The question My daughter is now 34 years old, but she wants to be a teenager again, because she feels that she missed out on the fun she should have had back then. She hates the way she looks, because she thinks she looks older than 16. She wants cosmetic surgery and orthodontics to look younger.

She wants to experience university life as a fresher again and have young fun, but she also doesn’t want to as she feels too old. She wants to earn and have independence, but also fears it. She relies on her mother and me and is not interested in getting a job. She never goes out and has no friends. She has no interests and spends most of her time comparing herself with teenage social-media idols.

My daughter says if she can’t go back to being a teenager, then she wants to die. It is very easy to say the wrong thing. Then she has frightening fits of raging and screaming.

She has tried both medication and therapy, but nothing worked for her. What can we do?

Philippa replies It sounds as though your daughter’s life is online, where curated and idealised images are likely feeding her body dysmorphia and sense of inadequacy. It seems her actions, or inaction, are motivated by external referencing. Instead of relying on her own sensations and experiences to guide her decisions, she appears to be overusing her imagination about what others may be thinking and feeling about her. This distorted external referencing can keep her paralysed, because she’s trying to live up to an imagined ideal or pre-empting imagined judgment. Moving towards internal referencing would allow her to ground herself in her own sensations, experiences and values rather than being ruled by her assumptions about others’ opinions. Being stuck in external referencing is a recipe for anxiety and depression.

She seems to have not yet acquired some necessary life skills, namely: tolerance for frustration, flexibility, problem-solving and empathy. Many people learn these skills early, but for others, it takes much longer. The good news is that they are all learnable and your daughter can develop them at her own pace with the right support.

I’m also concerned about her isolation and suicidal thoughts. She seems caught in a cycle of comparing herself unfavourably with others, which online spaces exacerbate. Many professionals might suggest diagnoses such as autism, borderline personality disorder, ADHD or bipolar disorder. While labels can sometimes help contextualise behaviours, I believe the focus should be on equipping her with the tools and skills she needs to move forward, regardless of any label.

Group therapy, particularly in a residential setting, could help her begin this process. In such an environment, she would have the opportunity to interact with others, practice essential skills and build trust in relationships. Facilities like Priory Hospital in Roehampton or Nightingale Hospital in London offer structured programmes that may help individuals develop social and emotional skills necessary for personal growth. Alternatively, she might benefit from something like the Hoffman Process – a week-long residential, intensive-therapy course. All these treatments would require money and some self-motivation from her. Therapy is not a passive cure, it isn’t like a cream you rub into a rash, it requires work by the patient.

Your daughter’s fear of independence could be tied to her lack of belief in her ability to cope. She needs to understand that independence doesn’t mean being entirely self-sufficient. Humans are interdependent; we rely on each other in healthy, reciprocal ways.

It’s also important to distinguish between “rescuing” and “supporting”. Rescuing involves doing things for her that she is capable of doing for herself, such as managing her finances. Rescuing reinforces her dependency and undermines her confidence in her abilities. Supporting, by contrast, means encouraging her to take responsibility for her own life while offering encouragement and being a safety net when needed. Family therapy could help all of you establish and maintain boundaries while improving communication. By stepping back from rescuing behaviours, your daughter would need to take small but meaningful steps toward independence.

Developing internal referencing, building skills and learning to trust herself and others can happen at any stage in life. These shifts, though gradual, can lead to a life where she feels more grounded, capable, and connected. I personally believe plastic surgery and orthodontics would be a disaster for her. It would further entrench her external referencing mindset.

I haven’t met you or your daughter, so my advice is limited. I believe the best option would be a psychiatrist who is also a psychotherapist. Whether therapy works depends on the relationship between therapist and patient, so if it didn’t work out the first time, that doesn’t mean it never will. Likewise with medication, so a different approach there may also help.

Recommended reading: Searching for Normal: A New Approach to Understanding Mental Health, Distress and Neurodiversity by Sami Timimi

If you have been affected by any of these issues, please call Samaritans on freephone 116 123, or contact Mind