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We have had several days of good reports - almost a week without self-harm and she had told us that she didn't want to do that to herself anymore. She has also been eating nearly all of her meals. This is a huge win. It may not sound like a lot, but it's huge for us.

She had her call with her dad tonight - she can only call one of us per day, and only talk for 15 minutes. Earlier this evening, she had been playing foosball with another patient. She told my husband that she had been joking around and being competitive. She had - in her mind - jokingly trash talked with the other patient while they were playing. In other words, she was sounding a little more like her old, confident self. At some point, one of the other patients who had been observing the game asked her why she was hating on the other player. This sent her into a downward spiral and her anxiety and self-harm intentions went through the roof. She felt like she was bad for feeling competitive. My husband tried to tell her that it was okay to feel competitive and that we knew she hadn't meant anything by it. She had just been trying to have fun. Feeling like she may have hurt someone, though, was too much for her. She told my husband that her anxiety and self harm were at an 8 out of 10. This usually means that her self-harm actions are imminent. The call time was almost over and he only had time to tell her he loved her and encourage her to talk to a nurse. He told her he would contact the nurse, too, to back her up. He did this, and mentioned that she had promised that she would talk to them, but he wanted to make sure someone intervened just in case she changed her mind. He asked that they give her the anxiety medicine as soon as possible and asked for someone to sit and talk with her to bring her down a bit. He also emailed the details of the call to our daughter's therapist. This is how I learned about what happened.

I got home later tonight because I had been at a goodbye party for a good friend. Even though I still feel awkward around other people, it felt good to get out with other supportive friends and to support my friend who will be moving in a few weeks. I didn't read my email messages until my husband went to bed. He hadn't sent the email until after I was already at the party. It is now well after 2:00am and I can't sleep. This, unfortunately, seems to be the norm for me lately. It's worse, though, when I feel guilty because I missed something for her. Again, I wasn't there to comfort her. Tonight was one of the first times I had tried to enjoy a night with friends and now I feel guilty for doing it. I know this isn't helpful thinking, but it's so hard to make sense of everything when I can't be there in person to comfort her. It's also worse when it isn't my day to talk with her and something happens. I want so much to tell her that I love her when she feels this way, and right now, I can't even do that. I should get the chance to talk with her tomorrow, but it's just not the same as talking to her and helping her when she is feeling this way. It feels like another form of forced abandonment and as her mom, it's really hard to not feel guilty for not being there.

I want so badly for her to feel better and to get past this so we can move on and have her back with us. I'm scared that this will take longer than we thought, and I'm scared about what happens once she is better and if she will have a relapse. Will we be able to reach her to help her then? I want so much for her to know how much she is loved and that she has a right to feel what she is feeling and not beat herself up over it. She has a right to feel proud of her accomplishments and she even has a right to feel competitive once in a while. None of this makes her a bad person, yet this is where her head goes right now. It's the combination of not having the maturity and life experience to handle her thoughts and emotions, coupled with her underdeveloped prefrontal cortex that makes this so scary. Teenagers, as a whole, are impulsive because the reasoning section of their brains are underdeveloped compared to the impulsive or "fight or flight" section. How this translates is that, for a teenager experiencing depression or other mental issues, they will feel bad and want to immediately do something to ease the pain. Since their reasoning portions are underdeveloped, they are more likely to turn these feelings inward on themselves. Even adults do this, but generally, adults have developed the reasoning section such that we can talk ourselves out of these feelings and at least sort through them. For a teenager, this often means taking some kind of action - like cutting, destructive behavior, lashing out, or worse, suicide. It's these brain connections that we are trying to rewire through therapy. The hope that is if we can help her early enough, we can successfully rewire the section of her brain that is telling her to hurt herself.

I know all of this rationally, but as a parent who can't be there to comfort her child, it is really hard not to turn all of this on myself, even with my adult reasoning capabilities. I can only imagine how hard this is for her, since she is learning these skills in addition to fighting her demons. All I know is that right now, I would give anything in the world just to hug her.

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