'When should you seek help?'

Vicki (208.155.174.43) -

Dear Dr. Doug,

I have a fifteen year old daughter who has recently gone through some "disturbing?" changes. She is hanging out with a completely new group of friends, and although I know some of them are extremely at risk, I am not sure whether they themselves are a problem. They are always quiet and respectful in my house. They are mostly of the punk fashion and some gothic measure added in.

Her grades have been horrible for most of the school year and I am not sure whether she has a learning issue or whether she just doesn't care.

She is currently taking Effexor XR for depression and I am taking her to an appointment April 15 for an evaluation to see if the medicine is appropriate for her. It was prescribed by her medical doctor who I am quite sure has never had a depressed teenager and doesn't really know the effect of one as opposed to another.

She is angry when confronted with the word NO, which she does experience quite often. She indicated to me that she has these extreme feelings of anger and that she "hates" us sometimes for no good reason.

I truly do not believe she is into the drug scene, and I would like to believe she is being honest about the "boy" thing, but I am just unsure where my trust should end.

Aside from the depression issue, is there something I should do or just ride out the storm?

Comment #1 Dr. Doug (200.91.169.133) -

Thanks for writing, Vicki,

It sounds to me like your 15 year old daughter is going through a very rebellious stage, common to adolescents. How stronly reblelious your daughter is would depend on the extremes that her behavior displays. The examples you have given suggest that she should be evaluated by a good psychotherapist. There are a number of things that could explain your daughter's behavior, so rather than guessing or listing possibilities for you to worry about, try and get her seen by a mental health professional.

This is not likely to be easy, and may not be necessary, if you can get her to talking to you with you listening to her words and the meaning behind them. When most parents tell their kids they want to have a talk with them, that means the parent talks and the kid listens, which is why this doesn't work. When I say talk to her I really should say Listen to her.

Given the situation, it has pobably been some time since the two of you really listened to each other and empathized with each others feelings. This is another reason I suggest a therapist. However, if psychotherapy is not an option, it is important to encourage her in finding a trusted adult with whom she can confide, such as: a school teacher, or guidance counselor, priest, rabbi or minister.

Such a drastic change in peer groups could indicate drug or alcohol abuse, so don't rule that out until you know for sure. If substance abuse is a factor there are drug tests that can be run by most health departments, mental health departments and private practioners.

It is "possible" she is just going through a "phase" but I seriously doubt it. Have a conference with her teachers and find out what they say regarding her classroom behavior. If her comportment in declining as well as her grades, she may be subject to mental health referral through the school system. In this way she can see a therapist even if the family cannot afford the financial cost.

Her bizarre change in behavior and choice of friends is obviously an attempt to give you a message that your daughter may or may not completely understand. Don't let this strangeness dim your love for your daughter. In fact, one of the reasons adolescents behave this way is in an attempt to gain attention and hopefully find love.

If she is unwilling to seek help, you should seek therapy for yourself, in order to learn how to emotionally cope with this situation. You also need a safe place to vent your own thoughts, worries and fears, with a reasonalble expectation of getting objective professional advice.

You did not say how this relationship was affecting you but your writing indicates that the more information you can get on dealing with troubled teens will also be beneficial to you. I recommend such authors as: Dr. James Dobson, Don Dinkmeyer, John Brashaw and John Mc Arthur, among others. Amazon.com has a lot of good books on parenting to give you knowledge and understanding. However, I suggest you talk to a therapist, or counselor about your feelings and how you should react to the changes taking place in your home.

If you are interested in speaking to me verbally, in a secure chat room or over e-mail, please e-mail me at WWW.noeldouglas@ice.co.cr for further informaton.

Comment #2 Vicki (208.155.232.5) -

Dear Dr. Doug,

Thank you so much for your response! At least from your outline, I feel I am headed in the right direction...

She has an appointment on April 15th with a psychiatrist to be evaluated and her medication adjusted/changed. I have already taken the necessary steps to find out what is happening in the classroom as far as how her teachers view her currently. I suspect that her deportment is not as much of an issue as simply not giving much of an effort.

The kids she is hanging around right now all have some family issues of varying degrees, but my gut feeling tells me that their appearance is just different and not that they are necessarily involved in drugs and what have you.

What a wrenching thing to know whether they are telling you the truth or not. I have recently sat down and had a conversation with her (just the two of us), during which she indicated her feelings of unreasonable anger and sadness. After this conversation is when I made her appointment, because she did say she didn't feel that her medication was doing her any good, being she was still sad a lot of the time and the anger just wouldn't go away. She admits to pushing my buttons on purpose, but just doesn't understand why she would WANT to do that.

So...I will wait and see what all of the info put together shows when these appointments/teacher evaluations are received. I will keep you updated. Thanks again for your help.

Comment #3 Dr. Doug (200.91.169.133) -

Hi Vicki,

I am always glad to help where I can. Some of the most common signs of depression include:1) periods of several weeks or longer where a person feels depressed for most or all of the day 2)The intensity of the depression may ebb and flow but the depression is a predominant feeling 3)anger is the most common way we try to mask anger, we get angry with those we love and take our anger our on them, when it is really ourselves we don't love and are rejecting 4)WE reject ourselves because of our low self-esteem and lack of true self-love. When we are depressed, we

view our failures, not as merely mistakes to be corrected, but failures in our personality. 5)A depressed person wants to escape from the realities of life. They would prefer to live the life of a turtle who never gets out of its shell, so they can be protected from life's pain until they starve themselves to death emotionally. 6)Guilt of feelings of guilt are usually a symptom of depression. We feel guilty for what we do and say or we refuse to feel guilty, even when warranted, and let it turn into bitterness hatred and resentment. 7) Drastic change in sleeping patterns. The depressed person has difficulty sleeping according to normal patterns of 7-8 hours per night. They will either sleep very little (3-4) hours per night or will sleep 12-14 hours a day. And depressed people will slip from one pattern to the other on rare occaisions. 8) The depressed patient usually experiences a drastic change in weight over a sufficient period of time. They tend to overeat, gaining undesired weight and thus increasing their depression, or they lose their appetites to a great extent and lose weight.

9) Depressed patients will often talk about death and death related topic, which at first, may not have anythng to do with them. 10) Any suicidal threat should be taken seriously and be treated by a mental health clinician immediately. Changes in medication are often needed, especially in your people whose bodies are growing and changing, physically and chemically, so the medications have to keep up with those changes. It also may require a search of the different types of medications with which to treat depression. The good news is that with the right medication and the right treatment, recovery from depression is about 90% effective. The biggest problem that I have seen is that people don't begin seeking counseling until the problem almost takes a miracle to resolve.

Counseling and guidance are not just for "crazy people". When I began having my heart attacks I consulted with cardio-vascular surgeons and followed there advise. Why? I am a pschologist not a heart doctor. So when you have a problem in your life it makes sense to ask someone who specializes is fixing that problem. What do you think?

Comment #4 Vicki (4.41.102.146) -

Well Dr. Doug,

I completely agree once again. Much of your writing sounds exactly like me, so I can at least relate to what you are saying. I just never had anyone put it exactly that way before. I understand (maybe correctly or incorrectly I am not sure) that depression can be carried down from one generation to another and the same medication that will help the mother will help the daughter and so forth. I have indeed made that appointment for her which is like the 15th of April, and actually made one for myself. Some of, if not all of, the signs are there. Guilt is realy a crushing thing isn't it? Sadly enough, sometimes the guilt has no basis whatsoever, it just happens as a result of a multitude of influences. Maybe one day I will get us all straightened out. Until then, I appreciate all of your kind advice. It really helps to put things into perspective. :-)

Comment #5 Dr. Doug (200.91.169.133) -

Vicki

I cannot say that depression is hereditary from one generation to the other through chemical means or through behavior training, however unintentional, in early childhood. There are a number of factors that pre-dispose a person to depression. But the best course of action is the one you are currently pursuing, speak to a good therapist and particularly seek family therapy to resolve underlying parent-child issues. Keep me posted and thanks for writing.

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