of child abuse at one time). And even when we did know, the medical advice was to force her to push against the pain- guess who ended up having to do the day to day forcing? Not very good for family relations. And now I even know it was wrong from the physical point of view. So there's been a lot of anger there and she still has times when she seems to think she is a fraud or people will think she is a fraud.

Should add that dd's condition is almost certainly less serious than your dd's. It's lifelong and occasionally v painful, but not serious serious.

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morningsun · 14/01/2009 23:56

do you mind me asking is it a type of childhood arthritis?yes or no is ok
I understand can give too much info away in rl,without realising.

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cory · 14/01/2009 23:58

it's Ehlers Danlos.

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morningsun · 15/01/2009 00:15

oh i see its a ct disorder isn't it with fault in collagen.is she affected by pain,fatigue etc day to day?

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cory · 15/01/2009 00:20

Yes, that's right. Though not so bad atm. The year before last year was grim. Also affects her balance, so she falls easily. Though it's a long time since our last A&E admission. And her bladder control is better too. But since she got physically better she seems to have had a bit of an emotional backlash. Worrying about what people will think of her, wondering if perhaps it isn't all in her mind after all.

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morningsun · 15/01/2009 00:33

thats what happened to my dd exactly,as her physical condition improved the emotional backlash has come,mainly in being tearful,crossetc.it wasn't helped by a friend who let her down,se from medications etc.For her,she's been a busy capable person who does a lot and she thought she would get back to normal v quickly but things have changed and its a lot to cope with so its not been as simple as that.

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morningsun · 15/01/2009 00:50

not suggesting your dd not busy and capable obviously

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cory · 15/01/2009 08:58

I spoke to one of the Young Minds counsellors last week, and just speaking to somebody else made me realise that perhaps my expectations had been unrealistic. I'd been thinking 'oh, now she's feeling better, she'll start being happier' when I should have been thinking 'now she's feeling better she'll have the space to be angry'. Because our youngsters do have a lot to be angry about. I just wasn't prepared.

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morningsun · 15/01/2009 10:38

yes i agree,they do.
she speaks to a counsellor at school and always seems better for that [only had 3/4 sessions so far]
its about being calm and steady for her to vent and protest,i take your point about expecting too much,its easy to think things will get back to normal after a period of time and i need to be more open minded than that.equally its not right to focus on her illness all the time.
a minefield perhaps and one i'm stumbling across.

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cory · 15/01/2009 10:40

me too, me too!

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morningsun · 15/01/2009 11:31

it'd be good if there was a support thread for parents of children with chronic illnesses ,do you think?

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