BPDFamily.com

Hello, My daughter had three suicide attempts in the last 6 weeks and will not take medication, she is vegan and says she can cure herself with marijuana, diet and exercise although is so depressed she will not exercise and only wants to binge eat. I am overwhelmed with guilt and trying to talk to her when she is so fixated on something or blames me for her problems and depression. She is getting outpatient therapy since out of the hospital and has her first outpatient psychiatrist appointment tomorrow. It is hard to talk to her when she twists my words or adds things to the discussion that I never said to make it an insult toward her when it started out as a simple benign question or response to a question. I am just wanting to learn strategies and build up strength to be able to help her and set boundaries without her acting out. This is a new diagnosis for her, she has been depressed in the past but nothing like this where she has severe outbursts, crying and violent behaviors toward me. Thank you for any advice.

It sounds like things have built up to a crescendo in your life with her, three attempts in six weeks is definitely alarming. It's good that she's getting outpatient care, from my understanding hospital psychiatrists dealing with outpatient suicides have a pretty good grasp on issues like BPD (is your daughter diagnosed btw?) so don't stress about her bad-mouthing you to the hospital or anything...they know not to put stock in BPD accusations of terrible caretakers, etc.

The best strategy to reduce the number of times she's triggered into a fit, according to most of the people on this site and elsewhere, is for you the caretaker to learn about Cognitive Behavioral Therapy so you can practice it yourself when speaking to her. There's a specific branch of it called Dialectical BT which was developed by Marsha Linehan...a high-functioning BPD patient herself although one with a PhD in psychiatry. Basically it's tips on how to phrase things to avoid disasters. She has a lot of Youtube videos, the most useful ones in my opinion are about how to validate the indefensible positions of your loved one - but there are others about setting boundaries, DEARMAN, etc.

Of marijuana, diet and exercise - the third one sounds the most useful...and the most difficult. Marijuana may ease her tension, but it also leads to long-term paranoia that remains even when not using...hardly ideal for a BPD who already struggles with an abandonment complex, pathological dishonesty or theatricality - the last thing it needs is paranoia layered on top. You might be able to reduce the marijuana use by warning that it's likely doctors will have to prescribe her even more meds in a few months if she's using marijuana. The state hasn't technically told me I'm not allowed to grind up some fraction of her prescribed medication (that she has confirmed and I am certain she is not otherwise taking) and put it in her oatmeal in the morning, but I get the feeling that they assumed I would at least read between the lines given our last exchange that they would not approve of such efforts.

Exercise, any chance you or the father would be able to convince her to go jogging "to help you lose weight" (making it about your supposed failings, not hers), even promising that during a jog you'll fall absolutely quiet and just listen to her without saying anything yourself so long as you're still jogging? Might get her to open up, get exercise, AND feel like she has some control and autonomy. The downside is, you have to jog with her for a few weeks. And it's winter.