Crisis?

[busymind79]

Recently, my dd15 has had me back in crisis mode. I know she has been cutting daily, because I have been stalking her Instagram. Her heading always says how many days "clean" she is and it hasn't gotten higher than 2 in almost a month. I search her room frequently and remove any cutting tools I find, but there are always more. She is either getting box cutters from someone or buying them at the local store in town. I have taken three out of her room in the last two weeks. I throw them out at a friends house each time, so I know they aren't in the house.

Today, my sister text me a picture that her daughter got off snapchat of a sliced up arm with a box cutter balanced on the wrist. My daughter posted it last night about an hour after she lay cuddling with me in bed while we talked about yet another friend who "ignored" her. In the past week, she started dating a boy, got in an Instagram fight with several kids from school, had boyfriend break up with her, started talking to another boy who last night brought his girlfriend to a basketball game and didn't pay enough attention to her. She knew this guy had a girlfriend and seems baffled that he would say he was looking forward to seeing her at the game and then bring his gf.

Every one of these events individually were devastating for her. In the past, any one of them on its own would have triggered a suicide attempt. I know that this is an improvement, as sick as it sounds, but I feel it coming. I don't know what to do with it. I am planning on asking her about it when she gets up, but where to go from there? I am tired of her throwing this all out on social media constantly and then getting really angry that people say she's looking for attention. We've discussed before with counselors how this can look like that to her peers, but she continues to do it and is shocked that they feel that way. I am at my wits end and hate feeling like its hopeless.

Our objective is to better understand the struggles our child faces and to learn the skills to improve our relationship and provide a supportive environment and also improve on our own emotional responses, attitudes and effectiveness as a family leaders

[lbjnltx]

Hi busymind79,

I'm so very very sorry to hear that this is happening with your daughter.  I can only imagine the pain and fear you are both living in.

Is your daughter currently in therapy?  Is she learning alternative coping strategies? 

It seems from your post that you believe this is heading towards a real suicide attempt?  Has she made attempts before?

I will wait for your reply.

Know that we are here with you.

lbj

[busymind79]

Thanks for a quick reply, lbj.

She see's a counselor twice a week. She was there yesterday. She was in a dbt RTC for five weeks and just came home the last week of January. She refuses to use her dbt skills. She refuses her meds, even though she says they help. I try to talk to her using the skills we learned from treatment. She says yes, nods her head, answers appropriately, seems to be working through it and then goes off and does the opposite. She is sad and angry all the time. It's really hard to have a conversation with her because she says she doesn't want to talk about it.

She has had four previous suicide attempts in the last 10 months. Since the first attempt last May, she has not been able to go more than 6 weeks without an attempt while out of inpatient care. We are now 6 weeks out.

My husband is pissed. I can't hide everything from him. He thinks we should take everything away and ground her to the house. I disagree. We have tried that before and everything was the same, but we had to live like corrections officers.

[lbjnltx]

Oh my. :'(

You and your family have made some good choices for your daughter's care.  DBT is an excellent therapy for learning coping skills and dealing with thoughts and feelings.  Having said that I would be remiss not to mention that it didn't work completely my daughter.   We didn't have access to  a true dbt therapy plan... .few do.  The components and concepts were just not something she would grasp onto.

After over 2 years of outpatient therapy with little to no improvement and time ticking away... .we chose to place our d (then 13) in long term residential  treatment.  I purposefully chose a program that had DBT concepts mixed throughout and also had several other kinds of therapy models.

Do you think it is time for a long term inpatient treatment plan?  Does your d need longer term DBT or do you believe she needs alternative treatment?

Yes, busymind79... .you are in crisis.

[busymind79]

I do believe she needs long term treatment, but I don't even know where to begin. We are not well off financially and we had to fight insurance tooth and nail to keep her in a treatment center for the five weeks we managed. Even then the bills are coming in left and right for all I the stuff that wasn't covered or only partially so. The center there said that she presents very well and knows how to work the program to the point that they can't clinically keep her. We live in Michigan and I haven't seen any good long term options. I feel like I am searching and searching and getting nowhere.

[lbjnltx]

The search for and financing of residential and clinical residential care is a tough row to hoe!

Been there... .done that so I understand what you mean.

First thing I would do is ask her MD (psychiatrist) for a written statement that she needs to be inpatient.

The next thing I would do is get this info to your insurance company and find out (I mean completely understand) what they will cover.  The glitch here is that after so much time has passed she will "appear" as you know to be stable enough to leave residential.  The insurance company will need to know that it is "medically necessary" for her to stay.  That determination will be made by the staff at an RTC.

Other financing options for RTC:

IEP

Use of college funds (if you have them)

Low interest loans specifically for RTC (there are companies that do this)

Medicaid

Home Equity Loan

Any and all of these options take time to come to fruition.  Do you have a safety plan in place if this escalates any further?

lbj

[busymind79]

I'm not sure what to do in terms of a safety plan. I am thinking of calling the treatment center she just left to ask the counselor there what we should do. I want to talk to my dd first to see where her head is and find out what she might think she needs. Maybe she will be cooperative in thinking this through. I just now received a call from the school about the photo online. She is supposed to be returning to school for the first time since November on Monday. Now that is unsure. I will keep you updated as we try to figure this out. I pray we can keep her from another attempt.

[lbjnltx]

Here is some information you may find helpful regarding making a safety plan.  Not all of it will apply to your family.  Implement what you believe you need now and what you might need in the future.

Develop a Family Crisis Safety Plan