Anyone see significant and lasting improvements with medications?

[Pepper76]

Hi all. Grateful to have found this group. Very difficult as a parent to navigate. My daughter is 17, started having problems at age 11, we have had countless hours of therapy,DBT, and have been seeing a psychiatrist the past few years for medications. Has been diagnosed with autism and mood disorders with borderline personality traits.  I am finding the personality issues with the borderline traits to be the most difficult to see any improvement, however their psychiatrist thinks that if we can just get that magical combination of medications then we’ll see progress and start moving forward in life. She is on anti depressant, mood stabilizer and a medication for adhd.
She has improved from when she was in school, I ended up pulling her out because moods were getting so labile in the last year and now we have made no progress with school or working for the last year. Moods go up and down and can change within a couple hours and can be very intense. Extreme victim mentality and is frustrated and bored at times but has no motivation to find interesting work. Very very little ability to manage any amount of stress.  She does have some good friends that she sees weekly but with the autism once or twice a week is enough. No problems with drugs or the law but no motivation or follow through with drivers Ed, doing any type of class, consistent volunteering or trying to work. And at times the blaming me and just society in general for her problems along with various demands of things she thinks that she wants (latest one was wanting a facial piercing).
So I guess my question is am I being a negative Nancy to be skeptical that there is a magical combination of treatment that will help? I’m finding that my child’s mentality of I just can’t do this towards so many things in life along with their poor emotional regulation to be the issue and I don’t see how that can be medicated. I have looked into an IOP but nobody in our area takes our insurance until she is 18. I’m also pretty skeptical about that as it seems like she has to have some sort of break through that she wants to improve. I am just finding all of this treatment that we’re getting with psychiatrist and  therapist is like spitting in the wind. I do try to see it as without the treatment we have that my child could be much worse. I do know reading on this site that it could be much worse. Any thoughts or experiences with medications that you all can share?  Good, bad or kind of like mine frustrated but still trying.

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

[Pook075]

Good question and unfortunately, it's a very complicated answer.  Medicine is great for treating symptoms- if you're depressed, then take a happy pill.  If you're hallucinating or hearing voices, there are drugs to stop that as well.  But these aren't cures and in most cases, the effects wear off after 12-24 hours.

The path for BPD is intense therapy (DBT), which you're familiar with since she's been through it.  But for the "magic to happen" as you said, it takes full buy-in from your kid.  She has to want to actively change for things to happen and that's going to be on her timelines.  And unfortunately, that often doesn't happen without someone hitting rock bottom and realizing that there's no other hope.

Back to medications, it is possible to find a combination that "stabilizes" many of the more extreme BPD feelings, and it might help for a time.  But also remember that most people feel like the side effects of these meds are worse than the benefits they provide.  My BPD kid (now 27) gained 100+ pounds and quit her meds too many times to count.  The ADHD meds in high school, however, made her rapidly lose weight so she loved those.  Mostly she says that she feels nothing when on her meds, like all her feelings are muted and she's not herself.

So meds absolutely do help, but they're probably not a long-term answer.  It is wildly frustrating that they take an average of 4-6 weeks to fully regulate as well, since they get feeling good and decide they don't need the meds anymore.  A month later there's crisis and it takes another 6 weeks before they're stabilizing again.  I've been through that dozens of times in the past decade and it's maddening.

[Pepper76]

Thank you for your input. I tend to agree with you that there are really just to tamper down some of the more troubling symptoms but there are not a cure. I think I’m frustrated with the psychologist because they seem to have an overly simplified optimistic view that if we just keep trying that my child will suddenly be functioning in the world, happy and working and I just don’t see that. We have tried every type of class of medication and like you said some helped with the extreme emotions and troubled behavior to a degree and others the side effects were terrible.