Expert: Libby Bonner - 5/23/2009

Question
My 22 year old daughter became a new person..within a 72 hour trip she made out of town..It is as if someone took her heart, mind and soul.and replaced them with that of a total stranger, everything she was, everything that made her unique and special is gone. I have been seeking understanding every since..She has horrible mood swings. She took off 4 months ago and moved in with people she didn't know. Leaving her new husband and entire family. This from a girl who would not go to the grocery store alone. She repeats phrases over and over again. Rages, insults, and flips from "finer then she has ever been" to " I can't take this anymore". She quit her thyroid meds cold turkey, and has a few seizures per week, migraines as well. I have convinced her to come home in June. She will only stay 5 days and I am taking her to a doctor..but who first..Thyroid, epilepsy..Bipolar..? I realize she has a mood disorder..but has lied to so many people and turned them against me, her grandparents and her new husband. We are helpless..because she is very convincing. What do I treat first. I must treat fast before she "runs" again. She often threatens suicide.. I need help... She either sleeps too much or not at all..she has had 25 jobs and has trouble each time..she is breaking me financially..She takes no seizure meds..I am afraid to talk to her new roomates because she is very likeable at times and I am sure she has told them we are "out to get her" which is not true at all..but we are worried to death.. her common sense seems to be way off.. and she spends every dime she gets her hands on..and then talks about selling her blood to get money.. How do I make sure I make the most of my 5 days..to get her help? Where do I start?

Answer
Because your daughter is legally an adult, I doubt that there is anything YOU can do, like make doctor's appts for her.  She would have to make the appt, and then agree to go, w/ you along, at the appt time.

Likely??

Five days also doesn't give you the time to start w/ doc #1 and then go to the second doc that #1 refers you to, even if Doc #1 really leans on the second doc's office and calls in all his chips.  

IF, however, you live in your daughter's hometown and at one time saw the same doc - fam doc, OB/Gyn, any doc - maybe:  they would permit you to make an appt for her; or you could make an appt for yourself, ostensibly, and haul you daughter w/ you.

Because she is married and not a minor, the person w/ leverage here is her husband.  She has quit her thyroid meds, has seizures, and continues to drive, I assume.  I don't know if he could get a committal order on that basis, or become her guardian, or what.

You or he could and should rat her out to the Dept of Motor Vehicles in the state where she lives.  She has no business driving.

[The thyroid med was controlling the seizures?  She has epilepsy??  Never had seizures til off the thyroid?  I'm confused.]  Did she start the thyroid while still a minor living at home and/or as an unmarried student?  Maybe you even went to some appts?  If so, this is a doc who might listen despite her now being an adult.  If not the doc, ask to speak to his nurse.  Is this a doc to which she could be taken while she is home???  Would they see her?  I would start ANYWHERE w/ any doc who would see her.

Where is her father?  Where are you, she, the husband - what states and/or cities.  Does she have any near-age sibs w/ whom she used to be close.

Let's do the trip and the people she doesn't know, w/ whom she now lives. [And how long ago was the trip??]  People do quite suddenly become obviously ill w/ mental illnesses, and I guess this might have occured during her trip.  BUT - any reason to believe she has hooked up w/ druggies, or a cult??.....if the trip, the behavior changes, and the living w/ strangers are connected.  Are the strangers a group, or just a household.  Oh -wait - I re-read: she has roommates.  BUT surely not for long, if they are grounded and living responsible lives....I suspect they are not?  What do we know about this?

No reason not to sell blood.  Legit money.  

How is it that she is ruining you?  You are her sole source of money?  Don't give her money.  Figure out what money is needed for, and then you and the grandparents and any others go in together, to the extent that you can:  you pay the rent to the landlord, you pay utilities to a roommate, you get her a month prepaid credit card at McDonald, or some such.

You, or someone, show her where there are food pantries and other free services, incl med services...teach her to be a poor person.  Your Dept of Human Services may be able to suggest helping agencies, and also tell you or her what they can do; United Way will know agencies.

What you have here, apparently, is someone w/ a mental illness, too impaired to live semi-responsibly and too impaired to work.  IF you can ever get her seen by a paychiatrist, someone needs to make an application for SSI.....call your Soc Security office to find out.  

She also talks of suicide.  Ever tried it?  That is anyone's best route to the emergency room - but the hosp probably will only keep her 3 days.  BUT during those three days, someone takes out a committal.....

Here's help.  nami.org   See if they have a roster of attys who could help w/ committals.  See your own state bar - or that of the state in which she lives - for the same info.

Get the book:  auther is Amador, title is I am not sick, I don't need help. Get the LATER of the two editions....maybe 2007 or so.

Meanwhile, to help w/ communication, get anyone who is sympathetic to her and to this situation to buy, or at least read, the book by Woolis, When someone you love has a mental illness.

At nami.org, also locate a NAMI affiliate near you and start attending.  If you have choices, choose one that offers a Family Support Group.  And, when any of you can, take their free Family to Family class.

You may want to contact your own atty as well.  

Depending on the size of the city where she lives, and whether any family members are known there, you might contact the police and the sheriff about your concerns...that you are worried that she will eventually end up in an encoutner w/ law enforcement.  Maybe they will take some info from you - who would take her if it's iffy and she could be taken to someone rather than to jail.  Listen to whatever they offer.

I wish you, or I, knew more about that trip.  As I said, certainly she could have snapped during that trip, in a way that was going to happen soon anyway....but -- .

This is a long wordy answer, mainly because I had some free time.  But here's my bottom line.  Turn your attention for a bit from The Problem [her behavior], and prioritize the things most important to finding immediate Solutions [there will later be intermediate, long-range,etc.]  You need any doc to see her for any reason, w/ you present to give some history.  You need the Woolis book so that you will feel less helpless and so communication w/ her will be less stressful for both of you, and more effective.  You need to contact NAMI, a local affiliate and/or the state office; state office might know of attys and might know your state laws re guardianships,etc.
You need to $upport her but not w/ money given directly.  You and the family, after reading Woolis, maybe need to be prepared, in June, or anywhere anytime, to talk w/ her about limits, or maybe about contracts:  we will do this; you will do that.  [This talk, and any doc, would be my June agenda.  Get that book read!]  Don't hound her while she is home.  DON'T plan any elaborate social whatever: low-key visit home.  She is not up to it, and it will keep you from more important things.  

Follow her lead about how she wants to spend time....IF she comes.  This if my very favorite line from Woolis, and it will stand you in good stead:  "Never become attached to any plan."  The BEST advice in the world for dealing w/ the mentally ill.

Take heart, and focus on solving, not panic.  Keep your eye beadily on: what are my most important actions right now, after she leaves, the rest of this year.  ONE is going to NAMI w/o fail.

Ah - just in case things fall wildly your way in June.  Go to samhsa.gov and find the two community mental health centers nearest you [or grandparents, or -  whomever.]  Again, you cannot make that appt, darn it.....well, yes, you can.  And maybe a doc's appt as well; I have done it.  Present yourself as your daughter making an appt for self, unless your voice is known to them.  Be prepared to rattle off her birth date AND her social security number, confidently, like they were your very own!  [And "your" current address, w/ zip, and phone number.]  Describe - if at the mental HC - some of the problems you've been having, and say you want a first appt w/ a doc or social worker.  They may still have June openings.

Ah - I recall a website nearly as useful as Woolis.  helpguide.org  Much excellent material on communicating empathetically w/ the mentally ill.  Use bipolar, tho they cover others as well.

Ah, again.  Wondered why she is repeating phrases.  Could be obsessive-compulsive disorder, the repetion being an obsessive symptom.  Don't worry about that tho.  It is the least of her problems.  And I'm not a doc anyway.

NOTE.  If you live in separate states, it is her Dept of Human Services, etc., that you should contact.  Oh - if she is out of state, it's probably that a community mental health center where you are won't see her.  A lot depends on residency, and there is a good amount of variation amongs states, and sometime w/in a state, among counties.  NAMI can help you sort this out.

More often than not, situations get better, but it's a nightmare at the start.  Good luck.