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We are desperate.  Our 18yo daughter is suicidal again.  She has attempted twice.  She was recently hospitalized for suicidal ideation, and was only discharged Aug 16, but at the time she felt she still wasn't stabilized.  We expressed our concerns,  but were told that she had lots of supports (psychiatrist, psychologist that does DBT with her, case management worker, and family), so they sent her home and told her she needs to use her tools. 

For the last 3 days she has felt intense isolation (her peers are going away to school, she is not).  She started feeling suicidal and had a plan.  Here is where we don't know what to do anymore.  Part of her safety plan is to call the crisis line in this case.  They are required to tell her to go to the hospital if she says she is suicidal with a plan.

On Sunday, they called the police and had to taken to the hospital.  They wouldn't admit her, and we brought her home.   Yesterday she tried using some of her distraction skills, but they didn't work, so we called the crisis line.  Again, they told us to go to hospital. Again, we were sent home.  They  believe that BPD patients do not benefit from hospital stays, and will learn to manipulate to get into hospital rather than learn to cope with their feelings and deal with them effectively. 

Today we met with the case management worker.  She also told us to go to hospital since she is still suicidal. The worker told us to go to another hospital, so we did, and she is now on a 72 hr hold. 

Our question... .who is right?  We see both sides.  We don't feel she is getting any help at the hospital, other than she usually stabilizes.  She doesn't get treatment, but does attend groups. Last time they upped her meds.  Last night the doctor basically said that if she keeps going into the hospital she will not improve, and we will be enabling her.  Has anyone been here before? 

What do you do when all the people on the crisis team tell you to take her to the hospital, but the doctors say no?  FEELING SAD AND DESPERATE. 

Hi 1hope

I am very sorry your daughter is still struggling with thoughts of suicide. I can only imagine how difficult this must also be for you as her parent.

It is very positive though that she has a crisis safety plan in place.

How often is she getting DBT sessions?


Though there might be some validity in this line of thinking of these particular doctors, I think the important element here is that it's something they believe and beliefs aren't necessarily solely based on facts. Every person with BPD is different so for these doctors to make blanket statements like this is something that seems rather irresponsible to me. Something to keep in mind here is what Dr. Blaise Aguirre has said about BPD and manipulation in relation to adolescents:

"The effect of feeling manipulated, doesn't mean that the intention was to manipulate.
... .
Another thing is this, and Marsha Linehan has talked about it, if they're so good at manipulation, then why do they end up in hospital all the time? Why do they end up in treatment all the time? Well, very good, if they are manipulators, they are terrible manipulators."

Take care

The Board Parrot

Hi 1hope,

I'm so sorry that you are going through this. How frustrating and confusing to be hearing two different recommendations from professionals.

Most of the general membership at bpdfamily is not comprised of professionals in mental health. That said, I want to echo something that Kwamina mentioned. Your daughter is not a diagnosis—she is an individual, with individual needs and reactions. It sounds like the crisis team sees things similarly. Perhaps the doctors have had experiences that have influenced their thinking the other way. I think it's important, however, to advocate for treating your daughter as someone needing suicide support and not someone with BPD manipulating the system. 

Is there a hospital that works with the crisis team where your daughter could go?

We're here for you. 

heartandwhole

Hi there Hope 

I'm so sorry your DD is struggling; did your DD have a few weeks of some relief? I ask as it was a winding road for us, one step forwards two back, the road not linear, it was a pattern gradual overall progress, over time and navigating services as you are while supporting, keeping DD safe.

It so confusing receiving contradictory advice at a desperate time, we find ourselves in the middle of supposedly joined up health services speaking from the same care plan, we learn they are not. I pulled out my hair a number of times in shear frustration, keep going Hope, they are respectfully responsible, keep asking your questions, we held them to account.

Our personal situations are unique. I do understand the emphasis focusing on practising the coping skills as I've seen it work with my DD in time, we also went through challenging times like you, feeling we were on a boat at storm with no anchor, in search of the anchor, the goal.

Hope does the safety plan include her calling her DBT therapist who is working with her on suicidal ideation? My DD often called her therapist who'd listen and talk through reinforcing the skills she was being taught agreeing a plan and timeline when the therapist would check in with DD to see how she was progressing, it was very important to my DD she had access to the therapist, for support to continue their work.  This is where the work took place at times of crisis, directly with the therapist.

You say they have increased the meds, is this for depression?  Getting the meds right made a huge difference for my DD, anti-depressant medication to increase the amount of serotonin.

I’m glad to hear your DD is safe, she is fighting to be well and I hope sharing our journey helps you through these days. I'll come back to you shortly about 'fighting to be well'.

Can you let us know how you are? Big hug from me to you.   

WDx 

I'm so sorry you are going through this , we've been there too , countless times ,not sure what do to keep our DD safe . 2 years ago my DD seemed fascinated with going into hospital and while I do feel some of her admissions were absolutely required , other times I felt she was using hospitalization as a way of drawing in her friends / boyfriend again if they were beginning to withdraw . It's so hard to know what's real/ what's not / whats a passing moment and thought that she can be distracted from. My DD has had 7 hospitalizations since September 2015 . Her last one was in March earlier this year . So we have 5 months under our belt now with no hospitalizations , the longest " hospital free spell" we have had since this whole nightmare kicked off in September 2015. My daughter has most definitely sickened herself with mental health units having been in every single adolescent mental health unit in the area , and she's most definitely very fed up with them now , her priority is to stay out of them ! So if/when the next hospitalization is looming , I'll at least know it's for very real reasons . I share this with you to give you some hope that you might not be stuck in this revolving door Of hospitalizations and the victim of professional differences in opinion regarding what's for the best for ever more xx

Thanks to all of you for your words of support!  They mean so much right now.  It's nice to know someone else knows how I'm feeling. It's so hard for others to understand something like this.

We are taking things one day at a time. We are supporting her the best way we know how.  We are seeing some small changes, such as her being more able to identify why she is feeling this way, and what she feels she needs to focus on to help her feel better.  We're hoping this is a sign that some of the DBT skills are starting to help. 

Wendy-thanks for the suggestion of including her therapist higher up in the safety plan.  Her therapist has told her she should do this, but I think she is hesitant to do it.  One of her issues is not wanting to disappoint others, and I think she feels that the therapist would be disappointed in some way... .something for us to explore. 

Heart- I like your quote, "Your daughter is not a diagnosis, she is an individual "!

Again, thanks everyone!  Your words of encouragement will help me through! 
Hugs,
1hope

Those small changes we see are huge strides forwards, what I also learnt was there were positive changes happening that I could not 'see' or 'hear' - realising that gave me some comfort.

Disappointing others can be an issue, you've hit on something for her to work through to 'flip it over' - her therapist validates her reaching out when struggling so they can work together at that time.

Does your DD attend group skills sessions?

Hoping you are able to make time for you today. What do you do for self-care?

WDx

Wendy... .I spent the day with my husband and son at the fair yesterday.  To some outsiders it probably sounds terrible, but I have learned on here that it is absolutely necessary.  We needed time to reconnect and recuperate after some very tumultuous weeks!  It did us a world of good!  Thanks for asking!

Today was another roller coaster day. Our daughter called from the hospital several times because she was feeling anxious about not seeing a doctor yesterday.  She is starting a new school program Tuesday which helps students bridge the gap to post secondary, and is eager to get out of the hospital. (She feels much more stable now, and is more positive.). At one point the Dr came in and said that although she seems more stable , he was going to have her wait until Tuesday when her admitting doctor was back. This was the cause of the phone calls.  We had to talk her through the reasons for waiting, talking to the weekend doctor, explaining her school program etc.  She is still learning to advocate for herself. 

We visited her this afternoon and she seemed to be more accepting of the decision.  We discussed ways to demonstrate that you are stable now, and strategies to continue to help her. 

Soon after we left, she called to say she had spoken to the "weekend doctor ", and he said he felt comfortable discharging her.  She will spend the night in the hospital tonight, then he will discharge her in the morning after he has met with her again.

She was pleased that she advocated for herself, and that she chose to stay one more night to ensure she is ready to come home. Baby steps... .

It is absolutely necessary as you say, I'm glad your day at the fair did you, H and son the world of good, how old is your son?

It's great to hear your daughter was pleased she advocated for herself and the outcome, not easy when dealing with so many different Drs as they come and go on their shifts. Being able to advocate is so empowering, I also coached when my DD was where your DD is and now well DD is on the most amazing journey, she's a mental health advocate destigmatizing BPD on twitter, it's a thriving caring community, reminds me of ours here! She's certainly found her voice and passion, it's helping her manage her BPD! 

By the sound of it the school program has come at a good time, what are your DD's interests/hobbies?

WDx