Father of D21 recently diagnosed

[Fyzzles]

Hello  ,  I am new to this board, confused/devastated and needing to vent so please bear with me.

So this past weekend my 21 year old daughter walked into the ER saying she wanted to kill her self.  The doctors sent her to an inpatient facility for 6 days.  Even thought she is an adult we were able to meet with the social worker assigned to her for a family session and she explained that their diagnosis of our Daughter was BSD.  Which I had never heard of before.  The social worker also acknowledged our daughter was extremely bright and caught on within a couple days of the "lingo" they were looking to hear from her, and started saying what the doctors wanted to hear so that she could be released.  Although, I really really wanted to bring her home I am wondering if a few more days or weeks might have been beneficial.

We have had our daughter in therapy with different  psychiatrists and psychotherapists for months for severe depression and Bipolar disorder (the previous diagnosis), and had never been told by her doctors this diagnosis of BSD before.  She would work with a doctor for a while and then claim that the doctor was no longer helping her in a positive way and would want to switch.  Looking back I am now wondering if the doctors were catching on to her manipulations and starting to call her out and therefore, she didn't want to face the reality they were confronting her with.

Some background: In 8th grade she got caught up in the EMO phase and we caught her cutting herself.  We confronted her, and she promised to stop.  She became a recluse from most of her peers in high school and spent most of her high school time wanting to be seen by doctor after doctor. 

Prior to this she has had a long long history of seeking medical attention:

In High school she was seen for Migraines for years, followed by physical therapists for back and shoulder issues, and the Coup de grace, at 17 she was diagnosed with CRPS for chronic pain she insisted she felt in both hands.  Her Mom and I took her to doctor after doctor, most of them didn't believe her symptoms and insisted she was only drug seeking. Her entire world has become nothing but seeing one doctor after another.  Every time we feel like we make some progress see regresses and develops new symptoms.  Last year, we finally found a doctor that confirmed she never had CRPS, and this is after numerous nerve blocks, massive amounts of prescription drugs (including opiates and methadone and Ketamine) and three major surgeries to implant Spinal Cord Stimulator's that she was convinced she had to have to manage the pain.  She still has one implanted in her back, but no longer uses it as it literally did nothing to help her pain.

The newest physical diagnosis by a new neurologist was Ulna nerve entrapment, which again required two surgeries to fix however, that has actually seemed to help her hand pain.  Enough that after the physical therapy concluded, she began to seem like our old daughter, had some hope and was almost "Happy".  She decided she wanted to begin working on her future and we suggested an easy retail part time job as a small first step.  She landed a seasonal part time retail job at a local clothing store, and was very excited.

That was 2 weeks before she walked into the ER claiming to be cutting herself again and wanting to die. 

Now we are not sure if she will be let go by her employer or remain employed. And we have no idea how to support her emotionally with this newest diagnosis.  We are trying to reach out to her current therapist to see if we could meet and discuss what we can do to help in her therapy.

We have not had to deal with some of the physical out bursts of anger and rage some others have described, but our daughter is the master of manipulation and lies.  She has had scores of friends (mostly men) eager to buy her what she wants, at least for a time, and then the relationship ends, usually horrifically once they realizes that she is just manipulating them to her own ends.

At this point, I, her father am not sure what I should expect from her treatment, not sure what I can do to help. 

Lastly, we found out not two days after being released from her inpatient stay, she purchased a knife.  Do we call her therapist, do we ignore it until there are signs of self harm? 

Sorry, for the long rambling post.  We love her so much and only ever wanted to she her grow up and achieve her amazing potential.  Now I am not sure what if any future she may have.

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

[lbjnltx]

Hi Fyzzles,

We are so glad that you are here looking for answers and exploring what can be done to help your daughter.

It is good that she spent some time inpatient to allow an assessment to be made about her condition.  Do you believe that she is Bi Polar?  So many young people are misdiagnosed Bi Polar in their teen years... .does she take meds for Bi Polar disorder and do they seem to make a difference in her behavior, mood swings, and choices?

That is not to say that she isn't Bi Polar as there is a hi comorbidity rate of Bi Polar and BPD... .just not sure how accurate the diagnoses are as doctors rarely give the BPD diagnoses before age 18.   

Re your question about a few more days or a week longer inpatient making a difference... .probably not as it is a system of beliefs and thinking errors coupled with intense emotions that drive our kids to self harm and suicidal ideation. Long term therapy is warranted to learn skills to cope and untwist their thinking/beliefs about themselves and the world around them. 

It would be awesome if you could meet with her therapist and get a perspective and skills knowledge on how to assist your daughter in her recovery process.  If she is doing DBT then learning the skills taught will help her as you model them for her, remind her to use them and benefit from them yourselves.  The knife... .instruments of self injury are plentiful and easily accessible   If you want to ask your d about the knife and if she is willing to give it up for now then that might not be a bad idea as it will send the message to her that you are looking out after her own best interest and without judgment.  It might be perceived as a breach of trust to discuss it with her therapist when she is not present so I wouldn't go there.

Your daughter will have a future, it may not look like the one you envisioned for her and have it she will. With your support, encouragement, and providing opportunities for her to help herself she will have a better chance of living a meaningful and more balanced life.  The best thing you and mom can do is model self care for her which will include healthy boundaries, good health habits, and living your lives.  We have the skills in our Tools and Lessons to learn the most affective communication styles, how to set boundaries, and how to practice self care in midst of fear.  I hope that you will also allow the membership to support you and your wife along the way.  It's a long and winding road that none of us have to travel alone.



lbjnltx

[Rapt Reader]

I'm so sorry, Fyzzles, for all of the pain and stress your family is going through. Your daughter's troubles must be so hard for her, and the pain she is dealing with must also be difficult... .It's great that you have found us, and I hope we can help 

How are things going now?

How is she doing today?

It's true that until our children with BPD finally realize what their troubles are, decide to get help for them, and then accept that help, things might not get any better for them. It does sound like your daughter has some understanding of what she needs to do to get help (checking herself into the ER was a way to do that); not following up with more Therapy or Counseling may be something she isn't ready for, unfortunately. But have any of her health providers suggested a Dual Diagnosis Program to her? That sort of treatment would center not only on her mental health issues, but also her drug dependency, and she might really enjoy that type of program.

My adult (38) son was addicted to opiates for several years, besides having many other diagnosed issues: Hyperactive Thyroid; ADD; Clinical Depression; Social Anxiety. He finally checked into a Dual Diagnosis Center's 21-day Intensive In-Patient Program in March of 2013, and it changed his life. They diagnosed his BPD, treated him with DBT and intensive Psychiatric, Psychological, and Group therapies, and he has continued with Therapy ever since. He is successfully in recovery (has been clean and sober for more than 2 years and 8 months now, and I don't think he would even be diagnosed with BPD anymore, at this point), and doing very well.

lbjnltx has some great insights for you, and I would look into a DDx Program in your area for your daughter, if you think something like that could help her. My son's story is linked to in my signature line at the bottom of this post, if you'd like to learn more about how such a program works. My son had been in and out of 2 regular Rehabs in the few years before attending that Program--and went back to his problems afterwards because they didn't address his mental health issues. He LOVED the Dual Diagnosis Program, was very engaged with the treatment, and it honestly changed everything for him. I wonder if something like that would be beneficial for your daughter, too?

I'm so sorry for the trauma you are going through, and hope that you will give us an update as to where things stand today... .

[Fyzzles]

Update Post 

First thank you for the kind words of support.  It has been a true roller-coaster ride since Late November - early December 2015 and that hardest part is feeling like I have no one to talk to about this.  Her mother and I can not talk about her without it becoming a huge argument, which makes things all the more difficult to handle.

So, yes in mid December my daughter, my wife and I met with my daughters psychotherapist.  It was not particularly helpful as many of the questions her mom and I wanted to get answers too we could not ask in our daughters presence.  Also, frankly the therapist seemed rather confused why we were there at all.  Some issues we were able to discuss but overall, I would say it was rather non-productive.  I asked my wife if we could try to schedule a new meeting with the therapist, just the two of us, as I feel with some of the new developments I'll explain in a moment that we need some significant help/advice from a professional.

So, when last I posted my daughter got a short term seasonal job at a department store.  It was easy work and low expectations.  Well, within a couple weeks she no longer wanted to go, she had developed some enemies that she insisted were trying to get her fired and no longer wanted to deal with them... .  She was let go two weeks later.

But, overall things at home and with her personally seemed to be somewhat stable.  Until.  She applied and was offered a job at a major national chain that we will just say rhymes with smallcart.  It was actually a good job, 32 hours per week, a good hourly wage and most importantly, it was something she accomplished on her own.  I as her father was very proud/excited she seemed to be making a great step ahead in her personal development.  That lasted about a week.  Within a week, she stopped waking up to get ready (she had to be at her dept at 7:00am) She would sleep right through her alarm, I would have to constantly wake her, and then check to make sure she was actually getting up and getting ready.

Her second week she was written up by her manager, a customer apparently did not feel her attitude was proper or that she was performing her job well.  He insisted she be written up or be fired before he would ever return to that store.  Then of course against my advice she started "seeing" a co-worker.  That lasted three weeks and in typical fashion ended horribly.  Rumors flew, drama soared and my daughter just made things worse by getting into a feud with another female coworker.  Two more call-in sick days later (3 total in 4 weeks) her manager informed her she was going to need to transfer to a different department as she was causing more drama than he could accept, and it was affecting job performances.

Surprisingly, they actually were planning to transfer her to a closer facility that would have been a much better fit for hours and easier to get her to and from work.  Well, the following day she called in sick again (all of which including the previous call-ins  had no doctors note, etc)  They called her that evening, and very cleverly convinced her to quit instead of firing her.

Then as they say, the wheels feel off.  Within days of losing the smallcart job she was out all night with god knows who, she began sleeping all day, missing all her scheduled doctor and therapist appts.  She pierced her nose, her cheek and changed her hair color to the bright florescent red.  This morning as I was getting ready I overheard a phone call, she was discussing dropping acid and getting drunk with her friends.

Regardless of how much I love my daughter, I am to the point of asking her to leave.  I do not feel providing for her financially so she can engage in self destructive behavior is helping her, in fact I feel all I am doing is enabling it.  No, she has no where to go, yes I am terrified what might happen to a young woman with no resources.  But, talking, threatening, pleading, encouraging, praising and supporting have done nothing to fix the problem. 

Lastly, I know it very likely to lead to the end of my marriage ( I love my wife, we have been together 22 years this January and I do not want to lose her in any way).  But if I ask my daughter to leave and something happens to her, I know my wife will never forgive me and will hold it against me.  Her opinion is to just ignore her, pretend the problem doesn't exist and just deal with it.  While that sounds easy for some people, I am the type that it eats into me, watching her destroy her life and providing the finances so she can do it, to me feels like I am condoning the behavior.

[lbjnltx]

Have you thought about sitting down with your wife and constructing some accountability/requirements for your daughter to continue to live in the home?

Maybe you can both agree that she be required to attend weekly therapy.

Maybe you can both agree that she be required to be employed a minimum number of hours per week with no more than 2 weeks between jobs.

Maybe you can both agree that she be enrolled in a minimum number of college courses.

Maybe you can both agree that she not be allowed to have illegal drugs in your home.

All or some of these would have to be enforced diligently by both you and your wife.  The consequences will be up to her, ie... .she doesn't meet the requirements for living in the home then she must find another place to live.  Put the responsibility on your daughter.