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TherapistMarryAnn, Therapist
Category: Mental Health
Satisfied Customers: 5821
Experience:  Over 20 years experience specializing in anxiety, depression, drug and alcohol, and relationship issues.
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My daughter 19 years old, is at college. She has recently

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My daughter 19 years old, is at college. She has recently been writing to me (her mother) saying that she is sad, having anxiety or panic attacks, and is sometimes angry. She has mentioned also feeling of suicide. She is now willing to go to the college counseller. What can she expect in terms of diagnosis, but more importantly support and follow up. She needs help, since she does not have her family, living in the US.
She has been checked out for thyroid disease and this seems to be under control (some non hormonal medication was provided). She has had episodes of depression with varying degrees of severity between 14-17 years; she was prescribed Paxil, for a time, but voluntarily came off it as she felt it didnt really make a huge difference. She would prefer more alternative management techniques. She is feeling embarrassed, sad and lonely, and she has been not eating as well as she should. She has suffered from acid reflux since infanthood and has had all the usual medications, so she does have to apply the small and frequent portions approach, which she does, but she is rather thin right now. This comes from a worried parent, who wants very much to help her daughter and get her healthy and happy again. She is a perfectionist and over achiever, so even despite her depression she is getting A's and is in an Honors Programme, but I do want her to be happy, healthy. Hope you can help
Submitted: 5 years ago.
Category: Mental Health
Expert:  TherapistMarryAnn replied 5 years ago.

Hi, I'd like to help you with your question.

How motivated do you feel your daughter is to seek help for how she is feeling?

How far away from home is her college?

Thank you,


Customer: replied 5 years ago.

well, she is going today for an appointment to the counseller service at her college. I am here for a week, today is the first day... so I take that as a good sign... and good start.. recognition by her that help is needed.

She is studying in New York City, and her home is in Nicaragua, (she is not Nicaraguan, our family are there, I work in international development) just for clarification.

she is very well travelled, has done summer courses abroad, so this in not home sickness

Expert:  TherapistMarryAnn replied 5 years ago.

Thank you for the additional information. It helps.

Although I cannot diagnose your daughter without seeing her for an evaluation, it sounds like your daughter may have Major depression and anxiety disorder. It is common for people to experience both diagnosis together. Since she did get some relief of symptoms from the Paxil, this may also indicate she has depression and anxiety.

The main symptom of concern is her suicidal feelings. It is important that the school counselor she sees assesses her risk of suicide. Your daughter may be saying she only has thoughts of suicide but being sure is always a priority. Once her feelings of suicide are addressed, the remainder of her symptoms should be treated.

Your daughter may want to consider medications even if she feels the Paxil was not that effective. Whenever medications are used for treatment, it is very common for people to need to try at least one or two different medications or more before finding one that helps. This is because everyone's body chemistry is different. So if one medication works for one person, it may not work for another or it might even cause adverse side effects. So tell her not to be discouraged. She will find the right medication.

The second type of treatment is therapy. If she is able to get individual therapy through the school counseling that will help. But if not, she may need to see someone off campus. A therapist with a Master's Degree or above can help.

The third type of treatment is self help. This includes learning more about depression and anxiety so she can help herself. Also, she may want to consider support groups on and off the internet. The support she could get from others who feel as she does is invaluable.

Here are some resources to help her:

You can get ideas and support on how to help her from NAMI, which is the National Alliance for Mental Health. They offer numerous resources to assist those with a mental illness and those trying to help.

For her anxiety:

The Anxiety and Phobia Workbook by Edmund Bourne is excellent for any fears. It is self help and contains everything from supplements to relaxation techniques.

The Cognitive Behavioral Workbook for Anxiety: A Step-by-Step Program by Bill Knaus Ed.D. and Jon Carlson Psy.D. Ed.D.

From Panic to Power: Proven Techniques to Calm Your Anxieties, Conquer Your Fears, and Put You in Control of Your Life by Lucinda Bassett

The books can be found on or she may be able to find them at her local library.

I hope this has helped you,


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