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Sylvia's story

Sylvia is a 17-year-old adolescent girl referred to the outpatient clinic due to suicide risk, depression and excessive use of alcohol.

Symptoms and behavioural problems
In the past year, Sylvia has spent a lot of time with a gang of adolescents who have been under surveillance by the police. She has attended parties every weekend, sometimes also during weekdays and has gotten drunk once or twice a week for the past half-year, most recently a week ago. The police have intervened at several of the parties she has attended. Once they arrested a party participant because he had fired a shotgun through the window at someone outside. She herself has never been violent towards others.

Two months ago, one of the adolescents was killed after hanging behind a bus on a bicycle. This has caused a lot of discussion and strong reactions in the neighbourhood because this activity had been a major problem for some time. Since then, Sylvia has said several times that although she did not know him very well, she would like to meet this boy again by killing herself. She has been more aggressive at home in the past week and has broken some objects in anger. She has been unable to concentrate on schoolwork or other things, has continuously been out with friends and has been unable to accomplish plans. No psychotic symptoms.

For many years she has suffered from low self-esteem and fear of standing out and being noticed. Over the past three months, particularly n the past three weeks, she has been very depressed, cried a lot, said she is worn out and that everything is hopeless. She has been more unkempt, very passive and takes little initiative. Her parents feel that the problems have increased in the past weeks. Three days ago Sylvia took 10 Paracetamol tablets with intent to die, but grew frightened and told her mother, who took her to the emergency room. They have been particularly worried after this. She has stayed in bed the past two days, says she feels terrible, and is not up to anything.

She does not think anyone can help her and she says she still wishes to die. She thinks she has to take more tablets than the last time in order to die. Her parents often look in on her, but are not presently afraid she will hurt herself, because they have removed all tablets from the house. They despair, however, over her condition.

Developmental disorders and somatic problems
Physically healthy. Only two years ago it was discovered that she is dyslexic. She has always had poor results at school, but the past months she has had so much absenteeism that the teacher cannot give her a grade.

Social problems
She says she previously had a few close girlfriends, but that she made several new friends last year and said that she became less inhibited. However, she often experiences being exploited by others and feels that they do not take her feelings into consideration.

For a long time she has been completely dependent on her parents to get up in the morning and often she has not made it to school. During the past weeks she has been more at home than at school. She argues a lot with her parents. The parents have a stable relationship and cooperate as best they can although the father is on work assignments abroad for several weeks at a time. Her mother is exhausted.

Lack of information and knowledge
Sylvia’s parents feel their daughter is in strong need of help. They do not know why she is so depressed, but think she needs help to reduce her alcohol intake and get away from the gang. They wish for her to receive treatment for her depression, but do not know what is possible or if CAMHS is the right place.

Page last updated: 9 December 2008