Psychiatrist and therapist needed for a teen in crisis

I desperately need to find a way to help my 15 years old daughter for depression, anxiety, ADD, insomnia and possible selective eating disorder. 

Looking for the recommendations for:

-great Psychiatrist

-psychiatry center (UCSF vs Stanford vs UC Davis)

-great therapist who can works with those issues by Skype. 

-did anyone use Amen clinic?

2.5 years ago after the sudden death of a close friend she became very depressed, anxious and stopped sleeping at nights. When she sleeps she has nightmares. Then sleeps during the day, unable to function. Previously active and happy girl now doesn’t want to leave home and stopped all her usual activities. She is under the care of Psychiatrist and on meds. After partial improvement on Lexapro and vitamin D for 2 years her condition worsened again last fall after the minor stress at school to the point that she is mostly housebound, except doctor’s appointments. 

She did therapy with 3 therapists without improvement. Now she refuses to leave home to go to therapist office, so the only option for weekly therapy would be by skype. This semester she takes classes online, plus 1 tutor comes to our home and 1 helps by Skype. She still struggles to complete schoolwork due to inability to focus, low energy and profound sadness and it is getting worse!!! Used to have mostly As. Now unable to tolerate schoolwork for more then 2hours a day. She eats only few meals that she likes, and is underweight. Tried multiple meds for sleep and 3 ADD meds that helped with focus but all caused severe side effects so were stopped. Extensive medical workup and labs are all normal, including thyroid. 

She refuses to change diet or to try essential oils (extra sensitive to smells) or to exercise. Or in bed. I am a single mom, no family nearby. We have a dog, who she loves to snuggle with but doesn’t walk him. All day she spends coloring or listening to quiet music or reading. 

What should I do??? 

Your recommendations will be greatly appreciated!!!

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Some possibilities

Medical Cannabis. Try CBD. No high, but can help with many problems. 

Forest Bathing. Even just getting out to the backyard or neighborhood park can help.

Try coloring, reading and listening to music with her. Do anything you can to make her feel supported. I get the impression that you are spending a lot of time pressuring her to be different. Which is understandable. But you also need to make her feel loved and accepted. 

Maybe gentle yoga. Try doing it yourself and maybe she will join in. 

Touch. Will she cuddle with you? Can you give her a shoulder rub? Can you take her for a massage?

Try CBD, which is a part of cannabis that isn’t psychoactive. It helps to regulate GABA  neurotransmitters and addresses neurological issues including anxiety. ADD, and insomnia. Alleviating the anxiety can help with the anorexia. Many psychiatrists are ignorant about the medical uses of cannabis and freak out about it. But we found it to be much more effective addressing these same problems than anything western medicine had to offer. Antidepressants can worsen anxiety and depression symptoms in teens. The anti anxiety meds made my daughter dopey, sleepy  and not functional. The CBD we used was a. Sublingual spray made by CARE BY DESIGN. I was not into weed my entire life by I researched the hell out of CBD and saw how much it helped my kid. Check out website for the CBD project. I’m sorry you and your daughter are going through this!

First, I wanted to say that my heart goes out to you. We have spent years dealing with our teen who has been dealing with many of the issues you wrote about in your post and others...My kid ended up taking the CHSPE (the CA high school equivilency exam) instead of graduating from high school. They were too anxious for high school classes, and then had trouble with anxiety around doing class work and trouble concentrating, and ended up with a home/hospital tutor during their junior year. I am very proud of them for actually passing their CHSPE--since they took it while simultaneously dealing with all the above issues. A couple things lately have helped a great deal: one is it seems like they've finally found meds that actually work and don't cause too many awful side effects. For a psychiatrist, I recommend Dr. Eric Arnold at Bay Psychiatric Associates. He has been very kind and patient with my teen. (ps Lexapro didn't work with my kid and it was HORRIBLE to come off of.) Another was that we got our kid a neuropsych exam and they were diagnosed with high-functioning Autism. Which was an incredible relief--for all of us. Our kid finally had a diagnosis that they could work with and that explain many of the issues they'd been having for years. And, they've been accepted to college and actually have hope again--and are working hard to get there. You probably can't even see that as a possibility for your kid at this point, I know I didn't when my kid was in the depths of their symptoms.  

So, some things we tried--BACA, in Oakland. Did not work for our kid or us, frankly. It was too cookie cutter and was not able to flex for a kid with physical illness as well as emotional issues. Other people seemed to like it. UCSF has been a good resource for us. Dr. Brittany Blockman leads a group for teens with chronic illness; which also has a parents group--which both my kid and I found really helpful. They also have groups for kids with mental illness as well. Edgewood, in SF, has a short term residential program for teens. It is an exceptional program and very helpful for our kid and us. When our kid was not feeling safe and we couldn't provide 24/7 safety for them, Edgewood really provided a safe haven. I realize I could go on... 

I know you need to find help for your kid, but also, find support for yourself. This is a really hard and painful road and most people do not understand--even other parents. I realized that people thought I was a great parent until my kid was sick and then suddenly I wasn't. And I learned that of course I've made mistakes as a parent, but no more than any other parent, I just have a (insert sick, autistic, etc) kid. Take care and hang in there!

I am so sorry your daughter is in crisis.  When a child/teen is in crisis the whole family is in crisis. You might consider attending a Willows in the Wind meeting for support and ideas for next steps, including therapeutic wilderness or residential programs.  Each situation is unique, but you will find that you are not alone, hear others's stories, and gain some references and resources for further support and treatment.  These meetings are fee (donations accepted), confidential, nurturing, and professionally run.

A little over a year ago, my (ADHD, anxious, depressed) teen was medically unstable and on hospital watch with weekly pediatric weight checks for six weeks while waiting for intake at Stanford Eating Disorders Clinic.  My teen managed to avoid hospitalization (mostly by getting off the ADHD med), and was diagnosed with an eating disorder (ARFID, very different than anorexia or bulimia).  The whole process was traumatic.  The care at Stanford did not feel supportive or nurturing; it felt very one-dimensional and not dual- or multi-diagnostic appropriate.  The treatment offered at Stanford is considered the gold standard in eating disorder treatment and requires treating the whole family with a minimum of 16-20 week, weekly family therapy appointments.  My family would not agree to this.  I won't go into details (too many to briefly summarize), but we're (barely) managing while I continue to work toward long term teen and family stability and health.  It's a long process, but support is out there.  There is a caring community here to support you.  I am sending supportive thoughts your way.

Have you tried any grief counseling?  It sounds very much like she is still in the depths of the loss of her close friend.  Does she have friends now and is she willing to see them?  Is she willing to leave the house at all to go for a walk or a drive?  What are her interests?  While counseling can help, she also has to be willing to do the work to get better.  My daughter goes to BACA in Oakland and they may be able to assist.  I would recommend counseling for both of you.  You also need the help to assist her.  Her medication may need to change as my daughter's did three times before we found the combination that worked for her.  So the medication she is on may not be working.  Do not worry about the food at this time, just let her eat what she wants.  Remember to let her know that she is loved.  But get her some grief counseling.  This may have also woken up fears of her own death, this can happen within her age group.  I know my own had this happen when her grandmother died.  It was the first person in her life that passed and they were very close.  

Apologies for the random suggestion, but I have just read two accounts of Lyme disease being misdiagnosed for many years. I resolved that if either of my kids were to suddenly exhibit unusual behavior, I would get them tested. Maybe worth a try? 

So sorry to hear about your teen struggling. I am a therapist and also have a teen daughter. All these recommendations sound good but I just wanted to add that you might consider a trauma therapist because it sounds like besides the grief and depression, she has PTSD. The effects of trauma can include anxiety, depression, insomnia and self harming behaviors. 

Wishing you all the best.

A couple of additional tips.  When you have her evaluated by a psychiatrist, make certain they screen for bipolar or other mood disorder.   If she has a mood disorder depression medication won’t help and can be dangerous.   Also a weighted blanket (can order on Amazon) can help reduce anxiety at night and improve sleeping.    We have been through very similar issues with our own daughter, now 19.   Sending you strength and hope!

Like others, my heart goes out to you and your daughter. There have been some great suggestions--including attending Willows in the Wind. They'll have a speaker on May 19th at Kaiser, Oakland (in the basement of the hospital) who will be speaking about how to get your insurance company to fund treatment. You might want to contact the speaker, Karen Fessel at karen [at]  Parents can't do all of this alone. You'll need some assistance, either from your school district, your health insurance, or the Regional Center if your daughter has already graduated from high school:   Since your daughter is already refusing school (I think), the school district should be a part of the solution. Does she have an IEP yet? An IEP will cover either a learning difference or an emotional disturbance (if she qualifies). If the school district helps you, you should consider giving their solution a try even if you think your daughter will refuse to cooperate. They will then have to come up with another solution. There are many resources out there--you're not alone. Consider attending a Willows in the Wind meeting this weekend--May 19th in Oakland and May 20th in San Rafael at the Center for Families on Lincoln Ave. You'll need support for yourself--to be in the company of other parents who are traveling the same path. Good luck to you...