Dear Dr. G.,

I am writing hoping you can give me some advice regarding my 21-year-old daughter. I am a single mum and my daughter is an only child, up until she was around 10 years old we had a fantastic relationship,friends as mum and daughter. There are various issues I am so concerned about as a mother, but to keep it short she has very low self esteem. It all started around her getting her periods at 11 years old,she started with a few spots and a little acne, her school had tough rules, and makeup etc was a no-no, although I helped her put a touch of concealer, then things got worse,we went to a dermatologist who gave her antibiotics,then roacatine! Which after two years we did not realise it has side effects, such as depression and causing redness on her face! We then went to another specialist who gave her laser treatment for the different pigmentation on her cheeks. To cut a very,very long story short she is so insecure she will not let anyone see her without a stitch of makeup on,she won't go to sleep overs, she won't go on holidays with her friends, and to make matters worse, she has an on and off boyfriend who mentally abuses her, and I also believe some physical too. He calls the shots,he tells her what to wear, when they are seeing each other, where they are going etc. and then when she complains about him flirting with other girls because he has photographs flaunted on Facebook. She is now obsessed with him. She has always been very academically conscientious in school and university where she is in her 3rd year but has already declined from studying,she loves her university course (fashion buying)but I am so scared for her health, happiness, and future. She also has threatened me that if she doesn't get back with him all she wants to do is die. She blames me for many things. I am so worried. She has googled suicide ideas. I have tried to comfort and support her even giving her ideas about how she should get him back to love her. I honestly don't know what to do, she also has a few health issues, bad back, always having stomach problems such as bloating, being sick,and psoriasis. She is constantly tired, has insomnia and has an underactive thyroid. She had the misfortune of catching an STD(genital wart infection) and since has had very bad bleeding in between periods. We have been going back and forth to our doctors. I have googled and searched looking to see what could be causing all of these health issues.They became worse from being with the boyfriend on and off for six years.

Her father has been around mostly for financial support. She has never had a very close relationship with him although they get on when they do see each other. Unfortunately, she does not want me to divulge these issues with her boyfriend to her father.

All of this is causing me to be very low myself. I am constantly worried. I don't sleep well. I am anxious and I am now on an antidepressant.

Please I hope that this is not a hopeless case. Please advise what I can do to help. I know that my daughter is an adult but I cannot watch my only daughter deteriorate.

A VERY Frightened Mother

Dear Mother,

You have every reason to be worried about your daughter. Our children remain our children no matter what age they are. It seems to me that your daughter's issues began around the time of puberty which is not uncommon. Those raging hormones affect moods and may cause physical issues such as the acne that you refer to. Your daughter had low-self-esteem so it is unfortunate but not a surprise that she tolerates a boyfriend who reinforces her low self-esteem. I would advise against helping her get the boyfriend back.

You describe symptoms of depression-insomnia and talk of suicidality. In addition, somatic symptoms like psoriasis etc. may be exacerbated by stress and physical problems may in turn affect mood.

Here is my very best advice to you. Get a professional team to work with your daughter. It is impossible to be both mother and therapist. She needs a therapist who she trusts to work on how she feels about herself, assess her safety, and to help her get out of the trap of an obsession with a young man who hurts her. She also needs an M.D. who will assess her physically and stay in touch with the therapist with your daughter's permission. The M.D. may recommend a specialist for the variety of physical symptoms that you are describing.

Finally, to answer your question about whether or not this is a hopeless case-my answer is absolutely not. I have hope for everyone or I would not be in this field.

Good luck to you and please take care of yourself in the process.

Dr. G.

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