BPDFamily.com

Hi,
I have a 23 year old with BPD. She also got a TBI in 2018 from a car accident. Since 2018 her BPD behaviors has been much more over reactive. We are finally seeing Neurology tomorrow (Tuesday), we waited an entire year to see!
I’m her mom, no medical background. Things got so bad with her breakdowns that I completely had to stop working. She’s been under the care of a Psychiatrist but he is at a loss. We have gone thru so many Med combinations and nothing is really working affectively since her TBI!
I’m up during the day with her, at night with her and I feel hopeless & lost. I don’t know how we keep this going long-term?

I’m exhausted, she’s in a lot of emotional & physical pain. Her anxiety & depression has become unmanageable at this point. In 2020 she refused any further counseling. She relies on me for med management, to help with her meals, to take a shower and everything seems very bleak.

Welcome.  I am so sorry you are going through this pain.   In the meantime are you dealing alone or do you have support to help ?  Did her psych provide any ideas in the way of support for you to take care of her? Please keep us posted on her neurology consultation . 

It sounds like a situation that would strain anyone's endurance, I can certainly understand the feeling of exhaustion. I knew a man in a warzone who had a TBI layered over what appeared to be BPD but since he hadn't been diagnosed before the TBI it was difficult to draw firm conclusions. He was actually quite high-functioning though, so even still he was less of a handful than your daughter. I've never been in a car accident, but I assume it's also possible she may have PTSD to the incident that also colors/amplifies her reactions to things...I'm really sorry to hear about it.

The only two minor ideas that spring to mind are whether a new psychiatrist is necessary (I'd agree psychiatrist is better than psychologist or therapist, but maybe we're overthinking this and if she resolves some psychological angst and just gets to scream into a pillow at a minimum wage therapist then she'll cut her BPD breakdowns in half or something?)...and the other thought is just whether it would help for you and yoru spouse to consider taking something like the NEA-BPD "Family Connections" course once a week. It has two benefits, one is just the AMAZING emotional crutch of being surrounded by caretakers with similar perspectives, and the second is teaching ways to communicate on a daily basis that avoid triggering BPD rages/fits. "Normal" cases they want the BPD patient to ALSO attend similar classes, but it's not necessary and your daughter sounds like she may not be ready for that this year.

The good news is that hopefully the neurology report will definitely be helpful regardless of how vague, specific, dark or light it appears - because it will help clear away some of the resulting fog and focus attention on the most promising avenues. Even if it comes back not showing anything of substance, the LACK of neurological scan anomalies helps rule out many things you don't need to explore.