Progress with SS10- and some interesting side notes from the neuropsych

[mamachelle]

I am having a good week so far in making progress for my SS10. He just got an Autism diagnosis from the latest round of tests from the Neuropsych. This was after a series of posts here where after a number of you chimed in... .  and I realized some of his more idiosyncratic / odd  behaviors were more like Asperger's kids.

This will at least allow me to get him help at School and also get a Behavior Therapist.

I am meeting with a new therapist tomorrow to discuss his gender identity issues (again, after posting here... .  I realized this needed to be dealt with in a more direct fashion than it had been with his current (6 years with) Psychologist.

The distressing thing though is that when I brought up BPD as just a side note after the psychiatrist mentioned DID in his future possibly... .  the NeuroPsych told me that 90% of BPD comes from abuse

--- and I said NO---

and he said yes, the latest research studies show this.... .

And I said, I just need to correct what you just said... . I am not a doctor but I know this is not true.

... .  He then back tracked and apologized and said, it just didn't make sense to Label him as BPD since most practicioners will assume he has been abused and if you are trying to deal with these issues you don't want to label him yet.

ahhh haah 

Also when I got the report back I asked him why he had not included the "Mood Disorder" or "Emerging Bipolar" which had been mentioned in the report and also by Psychiatrist last year as he put him on Lamictal and then this year on Abilify to help with his "Emerging psychotic" behavior... .  

he told me... .  "we are treating a cluster of symptoms yes... . but it is too early to label'

So--- at this point I have to throw up my hands and say... .  13 years old must be the magic number to get a diagnosis of Bipolar or emerging BPD or what ever else and until then it's nod nod wink wink unless he gets hospitalized, in which case, I am sure they will give him a diagnosis.

It's funny how they have no problem giving an Autism or ADHD diagnosis.

so it goes.

mamachelle

Our objective is to better understand the struggles our child faces and to learn the skills to improve our relationship and provide a supportive environment and also improve on our own emotional responses, attitudes and effectiveness as a family leaders

[angeldust1]

mamachelle,

Is this  fact that abuse is the factor in BPD?  It makes me feel like I must have in some way abused my child.  He was my first and I was probably a little harder on him,  but abuse,  I really don't think so. At least I hope not.

[pallavirajsinghani]

I think that he may be approaching it this way because typically insurance companies will not provide mental health benefits or very little mental health benefits.  Many doctors actually help their patients by NOT using the actual diagnosis of a mental disorder.  Instead, they will first use symptoms and codes that the insurance will cover.  For instance, almost all insurance policies will cover anxiety and depression meds, or ADD/ADHD meds etc.  However, the moment the diagnostic code changes to BPD and the conclusion that these symptoms are symptoms of a mental disorder, that is when the coverage is denied.

If you ask the doctor directly... .  you won't get a clearcut answer.

Further, BPD diagnosis is considered more accurate after certain behavioral patterns are documented over a loong period of time.  In a very young person, even though the doctor may be quite certain that it is BPD, the doctor may believe that there is enough neuroplasticity in the brain that the patient can still be helped without using the diagnosis.

Hope this sheds a little bit of light on the puzzling comments of the doctor.

[mamachelle]

mamachelle,

Is this  fact that abuse is the factor in BPD?  It makes me feel like I must have in some way abused my child.  He was my first and I was probably a little harder on him,  but abuse,  I really don't think so. At least I hope not.

angeldust1

oh no no... .  see pallavirajsinghani response above. You did not cause this!

See this link  https://bpdfamily.com/message_board/index.php?topic=49127.0

pallavirajsinghani

thank you for your response. So many of us struggle to get appropriate therapy for these younger kids. Plain ol' Talk therapy just doesn't work well these days with SS10. Now that he has the autism dx a whole world of therapies opens up. I had Behavior Therapists coming in to the house to help but then my insurance company stopped paying because of no autism dx as these were all ABA (Applied Behavior Analysis) certified folks.

I should also mention his mother is dx with BPD and Bipolar and his older brother SS15 is also PDD-NOS, Bipolar, LDs, Hypotonia, and more and also possibly pre-schizophrenic.

Anyway, thanks for your insight. It does help. 

[parent of bpd daughter]

I am very very happy for you to get a diagnosis - autism - at least now they can come up

with a treatment plan, a school E? whatever it's called.

An official diagnosis is what we all hope for - I am so happy you got this today - I hope

things get better for you now and your SS10.

Peace be with you

[jellibeans]

mamachelle

Looks like you have narrowed things down which is good... .  your little guy has a lot to deal with and the sooner he gets the help for his issues the better. How frustrating for you to deal with docs and the whole insurance part of this whole problem... .  I really dislike insurance companies and how they treat the insured... .  don't get me started!

You keep doing what you are doing... . advocating for your ss. baby steps... .  he will get there... .  he is still young and has his whole life to live. I am happy you have more answers to the puzzle.  

[qcarolr]

mama -- I think the neuropsych has a valid approach to limit the labels to what can get his needs best met at this point in his young life. Autism will be the most likely to get him the treatments he most needs right now. And he was honest with you about this - that is most amazing.

Sometimes as parents, we need to clear cut answer to be able to hold it all. It is very complex in your family. Good to take it a step at a time. There is alwasy the possiblity that treatments being given can help soften the impacts of BPD or bipolar.

Hang in there - you are a great mom.

qcr  

[Tkwoody]

Mama,

I am thrilled for you with your progress! You are an inspiration to not give up. I agree with previous posts that too many labels can get confusing. I get lost in it myself. So many symptoms are co-morbid... .  I think that is the proper term... .  They overlap.  So maybe some of the autism symptoms will lead to your ss10 getting the help he needs in other areas as well? Good luck!

[vivekananda]

Hi mamachelle,

Have you seen this? There is a discussion on BPD in young people in the chapter in Identifying and assessing BPD, p 43:

Clinical Guidelines for the Management of BPD (Aust)

You can download it for free. It was only published this month... . hot off the press.

It also has an interesting discussion on 'risk factors for BPD' pp 40 & 41

Finally it has a template for a management plan, p 137. Maybe that neuro psych could do with a copy?

thinking of you mamachelle, I hope your ins. gets back on board with you and you get that help in the home, that would be good.


Viv     

[mamachelle]

Thank you all so much for the continued support and guidance.

 

I just met with a new therapist for SS10 today! 

She is a psychologist that first  worked with kids in residential treatment that are my SS age with similar issues including gender identity and also on the spectrum and also with mood disorders and psychotic and she didn't look at me like I was crazy ... .  and when I mentioned DBT she was like totally cool with it but said she didn't do that but she knew and understood what I liked about it... .  I like that she went back to school to get her PsyD after first working in RTC ... .  . I guess I just have to be realistic that it won't fix all but right now I have hope for the first time in a while that there are professionals out there that get it and might actually help things get a little better.

yaa yaaa   

mamachelle

[jellibeans]

when you have hope anything is possible... .  

Our objective is to better understand the struggles our child faces and to learn the skills to improve our relationship and provide a supportive environment and also improve on our own emotional responses, attitudes and effectiveness as a family leaders

[Cici]

Hi mamachelle,

Have you seen this? There is a discussion on BPD in young people in the chapter in Identifying and assessing BPD, p 43:

Clinical Guidelines for the Management of BPD (Aust)

You can download it for free. It was only published this month... . hot off the press.

It also has an interesting discussion on 'risk factors for BPD' pp 40 &

Finally it has a template for a management plan, p 137. Maybe that neuro psych could do with a copy?

thinking of you mamachelle, I hope your ins. gets back on board with you and you get that help in the home, that would be good.

take care,

Viv    

Thanks for posting this link it's a great source of information on adolescent BPD treatment!  Easy to understand for the lay person.

[Tkwoody]

This link is amazing!

[vivekananda]

I like it too. When you see how to avoid all the research gobbledegook and get straight to the guts of the matter. It has invaluable stuff. I have also read the guidelines for PTSD (that's what dd has been misdiagnosed with), that was really interesting too.

I like the stuff about the importance of working with families. When I spoke to my T about this in relation to dd's T and the stuff dd was reporting back about not letting us pay him direct (because then we would know who he was - but I do anyway!) my T spoke about the dinosaur culture amongst psychologists that was so slow to change.

Nonetheless information in those guidelines helped me to understand lots, especially about cutting and suicide ideation, about drugs and about the different therapies. And it can make much better advocates of us. Note however that it is for the Australian system and we don't really have rtc's like in USA.

Vivek