How to best help young adult daughter with mental health issues

We have a 23 year old daughter who has had a tough time over the past few years. As a young girl, she was generally well adjusted, happy, did well in school, although showed signs of emotional disregulation, ADHD, and learning differences. We sought out educational and mental health therapists and followed their recommendations. She now claims it made her feel like there was something wrong with her, that she is different and not as smart as classmates, was forced to work harder than everyone else because of our expectations and values.

In her 1st year of college out of state she sought medication for ADHD. In her 2nd year she was medicated for bipolar disorder. In her 3rd year of college she contracted mononucleosis, dropped a demanding academic program and changed majors. In the start of her 4th year, she developed severe GI problems, and eventually was diagnosed with Celiac's disease. During that summer she was under the care of a functional medicine doctor (she was malnourished). Her physical health improved, but blood tests indicated a thyroid disorder, so she started on thyroid replacement meds.

She went back to school in the fall 2020 for a 5th year with 60 credits needed to graduate. By spring when covid hit, and she decided that online learning didn't work for her. She dropped all her classes and came home to live and work part time. While her physical health was improving, her mental health issues continued. It was unclear which meds she was using but we learned she was self-medicating with cannabis regularly. She claims is the only thing that helps her (we are skeptical). 

By early fall 2021, she decided to transfer to a new university 60 miles from home for a 6th year of college. We set her up with a therapist and psychiatrist at the new school. She is taking 3 classes and doing quite well in school. However, she continues to struggle with her mental health issues and continues to self medicate. She wants to take 2 classes in spring and get in a therapy program for eating disorders or similar program, which I know could be expensive.

She has not been willing to let us be involved in talking to her therapist and psychiatrist, or in helping her find a program. She is 100% financially dependent on us, and while we understand she has mental health struggles, we really want to be more involved, especially since she routinely reprimands us for not understanding her situation especially when we try to problem solve instead of just be empathetic. 

We are concerned about potential self-destructive behavior or damage to the relationship if we make too many demands on her. While we want her to get help, we have not demanded since we are paying for her entire lifestyle and medical care, that she allow us to talk with her therapist or psychiatrist to be more involved. We'd like her to get a part time job and contribute financially if she is only going to school part time. We have not demanded that she quit cannabis (which she is adamant helps) and we worry it is contributing to her problems. I know mental health issues are real and can be challenging, but sometimes it feels like they are an excuse to not take responsibility and to claim oneself as a victim of one's physiology. We really want to help her but not sure how demanding to be. Hoping someone has experience and advice.

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This poor young woman!  Kudos to her for hanging in there and pursuing her goals against such overwhelming odds.  Underneath all that trauma, she is a strong, determined person.  And kudos for you for supporting her through this.  As parents, it's hard to see your child suffer and hard not to want to fix it.  Having said this, you have zero rights to talk to her psychiatrist or therapist, even if you are paying for it.  It's hard, but you just need to be there for her, as you have been, without judgment.  It takes a lot of faith to let go and not try to manage their lives. She'll let go of cannibus if and when she's ready. She's right, you don't fully understand her--sometimes we can love them, but not see them.  Don't be an obstacle in her path to wellness and a full adult life.  She's made progress.  She's moving forward. At this point, in addition to backing off, you might join a support group so you can get some perspectives from other parents who've walked in your shoes.   You posted in BPN, so it seems you are moving in this direction anyway.  

It is not easy and my experience is that a practical way to achieve some success is to focus on the main issue, i.e., define the goal of your intervention and getting specific results, then find the means to do so together with your child. Do not insist on the means without defining the goal. Also, there may be an underlying issue for so many problems she is having. I have heard stories about unreported rape during college years and the following trauma. College rape is a serious unreported issue.

Dear Anon,

My family has been in a similar situation with our 19-year-old daughter. She just today completed a PHP/IOP program at Alta Bates (Partial Hospitalization Program/Intensive Outpatient Program). I think it was helpful in several respects and although she is stabilized I have no idea what is next! We got the referral to this program from her psychiatrist and also the doctor that did a neuropsych evaluation last spring. The latter was performed by Rima Dolgoff-Kaspar at Berkeley Therapy Institute. 

I wish I could offer any advise, I am on a similar path with my 2nd year college child. My child is very resistant to any support and lashing out in response to any attempt to help/support (unless it's financial or use of our car).  My understanding is that the black/white thinking and oppositional lens can be part of ADHD and hormones/moods for girls/women with ADHD, as can the resistance to treatment. The only think that is helping me manage through this process is working with a mentor for parents of kids/young adults for ADHD, Impact Parents, https://impactparents.com/help-for-parents/. They also have podcasts and a you tube channel. Please check them out. In addition I am working with my own therapist (my daughter points to the past family and individual therapy she had as a teen as being part of her problem now). Good luck to you and I will be following this thread hoping to hear how other parents manage similar issues.

Please consider getting involved with NAMI (National Alliance in Mental Illness--.  There are family support groups --attended by others whose adult child is diagnosed with a mental illness. There is an 8 wk course "Family to Family" which we just completed:  it's very helpful. Ours was all on Zoom--and that's ok. It was moderated by 2 highly trained individuals; there were 8 families involved (in most cases, only the mother was there..but in our case both of us were happy to attend).   Here I'm assuming that the bipolar diagnosis you mention still applies.--- About cannabis:  my experience with my adult son, now in his 30's, is that cannabis, especially the THC part, was /is the worst thing for his bipolar.  It intensifies the mood swings.  His therapist warned him that he could go completely off his rocker. -- So he stopped seeing her & has gone deeper into vaping.  Good luck to you, and to all of us with loved ones diagnosed with a mental illness.

To me it sounds like your daughter is in pretty good shape. She is in school now and doing well. She has run up against so many obstacles but she has repeatedly picked herself up and dusted herself off and started over again.  That's remarkable and you should be proud of her!  I have two kids who have ADHD and have always struggled with academics and life in general. One of them, who is currently finishing grad school, told me when he was around your daughter's age that he didn't think he could succeed at college unless he "took it slow." He asked us to help out financially so he could stop working and focus on college.  Since moving out at 18, he had worked various crappy jobs, had fun with his friends, and had spent years enrolling in community college classes and then fizzling out in the middle of the term. He had not finished high school and it didn't seem like he was going to finish college either. He had a terrible track record. So I was skeptical. But he very sincerely said that he was now motivated.  I agreed to pay school and rent as long as he didn't get below a C in any of his classes. He started out with just one class, and went on to ace all his classes at BCC, transferred to a UC where he aced all his classes there, and then went on to grad school where he's just about to get his MS, again all A's.  This is a kid who flunked most of his high school classes. He knew better than I did what he was capable of and what he needed to succeed, and he was right. My other ADHD child on the other hand, dropped out of college just before Covid hit and has made no effort to do anything at all. He is satisfied to say that he has no interest in anything and has no motivation to take classes or get a job. Hoping the therapy will help. It's very frustrating. 

So ...  hang in there and give your daughter some space. It sounds like she's figuring out how to navigate and not doing badly at all but she still needs your support. Lots of kids out here in their 30's still need help from parents so don't give up yet!   Good luck!