teenager daughter refuse to get help with mental illness.

[Nb324]

Hello all,
thank you everyone for sharing your stories and replies in this forum. after reading for the past couple of days, it has given me a sense of belonging. I am glad I found others going through similar challenges in life.  I am a father of almost15-year-old girl who started her episodes about 1 year ago. My wife and I have googled, but couldn't find any local group, but I am glad I found this forum and have spent many hours since then.

my daughter started these episodes from 1 hour + of loud crying, to crying but more with anger and intense screaming. the kind of screaming where you can tell she is trying to get all the frustration/anger out of her. she is usually not responsive during the episodes and lately yelling for help. she scratches herself sometimes, but we haven't observed any cutting or self-harming. so far, her episodes happen in the house or in the car. The causes/triggers are usually very minor, disproportional to the anger and crying, which usually last for 1-2 hours until she screamed all the anger out and tired, she slowly comes back and usually pick up her phone and try to use social media to get distracted and cope. After that, she is able to put herself together, get some food and clean up. However, during the rage, there is a lot of anger, she'd scream things such as, help, I can't do it anymore, yelling "I hate you" to my wife etc.

She has been very needy of us and have unreasonable requests for us to fulfill, when she doesn't get her way, it usually builds up and, in a day, or two, she will melt down.  she goes through the same routine of crying, but now most switching to unbearable screaming for an hour and started kicking things either in the car or in her room. She refuses to talk about it afterward and pretend it never happened. If we bring it up, she will become intense and refuse to discuss. but she could be on the phone laughing with her friends in matter of hours.

Recently, she has switched and decided to blame her illness on us because we sent her to local ER when she had idealization of suicide, which we did regret but we didn't know what else to do at the time. she had a terrible experience there and was very Shaked. she has since refuse to go near that hospital or talk about it. she has also started to attack my wife more often with mean messages with lot of anger, blaming everything on us.

We have noticed the frequency has been increasing to 2-3 times a week now, but mainly the screaming is really hard to bear, I usually drive her to a quiet parking lot to let it run through.

I am trying to pack a lot of things into this post. I'd like to get some suggestions on:
1. I guess the main question we want to ask is: is She BPD? or just a teenager with some kind of depression and anxiety. we had numerous conversations with our PCP and some psychiatrists, it's very hard for professionals to diagnose her if she is not willing to be open and talk about her feelings. the last conversation our PCP had with my daughter and my wife separately, the PCP said, my daughter seems very intelligent and knows about how therapy works and the consequences of taking medication, there is not we as parents can do until she wants help, is anyone here experienced with this?
2. how can we get her to get help when she refuses to (dozens of appointment cancelation in last minute)? refuse to see any psychiatrist or psychologies, tried online therapy twice, but claimed its waste of time)
2. we know she needs help and the sooner the better, as parents, are we delaying the time for her to get treated? what options do we have if she doesn't cooperate? with the hospital experience, we hesitate to force her and traumatize her more?
3. any parents here share similar experience with teenagers? are we over-reacting?

Thank you for your time to read our story!

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

[In4thewin]

I's sorry your are going through this. I know exactly how you feel, and no, you are not overreacting. DBT is known as the "gold standard" in treating BPD, but even if your daughter doesn't have BPD, it sounds like she could definitely benefit from this type of therapy anyway. My daughter started showing signs that something was really going sideways at age 14. Unfortunately, I had no idea what what I was dealing with, so I didn't address it correctly, and things worsened. What started as screaming and scratching at her arms etc. turned into physical violence toward me and hightened levels of self harm---- head banging, cutting, pulling her hair out. She is 17 now, and it wasn't until about a year and a half ago that she was  thrown into the borderline category, although for some reason, none of the specialists want to formally diagnose her since her brain is still developing. That said, no one is denying that she is showing all traits. The goal now is just to lessen symptoms to the point where she'll no longer meet diagnostic criteria. I don't have to tell you that your daughter is in a lot of pain. I think the best thing you can do if she's resistant to therapy is learn as much as you can about BPD so you best mitigate her episodes with skill use. The more episodes she has, the worse the disorder will become, so anything you can do to at least hold it steady or dial it back a bit until she's ready to do some hard work herself, the better off everyone will be.

[Nb324]

Thank you so much for your reply and sharing your experience. We will start learning about DBT as you suggested. I hope to limit the episodes, but sometimes we feel like losing more grounds and not able to set up boundaries. I hope she will start seeking for help, but based on last conversation I know we have a long way to go. Hang in there and hope your child is getting the help needed and improving. 

[Pook075]

Recently, she has switched and decided to blame her illness on us because we sent her to local ER when she had idealization of suicide, which we did regret but we didn't know what else to do at the time. she had a terrible experience there and was very Shaked. she has since refuse to go near that hospital or talk about it. she has also started to attack my wife more often with mean messages with lot of anger, blaming everything on us.

First off, welcome to the forum!  I wish it was under better circumstances and I am so so sorry for what you're going through.  I have a BPD wife (finalizing divorce after 14 months separation) and a 24 year old BPD daughter.  Our kid put us through the ringer and I can completely relate to everything you've shared.

I quoted the above text because like me, you're assuming that holding your daughter responsible for her actions was/is a mistake.  Of course your daughter had a terrible experience there since she wasn't allowed to just rant and flip out on people and have her every last desire attended to.  This is called setting boundaries- if you do this, I will have to do this.  It gives order to disordered thinking and sets clear rules for someone to follow.  It's not escalating or threats though- it's simply saying "I will not accept being treated this way and if you force the issue, I'll have to take appropriate action."

My advice?  Call 9-1-1 more often.

I worked in a prison for a few years in my younger days and in the police academy, they taught us to be fair, firm, and consistent in everything we did.  You could treat inmates with respect and show them kindness, but too much kindness was seen as weakness and the inmates would quickly try to take advantage of you.  So it's a balance of firm and kind, giving respect when it's earned but always prepared to take action when it's necessary.  This applies to your daughter as well; she needs love but not love without boundaries.  Bed behavior always must be met with consequences.

For example, is the school calling you saying that your kid is screaming for an hour at a time in the classroom?  Probably not, because that's not acceptable and they would suspend/expel her (or dial 9-1-1).  She probably doesn't scream in the middle of WalMart or Taco Bell either.  Why?  Because she knows that it's not acceptable.  Yet at home, when she freaks out and directs all of her frustration at you...it's accepted and rewarded.  You're giving kindness and she's seeing weakness, which not only enables her behavior, but encourages it.

My friend, I deeply sympathize for what you're going through.  But there is light at the end of the tunnel.  Read all the sticky threads at the top of this site and order "Stop Walking on Eggshells, 3rd Edition" today.  Maybe grab it in audiobook so you can listen with your wife in the evenings.  The prologue contains a formula to unofficially self-diagnose BPD and NPD, and I can already tell you that your child clicks enough of the boxes.  The rest of the book, however, is explaining your child's behavior and how you must react to help her stabilize.

I know that seems impossible right now, but my 24 year old has largely overcome the anger and frustration in her heart.  She still struggles all the time, but she does know how to react appropriately and she NEVER directs her anger towards me anymore.  This is the kid who told everyone I was the devil for most of her life and continually tried to punish us whenever we showed her boundaries.  So please trust me when I say that I've been there and felt that terrifying wrath.  Your job is to meet that wrath with calm, reassuring love while also making it perfect clear that you're on her side.  Empathize with her pain, not her words, and you'll get a lot further than you'd expect.  However, do not under any circumstances accept the abuse because she will mistake kindness for weakness.  Be strong and firm, but also loving and compassionate.

Easy right?  LOL, it's absolutely impossible at first and it is definitely a journey.  But in time, when your kid realizes that you always have her best interests at heart, the anger will fade from your household and real healing can begin.  You can't force it though, this will be on her timelines since she's the only one who can decide that she's ready for change.