Diagnosing in order to treat BPD in a 17 year old

[Middlesister]

Hello,
After many years of counseling and drug treatment for anxiety, depression, clinical screenings and psychological testing ... .and no real sustained progress, I have come to believe that my daughter has BPD. It was mentioned in her psychological testing (at 14) that we should "watch for symptons" of BPD as they saw evidence that it was present but would not "officially diagnose" it .
I can't go into the many many reasons why I believe she truly struggles with BPD, rather than anxiety or depressive disorder / rather than just being a rebellious teen (signs began as early as age 8 or younger)/ rather than bipolar, etc... .but I continue to get push back from professionals who do not want to "label" her with this "so early" and yet, the best counsel I can find on the subject says to get help/intervention EARLY to help the most! Therapists do not see or know ALL that I know. It seems that to truly unravel a diagnosis they would need to be able to connect the "cleverly disguised dots" in my daughter's untrue statements and rabbit trails of discussion about how "controlling" we are and how we expect "perfection" and how stressed she is. If we were to get a diagnosis... .what WOULD the treatment be? I have read some wonderful, helpful information on this website that I WISH our family therapist and her counselor could use, but unless they KNOW that BPD is what we are dealing with, we will continue to come at our issues from perspectives that generally do NOT promote progress or healing. HELP! WHere have you found the most help?

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

[livednlearned]

Hi Middlesister,

Welcome and hello 

It's good that you're doubting what doctors are saying, listening to your own intuition. Have you read Blaise Aguirre's book about BPD and adolescence? He is a leading expert about BPD in teens and has a lot to say about the goofiness of not diagnosing people before the age of 18, like something magic happens on your 18th birthday. I would go get that book immediately and read it cover to cover, there's a lot of really helpful and up-to-date clinically researched information that will give you hope.

In the book Buddha and the Borderline, the author finds out over a decade later than she was diagnosed BPD as a teen, but no one told her or her parents.    If nothing else, it will convince you to advocate for your daughter getting the right diagnosis.

If you do get a diagnosis, the treatment is often dialectical behavior therapy to help with distress tolerance, reality testing, emotional regulation. It's sort of like cognitive behavioral therapy (CBT) with mindfulness skills, and was developed by Martha Lineman, a psychologist/researcher who suffered from BPD herself.

My partner's daughter was diagnosed bipolar II after experiencing a psychotic depression at age 16. I am convinced they missed the dx, or else did not want to tell her. I'm not her bio parent so feel it is not my place to say anything. Your D is lucky that you are listening to your intuition on this. Trust that voice in your head. The worse that happens is she receives the same treatment that can help her with the other diagnoses you mention -- depression, anxiety.

[Mutt]

Hi middlesister,



I'd like to join livednlearned and welcome you to bpdfamily. I would feel frustrated, distressed and alone if I were in your shoes. I'd like to tell you that you're not alone. Many members here can relate with you and offer you guidance and support.

You have a good point that therapists may deal with a pwBPD for a few hours a week where you have to cope with a pwBPD 24/7/365. You'll find the lessons to the right side of the board that will help you.

Some experts say that BPD is a shame based disorder. A pwBPD feel a lot of shame, have low self esteem and feel more negative feelings than positive ones. I'd also like to add that feelings equals facts, rather than feelings followed by facts.

What helps a lot in a r/s with a BPD is validation and validating the person's feelings, a pwBPD need a lot of validation due to core shame, they're incredibly difficult and hyper critical on themselves. I'd like to think that the hyper criticism that you hear projected sometimes is probably how their inner dialogue plays out but that's just my opinion. You'll notice improvements with communication in your r/s  if you validate.

Professionals are hesitant with  diagnosing an adolescent because black and white thinking is prevalent in adolescents. Black and white thinking is a cornerstone trait in borderline personality disorder. The world and people in it are viewed as either all good or all bad and a pwBPD have a difficult time with viewing people as an integrated whole.

Does she have any other siblings? How are the r/s's with other members of the family? Have you talked to a T for yourself? How is your support network? It helps to talk.