I think a main question is- if they officially diagnosed BPD- would it lead to specific treatment that could be more effective?

Note- we are all lay people here with our own experiences, so these are not professional opionions. I think you know that but I wanted to make this disclaimer.

There isn't a specific medicine for BPD. Medicine can be used to help some associated symptoms. In the case of my BPD mother, she took medicine for anxiety- and so "anxiety" was the diagnosis on her chart. Her medical team was aware of her BPD, but as a diagnosis, it would not have changed the choice of medicine to treat her because there isn't a BPD medicine.

There are certain therapies that have helped pwBPD and other disorders. DBT is one of them. If there is a history of trauma, then EMDR helps with that. However, in a 15 year old, how much of her cognitive and emotional development at 15 to work with these therapies is a part of the decision. If there's a history of trauma, she may be too young for EMDR. So the benefit of having BPD on her chart may be lessened if she's too young for full participation in these therapies.

They may also feel she's too young for this diagnosis to be official on the chart, since she's still maturing. The therapists can be aware of it, without it being on her chart yet. Since she's young, they may be incorporating therapies into age appropriate approaches with her.

With a sudden change in her behavior, I assume they have looked for and ruled out other causes, medical, events that cause emotional trauma, bullying, abuse, and substances. This isn't to blame parents- even with good parenting and monitoring, kids today can be exposed to the internet, cyberbullying, through peers. Sometimes none of these are factors, but I assume they've looked at these to rule them out.

Since she is a minor, I also assume her treatment plan includes family therapy and meeting with you as parents. If BPD is being considered, you can go ahead and learn about it without having a definite diagnosis at this time. It can help to have your own personal therapist for support as you navigate this situation.
 

Hello and welcome to the family.  I'm so sorry you're going through this and I'm going to try to be brief here.  I went through the exact same thing with my daughter, who's now 27.  She was first diagnosed bipolar and it switched to BPD. 

A criteria of being diagnosed BPD/NPD is that you're 18 years old.  Why?  Because sometimes, kids can grow out of it and doctor's don't want a life-long diagnosis if it's not necessary.  Once it's on your chart, it's almost impossible to remove.  So doctors and psychiatrists are very careful what they actually place into writing for minors.  Bipolar doesn't have that same criteria though, so it can be diagnosed at any age.

For what it's worth, my kid is diagnosed BPD/Bipolar/ADD.  I don't know if I agree but in the grand scheme of things, it actually doesn't matter.  Here's why.

You mentoned that the treatment hasn't worked, which means you're looking at this like the flu or a broken arm.  For that stuff, there's logical steps to get the patient better.  Take the meds, get some rest, eat a balanced diet and waalaa...the patient is cured.

For mental illness, it takes complete buy-in from the patient to actively change.  You have a rebellous teen who's mentally ill, who likely resents you and resents her care team even more.  Of course she's not getting better, she's not trying to get better because she sees "the problem" as all the people who's telling her what to do.  Until she actually realizes that the problem is inside her, the best therapists in the world aren't going to make a bit of difference.

My kid was particularly stubborn and it took a series of terrible choices for her to finally realize that she needed to change.  That happened when she was 23 and both her partner and her best friend cut her off.  They were right in doing so, my kid did them both wrong and got caught doing it.  But it was devestating and she was suicidal for weeks.

This might sound horrible, but betraying the friends and having her heart ripped out was the best thing that ever happened to her in life.  That was the thing that actually made her realize, "Hey, I destroyed both these relationships because of what I said and how I acted."  She had nobody to blame but herself, and it was the first time she actually started working in therapy.  Within 12 months, she was a different person entirely.

My kid is still mentally ill and she still has bad days.  She has learned to manage it though and let go of those deep, dark thoughts that send her spiraling.  She also understands relationships a lot better now and how to treat people; especially those she's close to that do a lot for her.

I've lied, I didn't keep this short after all.  But I wanted to give you the full picture of the path your kid is on.  Medicine can help somewhat and therapy let's her get out some emotions.  Those are surface-level fixes to a much deeper issue though.  It's like taking Tylenol for a broken arm- maybe it helps with the pain for an hour or two, but the problem remains.  More Tylenol doesn't fix anything.  Dealing with the root problem does.

One last thing.  As a parent, you'll try working harder than your child to "fix her."  You'll think, "If I just tell her enough times, she'll get the picture and this will all work out."  But that's only pushing her further away because she feels like you don't understand her and are rejecting her.  There's so much more we can talk about, but know as an intro that this is not your fault, you can't fix this, and you're going to learn quite a bit about affirmation and boundaries while you're here.

Please ask the tough questions or let us know where we can specifically help.  Again, my heart breaks for you!

We all struggle with these relationships and we all fall short from time to time.  You're learning to adapt, set expectations, and implement boundaries that make your life more balanced and fulfilling.  Please remember that; this is about you, not someone else.

With that said, if you want to message...then message.  Just do so with the expectation that you're not going to get a reply or even worse, you're going to get scorn because your message was taken the wrong way.  Why would I tell you to send a message under those terms?  Go back to the first paragraph and really let it sink in.

There will be times when things are great, conversation is productive and you feel like everything is just fine now.  Those are wonderful times.  Just remember with mental illness, those periods of time come and go like a swinging pendulum on a clock.  You accept the good and let go of the bad, because it's never actually about you when you're dealing with someone with mental illness.  It's about their unstable feelings and emotions, so you can't take it personally.

That's why the first paragraph is everything- this is about you, not him.  Make it about you and when he's disordered, realize that it's something you can't fix because it's all about him.  The insulting words are his way of expressing pain and blaming the world for what he can't deal with.  That's okay.  Let him figure it out while you focus on what's best for you.

Hey friends.  Remember that this is the "Bettering" forum and the advice should focus on restoring the relationship since that's the member's intent.  I understand that he's opened up about staying or leaving, but our goal is to meet him where he's at regardless and offer peer support.

In terms of rock bottom, that can often come from situations exactly like this one.  This is a great time to work on both boundaries and affirmation, which are tools that serve us well regardless if the relationship suceeds or fails.

I've never really posted in a forum before, so excuse if my thoughts are a bit scattered.

My daughter began showing BPD traits over a year ago. She is currently 15. In the beginning, every medical professional we met with diagnosed her with bipolar disorder. She began therapy and medications immediately. After a year of changing therapy, changing medications (many times) and a PHP program, I had to make the choice and send her to a residential treatment facility. She spent 60 days there. During that time the on call psychiatrist agreed that she was misdiagnosed and was not bipolar, but had BPD. She would not formally diagnosis her because of her age. Fast forward to today and she is currently doing and IOP program and I have been told the same thing, "We agree she has BPD but we won't label her at this age". Unfortunatly the IOP is not working and it looks as though she will need to go back into residential treatment.

My question is, are there any parents whose children have been given this diagnosis during the teen years (or younger) and did it make any difference in the treatment they received? Nothing seems to be helping her and I don't know if medical personal would take a different approach if she were properly diagnosed.

I just feel like my child is a completely different person these days.  And it happened what seems like overnight.

All the above in my last post is true and still I can feel off balance and in fear not long after posting all that. I just looked at a FB post from my swubpd. He has been lifting heavy weights at the gym and today was day six for him. He mostly takes a picture of the kind of weight and lift and plays a song with it. I know that working out helps him a lot. Today's song had lyrics about the devil in his head, being no good, asking God to make them stop, life doesn't seem worth living with the devil in his head.
I feel the urge text him later - the urge to stop watching his posts because this one hurts. Maybe guys listen to this kind of stuff,  maybe I'm overreacting and need to center myself. I hate his painful struggle, I hate my thinking about it, I hate that his choices as an adult are sometimes painful choices.

Thank you guys,  your input and shared experience  helps me to keep walking forward.  I don't rehash all the times he was in anguish or ranting how he hates me but I'm all that he has. I don't replay the ways he's painted me black. I'm believing in myself more . Knowing other good loving people go through these struggles helps me to accept my son has a painful illness and it's not my fault. I'm beginning to see more clearly. 
Many years ago I was married to a pwbpd. There was abuse on every level in our marriage.  I believed I deserved it,that I was the cause.... I believed his "words". ( My Dad was mentally ill - so my self-esteem was pretty non existent when I married ) Anyway,  I got healthy by being in rooms with other women like myself.  Some further along in healing. They helped me then as you all are here. For me therapy alone isn't enough.  It's about others who've walked this road saying here's the way through and out. 

If your son follows through with promises, be content.  But always keep in mind not to expect too much or else your hopes disappoint you if/when they fail into unrealistic hopium.

One general but practical boundary is to exit a conversation when it starts spiraling out of control.  Hopefully, over time he will come to expect you to say, "Son, I'm hanging up.  We can talk later when it's a better time for you."  Or, if "calmer" is a trigger for him, then a calming phrase that works for you and your son.

The main "rule" in my family was "don't upset mother", so we all walked on eggshells. However, this led me to believe I was to blame for things that weren't my doing, such as the issues at home. I actually believed that when I went to college, things would be "normal" at home.

Your D is also learning that "don't upset BPD mother" is the way to avoid repurcussions but for her, it can be more of an adaptation to her situation rather than to adopt a false belief about herself, as you can validate that for her.

Some good nuggets of wisdom here.


And what would hitting bottom be like for her?  Have you ever skipped a flat stone across a pond?  Did you notice how many times it seemed to hit bottom but just kept skipping?  Similarly, what appears to be a bottom now may just turn out to be one of many bottoms.  It's impossible to predict when she might begin and stick with real recovery, if ever.


Listen to your head.  In time your heart will catch up.