"like gender issues, cutting herself(minor), smoking, piss-poor school work, etc."
This sounds like the standard difficult-adolescence "I don't know who the hell I am or who the hell I want to be" angst.
Which doesn't make it any easier to deal with.
It's heartbreaking to watch your beautiful baby, grown into your beautiful child, struggle.
(Can you tell I'm a mom?)
Pieper, you've really got my sympathy.
The smoking and the cutting are both things people use to "self-medicate" by reducing anxiety. The smoking because nicotine increases available serotonin---just like prozac. The cutting because it releases endorphins.
The piss-poor grades sound like she *may* be avoiding doing school work because she's so anxious about whatever's bothering her that she gets more anxious every time she tries to do her schoolwork and just shuts down.
The anxiousness may or may not be school related---but because of the pressure over grades (which comes from life, not just you), if it didn't start off school-related, it's spiralled into that. She's afraid of her bad grades so she avoids everything to do with schoolwork because it reminds her of her angst----which further sinks her grades.
If she doesn't have a major mental illness, she *might* benefit from a low dose of an anti-anxiety drug long enough to let therapy start taking effect. If you can get her exercising to get her endorphins instead of cutting, you can eliminate the cutting. If you can get her to have reduced anxiety, as part of therapy, you *may* be able to get her to quit smoking. If you can reduce her grade-related anxiety temporarily with meds, then homework help with someplacy like Sylvan can help her get her grades back under control and eliminate at least *part* of the source of the angst.
I'm not sure where the gender issues are coming from and whether there's anything "real" there causing her angst, or whether they're a symptom of the angst.
Well, I'm not sure about *any* of it since I don't know you.
Except that what you've described *sounds like* loads of pain and angst and you may need to temporarily take that load off of her chemically for her to have the energy and focus to start, one by one, coping with the problems that have built up so much angst.
Or a good therapist may be able to do it without meds.
All I can suggest is that you keep an open mind and ask around with other parents in your area to find a really good therapist.
You're obviously a very caring mother, and your daughter is obviously in the throes of some serious teenage pain.
Dang, you couldn't pay me enough to get me to go back and be a teenager again.
Timoclea