18 year old daughter - how do I help her

Hi, my beautiful 18 year old daughter is becoming increasingly self destructive.

In the past 4 years she went through a period of self harm and I managed to get her to a doctor who diagnosed her with anxiety. She has never been on medication but i got her to see a counsellor. After 2 sessions she refused to go back insisting she was fine and wouldn't hurt herself again.

She is the youngest of my 3 children and

she has always been quite open with me (obviously I'm aware that she doesn't tell me everything) self medicating, at first with marijuana, now including alcohol and occasionally other drugs at parties. She's disrespecting herself and her self esteem has plummeted. This is exacerbated by living in a small town where everyone knows her business.

She was in a relationship with a boy from the age of 16 which is when her marijuana habit started. This ended recently and he smashed up her car with a shovel. We had the police involved and an AVO is out against him. I know he hit her on at least 2 occasions after he found out she had slept with someone else.

She has 2 cautions for cannibas possession and 1 point left on her license.

Despite all this she is well liked and many people have reached out to her, tried to offer help, guidance and advice.

She got a job cleaning when she left school and she's extremely good at it. Unfortunately she has had several jobs because she gets bored or doesn't like someone she works with Or some other excuse... just more erratic behaviour and instability. All her bosses have praised her and valued her. She's been offered leadership roles. Then she has a big night and misses work. They always forgive her and give her more chances because they know she has problems and want to help her.

She talks about wanting to be dead. That's the hardest for me. While she has never attempted suicide, I feel like, by being so reckless with her safety, that she just hopes it will happen without making a conscious choice.

I even started seeing a therapist for several months because I thought I was going to have a breakdown.

I've taken her to the doctors several times but they haven't given any real direction, just the standard therapy, medication & diet suggestions then put the ball back in her court. Just last week she saw a wonderful female doctor who she really connected with. She walked out so positive. She is meant to get a blood test but she hasn't made an appointment. I feel like she needs to be assessed. She is dependent on marijuana to sleep, is anxious possibly depressed. I don't know how to ask for this.

My heart is breaking because I have seen my confident, caring, funny, creative and talented daughter ever so slowly decline and I feel so guilty for not pushing harder to get help before it got to this. It's a viscous cycle... her low self esteem is made worse by her substance abuse and poor social choices but she is reliant on the substances to give her the ability to "function" and she refuses to see anyone or make any changes. I believe there is a lot of shame there and how do you convince someone to open up to a stranger - be it a doctor or therapist - and tell them your most shameful truths. Hard enough as a seasoned adult let alone an 18 year old.

I don't know where to go from here.

I welcome any advise, suggestions and experiences.

❤