What am I doing wrong?

August 1, 2009 7:13 AM

Any insights on how I can help my daughter?

My daughter:

She’s 12, almost 13. Extremely smart, creative, musically inclined, beautiful, compassionate, loves animals and children are drawn to her.

Mood swings a constant in her history since age 4. Therapy and medication tried from age 6 until now. Adderal and Zoloft a powerfully bad combination ending in psychotic episodes and hospitalization at age 7. Irrational perceptions and can be very violent towards her older (aged 15) sister and even to me.

Specific behavior that I’ve never heard of; she won’t wear a seat belt in my car (it’s “uncomfortable”), refuses to do homework and when forced, she will rip it up or not turn it in, and she can’t wear jeans… in fact she will wear the same outfit over and over for MONTHS on end. Various things tried in therapy, never resolved. This is life as we know it since she was 6.

She is socially somewhat awkward – but can be the life of the party. She gravitates toward adults and can hold a great conversation. She is clumsy and frequently breaks things – sometimes on purpose.

She is living with her father right now because she started failing 6th grade and had multiple problems in school with teachers and students alike. It was her idea (and often discussed in therapy) and she obeys her dad (I have very little control of her). She was becoming dangerous to my other daughter, as well. I frequently think “She is her own worst enemy.” She has never had friends in the traditional sense like my older daughter has – sleepovers, etc.

She wants to come home – she hates the oppression and discipline of her father’s house. This is greatly opposed by my oldest daughter.

Multi part question: What can I do for her?? Years of therapy have done nothing. How do I protect my other daughter? Has anyone heard of this behavior? I have read extensively on various mood disorders and still don’t know What To Do.

Any insights are SO appreciated.

(Various notes – I’m a good mom. Her dad is a good dad. Her sister is very popular and easy going with tons of friends and this causes jealousy. Her dad and I disagree on the severity of her mood disorders and is vaguely anti-therapy. We’re really very normal looking on the outside with very normal aspirations in life. No childhood trauma and I was a SAHM until she went to school.)

posted by anonymous to human relations (48 comments total)

I have no comment on therapy or whatever, but:

Specific behavior that I’ve never heard of; she won’t wear a seat belt in my car (it’s “uncomfortable”)

That's completely unacceptable. If she doesn't wear her seatbelt, you don't drive her anywhere.

If you're incapable of making her wear her seatbelt, you don't drive her anywhere.

Regardless of whether it's somewhere she wants to be taken or somewhere you want to take her. You don't drive her anywhere.

Anywhere.
posted by Flunkie at 7:19 AM on August 1 [21 favorites]

Wow, this sounds really tough. And it also sounds like you're doing everything right to help this situation. I have no experience with children with disorders like this, but a couple of things popped up for me while reading your question.

You mention therapy and medication - but has she seen one psychiatrist? (It's been my experience that seeing more than one and getting multiple opinions is important in obtaining a correct diagnosis.) There is obviously something going on that is far more than something simply therapy can deal with - what is her clinical diagnosis? Your previous experience with medication sounds awful, and I am never one to advocate for medicating children, but it may be worth re-visiting this route again.

The therapy she has been in - does she like the therapist? Has it only been one therapist? Kids are picky and I bet if your daughter found a therapist that she really, really liked that she may open up and be more receptive to behavioral modifications, which may make both of your lives a little easier. Very best of luck to you and your daughter.
posted by meerkatty at 7:21 AM on August 1

Does she have a diagnosis? The sensory issues with the seatbelt and clothing, combined with clumsiness, social awkwardness, stubbornness, and rages, sound like the autism spectrum to me. (IANATherapist).
posted by headnsouth at 7:23 AM on August 1 [10 favorites]

Wow, I feel for you. I've been there. Has your daughter's pdoc considered a diagnosis of bipolar disorder? Adderall and Zoloft can trigger mania in bipolar kids. The Bipolar Child is essential reading. You are probably not doing anything wrong.
posted by Wordwoman at 7:25 AM on August 1 [1 favorite]

I'm thinking she definitely could have sensory issues. Your doc needs to check that. It also sounds as if she could be on the bipolar spectrum-the reaction to Adderal and Zoloft should have tipped off the docs IMMEDIATELY.

Add to all this adolescent hormones....you all have my sympathy, to include her as well.

On one hand Dad is on the right track-structure is incredibly important-but on the other hand he needs to know this child needs and deserves some second opinions and proper treatment NOW. If she is on the bipolar spectrum she WILL get worse without treatment. If she is on the Autism spectrum she needs help-and for goodness sakes, if she has the sensory issues, there is help for that! She probably is incredibly uncomfortable and that in itself could cause her to have trouble coping.
posted by St. Alia of the Bunnies at 7:59 AM on August 1

The book The Out-of-Sync Child might help you begin to understand the sensory issues. Your daughter's school district should be able to help you find help. This website might help you with resources related to evaluations, etc., though some of it is state-specific. Good luck.
posted by maloon at 8:10 AM on August 1

My wife is an early childhood expert, so your daughter's out her normal range, but she read your question and has a suggestion:

It sounds clearly (as clear as it can be in a short question anyway), that your daughter has Sensory Integration Disorder based on her problems with seat belts and clothes. This is usually a symptom of a larger issue (often Autism or ADHD, but my wife isn't suggesting that based on your question).

She suggests that you talk to your daughter's school to have her screened by someone trained in Sensory Integration Disorder, who will also have broader knowledge of the other issues that your daughter has and can suggest a course of action.

MefiMail me if you want/need further suggestions about how to go about setting up a screening if you find the school less than accomodating.
posted by Mayor Curley at 8:15 AM on August 1 [5 favorites]

IANAD but I worked in a psych facility for about 8 years and have a
master's in Counseling Psych. Admittedly I don't have all of the info and I have not seen your daughter but the first word that popped into my head was 'neuro'. I agree with everyone that she needs to see a psychiatrist willing to fully evaluate her. We treated kids who sound behaviorally very much like your daughter but had ever so slight seizures as well (usually petit mal that were triggered with overstimulation and that would result in some aggressive behavior as well). Some would definitely look like they were leaning more toward bipolar and some would seem more autistic. I remember though, that I could just 'feel' (unscientifically of course) that they were just more 'edgy' and 'high strung' more than the other patients, and yet it was different than an anxiety disorder. They wound up on meds like Depakote and Trileptal (I think).

So all of that is to say that you should strongly consider a psychiatrist that sees children and has some knowledge of neurologically based disorders. And that you may not be doing anything wrong...you just haven't found the right answer yet. Also, hormones at this age will throw everything out of whack. You can help by keeping a structured, predictable ( as much as possible) at home, set clear rules and consequences, and enforce them. Like the autism spectrum, unpredictable environments tend to make things worse. I wish you the best!
posted by MultiFaceted at 8:40 AM on August 1 [7 favorites]

Sensory integration disorder is a controversial "diagnosis" despite the declarative tone of some of its advocates.

Don't get your main advice on this from the Internet, please. You need to find a really good psychiatrist with an open mind.
posted by fourcheesemac at 8:43 AM on August 1 [2 favorites]

Have you considered getting your daughter a pet? A pet will help calm her, teach her responsibilty and provide unconditional love. Please consider all the aspects of pet ownership before you take the plunge - a life-long commitment to a living companion, with time and financial costs, but with huge rewards.
posted by Wooden Doll at 8:44 AM on August 1 [1 favorite]

Foorcheesemac, I know kids who have this. Diagnosed by real doctors. I think the OP can trust the real docs she goes to to sort this out.
posted by St. Alia of the Bunnies at 8:45 AM on August 1

You're getting alot of armchair diagnosis thrown out here, and I would take it all with a grain of salt. Bipolar disorder is extremely rare in kids her age. Autism is maybe a start, but it doesn't make alot of sense if she's openly defiant (ripping up homework) and she does it because she knows it upsets you.

Go see the best child psychiatrist you can find in your area, and go with her dad. If she needs to go to a psychologist for more therapy, make that a group project too. If she's not making progress with one therapist, seek another. It's really key that the treatment plan that anyone gives her is implemented consistently at both houses. If the psychologist advises some behavior management strategies, but only you use them and her dad doesn't, she won't make progress.
posted by slow graffiti at 8:56 AM on August 1 [3 favorites]

The pet idea coupled with a child who can have violent outbursts towards people she loves is not the best idea. It may put the child in danger, as the pet, when older, may react badly to a violent outburst. It may put the pet in danger. At best, it may also end up being one more thing to which mom has to attend.
posted by oflinkey at 9:04 AM on August 1 [7 favorites]

slow graffitti,
I dealt with a child who would have melt downs over homework -- to include destroying it. He went thru a couple of diagnosis. He was finally dx with Aperger's syndrome. Don't underestimate the power of overstimulation and inability to deal with frustration to lead to melt downs in Aspergers' kids.
I agree with everyone else that is saying get additional opinions, your daughter sounds miserable.
I also think that your older daughter needs to be and feel safe. If she is against her sister moving back with you, that needs to be addressed.
posted by Librarygeek at 9:37 AM on August 1

I certainly agree with everyone else here that you need to continue to seek psychiatric help until you get these issues figured out. However, all of this concerned me, and I haven't noticed anyone speak up about it yet:

can be very violent towards her older (aged 15) sister and even to me

she obeys her dad (I have very little control of her). She was becoming dangerous to my other daughter, as well.

She wants to come home – she hates the oppression and discipline of her father’s house. This is greatly opposed by my oldest daughter.

What can I do for her?? How do I protect my other daughter?

It sounds as though she's getting some structure and discipline that she desperately needs at her father's house. You say he's vaguely anti-therapy, but as long as he's willing to enforce that she participate in the process, it sounds like his house is a far better environment for your younger daughter. Also, psychiatric help is a different animal from talk therapy, and perhaps he'll be more supportive of her treatment if it involves a combination of the two?

And I think you really, really owe it to your older daughter, who has suffered abuse at the hands of her younger sister, to keep her safe. And safe means that until these issues are resolved, you keep her younger sister at her Dad's house. It's not punishment, it's just the best place for everyone: you and your elder daughter are protected from her violent outbursts, while your younger daughter is actually learning some discipline and self-control at her father's.
posted by amelioration at 9:48 AM on August 1 [13 favorites]

I displayed most of those behaviors at that age until puberty and some, beyond-- I wouldn't wear jeans or a belt of any kind (seatbelt, yes, though), I wore the same baggy clothes every day. I couldn't stand the feeling of anything around my waist and I still can't. I was obsessive about certain tv shows and music. I suspect today I would have been diagnosed and medicated. Thank god I wasn't, because I grew into a well-adjusted however dorky adolescent and adult.

Nevertheless, a few years ago I was diagnosed with a major genetic neurological disorder. Little things I'd always thought were just "me" turned out to all point to something serious.

None of those things is something a psychiatrist would pick up on. Psychiatry does not equal neurology. I second the suggestion to see a neurologist.

This is not an armchair diagnosis. This is a recognition of your daughter's behaviors in my childhood past, and the reassurance I grew out of them. However as an adult a neurologists diagnosed me with a seriously painful genetic neurological condition that explained a lot of my childhood oddness. Consider it a data point.

I almost did not post because I dislike contributing answers to questions like these when everyone jumps on board the bipolar/autism or psychiatry/therapy train. Despite the popularity of these "diagnoses" on AskMetafilter, there are thousands of of things that could be going on with your child.

Finally, just from what you've written, I'd take into account that your attitude toward your "good" daughter ever so slightly influences the way your "bad" daughter behaves around you.
posted by vincele at 9:52 AM on August 1 [11 favorites]

This is something that my child's therapist said that helped me when dealing with my own child's unusual behaviors:
Every behavior has a function, even ones that seem inexplicable. If you can find out what need the behavior is serving, that can make it easier to help change it. The need might not be what you think - for instance, a child could refuse to do homework or rip up work because of anxiety and perfectionism, not defiance or attention-seeking. Also, the child has to change the behavior, but the parents can help by assessing and changing what comes before the behavior (antecedent) and what comes after it (consequence).

Also, I've found the methods described on this website: Think:Kids to be a useful way of framing and dealing with challenging behaviors.

Your child is entitled to an evaluation through your public school system, even if she doesn't go to public school. This probably varies widely throughout different school districts, but my child was evaluated thoroughly by two psychologists, a speech therapist, and an occupational therapist, and the results helped point us in a direction for seeking private therapy, as well as qualifying him for extra help and accommodations in the classroom. It usually takes a few months for the wheels of bureaucracy to turn and get this process moving, so if you want to go in that direction, it's a good idea to make your request sooner rather than later.
posted by Daily Alice at 9:53 AM on August 1

Like pretty much everyone said, your daughter needs to see a doctor. Once a medical professional has identified what her problem is, you will be much better able to help her. This isn't going to happen in therapy--your daughter is beyond therapy. In the meantime, I would not let her come back to your home. She wants to come back to your home because she can be more out of control there; this isn't good for her, it definitely isn't good for your other daughter, and probably won't be good for you, either. You and her father are the parents. Your first priority is to make sure everyone is safe, not that your daughter gets whatever she wants. That means that she should stay with her father until she can prove that she isn't a threat to your other daughter and that she will behave herself in your care. Also, as mentioned above, I certainly hope that she isn't being driven anywhere without a seat belt on.
posted by Polychrome at 10:03 AM on August 1

She is living with her father right now because she started failing 6th grade and had multiple problems in school with teachers and students alike. It was her idea (and often discussed in therapy) and she obeys her dad (I have very little control of her). She was becoming dangerous to my other daughter, as well. I frequently think “She is her own worst enemy.” She has never had friends in the traditional sense like my older daughter has – sleepovers, etc.

She wants to come home – she hates the oppression and discipline of her father’s house. This is greatly opposed by my oldest daughter.

I want to say that I totally, totally agree with amelioration due to the above. If her dad is appropriately disciplining her (IE, not using physical discipline, etc) and is successful at doing so, why would you take her out of that environment? It sounds like she needs a lot of discipline and structure, which you've been unable to provide but her father is able to give her. Of course she probably doesn't like it--although I'm not quite sure what she/you mean by "oppression." Is it an oppressive environment because of the rules, or for some other reason?
posted by PhoBWanKenobi at 10:41 AM on August 1

Multi part question: What can I do for her?? Years of therapy have done nothing. How do I protect my other daughter? Has anyone heard of this behavior? I have read extensively on various mood disorders and still don’t know What To Do.

The quality of 'therapists' varies enormously. Even worse is that quality is virtually impossible for outsiders to see. The lead in paragraph also has neuro-tinged aspects; a good child psychiatrist knows the neuro lookalikes, but you might want to see a child neurologist. There probably is no easy answer.

Did you see the Mayo page on ODD treatment? It seems close to what somebody smart told a class full of social workers. I'm not saying that she has ODD, and as they note other underlying problems can give a similar appearance, but if discipline in the other household is working it might be worth considering the kind of household discipline that works for those kids.
posted by a robot made out of meat at 11:32 AM on August 1

Vincele is correct that the input of a neurologist may be useful, but the idea that a psychiatrist is unqualified to diagnose your daughter is dead wrong. That is the first person you need to be seeing.

Let's clear up some definitions:
- psychologists do therapy, they don't do meds
- psychiatrists do meds, and less often than psychologists, therapy. they are usually the diagnostic front line, aside from general practitioners, and they are the experts on the behavioral and medical manifestations of mental disorder. they went to med school, but are less specialized in brain function than a neurologist
- neurologists do meds, provide input on surgery, and medical treatment of anything wrong with your brain. they will be little help if there is not an underlying neurological abnormality they can find and treat, like there may be in diseases like multiple sclerosis or Parkinson's.

You may want the opinion of any or all of the above kinds of specialists, and I think a second opinion from a different kind of specialist may be warranted, but I repeat my previous warning that none of the personal experiences here are going to tell you what's wrong with your daughter. See the best person you can possibly find, preferably a team of people, make sure they specialize in kids, and disregard the internet.
posted by slow graffiti at 11:39 AM on August 1 [4 favorites]

Does she rip up homework when her dad makes her do it?
posted by Pants! at 11:42 AM on August 1 [1 favorite]

Also -- children's psychiatric diagnoses are frequently murky and there is a good deal of overlap between them. The diagnostic categories are based on clusters of symptoms and they don't always cluster neatly. You may well go through several diagnoses, countless medication regimes, and probably a few different doctors before you hit on the right combo. This is normal. I'd highly recommend you find a local NAMI group so that you (the caregiver) can get the support you need, as well as support for your daughter. (IMHO that doesn't include being exhorted to tell your daughter she won't get to go where she wants if she doesn't wear a seat belt, as if that would compel her to comply. People who haven't been through this do not necessarily get that in kids who are neuro-different, the usual operant conditioning *does not work.* If it did, the kids wouldn't be engaging in these behaviors. Check out The Explosive Child for some alternative strategies.) Feel free to MeMail; I have gone through this in my family (and can offer hope).
posted by Wordwoman at 12:08 PM on August 1

You need to favorite slow graffi's post. Hard.

Our anecdotes are only useful insofar as you use them as a catalyst to keep searching for a solution for your daughter. Don't be afraid to keep looking!
posted by St. Alia of the Bunnies at 12:10 PM on August 1

I've had to deal with something similar. What worked for us was a consultation with an group that specializes in evaluating children. We had been seeing psychiatrists with little success. Finally meeting with someone who said "we see behavior this all the time and here is what you can do" was a real relief. In our case, occupational therapy and meds, combined with an intensive school setting made a huge difference.

Just like any medical condition, your best bet is to see someone (better yet a team) who treats lots of kids with similar issues. Look to major universities in your area.

This is where we found help:
JFK Partners

If you like, send me a mefi mail with your location and I'll see what I can find on this front.
posted by cosmac at 12:10 PM on August 1

To me this sounds like bipolar disorder, and Zoloft and Adderall are NOT the medications you use for such a thing. Have any of the psychiatrists you've seen tried any anti-convulsants (such as Lamictal) with her? I would recommend finding a psychiatrist/mental health specialty at an academic institution, as they will be more up to date with advances in the field (in general). I see you are in MD. Have you tried going to Johns Hopkins?

Some quick googling led me to this.
posted by sickinthehead at 12:15 PM on August 1

Nthing everyone who said see a psychiatrist and possibly a neurologist. And yes, ideally, see academic psychiatrists like the JFK link-- people at major universities are tied in to the research and are more likely to practice based on the evidence about what works. (Yes, many doctors don't do that).

Also, whatever you do, avoid "educational consultants" and "troubled teen" residential programs (wilderness, "emotional growth boarding school" 'boot camp" "behavior modication program") which are not designed by professionals (although they hire some to make it look like those are who the child will primarily see; in reality, the kids spend most of their time with other messed up kids and people whose highest level of education is often high school) and which are often abusive. There's also no real evidence they help anyone-- and simply concentrating all types of troubled kids together can itself do harm.

Signs that you have wandered into that world are programs that say they can treat virtually all problems and programs that restrict the child's ability to talk to you and use such "privileges" as behavior modification tactics. This means abuse can't be reported until well after it's been going on for a long time. There's no federal regulation on these places and there have been many, many problems and some deaths.

Also, the ODD diagnosis is basicaly a medical term for "bad kid"-- try to avoid having your child labeled with it, it doesn't lead to any particular treatment strategy but is extremely stigmatizing.
posted by Maias at 12:31 PM on August 1 [4 favorites]

Are you familiar with dyspraxia? Some of the things you mention strike me as being signs of it (although of course they could be signs of something completely different): the clumsiness, the social problems, finding the seatbelt uncomfortable, not wanting to wear jeans, the high intelligence, the creativity.

Occupational therapy can be very helpful, believe it or not. Dyspraxia isn't autism, but many of the therapies that help autistic kids can help those with dyspraxia, too. Feel free to e-mail me if you want to know more.
posted by The corpse in the library at 12:56 PM on August 1 [1 favorite]

In addition to the psychiatrist/neurologist/etc route, you might want to look into age-appropriate meditation techniques. Not a solution in and of itself, but a path to dealing with life-long mood disorders. There is something very powerful and empowering in the idea that one can train one's own mind to do what you want it to, especially if it isn't behaving as one would like. I know that when I was 11 or 12, I was drawn to the idea without knowing exactly what it was I was looking for. (Took another 15 years to start finding it.)
posted by tingting at 1:03 PM on August 1 [2 favorites]

Meditation sounds good and maybe even yoga or some other structured physical discipline. Does she swim?
posted by mareli at 3:34 PM on August 1

slow graffiti: As I said in my post, I was offering my experience only as a data point. My experience is that neurologists have broader training and exposure to the gamut of disorders-- neurological, psychiatric, otherwise-- than do psychiatrists. It is also my experience that a neurologist will say, "see psychiatrist x and physical/occupational therapist y. We work together as team." No psychiatrist has ever suggested a team-oriented approach to me.

And no, not every general practitioner does a basic neurological exam if you bring a problem that confounds him. For the record, I'm in what is supposedly one of the "top" hospital systems in the US. I have received wrong and downright harmful advice at every step of the way. That's the nature of medicine when it comes to complex problems, I get that. No one doctor is going to get something unusual right the first time, or on his own, unless you get very very lucky.

One of the purposes of AskMe medical questions is to suggest ways of looking problems based on experience. I had those symptoms the OP mentioned as a kid. I turned out fine. Then in my 30s I learned my childhood quirks were symptoms of something serious, but not life-threatening, the name of which I *purposely* left unnamed. That's a data point.

Another data point. My experience with doctors in this oh-so-highly-ranked-hospital system is that neurologists have a wider understanding of the brain, and the brain and body connection than do psychiatrists. A neurologist might very well send a child to a psychiatrist, and the child should be seen by both. However, the advice to start with a neurologist is hardly as mindless as diagnosing every medical problem on AskMetafilter as Aspergers/Bipolar/Autism, a manifestation of what I'll call ABA syndrome.
posted by vincele at 6:57 PM on August 1

She just doesn't seem very happy. Does she feel stereotyped? You mentioned she had horrible mood swings at four years old. You also seem to compare her to her popular older sister a lot, and then you mentioned that you'd had her medicated her at a very young age.

I could be wrong, but maybe she needs a break from your family to do some growing up without feeling ashamed of herself. I can't imagine what it would be like to be thought of someone with "problems" at such a young age. It would hurt me and make me feel trapped. Also, her older sister doesn't like her enough to not want her back at home. That must feel horrible too.

I don't doubt at all that you guys are lovely, deeply concerned and caring parents -- but maybe it would be better for her to attend a boarding school or something like that, if possible. You've lost control of her, and she seems unhappy at her father's house. Maybe it's time to ask her if she'd like to attend a school away from home, somewhere she can start fresh, free from her family dubbing her as the "problem child."
posted by anniecat at 7:07 PM on August 1

Actually, scratch my answer out, please. My screen was too small and I missed the third paragraph.
posted by anniecat at 7:19 PM on August 1

I have found that the mental health system doesn't deal well with kids. Be persistent, keep doing research, and try to get her appropriate help. You may be able to learn from her dad; if he's able to affect her behavior, investigate how he does it. Some kids with mental health issues/ diagnoses benefit from lots of structure and discipline. Can she visit your home more frequently even if she doesn't move back?
posted by theora55 at 10:08 PM on August 1

I can't diagnose crap, but your sick daughter right now is going to be unhappy right now no matter where she lives. Keep her away from the other one as best you can. That's all I've got.
posted by jenfullmoon at 10:59 PM on August 1

If a child has been having persistent behavioral problems since the age of 6 and is now 12, we can presume she's been seen by plenty of doctors and that no underlying degenerative neurological disease is to blame here. I disagree with vincele that a psychiatrist would not examine for or be likely to propose such an explanation, most especially in the case of a kid with persistent behavioral problems and mood swings. I'm going to guess the kid has seen more than one psychiatrist, and has had regular medical care for, oh, the last 12 years or so.

The speculative talk in this thread is absurd for the most part, especially those confidently asserting "bipolar" or "SID" or "autism spectrum."

Duh.

You think a kid who has been under medical care for these symptoms with prescribing psychiatrists hasn't been evaluated for all of these, repeatedly? Bipolar disease *rarely* manifests in a 12 year old. It's nearly unheard of for it to manifest in a 6 year old, and this child's problems (the OP claims) began even earlier than that. I love how confidently some people here say "OH, bad reaction to those meds, must be bipolar." "SID" is a fad diagnosis, rejected by many serious mental health professionals, and at best probably a description of a symptomology that could be the result of many different underlying neurological, cognitive, and emotional problems.

Or "must be" anything. As vincele correctly notes, there are countless possible explanations for the behavioral symptoms the OP describes. We don't know nearly enough about the background facts in this story to be offering *any* diagnostic suggestions, nor are most people posting here (probably all of us) qualified to be doing so. And if we were, we wouldn't be doing it online for a person we've never met or examined.

I was glad to see the comment blaming mom for medicating her kid was deleted. That was fucked up. "Get a pet" and "meditate" at least do no harm, although they are obviously silly suggestions given the severity and duration of the problems.

We are missing many crucial facts in this story, almost certainly. But even if we could grill the OP, we are playing doctor on the internet again. And that's just bad medicine. Far more so when a minor is the subject of our speculation, and all we have is the context provided by one of that person's parents.

OP, I understand why you'd post this question in a moment of desperation. The problems you are dealing with are unfortunately too common and so hard to handle even for the most well meaning and well adjusted and well resourced parents. But the only answers worth a crap in this thread are the ones that tell you a) not to trust strangers on the internet to know what they are talking about and b) to go back to seeking the best professional medical advice and care you can for your daughter.

No one here knows what is going on. And no one can do more than speculate given what you've told us and without knowing your child and family. The best anyone here can do is offer almost random guesses that your child's doctors have already considered or rejected if you've been through the ringer of 6 years of medical treatment for these issues and you are a conscientious parent, as you seem to be.

Most responses seem to overlook the one real question in this post asking "what to do?" I take that question as more "what can I do to keep myself sane and centered" than "what can I do to make my child better."

And the answer is, parenting is hard. Take a deep breath. Remember that you love this child no matter what her challenges and problems. Give yourself a break. Communicate with your child's father *and* doctors that you are overwhelmed. (I'm amazed no one has yet blamed the child's problems on the parents' separation, good for AskMe for pulling at least one punch.) Respect your child; she will be an adult -- maybe one with serious problems -- before you know it. Accept that you will sometimes fail to keep your cool, lose hope, want to quit. You can't lose hope. You're her mother. She needs you to keep trying.

So, in essence, my only advice here would be for *mom* to get some therapy for herself, and perhaps to join a support group for parents of children with emotional problems. They are legion, and you can connect with the best resources in your area more effectively if you have a community of people going through the same things.

Don't ask strangers for help diagnosing your child's problems. It will only make things worse.

/appalled
posted by fourcheesemac at 7:00 AM on August 2 [2 favorites]

Fourcheesemac, I was told by one of the best psychiatrists in the county that most bipolars suffer thru quite a few misdiagnoses before someone pegs it. The proof is in the pudding; if you treat for it and it works, bingo! And having actually been in that man's office while a ten year old bipolar was rampaging and raging in the waiting room, with cops on the way to transport her back to the hospital, I'd like to suggest to you that your assertion that bipolar doesn't happen in younger people is worthless in this particular thread.
posted by St. Alia of the Bunnies at 7:40 AM on August 2

SAotB: I didn't say bipolar disease doesn't occur in younger people. I said it was rare, and that if that diagnosis made sense, the child's doctors would not have overlooked it in 6 years of treatment. You seem systematically unable to reply to anyone without distorting their words. Your stories, if they're even true, don't prove anything at all.

And curley, not exactly. I write about music, although actually I have the PhD in a different field (anthropological linguistics, to cut a long story short). That qualifies me to say precisely nothing about the diagnosis of a stranger over the internet, which is all I said.

What I said about SID is factually true: it is a hotly disputed "disorder" at the moment, and it is being wildly over-diagnosed according to some experts who think there might even be something to it. I am -- unlike you and your wife -- not diagnosing a stranger with SID (as your wife appears to have done, however tentatively). I'm saying there is no definitive diagnosis for SID, and that we have no business confidently proposing it as a diagnosis here.
posted by fourcheesemac at 7:54 AM on August 2

The best anyone here can do is offer almost random guesses that your child's doctors have already considered or rejected

The problem is that doctors aren't perfect, and might not have considered everything. In my experience, it's not unheard of for a doctor (therapist, psychiatrist, etc.) to come up with a diagnosis too early on and then stick to it. We're throwing out other possibilities that the poster can than look up on her own, see if it seems to apply, and then bring in to the doctor's office to discuss.
posted by The corpse in the library at 8:03 AM on August 2 [2 favorites]

Oh, one more resource: you can find good support at the Conduct Disorders site. There will be people there who have experience protecting one child from another.
posted by The corpse in the library at 9:46 AM on August 2 [1 favorite]

SAotB: I didn't say bipolar disease doesn't occur in younger people. I said it was rare, and that if that diagnosis made sense, the child's doctors would not have overlooked it in 6 years of treatment.

ORLY? In the real world I live in, doctors make mistakes and fail to diagnose things all the time. That is why many insurance companies actively encourage second opinions at times. Particularly with this sort of issue in a young person, you need the correct set of experienced eyeballs to look at this, and the average person does not usually know what questions to ask or necessarily what experts to consult.
posted by St. Alia of the Bunnies at 1:08 PM on August 2

[fcm, Curley, Alia to a lesser degree—any more of this needs to take place somewhere else. This thread is not your personal thunderdome, please cut the personal infighting out.]
posted by cortex at 6:57 AM on August 3

Have you tried getting her a pet? A nice goldfish would probably fix this whole situation.

Actually though I get the impression that you are very caring and loving mother who adores her daughters. I'm not so sure you are doing anything wrong at all. Sometimes people just encounter emotional troubles...doesn't mean the parents neccissarily did anything wrong.
posted by rex quan hasslehoff at 8:19 AM on August 3 [1 favorite]

An attempt at peacemaking: I know many parents who will say their kids have "sensory issues" when talking about children who have a particularly hard time screening out stimuli (e.g. background music or seams on socks). It sounds less like an official disease, but helps explain why a kid might get overwhelmed in a situation that doesn't look especially problematic on first glance.
posted by The corpse in the library at 8:21 AM on August 3

[second mod note: please stop this now. Go to metatalk if you need to prolong this, you are derailing this thread.]
posted by jessamyn at 10:58 AM on August 3

This thread is only a few days old, and I hope it is still actively being read.

I HAVE A COMPLETELY DIFFERENT IDEA ABOUT WHAT MIGHT BE GOING ON. I OFFER THIS AS A POSSIBILITY, NOTHING MORE.

My mother could have posted this question when I was younger.

And I could have posted this question in the days, months, and years leading up to the events that caused a permanent break in my relationship with my mother. You see, my mother has Borderline Personality Disorder.

She favored my brother over me, hence, I was always the "trouble child" who was in therapy and being evaluated. She created problems with me to explain away her outbursts. I am thankful I was never medicated. I came pretty close to being sent "away" on various occasions while I was growing up. My mother made up stories about me that neighbors, friends, family, and teachers were willing to believe on some level. This is a common characteristic of the BPD parent, or so I gathered from the few Mefites who wrote in to answer the post I just linked to.

I find it ALARMING the OP doesn't talk about any history of neurological evaluations for her child, but she was seemed quick to go with a diagnosis of "Mood Disorder" and administer HEAVY medications at the age of 6.

Gravitating towards adults, acting out (which seems to be in ways that are meant to give the child control over herself or her environment,) intelligent and charming... these traits perhaps could also indicate that the child in question experienced some trauma or abuse at a very young age?

(My childhood abuse was ongoing via my BPD parent, i sound a lot like that kid, and my parent could put on a great show of concern and sound just like the OP. FWIW)

I'm usually very positive about being able to post anonymously to Ask.me. I just wonder why the OP felt this particular question needed to be anonymous? If the mother was serious about getting help for a 7 year long medical/behavioral mystery concerning her minor child, I would guess she might want interact with the good folks of the hive and get some solid strategies/angles. I might post anonymously if, like my own BPD parent, I was looking for false validation or ammunition.

A few sentences I find questionable:

"Mood swings a constant in her history since age 4."

and this is different from most 4 years olds how??


"Adderal and Zoloft a powerfully bad combination ending in psychotic episodes and hospitalization at age 7."

at what point did these powerful meds sound like a good idea? where is the mention of being evaluated for aspergers, autism, or some other neurological cause? why was the diagnosis automatically "mood disorder treated with pharmaceuticals"?


Specific behavior that I’ve never heard of; she won’t wear a seat belt in my car (it’s “uncomfortable”), refuses to do homework and when forced, she will rip it up or not turn it in, and she can’t wear jeans… in fact she will wear the same outfit over and over for MONTHS on end. Various things tried in therapy, never resolved. This is life as we know it since she was 6.

tone of OP disturbing - like it is more about what Mother had to put up with vs. what obvious discomfort might be causing a child to act out and demand control. also, these examples are not all that remarkable.


"Has anyone heard of this behavior? I have read extensively on various mood disorders and still don’t know What To Do. "

my mom had this one mastered! the more she read, the more phrases she could spout to make it sound like the problem was with someone other than herself. again, the collection of behaviors described doesn't sound all that perplexing. more than likely, OP has been rejected by plenty of professionals who have accurately diagnosed the main problem is with the parent, and not the child. OP could be turning to MeFites to help her find one more phrase or angle that might get some new medical professional to play along for a few more months/years.


AND LASTLY...

"(Various notes – I’m a good mom. Her dad is a good dad. Her sister is very popular and easy going with tons of friends and this causes jealousy. Her dad and I disagree on the severity of her mood disorders and is vaguely anti-therapy. We’re really very normal looking on the outside with very normal aspirations in life. No childhood trauma and I was a SAHM until she went to school.)"

usually when people tell you what they are (a good mom, a normal family from the outside, etc.) they are anything but. again, sounds like the OP is looking for validation rather than a true solution. the dad disagrees about the mood swings and is vaguely anti-therapy -- perhaps he has been advised by professionals that his ex-wife is the real problem, but ex-wife refuses to get help? that definitely happened on multiple occasions in my family.



FWIIW. I don't think it is so odd the youngest daughter wants to move home. Maybe she misses her school, her home, or her friends? We only have the OP's (perhaps skewed) opinion that the daughter wants to move home because her household isn't as strict as the dad's.

In truth, we can not know from this question what troubles the daughter. We have lots of perceptions and descriptions of drama, but few tangible facts. I find it hard to believe the OP had so few facts to offer up in an anonymous post if she really has been actively pursuing a diagnosis for 7 years.

That is all.
posted by jbenben at 3:07 PM on August 4 [1 favorite]

jbenben: "If the mother was serious about getting help for a 7 year long medical/behavioral mystery concerning her minor child, I would guess she might want interact with the good folks of the hive and get some solid strategies/angles."

I'm not touching the rest of what you wrote, but to that point: the OP wrote to me after I replied originally, and we've been discussing this in MeMail. I presume she's corresponding with the other people who've written in this thread, as well.
posted by The corpse in the library at 4:09 PM on August 4

I just found this quote which may be relevant....

"Borderline parents often "split", that is they project their good side onto one child who becomes the "fair haired boy or girl", the "golden child", the "all good child" while they project their bad side onto the "black sheep", the "scapegoat", or the "no good child"."

Without a factual list of medical tests and treatments tried, I found the question "what to do" difficult to answer for the OP.

All that came through to me was that one daughter was well-behaved and living with the mother... and the younger daughter.... not so much.


The corpse in the library: Good to know the OP has been in touch.
posted by jbenben at 5:30 PM on August 4