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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Bgirls on April 27, 2004, at 12:58:43
I'm in need of help w/ my 13 yr old daughter. "B" has been recently diagnosed w/ major depression, at risk for borderine personality disorder, binge eating disorder, a couple different personality disorders and a few other things I can't even remember. She has been on 450 mg of Wellbutrin XL and 12 mg of Gabitrel since Jan 1, 2004 and a week ago was placed on Geodon. The problem is, nothing is helping (I know the Geodon hasn't had enough time), but her behaviour is rapidly digressing. Her hygeine is atrocious, she refuses to wear pads when she has her period, she doesn't like to wear underwear, bras, or socks. B is very smart, but as of Friday she is receiving 5 F's and 2 D's and we just found out she is skipping band and wandering the halls or hiding out in the restroom. She does weigh about 300 lbs and has been picked on at school quite a bit, but she also has a distorted view of reality so if one person is picking on her, then the entire school is out to get her.
I've had her to different counselors since she was 4 and they always tell us that she is more than they can handle!! I finally was able to enroll her in an intensive Adolescent Day Therapy program and she is now seeing a psychiatrist for meds and a psychologist within the same office for counseling once a week. This has been since Dec and things are worse - not better. Her Psychiatrist is touted as one of our cities best and most well respected, but even she says B is a head scratcher. When she put her on the Geodon she said it was a last ditch effort!
Yesterday I found out she is spreading rumors at school that her 14 yr old sister was pregnant and had a miscarriage! It's like she is deliberately trying to destroy our family!!
Has anyone been in a similar situation? Any help or suggestions? Anything would be appreciated - I'm at the end of my rope!
Thanks,
Bgirls
Posted by rainyday on April 27, 2004, at 13:42:33
In reply to Need help w/ 13 yr old daughter, posted by Bgirls on April 27, 2004, at 12:58:43
How extremely difficult for everyone. My heart goes out to you, "B", and your family.
What about a second opinion from another psychiatrist? If she hasn't responded well to medication that she has been on since December, I would have thought something else would have been tried.
It sounds like she's not on the right track, and there is nothing wrong with getting a second opinion, not matter the reputation of the doctor. Maybe a fresh insight would help.
Good luck and let us know how she's doing.
Posted by shadows721 on April 27, 2004, at 23:36:14
In reply to Need help w/ 13 yr old daughter, posted by Bgirls on April 27, 2004, at 12:58:43
I am so sorry that you are having such a hard time with B.
It sounds like she is acting out her feelings. I don't know if you have tried it already, but found some other way for her to express what's going on inside by writing and drawing. Is she in therapy?
Is she jealous of her sister? I am guessing for the reason for her remarks. Is her sister more attractive and successful in school?
When someone stops taking care of hygiene, I think their symptoms have worsened. Does she talk with you? Can you ask her what's going on? Is she suicidal?
Thirteen is a very hard age for girls. There are so many changes and so many unattainable standards. With the weight problem, I am sure this has her feeling "on stage". Teens this age go through a period of feeling that the world is looking at them. Those remarks can go through her and really effect her in years to come.
My heart goes to you and your family. I think her behavior is lashing out to others the pain about she feels about herself. I try to look at behavior and the behavior is screaming out for something, but what? What is it that she needs?
Don't ever give up. I know it's trying, but just keep going. She needs you. Keep communicating with her even if you don't think it's going in.
Posted by Bgirls on April 28, 2004, at 8:28:37
In reply to Re: Need help w/ 13 yr old daughter, posted by shadows721 on April 27, 2004, at 23:36:14
Thanks for your responses. I have tried various forms of therapy w/ B since she was about 4. I agree w/ you that she is definitely in pain. Her dad passed away when she was 14 months old and she has always struggled w/ coming to terms w/ that. Plus, she has always tended to be overweight and has endured teasing about it for years. I've been re-married for about 5 yrs now and she has a great relationship w/ her step-dad and her two step-sisters that live w/ us. Naturally you would tend to think that my marriage had something to do w/ her behavior, but her behavior isn't any different than it has been since she was younger. I've tried to figure out if she could have possibly been molested, but honestly don't have the faintest idea who it could have been. I've asked her and she says no - but that's what some of her behavior would lead you to believe.
The point is - I'm exhausted. I love my daughter more than life itself, but I don't know where to go from here. I'm considering residential treatment, but feel torn about that as well.
Thanks again for your responses and suggestions.
Posted by Racer on April 28, 2004, at 12:02:50
In reply to Re: Need help w/ 13 yr old daughter, posted by Bgirls on April 28, 2004, at 8:28:37
I really do have way too much to say about this, but my own current crisis is not going to allow it. I'll say the things I think are most important, and hope they help:
First of all, that thing you said about her responding to one person teasing her as if the entire school were teasing her? Dont' ever say anything like that to her! Not because it's not true, but because to a kid that age it feels so invalidating. (Guess what? I was a 13 year old girl who had problems once... I remember that...) First step is Validation, even if what you're validating seems ridiculous to you. You have to validate her feelings, before you go on to helping her see something more realistic. Along the lines of "You know, I guess you feel as if this one person teasing you is saying what everyone else in the entire school is thinking, huh? That must be so painful and awful for you. It is? Poor kid, that really sucks, doesn't it. Do you think that EVERY single person in teh school thinks that?" That sort of thing -- validate the feelings first, then try to help her balance them. I guess what I'm saying is that her reality is different from yours right now, and the first thing you have to do to help her is to respect her reality.
The weight thing is probably involved in the hygeine thing. I've seen to many heavy girls who are so out of touch with their bodies and so distressed by them that they can't make themselves get naked or deal with any changes -- like periods -- that affect them. My first and most honest advice is to get her into some sort of program for that weight first thing. The body has to be healthy for any sort of healthy mind. I wouldn't try for any sort of weight loss program, though: can you get her into some sort of Pilates class and MAKE her go? Or maybe a gymnastics for somewhat overweight kids class? Maybe even swimming classes would help. If you can find a horseback riding program that would accept her, get her a series of intensive private lessons there with a really good instructor. (If you tell me what part of the country you're in, I may be able to get you the name of someone who can help with that, because most instructors do try to protect their horses from overweight students. There are good reasons for that, but I do know some people I trust who might be able to help.) The basic idea is to help her learn to live in her skin, and get comfortable within her own body. That will probably go far towards helping her with her hygeine, as well as her weight.
Unfortunately, reality for most of us means that we don't have the time to devote to kids in trouble. Jobs, bills, housekeeping -- none of those go away just because a child needs us. It's heartbreaking, it's overwhelming pressure on us, and it tears us apart. There's nothing that can be done about that, but getting yourself into some sort of supportive therapy may help you handle this better, too, and I recommend it very strongly. The more you do to help yourself stay strong through this, the more you can help your daughter. Don't you dare say that you just can't find the time to do something for yourself -- let me tell you as the daughter of a mother who said that, it just ain't going to fly. MAKE the time to take good care of yourself, so that you can take care of her.
Now back to B. Can you get her into twice or even three times a week therapy? A truly integrated program that includes some sort of physical program would be best, but I doubt very much you'll find anything like that. An eating disorders program might be very helpful, though, and might include a lot of what she needs. I don't think residential is the answer, only because most residential programs right now are geared towards warehousing these days. It's hard to get into a truly good inpatient program unless you've got unlimited financial resources. (At least, that's my experience.) It would also probably feel like punishment to her from what you've described so far. She doesn't need that. Of course, it might also give her a break from the pressure I'm sure she feels. It might be worth talking to her about it, though. Ask her if she thinks that a residential program to give her a break from these pressures might help her. Make it her decision. More frequent therapy might help light a fire, since 13 year old girls are pretty notorious for having trust issues that take a long time to break through.
That's about all I can offer right now, except to say that my heart goes out to you. It's good that you're trying to help your daughter, and if my comments about getting help for yourself, too, sounded harsh they weren't meant that way. I know that I needed help with my step-kids, and without even the limited help I got I couldn't have gotten through. I also know that my mother's refusal to get adequate help for herself had a significant negative impact on me that still causes me a lot of problems at [never you mind how old I am now!], so I wanted to say it strongly enough for you to hear it. Your daughter, despite the problems she's obviously facing, is lucky to have a mother who cares so much and is trying so hard to help her. That's a weapon in her arsenal that will go far towards helping her get through this.
If I can offer more, let me know. I'm having trouble myself, but I will offer as much as I can for you, if you want it.
Posted by terrics on April 28, 2004, at 16:12:53
In reply to Need help w/ 13 yr old daughter, posted by Bgirls on April 27, 2004, at 12:58:43
You said your daughter is in danger of becoming borderline. Can you find out from this pdoc if she is? If she is perhaps her therapist or pdoc can help get her into a DBT program.
It looks like you are trying very hard. I hope things turn around for both of you. terrics
Posted by shadows721 on April 28, 2004, at 17:23:22
In reply to Need help w/ 13 yr old daughter, posted by Bgirls on April 27, 2004, at 12:58:43
You mentioned about a home. Here is a web address
http://www.happyhillfarm.org/Now, I am going to tell you somethings that you may or may not know or want to hear. Children are mirrors. They reflect the parents issues. While this child may seem the enemy, she is not. She is reflecting the pain in the family. She is the "identified patient" in the family. In other words, she is not the roots of the problems. She is only the reflection.
Her problem is a family problem. The whole family is involved in this feedback system. No one is an island. Everyone affects one another. She may need a tough love approach by you. For example, who is bringing in the food to help perpetuate this weight problem? It needs to stop. She needs more exercise too. She will fight you, but that's what she may want out of you anyway - Action and not just words.
She is your daughter and will be so forever. Housing is a temporary assistance to a long term problem. We would all like to see them change, but you have to change with them. You have to an inventory of yourself and ask. "What are you doing to aid this behavior?" Is this her way of getting the attention. Has she been labeled in the family as the problem? If so, she is going to act out the role. This is a complex problem. There is much more here than you may be willing to see right now. What is your daughter saying with this behavior? What is she reflecting about the family?
I am telling you what any health professional is going to really look at. They will see this as a family problem and just not her problem. There is still a little girl in this child and in a lot of pain. It's easy to get into labels and dx, but that's not the answer. More meds are not going to fix a serious self esteem issue either.
This is a difficult problem, but I believe there is hope.
Posted by Bgirls on April 28, 2004, at 22:08:31
In reply to Re: Need help w/ 13 yr old daughter » Bgirls, posted by terrics on April 28, 2004, at 16:12:53
You all have given me some serious things to think about. What is most frustrating for me is the Dr's inability to effective diagnose B. She seems to vaguely fit into many areas, but there isn't one "dianosis" that is a perfect fit. Her psychologist probably said it best when she said that psychology is "at it's best an art and not so much a science".
I have had to look inside myself and actually see some of the same traits B has, just not so pronounced. I only want my daughter to be happy - and as Dr. Phil says, if it's not working try something different!
Another frustration I have is the Dr.s not calling back! B has had severly blurred vision since starting Geodon last week. I finally had her quit taking it and her vision cleared up, but her Dr. never did return my call. I'm finding my gut instinct w/ my daughter is worth every bit of their education! Not to knock pdocs, I truly respect them; but I'm being reminded that they are only human.
We have some big decisions ahead of us - she is flunking 6th grade, and we need to do something about her schooling. I pray we make the right decisions.
Thanks for your input!
Posted by Racer on April 29, 2004, at 8:05:44
In reply to Re: Need help w/ 13 yr old daughter, posted by Bgirls on April 28, 2004, at 22:08:31
Um, don't worry too much about the diagnosis, worry more about your daughter getting help with her problems. The diagnosis is not the important part, and concentrating on getting the right diagnosis just distracts everyone from helping your daughter.
As for the pdoc, keep calling -- call twice a day if you need to, until he calls back. Make sure your message includes the fact that you've stopped her from taking the Geodon. Not returning calls is NOT ACCEPTABLE. MAKE yourself heard.
Good luck
Posted by pinkeye on April 29, 2004, at 13:28:12
In reply to Re: Need help w/ 13 yr old daughter, posted by Bgirls on April 28, 2004, at 22:08:31
Hi,
Can I suggest something. Take a year off from school for her (since she goes there and gets bullied etc). Kids aren't going to be nice to a kid who is very fat. So, first thing, take sometime off, get her to reduce her weight first. Try enrolling her into tennis classes or gym or swim classes/ weight watchers stuff etc. Without her losing significant amount of weight, I don't think you can ever get some sensibility into her head ( I had been considerably obese before and know the torture that you go through when you are overweight ).
Posted by pinkeye on April 29, 2004, at 13:31:10
In reply to Re: Need help w/ 13 yr old daughter » Bgirls, posted by Racer on April 29, 2004, at 8:05:44
Another thought, try getting her to the local church. It doesn't matter if you are religious or not. Religion has a way of being effective when everything else has failed. It might work wonders for your kid.
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