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Dr. Michael
Dr. Michael, Psychologist
Category: Mental Health
Satisfied Customers: 2177
Experience:  Licensed Ph.D. Clinical Health Psychology with 30 years of experience in private practive and as a clinical psychology university professor.
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My 20 year old daughter is easily irritated by everyone

Customer Question

My 20 year old daughter is easily irritated by everyone, including her kitten. She has very high expectations of people and herself. She mimics words I say, the way I say things drives her crazy. She mimics noises I make, like clearing my throat. Will not eat around me because of the way it sounds. Always thinks people are talking bad about her. She might meet a guy she likes, but after only a few conversations they are annoying. It could be their voice, they way they say something, they are know-it-alls... She has no friends. She was diagnosed with depression and then anxiety disorder. She will take her medicine for awhile, then stop because she thinks she is doing better, or she cant afford it. I am worried! I am not sure how to help her or get her the help she needs. She called tonight begging me to take her kitten, shes throws  it and is afraid she will hurt it. Shes a sweet and very good girl.. no drugs, no drinking, no sex. I have researched and researched and cannot decide what her "issue" is whether bipolar, depressed or anxiety.
Submitted: 4 years ago.
Category: Mental Health
Expert:  Dr. Michael replied 4 years ago.
Hello. I believe I can be of help to you with this issue.

You are doing all of the 'right things' a mother can do at this point. 1) you are maintaining as good a relationship with your daughter, despite her emotional abuse of you, disrespectful behavior toward you. It is best to keep reminding herself that her odd behavior, her immaturity in relating to you and her inconsistent connections and commitments are part of her emotional and behavioral problems; you can look at her positive attributes as a mother should. So above all else, you need to work hard to keep the lines of communication open because you are in an excellent position to coax, nudge and encourage her to get help; 2) you realize she needs to be in therapy. I wonder if her therapist was really up to the task, given her complex of problems. She may do best on a combination of medication and dialectical behavior therapy or cognitive behavioral therapy. But above all else, she needs a good therapist whom she can connect with, and shift some of her dependency needs to. (Despite her ambivalent and 'mixed' treatment of you, she really is quite emotionally dependent on you and 'needs' this relationship with you.)

I'd like you to start 'stepping back' and looking at her behavior with more objectivity and THEN, start offering her gentle interpretations of her behavior. I think you are up to this job. I'd like you to start framing her behavior and thinking in terms of two sort of polar opposites that influence and manage her actions. Let's take the kitten for example. Of course, she loves her kitten and is emotionally attached, but one polar 'opposite' of her mind or 'self' is an irrational, emotional, demanding and somewhat infantile 'self' that can 'lose it' emotionally and want to throw the kitten. This is her emotional self sort of dominating and taking over her thinking and behavior. On the other hand, she has a wise, rational and more mature 'mind' or sense of self about her. This aspect of her 'self' is the one that calls you and begs you to take her kitten because she fears hurting it. Now, if you can sort out her inexplicable behavior this way and start interpreting it to her gently, calmly and lovingly, you can get her thinking more deeply about herself. So staying with this example, you might say, "I think I understand what you are saying about the kitten. Your emotional and irrational mind can take over sometimes and cause you to have thoughts of wanting to hurt your cat; but thankfully, you really do have a wise, rational mind that stops you, and you wisely call me and ask me to watch your cat for you. I realize you struggle with your emotions a lot, but I'm grateful for your wise rational mind taking over and controlling things". Now you can do this with all sorts of episodes of highly emotional, irrational and self-defeating behavior she engages in. It will take you time to think about this model for construing her behavior, and time to put together an interpretation for her that can help her look at herself in a healthier way. Now a good therapist of the type I mentioned above would work with her on this stuff, but you can do this if you really listen and process what she says, does etc. You basically want to reinforce the idea that more and more, her wise rational mind can dominate her thinking and emotional eruptions and cause her to avoid doing self-defeating things, and it can calm her impulsiveness and unpredictability. You'd be drawing her attention to her ability to inhibit an impulse, distance herself momentarily from strong emotions, think about a wise, rational behavioral response, and then act wisely and appropriately. This is the sequence of events she needs to 'get better' and help her improve her emotion regulation deficits.

I'll pause here and solicit your reaction. I may not be able to respond again until the morning at this point, so take your time.
Expert:  Dr. Michael replied 4 years ago.
I see you've read my last post. Feel free to respond and comment. If you have no further comments, please click on the green Accept button at the bottom of the screen. THANKS>
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Customer: replied 4 years ago.
I am impressed with your take on the situation from just words in my message. You hit it in the head! I do need a reminder to step back and try not to lose it myself.
Our daughter was an only child for 14 years when we started fostering. We adopted a baby boy and when he was 3 months found out we were expecting. She had always wanted siblings, and she loves then to pieces, but can act very childish with them at times. My fear is we "broke" her somehow. It's like having 2 separate famies and I fear she feels left out. BUT when she is here with us, or even just out grocery shopping as a family, we (she & I) end up arguing, almost always be sugar of her disrespectful attitude. I hate for the boys to see us behave this way and am afraid they will emulate her behavior.
She plans to go out of state for college this fall. I think it can be a wonderful experience for her, but want to be sure she is prepared. Dhe had olamned on going when sge graduated 2 years ago, buthave backed out. She says, and still says, she doesn't want to leave and miss out on her brothers growing up. I hope to find a good therapist that she can work with until she leaves. She is willing.
How do I find a good therapist and on the correct medication?
Sorry for typos.... Working from my iPhone.
Expert:  Dr. Michael replied 4 years ago.
I'd talk to the receptionist of the doctor you go to or send your daughter to see for health problems. Ask them who THEY THINK the best psychologist is in town that the doctor likes and trusts. I'd do this with other doctor offices as well and see what you hear the same name several times. The psychologist can then get her in to see her physician or someone he/she works with for medication. So, therapist first then, meds. People seem to react to this referral sequence best. Your daughter may react best to seeing her family doctor for and evaluation for her low moods and irritability, and then accept a therapy referral, but the other way is best because the psychologist can contact the doc ahead of time and alert them to what meds they should be thinking about.

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