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Doctor Rao
Doctor Rao, Doctor
Category: Mental Health
Satisfied Customers: 641
Experience:  MBBS,MD,DPM,MRCPsych
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Customer Question

Our 25 year old daughter has been on anti-depressants and anti-anxiety medications since she was 16. She has used these medications to attempt suicide six times over the past five years--after drinking alcohol. She says she goes to therapy, but we are sure she does not. We are scared, and need to know if we can commit her to a facility that will help her get better and save her life. What can we do? What do we do next?
Submitted: 4 years ago.
Category: Mental Health
Expert:  Ryan LCSW replied 4 years ago.
Thanks for your question. My name is XXXXX XXXXX I'd like to help you out.

I'm sorry to hear about what you are going through with your daughter. Most likely her current problems are not a result of something you have not done properly, even though I can certainly understand your desire to help her. Since she is over 18, the only way to have her committed involuntarily for help would be if she is currently at risk of suicide. If she can be considered to be a danger to herself or others, you would be able to call the police, who would take her to a psychiatric hospital for evaluation. At that point, depending on her level of risk they may decide to keep her there to make sure that she is stabilized or recommend a treatment facility for her.

It sounds like your daughter is highly intelligent considering what she has accomplished while going through these problems. With proper help there is certainly reason to believe that she should be able to make some progress, although it is very difficult to get an adult to be receptive to proper help if they are not otherwise interested in helping themselves. Sometimes being supportive and loving her despite all that she has been through is the best that you can do with the hopes of inspiring her to get proper professional help for herself.

I certainly wish you the best and hope that I've been able to answer your question. If there's anything else I can do to help just let me know.

Expert:  Doctor Rao replied 4 years ago.
Hi, It must be distressing for you.I can appreciate you are being proactive to offer your help to Allie.

We need to look in to the Diagnosis first. It is very important because the treatment options depends on the diagnosis and also the prognosis and what you can expect from the treatment also depends on the correct diagnosis.

Before proceeding further I just want to clarify, the following answer is based on the information provided and she should have a face to face Consultation with a Psychiatrist for confirmation of the diagnosis and drafting of the manageent options. From the symptoms you mentioned I can think of three possible diagnostic options.

1.Borderline personality disorder--Impulsive type (associated depressive symptoms,repeated OD)
2. Mixed anxiety depressive disorder with co morbid personality traits and alcohol misuse
3. Primary alcohol problems with comorbid mixed anxiety Depression.

Although the above diagnoses appears some what similar the approach to treatment and prognosis is very different.

If the the diagnosis is Personality disorder the main Tranent wiu,d be psychological therapy Mainly a therapy called Dialectic behavioural therapy. This can be done as an outpatient in the community or inpatient. If necessary in few patients medications are also required.

If the main diagnosis is mixed anxiety depression, it is important to look in tot he treatments she received and try different medications with different mechanisms of action( for example if SSRI are already tried then to consider SNRI or other antidepressants which can effect anxiety as well..for example Wellbutrin).

If the primary diagnosis is alcohol related problems, the aim should be to address them.From your post I noted Allie usually took OD following an episode of alcohol.We do know that alcohol helps to reduce the rational thinking behaviour.

Now coming to the option of whether you can commit her to an faith for therapy, it depends on her functioning and mainly risk to herself and others. I am aware how frustrating it can be for parents but according tot he law the decision can be taken away from the patients hands if the risk to themselves or others is severe.

You can look in to the possible triggers for her behaviour. We do now that in most of the occasions the self harming behaviour would be the result of interpersonal relationship problems.

You can also advice her to keep a mood diary to identify any mood disturbances.

I hope you find the answer helpful. I wish Allie and you all the best.

Thank you.

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