D17 in psych hospital

[I Am Redeemed]

My D17 is back in the psych hospital and we are pushing for long term residential treatment.

She has been through a lot of trauma and she exhibits Bipolar symptoms. I've wondered if she could have BPD, but what matters is her behaviors. She self harms and has had some suicide attempts.

This is super stressful for me as I also have a S9 with extreme behavior and mental health issues. We're in the middle of moving. My ubpdxh is in jail for assault on me, and now this.

It's frustrating how many times she's been in the hospital and had her medicine slightly adjusted, only to have no real effect.

I don't really know how to choose a residential treatment center, either. We're limited by our insurance.

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]

It feels like when it rains it pours with family crises. I'm sorry you have to juggle so much at once 

Has D17 been cooperative with going to and engaging with inpatient treatment this time?

Does she know you're considering residential? If so, what does she think about it?

Does her current inpatient center have recommendations for or connections with RTC's -- can they give you a few to check out, just to narrow things down?

Does her current inpatient center have a parents' group? I wonder if parents there may have first hand info on RTC's.

Would you want to be involved in her time at a RTC? If so, you may want to limit your search to places closer to home. Of course, that has to be balanced with the focus of and quality of the RTC.

Anyone at your church have a connection to RTC's? Might be worth asking around there, if you haven't already.

McLean Hospital in Massachusetts is highly regarded for BPD and for many other adolescent challenges. The University of Washington is also well respected, and while I'm not sure if it has an adolescent RTC, it does have a DBT focus and I wonder if they could recommend any BPD focused RTCs or other resources.

I hope you get some respite this week.

[CC43]

Omg your husband is in jail, you’re moving and now this?  Is this your daughter’s response to all the changes?  Is she afraid she’s “losing” a childhood home, even if she left it for someplace else already?  I’m asking because a move seemed to destabilize my BPD stepdaughter a lot at around that age. I never really understood that, except to wonder if she was looking for something/someone else to blame for her issues. But maybe the real problem was the stress/trauma of dealing with strife/change/instability in the house. Or maybe she felt she was “losing” her childhood without having a clear picture of what young adulthood would look like. I think that really scared her. Maybe it was a manifestation of “abandonment” of a past—the home, old friends, old routines, a child’s identity—and we know that feelings of abandonment are a real trigger with BPD.

Did self-harm land her in the hospital?  If so, I’m glad she’s getting some help. You must be sick with worry and stress. I’m thinking of you and hope to send some strength your way. You might need to take some time to process all this. It’s hard to think straight with the shock of it. My two stepdaughters had multiple suicide attempts, and each one was horrific. The younger one was diagnosed with BPD and eventually got the right treatment. Meds didn’t seem to do that much except for dulling her senses when she was in crisis.

Thinking of you in these very tough times.

[CC43]

PS my BPD stepdaughter was treated at McLean in Massachusetts.

[I Am Redeemed]

It feels like when it rains it pours with family crises. I'm sorry you have to juggle so much at once 

Has D17 been cooperative with going to and engaging with inpatient treatment this time?

Does she know you're considering residential? If so, what does she think about it?

Does her current inpatient center have recommendations for or connections with RTC's -- can they give you a few to check out, just to narrow things down?

Does her current inpatient center have a parents' group? I wonder if parents there may have first hand info on RTC's.

Would you want to be involved in her time at a RTC? If so, you may want to limit your search to places closer to home. Of course, that has to be balanced with the focus of and quality of the RTC.

Anyone at your church have a connection to RTC's? Might be worth asking around there, if you haven't already.

McLean Hospital in Massachusetts is highly regarded for BPD and for many other adolescent challenges. The University of Washington is also well respected, and while I'm not sure if it has an adolescent RTC, it does have a DBT focus and I wonder if they could recommend any BPD focused RTCs or other resources.

I hope you get some respite this week.

She's very cooperative with treatment and has been going to therapy twice a week. She knows we're considering TTC and she is not excited about it, but not hostile, either. She downplays and minimizes everything.

They will do referrals from her acute inpatient unit. There's not many great choices in our state. We're in the South, and the best treatment centers are across state lines which don't take Medicaid from our state.

She is staying with a church member who is a trauma therapist. We've scoured the available resources. It's a matter of just picking the best of what is immediately available.

I will be involved through family therapy by phone if she's not local. DBT is definitely something we're looking for.

[I Am Redeemed]

Omg your husband is in jail, you’re moving and now this?  Is this your daughter’s response to all the changes?  Is she afraid she’s “losing” a childhood home, even if she left it for someplace else already?  I’m asking because a move seemed to destabilize my BPD stepdaughter a lot at around that age. I never really understood that, except to wonder if she was looking for something/someone else to blame for her issues. But maybe the real problem was the stress/trauma of dealing with strife/change/instability in the house. Or maybe she felt she was “losing” her childhood without having a clear picture of what young adulthood would look like. I think that really scared her. Maybe it was a manifestation of “abandonment” of a past—the home, old friends, old routines, a child’s identity—and we know that feelings of abandonment are a real trigger with BPD.

Did self-harm land her in the hospital?  If so, I’m glad she’s getting some help. You must be sick with worry and stress. I’m thinking of you and hope to send some strength your way. You might need to take some time to process all this. It’s hard to think straight with the shock of it. My two stepdaughters had multiple suicide attempts, and each one was horrific. The younger one was diagnosed with BPD and eventually got the right treatment. Meds didn’t seem to do that much except for dulling her senses when she was in crisis.

Thinking of you in these very tough times.

I wish I was kidding, but, unfortunately, I am dealing with all this at once.
She has a lot of trauma from the DV she has witnessed. This latest incident was a bit different; instead of cutting herself, she tried to choke herself.
Her online bf that she never met broke up with her last Saturday, so this is directly tied to that. Plus, her favorite cat ran away and we're all sad about that.
Bio dad is not in the picture and her stepdad just assaulted me again, which she knows about and knows he's in jail and we're moving.

Thanks for your thoughts and support.

[kells76]

When is her discharge date (if any at the moment)?

[I Am Redeemed]

When is her discharge date (if any at the moment)?

Don't have one yet. They are going to make referrals for residential treatment.

She's upset but we are not budging on her safety with this. She tried to hang herself with a nylon rope and they x-rayed her neck because of it

I'm currently sitting in the ER with S9. Running away, throwing rocks and breaking windows, cut himself with a knife. Probably going to have two kids in behavior hospital.

Called police last night and spent the whole night in the ER. Got sent home. He ran away again, broke another window, and here we are.

D17 is just going to have to deal with us going for long term treatment. Her guardians and I agree that we can't keep her safe from herself. Atp, I don't feel like I can keep S9 safe, either.

They are both moody, attention seeking, dramatic, angry, self-destructive.

I've always noticed parallels between D17 and S9, since he was a baby. We are having D17 assessed for bipolar.

S9 and D17 may end up in the hospital together.

[Misty93]

Oh my gosh I am so, so sorry for everything you’ve gone through. I send a big hug.

This much trauma - it sounds to me like your kids are in fight or flight, and how could they not be? These are common symptoms of trauma. Especially attachment trauma. Could also be related to a mood or personality disorder, AND I say this so that you hold on to some hope here, that if it is  PTSD then that can and does remit (and yes, angry outbursts and reckless/self destructive behaviors are also criteria of PTSD), so I would encourage you to look into trauma therapy, or at least trauma informed therapy, for everyone. Including and especially for yourself.

Regarding Medicaid and treatment options. Sigh. Our systems suck.
Here’s what I would advise:
- ask about inpatient care, yes, and also about Intensive Outpatient Programs (IOP), partial hospitalization programs, and wrap-around services.
- if you are referred somewhere - ask what level of care they provide, and if it is determined down the line a higher LOC is needed, what program that would be with.
- ask about TBS (therapeutic behavioral services) and IHBS (intensive home based support)
- ask about other services the program may offer - therapy, medication, peer support, parenting support, groups,, housing, hospital liaison, etc.
- ask if your children will be seeing licensed professionals (often these places have many interns, trainees, etc. - I would insist that you need your kids to be with someone more experienced than that. If they place you with an associate, ask how far they are from licensure, who their supervisor is, what the supervisors background is, and make sure to get supervisors contact info as well as the clinician you’re talking to if applicable)


Are you working with a DV organization? They may also be able to help with advocacy and/or referrals.

It’s a good sign your daughter is complying with treatment so far and it’s really good they have you to advocate for care. Hugs to you.

[ForeverDad]

Do you have a protective order based on his DV case?  With the impact ex's abuses have had, not just you but the kids too, you all need to have no direct contact with him.  None.  Any communication goes through approved third parties.  Sorry, family and friends might not be sufficient, they probably won't be alert to risks and sharing inappropriate messages, use professionals if possible.  Can you get the protective order expanded to include the children, based upon their reactions to all this?  Probably not wise for even supervised visits at this time and probably for a long time.

[I Am Redeemed]

Oh my gosh I am so, so sorry for everything you’ve gone through. I send a big hug.

This much trauma - it sounds to me like your kids are in fight or flight, and how could they not be? These are common symptoms of trauma. Especially attachment trauma. Could also be related to a mood or personality disorder, AND I say this so that you hold on to some hope here, that if it is  PTSD then that can and does remit (and yes, angry outbursts and reckless/self destructive behaviors are also criteria of PTSD), so I would encourage you to look into trauma therapy, or at least trauma informed therapy, for everyone. Including and especially for yourself.

Regarding Medicaid and treatment options. Sigh. Our systems suck.
Here’s what I would advise:
- ask about inpatient care, yes, and also about Intensive Outpatient Programs (IOP), partial hospitalization programs, and wrap-around services.
- if you are referred somewhere - ask what level of care they provide, and if it is determined down the line a higher LOC is needed, what program that would be with.
- ask about TBS (therapeutic behavioral services) and IHBS (intensive home based support)
- ask about other services the program may offer - therapy, medication, peer support, parenting support, groups,, housing, hospital liaison, etc.
- ask if your children will be seeing licensed professionals (often these places have many interns, trainees, etc. - I would insist that you need your kids to be with someone more experienced than that. If they place you with an associate, ask how far they are from licensure, who their supervisor is, what the supervisors background is, and make sure to get supervisors contact info as well as the clinician you’re talking to if applicable)


Are you working with a DV organization? They may also be able to help with advocacy and/or referrals.

It’s a good sign your daughter is complying with treatment so far and it’s really good they have you to advocate for care. Hugs to you.

We are all in trauma focused therapy. We are going to do intensive home based counseling for both, as well.

I am working with a DV advocate and have found help through several local nonprofit resources.

I have a hearing for an emergency protection order coming up on the 29. I have included the children in the order.

CPS is not going to let him visit the kids anytime soon.

My kids are definitely suffering from complex PTSD, as am I.

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

[I Am Redeemed]

Do you have a protective order based on his DV case?  With the impact ex's abuses have had, not just you but the kids too, you all need to have no direct contact with him.  None.  Any communication goes through approved third parties.  Sorry, family and friends might not be sufficient, they probably won't be alert to risks and sharing inappropriate messages, use professionals if possible.  Can you get the protective order expanded to include the children, based upon their reactions to all this?  Probably not wise for even supervised visits at this time and probably for a long time.

I am being represented by the local legal services center for the order of protection.

[kells76]

 

[I Am Redeemed]

D17 is upset that we are looking at residential treatment.

S9 is mad at me because he's in the facility.

S14, S12, and D11 are going with the flow but they've all been affected. They're in counseling, too, except S14 because he refuses it. We'll try again later for him.

Thank you for the support and hugs.

[kells76]

 For both D17 & S9, is the anger about treatment mostly verbal or "tantrum"? I.e. saying things like "I hate it here, nobody ever listens to me" or pouting/yelling/stomping/door slamming?

I ask because if that's mostly it... but they're not eloping/escaping, then that sounds normal and, in a weird way, age-appropriate to me. Doesn't make it easier on you though, but if the anger is limited to words and "foot stomping" but the kids are fundamentally compliant, then it's stressful but survivable.

Source: I was a 19 year old in an IOP

[I Am Redeemed]

For both D17 & S9, is the anger about treatment mostly verbal or "tantrum"? I.e. saying things like "I hate it here, nobody ever listens to me" or pouting/yelling/stomping/door slamming?

I ask because if that's mostly it... but they're not eloping/escaping, then that sounds normal and, in a weird way, age-appropriate to me. Doesn't make it easier on you though, but if the anger is limited to words and "foot stomping" but the kids are fundamentally compliant, then it's stressful but survivable.

Source: I was a 19 year old in an IOP

Mostly verbal. S9 was gearing up for a tantrum yesterday when I dropped him off, but he calmed down.

D17 says she shouldn't be in residential treatment because she wasn't trying to kill herself, as if her behavior wasn't reckless and dangerous.

S9 feels betrayed that I put him back in a facility. He was traumatized by the last one.

I got some much needed sleep and have begun packing today.

Two friends I used to work with reached out and said they work at the treatment center where my children are, and they will take good care of them.

Ubpdxh has two cousins who are moving into my house after we leave. They came by today and told me not to stress about getting everything out before the first. I have some time to get organized and moved, and they will take the stuff that I don't want or want to give to goodwill.

One day at a time.

Hoping that medication changes will be made for both kiddos.

[ForeverDad]

D17 says she shouldn't be in residential treatment because she wasn't trying to kill herself, as if her behavior wasn't reckless and dangerous.

Before my marriage fell apart some two decades ago, we had a young mutual friend who asked us to drive her to the hospital.  Turned out she had cut herself deeper than she'd anticipated and she had no choice but to fess up to it.  She wasn't trying to kill herself.  Her explanation was that when she caused pain herself by cutting then she was in control of the pain.

That was before I got my crash course in BPD and mental health disorders.  If they are having flashbacks that reinforce the trauma feedback loop, one possible way to weaken that repeating pattern is discussed here.

[I Am Redeemed]

Before my marriage fell apart some two decades ago, we had a young mutual friend who asked us to drive her to the hospital.  Turned out she had cut herself deeper than she'd anticipated and she had no choice but to fess up to it.  She wasn't trying to kill herself.  Her explanation was that when she caused pain herself by cutting then she was in control of the pain.

That was before I got my crash course in BPD and mental health disorders.  If they are having flashbacks that reinforce the trauma feedback loop, one possible way to weaken that repeating pattern is discussed here.

Thanks for the link. I had not read that thread.

S9 is supposed to be taking propanolol, but he says it doesn't work. It helped mildly when I took it. I take hydroxyzine now.

They are both in therapy. D17 was in the process of starting EMDR when she went into the psych facility. I think S9's therapy provider offers EMDR, as well. I know my therapist offers neurofeedback treatment, which is another option.

Once we get through this move, I will have more time to devote to therapies. I do want S9 to do the intensive in-home counseling through our local youth provider. I'm very familiar with their services as S14, S12, and D17 have all been through the program. S9 had intensive in-home counseling two years ago at age 7, and it helped for a while. He and D17 both have high validation and attention needs. Four to five therapy appointments a week is a lot for both, but I do have some support with that from family friends. My job is also very VERY understanding about my need for flexibility, particularly during this crisis.

I am feeling more confident today. I know this is hard, but we will get through it one day at a time. I have plans in the works to address everyone's needs, and yes, it's difficult to keep up with what all these traumatized children need and take care of myself, too, but I am doing it. Not perfectly, but so what. I am doing it.