How to evaluate/diagnose teen with extreme moods

amother

Sun, May 01 2022, 2:48 pm

my teen dd (17) has a lively upbeat fun personality. she is very popular and a born leader. However, she has these extreme moods which are somewhat concerning and I'm not sure how to evaluate or get a diagnosis if needed. she has a serious rivalry with her younger sister, with whom she shares a room.
For example on friday night she was very tired, when she was in bed already but not yet sleeping she got triggered by being disturbed and proceeded to cry and scream for more than half an hour going on and on about how evil and terrible (I and) her sister are for doing terrible things to her all the time. satan, eichmann, mengele were among some of the names she called. and she described in detail how she would kill her sister. when she gets upset, (often when she is tired) she wreaks havoc in the house throwing things, flipping over the garbage can, etc. I thought it could be pms - but it happens too often to be that! and the next day she can be sweetly entertaining her younger siblings and telling me her latest upcoming trip or whatever as if nothing ever happened. or sometimes, not and she will hold a grudge for a long time. some shabbosos she refuses to come to the meals and stays in her bed because something upset her like I didnt make the food she prefers or her sister rubbed her the wrong way, or my dh or I criticised her (yes we are human and sometimes do this) . she often speaks to her friends on the phone spewing hatred about her terrible family while in the room with us and we all hear every word. there is definitely a strong sibling rivalry with her younger sister triggering her, but I still think her behavior is extreme.
I signed her up for therapy in a local clinic but she refused to go. my question - is this normal behavior? how can I get her evaluated? where do I start? can it be hormonal (all the time)? any more ideas?

amother

Brickred

Thu, Jun 16 2022, 12:56 am

I know it's a Lil while since you posted this but its worth the shot of answering just in case you haven't resolved the issue.

With my experiences of an explosive teenage daughter I ended up going to therapy myself and the therapist guided me on how to deal with her as well as how to encourage dd to therapy. Teletherapy or zoom therapy works for some teenage girls that wont sit in a shrinks room cuz they're too embarrassed to be seen by others entering /exiting etc

That all being said pls spk to you other kids and keep a close eye on how and if her behavior affects them. Even an occasional major meltdown...

amother

Cobalt

Thu, Jun 16 2022, 3:22 pm

amother [ OP ] wrote:

thanks for answering. its not resolved yet.
I thought to start with a gp. maybe its some weird vitamin deficiency or pandas? or hormonal?
I am in Israel (Bet shemesh area), so recs in NY wouldn't really help us but thanks anyway. Any recommendations in the greater Bet shemesh area are welcome.

I would absolutely look heavily into any and all biomedical pieces before resorting to psych meds. Dr. Shulman’s daughter is a pediatrician in Beit shemesh and is pandas literate. Keep in mind that even if it’s not strict pandas, there are so many other root causes that can be treated that can lead to this type of behavior. This book does a great job of going through them. If I were you I would make every effort to get my hands on a copy of this so I could be as informed as possible when talking to a provider. Because they are bound to be dismissive. https://www.amazon.com/Brain-I.....r=8-1

amother

Hawthorn

Thu, Jun 16 2022, 4:02 pm

amother [ OP ] wrote:

Has she always had these tendencies?

You have to address it, she is getting close to marriage age and you certainly don't want her getting married to act like that to her husband.

I don't think a GP can help you much with this. I strongly recommend that you see a psychiatrist (even if you're not ready to medicate, you can get a proper diagnosis and get some guidance in terms of an approach to dealing with her). If you really suspect pandas, go to a pandas specialist, not a gp. In my experience, pandas brought out issues that already existed, but exacerbated them. Doesn't sound like this is any sort of vitamin deficiency, though the idea of a quick fix sounds lovely!