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Dr. Mark
Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5313
Experience:  Dr. Mark is a PhD in psychology in private practice
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My 18-year-old daughter has behavioral issues. She is rude

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My 18-year-old daughter has behavioral issues. She is rude and dismissive to me; refuses to have a conversation with me. I want to tell her to get out. I feel her behavior is abusive to me and her two siblings. Do you think I should kick her out?

Hi! You know, to give you the best answer, I think I should ask you a few questions first that will help define the problem and the situation.


It definitely sounds as though she has pushed the envelope too far, meaning that she has lost your willingness to put up with her any further. So there may be no other option. But before giving you a definitive answer, I need to know: she was in therapy for a year with a psychologist. What was his/her assessment of her problems? Was there a diagnosis?

When you threw her out the first time, why did you let her come back? Was there a change in her behavior that swayed you to let her come back?

Has she ever had a psychological or psychiatric evaluation? Has there ever been a diagnosis?

Is she using drugs or alcohol?

Any extra information that will help, feel free to share.

Let's go forward from the answers to these questions.

I see you are offline at this time. I may be away from the computer for the night before you respond. If so, would tomorrow be okay for me to respond?

Dr. Mark

Customer: replied 6 years ago.

Hi Dr. Mark,

 

Thanks for your response. Amanda was referred to a psychiatrist. Her diagnosis is bipolar disorder and anxiety. Her symptoms included frequent panic attacks, hearing voices tell her to do dangerous things, severe mood swings and depression. She was prescribed Prozac, Lamictal and Seroquel. She unilaterally took herself off the Prozac and Lamictal months ago. She continues to take Seroquel. She also uses marijuana on a daily basis which actually helps reduce her anxiety a great deal. She has a history of alcohol abuse, was taken into custody for a 5150, threatening suicide in my home when she was out of her mind drunk. She did not drink the alcohol in my home. She is continuing treatment with her psychiatrist but lost interest in her psychologist. She is supposed to be researching to find a new therapist.

 

The reason I let her come back the first time is that I regretted "how" I threw her out. I used profanity and was very angry. If I ask her to leave our home, I want to handle it in a calm manner; at least on my end. She did not have any change in behavior when she returned and I requested that she not speak to me because she could not speak in a respecful manner. She says she hates living here, when I try to talk to her she flat out ignores me. She screams at her sister unless I intervene. She is a bully and is extremely self-centered. When Amanda is home there is always a sense of tension in the air.

 

I love my daughter. I want to do what is best for her and our family.

 

I look forward to hearing from you tomorrow.

Customer: replied 6 years ago.
Hi. Are you online now?

Thank you for the added information. It helps a lot. I believe I can now be of help with this issue.

First, let me say how difficult this situation is. You clearly are a mother who wants a normal, loving relationship, but Amanda is unable to maintain that type of relationship.

And this is actually the key to my answer to you that you need to consider and think about. There is no way for you to feel good about what you must do with Amanda. Bipolar Disorder (BD) with psychotic features is so tough. Because drugs and alcohol are never far behind. I know how tough this is for you to hear because it's not easy for me to write this to you. I'm going to give you some strategies that are important but here is the most important principle and it's tough:

Amanda cannot rule your life or be your first priority. Your other children have equal rights. Your own life and your personal needs come before Amanda's. This is the most important principle and you can't forsake it. Amanda's dysfunction can overtake everything and everyone else and you must not allow it to. So it is possible that you may not do it gracefully, but if you need to evict her, then that's your right. Doing it elegantly and the nicest way is great if it works, but it's not a necessary component. You need to do the best you can and no more.

Okay, that was tough. But now let's get to some strategies.

First, there's a good online support group for family of BD. Use it if you connect with that format:

http://www.dailystrength.org/c/Family-and-Friends-of-Bipolar/support-group

You can Google "family members bipolar disorder support group {name of your metro area}". Sometimes you'll find some that way. Other ways are to call the county mental health agency and ask. It will be a project because you'll get shuffled from one number to another. You'd have to be persistent.

Next is Al Anon. I would like you to start attending meetings to get support and skills in not enabling Amanda. That she may not be drinking at this moment is not as relevant as that you need the support and skills that Al Anon can give you. That's the part of AA that is for families. Not all meetings are the same, so if you don't connect with the first one, find one at a different time or location. Here's the directory:

http://www.al-anon.alateen.org/meetings/meeting.html

Third, is her psychiatrist. Amanda has given up on therapy. Okay. You can't force her. But she's not complying with the medications and what she is taking isn't doing the job. You need to make a condition of her staying (or some other help if you are evicting her for sure) that you have a release from her that she gives to the psychiatrist for you to be able to talk to him/her. You need to communicate with the psychiatrist to help monitor the medications and to give feedback so that the meds can be adjusted. She probably won't go for it because she sounds as though she is becoming treatment resistant.

Okay. I wish that Amanda's situation wasn't as severe and that it would be easier for you. But please get the support. Al Anon is very important I believe for you.

I wish you the very best!

Please remember to click the green accept button. Feel free to continue the discussion; my goal is to get you the best answers possible. Bonuses are always appreciated! If I can be of further help with any issue, just put "for Dr. Mark" in the front of your new question, and I'll be the one to answer it. All the best, XXXXX XXXXX

Customer: replied 6 years ago.

Thank you for your response. It was very helpful; at the same time I have to face the most difficult situation.

I looked into an inpatient program for Amanda. It is covered by insurance. Do you think I should require her to go to treatment as a condition of living here?

Absolutely! This is a very hopeful development. If there is any way you could get to an Al Anon group you like and go to a couple of meetings where there are some experienced people there, it would help you a lot in how to present this requirement. My point isn't to try to not make it a condition, but to present it in a positive way.

Let's try a little coaching here: the key is that you are trying to convey two things, the first is your love and excitement that there is a therapeutic possibility for her to get help. The second is that you are excited because this is a way that she might be able to stay at home. See how I'm framing it in positive ways?

The excitement is an adult excitement: possibilities for success that make you feel positive and hopeful that you want to share. And this is where I really want the Al Anon support for you: she may not go for it at all and you have to know when to back off and let her make her decision and not beg and then enforce the consequence. She has to live now in the real world of decisions and consequences. She wants decision making power, that's fine. With it come consequences. That's treating her like an adult. You can tell her these things too, by the way.

Okay, that IS encouraging that you have this possibility. So be as genuinely hopeful as I am.

I wish you the very best!

Please remember to click the green accept button. Feel free to continue the discussion; my goal is to get you the best answers possible. Bonuses are always appreciated! If I can be of further help with any issue, just put "for Dr. Mark" in the front of your new question, and I'll be the one to answer it. All the best, Dr. Mark



Edited by Dr. Mark on 2/7/2011 at 11:43 PM EST
Dr. Mark and other Mental Health Specialists are ready to help you
Customer: replied 6 years ago.
I thank you for your help. I needed direction. Now I have it.
You are most welcome and I truly wish you the best, Dr.Mark

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