Parents dilemma

[HelenaB]

We are in a dilemma over our daughter's ongoing depression and treatment.  She has had difficulties since the onset of puberty with severe depressive episodes.  She has been unwell since the middle of last year - her symptoms include thoughts of and actual self harm, lack of motivation difficulty sleeping, and feelings of wothlessness, She is very isolated socially and does not go anywhere other than university and only then when she has to, preferring online lectures and content.  She spends hours on the computer writing stories and creating animations and chats online with people who share these interests whom of course she never meets.  We try to limit her computer use to keep her to a reasonable sleep/wake schedule at least and have many arguments about this.

When she began feeling unwell last year, she told us about it and we got her first to a doctor who prescribed the antidepressant she has used before and also to counselling sessions with a cognitive therapist we were told specialised inthe needs of younger people.  

Nearly a year down the track, to us she isn't really much better and the therapy sessions have started to become extremely expensive at $180 per hour with around $40 back from Medicare or our private health fund.  The therapist recently asked for a review of the treatment plan to be completed by the doctor who has refused as it is less than 12 months old and says we need to wait.  Meanwhile our daughter is asking to see the therapist more often (2 weekly intervals) and we are obliging  but are starting to wonder how much longer our family budget can withstand it.  We dont want her not to be able to have counselling as we know it's important to her recovery, but we are starting to think we will need to find a therapist who doesnt charge so much over the schedule fee. Our daughter doesnt have even part time work and says she cant cope with trying to work and her study load right now so obviously she cant afford the therapy on her own.   Has anyone had experience of a family member changing therapist and if so what were the main issues?  Did it make things worse? Our daughter  told the doctor when asked that she thought the therapist was helpful and the sessions were good  so even though we cant see improvement, we are worried about swapping.  Any tips would be appreciated.  Thanks

[JessF]

Hello there, I can understand your difficulty. Therapists can have a big range of charging, $180 is towards the higher end from my experience, mine charges around $130. There are some (very few) who bulk bill, you will have to look around and do some research.

The doctor refusing to redo the treatment plan is probably because you are only entitled to ten subsidised visits per year, although I think there may be exemptions if you are younger or are in very high need, if you google Better Access Medicare you should find what the rules actually are at the moment, they get changed around depending on what the government is willing to fund. You used to get more sessions unfortunately but there were cuts.

On the subject of changing therapists, I think the question you have to ask yourself is whether what you save in a cheaper therapist you will actually end up 'paying for' in setting back your daughter's progress. The therapist relationship is a very personal one, you spend a lot of time telling your story in sessions, and it can be very disheartening if you have to start all over again - I have had to do this a few times and it was hard for me, and I'm an older person. I know the money situation isn't easy, but I would suggest your daughter needs some stability right now.

Is she eligible for any sort of support from Centrelink?

[HelenaB]

Thank you Jess - thats very helpful - I'm off to Google the sites as you suggested. I 

[JessF]

Thank you Helena, do come back when you get a moment and let us know how she is going.

[mwhits]

Hi Helena, 

I am also a young person attending university so I can understand your daughters pain and I also understand anxiety and have been through some depressive episodes in my short life. Another thing you may want to try is counselling at university. Psychology students offer counselling sessions for a very low cost at university and they are younger and may be able to relate to your daughter better with a lower cost for you and your husband. Regular exercise also helps me ALOT with anxiety and depression and also vitamin therapy which i have been on for a while now. If you want more info please let me know and i'd be happy to help.

x Madeliene

[Neil_1]

Hi there HelenaB

Welcome to Beyond Blue and thank you for coming here and sharing your post.

It’s great to see that Jess has provided you with a really helpful response, great information and advice.

I’m pretty much going to just back up what Jess said in regard to the changing of therapist.  Have you actually mentioned this to your daughter?   Or is she under the impression that all is good (obviously money wise) and that she’ll still continue seeing this current person?    IF however you have mentioned it and she’s fine with changing, then that should give you the green light to go ahead and look for an alternative one.

But I’m in Jess’s corner with the changing of therapist – it can take years and years of trying different ones till you finally find someone you can develop a repour with, where you can unload and share many thoughts, etc.  So if your daughter appears to be going well with this current person, I would very hesitant to break that off.  But as I mentioned before, I would just mention it, in an off the cuff fashion to your daughter – just so that she doesn’t potentially get upset if she thought you were going to change therapists on her.

I’m not sure how old your daughter is, but my son is 17yo and he’s into all this computing thing, on-line games, chatting with friends, but also chatting with people when playing these games (DOTA, I think the name of the one that he’s super interested and keen on).  So I’m hearing you loud and clear when you say you try to keep the computing time/sleep time situation in line – the key word here is “try”.   You mention you’ve had arguments about this – or perhaps differences of opinions, because at that young age, wowee, these youngsters can really hold their own in a debate over these kinds of issues.

And you know, it’s very frustrating.   More so when I look back to when I was that age and how little I could get away with – just the difference from one generation to the next, I feel is amazing – and not always sure it’s for the better?

Would love to hear back from you.

Neil

[HelenaB]

Hello Madeline and Neil,

thaks for both your helpful posts.  We have decided to take your suggestion Neil and just drop a comment about changing however if she doesnt want to thats fine I hear from all of you that changing therapists can cause difficulties in itself and that does make sense.  The therapist is quite a young woman and seems to have a good rapport with our daughter ( who is 19 ) - I will certainly keep in mind the University option as Madeline mentioned though too.  We did think of that earlier when our daughter first became unwell and she said she had tried to make an appointment at the counselling service there, but was told the waiting list would be about 2-3 weeks ane we thought she needed help a bit sooner.  then when her appointment came up there she was told she couldnt have counselling at both places - privately and at the University. I dont think she was told about the possibilty of Psychology students offering counselling but she wasnt coping very well with many things at that point and might have misunderstood. I have looked at the funding site today and see that she needs to be helped to keep a record of the appointments and the plan dates - one of the difficulties was that the GP had a different number of appointments on his record to what the counsellor told us had been attended.  It's something we need to keep track of better.   Yes the computer stuff is a double edged sword - she needs to be online to study download lectures listen to them and so on - she also really likes a writing fan fiction forum and another one where one apparently designs dragon characters to swap with others.  And she draws animations which she puts on a tumbler site.  Getting her to exercise beyond walking to the public transport (although that is something) is hard as she is loath to do it and reports having no energy.  The best we can seem to do at the moment is try and get her to come with us to things like walking the dog - or today I was going to a voluntary group work activity I do and as she didnt have a lecture to go to she said she'd come along when I suggested it.  She didnt join in which didnt matter but sat to the side doing her own things on a lap top. At least it meant she wasnt in the house alone as she'd been very down last week and started self harming after quite a long period of not doing that.  It is frustrating (and sometimes frightening) to see that even after a lyear of treatment she can still go backwards.

Ann

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[Neil_1]

Hi Ann

Thank you so much for your latest response.

That IS great news to hear that she’s got a therapist who she gets on well with – normally a huge drama and sources for a lot of frustration, but at least that’s something to not have to worry about – oh except though for the financial side of things.   And yes, the keeping up of appointments is something that also needs to be done – but at least she’s got you helping her out there, so that’s another massive bonus she’s got there.

And before I go on, might I say that not all parents are willing or able to help out their children with help and support for them – as shocking as that sounds, but it happens (or in those cases, it simply doesn’t happen) and that’s really tragic, I feel.  So I would just like to say how awesome this is from you and no doubt, your husband.  Really brilliant stuff. 

You know for ages, and I mean a long time, our son was locked away (not literally) in his room and he was more than happy this way – but of late, over the last few months, he’s been venturing out of an evening – sometimes we’re able to take a quick photo (without the flash, obviously, as that’d scare him back).  🙂    But seriously, yes, he will sometimes come out and sit with us and watch what we’re watching or just strike up some kind of conversation.  Which makes me think that he’s just moving into another phase of the teenager “ageing process”.

One thing that has really got him out and mobile, especially over the last couple of months is his now willingness to learn to drive.  He’s mad keen on driving and wanting to learn.  He actually first obtained his L’s about a year ago but for so long wasn’t interested, but earlier this year, he said he wanted too, which was fantastic;  and wow, he’s gone ahead in leaps and bounds with this.  

The family dog is always another good option to try and encourage outdoor activity, so good that you’re trying that also.

Write again as often as you like.

Neil

[HelenaB]

Hello Neil,

 It is encouraging to hear of your son's improvement afer a long time.  Learning to drive seems to be an attractive thing and a big confidence booster for a lot of boys.  Our son is in the process of learning to drive and is very excited by it too.

Our financial dilemma has had a happy outcome.  Just this week a chance remark by the counsellor while I was trying to sort out details of Medicare entitlement with her, alerted me to the fact that she thought we were getting a much larger amount rebated each visit.  It turned out she  has been putting an incorrect item number on the accounts so instead of getting $124 back each visit we were only getting $60! She has now contacted Medicare and is preparing us a letter and duplicate receipts so we will be getting another refund, so it isnt so hard to keep going with the sessions after all.  We are so relieved!

Both of us have siblings who experienced serious mental health problems as teenagers, and at times weren't well supported by our parents.  It wasn't that our parents didn't care -  there was such stigma around  mental illness and very little specialised support for adolescents, so they became frustrated by the behaviours they were confronted with and reacted accordingly.  I know my Dad regretted throwing my sister out of home when she was 16.

 Our daughter's first problems emerged at 14 years. She was initally diagnosed with Conversion Disorder, then later with severe depression.  At 19 she's actually doing better than the previously mentioned relatives and we attribute this to the early intervention and treatment which we are really hoping will give her a better outcome.  She has been socially withdrawn since 14 - not socialising with other young people at all except online. We are glad she actually managed to  finish school (as my sister never did). We decided early on we had to be positive and do what we can to avoid the kinds of events that occurred with our own siblings especially the multiple suicide attempts.  The thing that worked best was to keep encouraging them with any activity they could participate in positively and encourage them to go on with treatment -  counselling and medication.  

I found a book recently :"The Teenage Brain"  by Frances Jensen.  It's a bit heavy on the neuroscience for those without medical jargon knowledge but is quite a fascinating insight into adolescent brain development especiallythe chapters around sleep, and stress.

[Neil_1]

Hi there Ann

I think our son is about 2 weeks away from getting his “P’s” and become mobile – and as I’ve said to him, one of the most important things he’ll have to be able to do is to not only put petrol in the car, but to figure out a way to pay for it as well.  🙂   Kind of a little running joke with have at home.

Oh boy, that is some discrepancy there with Medicare – so that’s going to be a very welcome bonus for you very soon.   But wow, it does make you wonder that if there wasn’t that little interaction at that time, you may never have even known about it.  Makes you wonder how many other people out there might be doing it ultra tough, and may be missing out on extra funds which they should be entitled too.

That sounds absolutely awesome, all the support and help you’ve given your daughter and I don’t think any counsellor could have advised you any better with all that you’ve put in place for her.  I hope that she continues to keep getting better and as you know, it’s a long and slow process, but hopefully all will continue in the right positive fashion.

Kind regards

Neil