Psychotic episodes

[Bluetrue76]

Hi there,

This is my first post and I’m not sure where to start. My 17 year old has suffered since young with anxiety which then progressed to an eating disorder which is still mildly active, she has been diagnosed with BPD and has it in various degrees of intensity and lengths depending on the episode and trigger.  She sees a psychiatrist and a psychologist semi regularly, but right now we are in a hallucinating, hearing voices ‘I don’t feel safe episode.  I have permission from her PSyche to treat her PRN with olanzapine and seroquel,  which in small doses wasn’t worked yet.  I’m trying hard to ride this out with her at home by her side literally. 

WE are in Sydney and wondered whether anyone else has experienced this part of BPD and how you manage it?

Thank you for reading this.

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

[kells76]

Hi & welcome, Bluetrue76. No worries on where to start, we can just chat about what you've shared and I know we'll figure out where to go from there.

Your D17 has a lot going on. Can I ask, does she accept any/all of her diagnoses? How has she interacted with the diagnoses (i.e. "I don't have an eating disorder I just look this way" through "I feel relieved to be diagnosed BPD because it helps me understand myself")?

Has she done any kind of hospital time for anything? ED treatment center etc?

Are the hallucinations only auditory or also visual (or, I don't know, "other")? What is her level of self awareness about the hallucinations, as far as you can tell?

How long have you guys tried the Rx? I'm guessing it takes a while for the positive effects to kick in, or to know if there are even positive effects?

I’m trying hard to ride this out with her at home by her side literally.

What sense do you get from her about your support? Does she seem to accept/value it, or are you sometimes the "bad guy"? It could be positive if she accepts your help to get through this episode.

...

wondered whether anyone else has experienced this part of BPD

While the person in my life with PD traits isn't a child, you will see some stories on here of kids with BPD with delusions, for example, and then other stories on other boards of people with romantic partners who have "voices"/senses telling them to do some psychotic stuff. I believe BPD was so named because pwBPD seem to exist right on the edge of where neurotic traits meet psychotic traits (and I don't mean "psycho murderer" type stuff in the way "psychotic" sometimes gets used in popular culture, rather more the "psychotic break" sense where your mind/psyche isn't dealing with reality). So it's sort of "part of the program" for a person dealing with BPD to have moments or times of delusion, paranoia, psychotic episodes, hallucinations, etc. It does really depend on the individual, though, if/how it shows up.

...

That being said, you also are going through a lot, and you have for a long time. I'm wondering what your support system is like? Family members? Close friends? Therapist? When there's a pwBPD in our lives, there's no such thing as "too much support". I'd be interested to hear about how you take care of you.

Keep us posted on how you guys are doing.

-kells76

[wendydarling]

Hello Bluetrue76. I'm in the UK, London and my DD at 27yrs old (during 2016) experienced hearing voice.

My DD was voluntarily admitted to a Women's Crisis Home (for 12 women - provided by our local council, so it was free) for a month (maximum stay allowed). It's a step away from hospital admission, where someone is available to talk to 24/7, different wellbeing activities offered etc. A peaceful, homely place. At the time she was taking part in weekly DBT group and met the DBT therapist weekly, who recognised DD was struggling and proposed a stay at the crisis home which DD welcomed. My DD's male voice told her how bad, useless and unworthy she was, egging her to hurt herself. The crisis team attached to the DBT group, visited her weekly at the crisis home to keep in touch. It was a turning point, in the sense she came home and gave up work to just concentrate on DBT, and she has done well! My DD was 26yrs when diagnosed BPD, and I have never been directly involved in her care, though my gut feeling was the DBT team and the psychiatrist was on point at every step, provided me some assurance we were on the right path.

Here is a helpful link for readers to Mind UK that explains psychosis and how it can present.
https://www.mind.org.uk/information-support/types-of-mental-health-problem :heart:s/psychosis/types-of-psychosis/  My DD has fortunately not re-experienced, as she continued to moved forward with treatment.

Are your medical team home visiting?

Along with kells76 I wonder what home, local support you have as you literally have your daughter at your side.

WDx 

[Bluetrue76]

HI there, Kelly’s 76 and Wendydarling, thanks for responding,

Please forgive my group response and lack of using ‘excerpts’ I’ll figure that out soon..

My daughter re her acceptance and awareness of diagnosis:

She is accepting of her diagnosis and although she wishes it were different as she understands her emotional intensity and thus challenge to regulate are ARO this.  She is responding to a break up which is why things have deteriorated.

She is aware of her hallucinations and tells me when the voices get louder or more hostile.  She has one day about 3 days ago where she was seeing dead bodies everywhere and decided to blindfold herself.  Following this she has seen a black shadowy figure at the foot of her bed.  It also started when she was in class(year 12 bio) and she asked her friend why there was a second teacher standing in the corner of the class.  She texted me and told me and was confused as it looked so real, so. I went to fetch her.  This was Tuesday.

The PRN meds did not help emmediately but it seems there is some relief as she isn’t experiencing visuals anymore. Her PSyche upped her aripprizole by 5 and had previously taken her off seroquel 100 slowly as it has affected her glucose metabolism. We have given her seroquel again though under psyche guidance.   No more shadow figures- only voices now.

She is missing school and that always worries me but thats not important right now.  WE have decided against our original intentions to admit her to the clinic where her psychiatrist works.  That will happen tomorrow and I know how much I will miss her and how scary it will be for her to exit after.  Last year this time she was in fora month.

As for my support, I don’t really have too much. Husband is working and very busy and as I have COVID too( iso ended yesterday) he has been cooking and trying to let me sleep in so thats helpful.  I don’t want to share these with my friends repeatedly as its too much for the average person to hear.  I also tend to hunker down and isolate when DD goes through an episode because it’s overwhelming and I don’t want to have to over explain or have to deal with other ppl’s judgement or suggestions.  I’ve stopped attending church too as I find it too hard to explain stuff etc etc.

I need to find another therapist who can help me seperate myself from DDs journey a little as the enmeshment is real because every time we have an episode my life comes to a screaming halt.

My family are all in South Africa.

Thank both for your gentle curious questioning, WendyDarling, I truely hope your DD finds some respite and strength through her stay at the woman’s house.  I think its a great idea.

Kell76 thank you for your kind support it sounds like you are seasoned in this journey xx

Trueblue76

[livednlearned]

My stepdaughter (now 25) experienced auditory psychosis at age 16, a particularly challenging time for her. She was at risk for failing her senior year and I felt certain she was going to be institutionalized. Instead, she graduated high school and college and went on to become a special ed teacher and is living independently. Despite her challenges she has done remarkably well, altho there is certainly a cost and it has not been a smooth transition to young adulthood. It is often something, rarely quiet,, including several years as a trans man and relatively chronic suicidal ideation, and more recently body/weight issues with near chronic complaints. A bad break up led to false allegations of domestic violence however we seem as a family to be able to maintain on the side of stability when she is teetering on the brink. She is now in an aide position having been unable to manage the intense emotions of trying to navigate interpersonal relationships as a new teacher. 

The more educated and informed you are, the better for her outcomes! I see parallels with my son (20) who is on the autism spectrum and SD25 in terms of how our own advocacy can become second to none, including experts who can only know so much. You will be the person who sees the whole picture.

Remember to pace yourself in all this and keep your own cup full so that she  can channel your strength.