how do i deal with this one?

[trainwreck4]

My BPDd15 tried to overdose on pills this week. She is now in a residential treatment program. The reason this time she did it's was that I insisted she attend her classes. This was an agreement struck between us in the fall so that she wouldn't fall behind when she had to miss classes for her orthodontist appointments. I was before this suicide attempt, the only person except for her counselor who would call her on things. I have been trying to get my husband and her school on board with backing me up in matters of behavior management, but now because she tried to kill herself I am afraid my help will be less than I has before this incident. I have four kids, not one and her demands and behaviors before this were financially and physically draining to our family. The other three younger kids have not gotten their fair share of everything. I am (unfortunately) looking at her discharge with dread. Has anyone any words of wisdom?

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

[Reality]

trainwreck4,

What treatment plan/support plan will be put in place by the social worker at the hospital?  What is the dx given? 

Reality

[trainwreck4]

It is the weekend so all they have done is observe. She has given instructions that I am not to be notified of anything she says or does. I am so frustrated with this. I have been the only one looking for help and she is shutting me out. Unfortunately as you know whatever plans for follow up there is, I have to be involved due to lack of other options. This is how she has worked in the past year and I am wondering if completely disengaging from her chess game is the only way she will accept help. I feel the need to construct a boundary for myself here. I am useless to my other children and I am fast running out of sanity myself. Can I trust anyone to step up to the plate?

[cfh]

How would the discharge plan change if you said you could not take her home due to her being a danger to herself?

[Eclaire5]

I am so sorry you are going through all of this. It’s understandable you are dreading her discharge because it will be even more difficult now to manage her behavior at home. She can use the suicide threat at any time whenever you are trying to set firm boundaries and limits to her behavior. I know it’s easier said than done, but try to emotionally disengage a little from her and focus more on yourself, your other children, your marriage and anything else important in your life. Our BPD children are really good at making themselves the center of our world and that just can’t be!

[jellibeans]

I have been where you are a lot lately... .  when my dd15 had her last suicide attempt the hospital told us to stop bringing her back for hospitalization. They felt she was using the hopsital to aviod stressful situations and school etc... .  She had an over dose on Christmas night... .  I took her to the ER and spent the evening talking to the social worker and making sure she was okay phsycially. Then instead of transferring her to the hospital I took her home.

Since that night she has been great and has really tried hard to work on her issues with her therapist.

I think you need to change your approach with your daughter... .  the more to push her to do her work and harder she resists. I would pull back on this and let her experience some failure. Even if she loses a year of school... .  she needs to feel the real consquences to her actions and understand what will happen. If she doesn't do her work she will fail and she will spent an extra year in school or summer school... .  

I am guilty of rescuing my daughter and that is something I have tried to stop. I can't keep protecting her for her actions. It is hard to watch but she needs to feel the full weight of her choices.

I would sit down with the school and ask for more help. There should be consquences for not doing work or missing classes... .  is she on a 504? IEP? You should look into that... .  

[Speedracer]

Wish I could contribute more now than the empathy I have. Please know trainwreck4 that she did not do this because of you or your enforcing agreed upon responsibilities. She did this because she chose to. She chose a poor way to cope with her emotions and her emotional disability. Once one poor coping skill is extinguished, they go from coping skill to coping skill until they learn which skills are more healthy & appropriate to use. This will take a very very long time. You will be walking on eggshells and changing ways you relate with her, but this is NOT your fault. It seems as though a solid Marsha Linehan certified DBT program - weekly dbt group skills for her with others her age, weekly individual dbt for her, and for you dbt parent skill classes weekly - plus regular psych appts where the dbt therapist & psych can talk in between - would help tremendously with the self harm as soon as she is stable enough to come home. The program we did here was a time & financial sacrifice but she never attempted suicide or cut herself again. The right antidepressant helped as well with this. The parent classes were 4 modules over 4 months total. The adolescent group was the same 4 modules over 6 months. She did indvidual dbt weekly & I emailed the therapist before each apt to inform what was happening at home. After that we dropped to only individual 2 times a month, more if needed. You said you have 4 kids. My husband could not attend parent classes with me because of work & our 2 younger ones. I really would urge you to have him go with you if at all possible. And they will always blame mom, the one who loves & cares the most, try not to personalize it as hard as that may be. Stay strong, you are not alone!

[trainwreck4]

Just got home from hospital. They were willing to discharge her tonight. My husband and I both objected as we don't feel that she is safe in our home. It has also come to our attention that the neighbors are helping her to obtain a lawyer. God knows what that is for... .    They are keeping her against her will until there are definite treatment plans in place, safety plans in place. We were clear on wanting her home, but we are not willing to jeopardize the whole families safety and well being. Hopefully we don't get charged with child abandonment. The team was supportive and sympathetic to our problem.  I told them that she did this because of me challenging her on her behaviour and they see that her impulsivity is detrimental to her well being. I don't blame myself but it makes me wonder what our next disagreement will net.  It is the worst I have ever felt refusing to take my baby home.

[Speedracer]

Do you have anyone you see or can see by yourself or with your husband like a therapist who can guide you through this process with your daughter? Caring for a loved one with BPD requires such therapeutic support for yourself. Such a person can be your advocate like if she does obtain a lawyer. Such a person can direct you to the care you will need to put in place for her. What are those neighbors thinking? We have had outsiders who don't know the reality try to convince her to emancipate & she has researched & tried anything she could to do that, including trying to get pregnant. Do not be afraid to call the police when things get out of hand at home with her. Dr. Drew says that he often tells parents to call the police and they do not. There needs to be a documented trail. Get copies of all police reports. If you need to go down to juvenile court to have her deemed an unruly child then that's what you do. And if you are embarrassed & don't want police at your house? Go to them. Visit the station and pick their brains. Ask them what is a parent to do in this situation? They want to help. YOU are the parent and you have rights. If there is any evidence of any broken property, take pictures. If she touches you take pictures. Audio or video what you need to. Document everything.

[trainwreck4]

Thank you everyone. I am thinking I need some legal help. Just to see what our rights are here. I called the hospital and they could only say she is stable. Speedracer I have retained childrens aid society for our family to be able to produce my "parenting pedigree" at a moment's notice. I will go take pics of damage- didn't think of that!  Have already called police on her, I have no more pride!  The people next door feel I am too tough on the poor little girl... .  Feeling pretty paranoid!

[Reality]

trainwreck4,

Good for you and your husband to stand your ground... .  

Do you have anyone you see or can see by yourself or with your husband like a therapist who can guide you through this process with your daughter? Caring for a loved one with BPD requires such therapeutic support for yourself. Such a person can be your advocate like if she does obtain a lawyer.

Excellent advice... .  

Reality

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

[Speedracer]

What I had to do with the pics was bring them to the station & have a report made. Date time place, etc. don't be embarrassed. The police are trained to understand that she has a mental health issue. Anytime they need to come to your home they can see the history & work accordingly. Maybe the neighbors would like to have her for some overnight visits if they care so much. My neighbor stopped her car & walked into my house without knocking. Me my husband & 2 officers stared at her. She called to get the scoop & hasn't called since to follow up. She used the info to get herself in good graces with all the other neighbors.

It has had such a toll at home we are all in family therapy now. It really affects the siblings. Try to keep things as smooth as you can for them.

Have you thought abt a wilderness program for your dd? If you can survive til school gets out it would be good to send her away to give siblings a peaceful start to summer.

[Speedracer]

I'm remembering a time when my dd stood in my kitchen & told me that if I did not allow her to use our phone she was going to cut herself. This was before we started DBT. I freaked out. She ran right out the front door claiming abuse & the neighbors calmed her down. I told the neighbor exactly what she had the nerve to say to me.

[trainwreck4]

Actually funny you should mention a wilderness program. Reality has found one near me. The catch is, I really don't know if she will be returning to our home. My husband and I have made some stipulations that will determine that. We need follow up care. We need a safety plan she will follow. We need an agreement that she will follow basic rules. Today they had nothing in place. Oh and we want an assessment. This means that we are going to have to be in possession of SOME of her information. Her nurse today has told us she is under a "gag order". This means her team is unable to breach privacy laws to let us know anything about her care, condition etc... .   I am going to lose my mind... .   Yup we may need counselling. Although I am happy to say hubby is advocating beside me and seems to take the seriousness of this situation

[Speedracer]

Well you have rules and boundaries in your home. When we allowed our daughter to return, and she was begging, she signed a family contract we carefully drew up. It included us being able to talk with her health providers until she is 18. We had her sign releases and notarized them. She needs to go somewhere where she begins to appreciate what she had at your house & beg for it back. If the state wants to give her rights and take over her care, maybe that will work for you guys. If and when she does return, they return on different terms. It feels like you are allowing an adult child back in, even though they are so young, they have emancipated themselves out, and then asking to come back.

Try to take care of yourself. Hugs.

[trainwreck4]

I really doubt she will ever beg. Where did your daughter go until she came around?  We are in Canada and the rules here are so skewed in their favour.  I am so scared she will do something awful to our family. I have a terrible feeling this is going to get uglier. I don't want to push her out of the nest, because I really do love her, but I make my major decisions with the family as a whole's best interests at heart.  She is only 15!   I think jellibeans2012 suggested backing off. We did try that last year and things got WAY out of control.  I am at a loss.

[trainwreck4]

Sorry jellibeans!  My head is not working properly!

[Speedracer]

Our substance counselor suggested instead of a wilderness program we put her in a young adult rehab he refers to. They specialized in dual diagnosis of substance/mental health issues. She had oppositional defiance & polysubstance experimentation. She was cutoff from her world, watched 24/7 & kept on a strict schedule with addicts.She saw alot & it scared the hell out if her. Her case manager psychologist deprogrammed her. 32 days later she came home with an outpatient schedule in place. She would do anything to get her life back.

It is so hard to find the right balance of involvement. We want to let them go but they constantly show us we need to watch!

[Reality]

Speedracer,

Why did the counsellor recommend the rehab rather than a wilderness programme?  From what I have heard, the wilderness programme is very helpful as a first step. Dunno.

trainwreck4,

Do you suspect substance abuse with your daughter?

Everyone,

Is overdosing considered to be substance abuse or more impulsivity/ self-harming?

Reality

[trainwreck4]

I don't think substance abuse is at work here. She sure is defiant. She will also be appealing this hospital stay. I have a feeling this will get worse before it gets better. The wilderness program also requires her to be on board. I can't see that happening at this point. I hope she does decide home isn't so bad. I don't know what the alternative to us is. If we had let her out tonight, we basically got a babysitter for the weekend.  I don't need a babysitter.  I need help for her.

[Speedracer]

Its too cold this time of year & much more expensive. Plus this option offered some ability to complete school work. It worked, & BPDs are at risk for substance use as a form of self medicating or self harm. It seemed to be a deterrent for that. She saw alot of what could be if she continued down that path.

When she saw a townhome with her own bedroom & roommates she went willingly. They kept her under control during the first 2 weeks when we had no contact with her. She slowly earned visitation & wanted to return home.

I'm sure professionals in your area can discuss workable options.

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

[cfh]

Reality

On the subject of overdosing I've had lots of experience with ds.

There are a few theories but what I usually hear is that overdosing is either accidental or self harm/impulsivity.  The outcome they say is not to end your life but to end the pain or they simply lose track of how many drugs they have taken.

I am not an expert just know what I have read.