How can you get the doctors to recognize/diagnose BPD

[Parents! Get help here!]

My 20 year old daughter is on a downward spiral out of control. She has been cutting since she was about 14. She has rapid mood swings, drug addiction (heroin and marijuana are her main drugs of choice, but she'll take anything she can get), volatile personal relationships (current BF is also a heroin addict and they joined a methadone clinic). She threatens suicide almost daily, blames everyone else for her current legal problems (she violated probation, has active warrants, and I have temporary custody of her 6 month old through DCS). Recently, the cutting has become more frequent and MUCH more severe. Although she still denies suicidal ideation, she does cut when she becomes extremely anxious). She has been diagnosed with ADHD since she was 10 yrs old.

She also has extreme anxiety, but abuses her ADHD and anxiety meds as well. Through the years, I have had her at several different psychiatrists, and some say it's bipolar, others blame the drug use... .only recently, through MY OWN therapy, did I begin to realize that she seemed to have almost all of the features of BPD. Why has no trained psychiatrist ever considered this? I understand it's not a diagnosis to be given lightly, but after reading several books, joining this forum (recommended by my therapist) I am convinced she has BPD. She is currently in an intensive psychiatric facility on an EDO order after 3 episodes of severe cutting in the prior 2.5 weeks. (They let her sign herself out the first 2 times, although the cuts to her arms were deep enough to require treatment)

Please help... .since she is 20, I have little impact on any treatments... .add to it that she believes I am just trying to convince people she's "crazy". She does the "I hate you... stay the #$# away from me... .to mommy I love you... .give me a hug and kiss before you go" within minutes, so it's hit or miss when I can try and talk to her about seeking treatment... .and I know NOT to suggest any potential diagnoses, such as BPD. I did that once, when a psychiatrist thought bipolar, and she has been angry about that ever since.

[susan21024]

My 20 year old daughter is on a downward spiral out of control. She has been cutting since she was about 14. She has rapid mood swings, drug addiction (heroin and marijuana are her main drugs of choice, but she'll take anything she can get), volatile personal relationships (current BF is also a heroin addict and they joined a methadone clinic). She threatens suicide almost daily, blames everyone else for her current legal problems (she violated probation, has active warrants, and I have temporary custody of her 6 month old through DCS). Recently, the cutting has become more frequent and MUCH more severe. Although she still denies suicidal ideation, she does cut when she becomes extremely anxious). She has been diagnosed with ADHD since she was 10 yrs old.

She also has extreme anxiety, but abuses her ADHD and anxiety meds as well. Through the years, I have had her at several different psychiatrists, and some say it's bipolar, others blame the drug use... .only recently, through MY OWN therapy, did I begin to realize that she seemed to have almost all of the features of BPD. Why has no trained psychiatrist ever considered this? I understand it's not a diagnosis to be given lightly, but after reading several books, joining this forum (recommended by my therapist) I am convinced she has BPD. She is currently in an intensive psychiatric facility on an EDO order after 3 episodes of severe cutting in the prior 2.5 weeks. (They let her sign herself out the first 2 times, although the cuts to her arms were deep enough to require treatment)

Please help... .since she is 20, I have little impact on any treatments... .add to it that she believes I am just trying to convince people she's "crazy". She does the "I hate you... stay the #$# away from me... .to mommy I love you... .give me a hug and kiss before you go" within minutes, so it's hit or miss when I can try and talk to her about seeking treatment... .and I know NOT to suggest any potential diagnoses, such as BPD. I did that once, when a psychiatrist thought bipolar, and she has been angry about that ever since.

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

[qcarolr]

susan21024 

It is so hard to deeply love our kids that are now young adults - limiting our access to information about their treatment, and often limits to the treatment team accessing this love to benefit the treatment process. I am glad she is in a safe place for now, and will keep her in my thoughts and prayers for effective treatment while there.

My BPDDD is now 27. I have been her advocate, when she allows me, since she was very young. THe ADHD dx came for her at age 4, bipolar age6, etc. The BPD dx was added at 23 when she was court ordered for psych and neuropsych evals. She has never accepted any of her dx except the depression and anxiety/panic dx. She claims to not use heroin (fear of needles), though she participates in whatever is available to her. She denies any substance abuse problems. She refuses treatment, though her current time in jail on probation violations may push that closer for her.

It is such a good thing to have found a supportive therapist to work with you. Taking care of myself is the only way I have found to be available for my DD. That is the first step in building a healthier relationship with our kids, esp. when they are beyond our direct influence as adults. Then we have to work on Radical Acceptance (a DBT skill). This can allow us to step back and get out of the way of them finding their own path. Building boundaries to protect our core values - while we finds ways to be there for them - validation skills.

Our kids need us and love us in the best way they are able. This is a lot to work on - you seem to have a good start. Keep coming back and let us know where you are at in your process and how we can help. There are lots of resources here to choose from.

qcr  

[Eclaire5]

Welcome Susan; hope you find some relief in this forum. I know I have… All of our stories are different, but what we all have in common is a very challenging mental health problem in our lives, and the endless love and concern that we have for our children. Some have it much worse than others, but we all go through the same anguish. My daughter’s BPD is rather mild, but our suffering has not been mild because my husband and I constantly worry about her. I would suggest not bringing up any new diagnosis since your daughter is still not ready to hear it, but gently encourage her to get help for her “depression and anxiety”. That’s how we started with our dd20 and she is now in treatment. Not ready to hear the BPD diagnosis yet, but she is beginning to wonder if she is “a little” bipolar. Please take care of yourself and come to our board often, sometimes just reading other’s stories and knowing that we are not alone is helpful enough. Big hugs to you.

[susan21024]

qrc,

Thank you for the kind words and prayers. My D was just started on Lamictal yesterday for mood regulation during this current admission. Because she tends to Dr. shop, she has not built a stable relationship with any psychiatrist, and the current one she has (prescribing her Adderall and Xanax), has never performed an actual eval because she was sent to him by her Ob-Gyn to monitor these meds while pregnant, after her other psychiatrist refused to prescribe them once she told her she was pregnant.

I have learned through my own therapy to avoid letting her take me down the road to the "blame game" and past history as much as possible. I have also learned to try and accept her exactly where she is at on any given day, and to only try and address what she feels she needs to address while trying to avoid my own enabling of her negative behaviors (esp the drug use, she's stolen valuables from several family to obtain money for drugs).

So far, that has helped to avoid the endless "no win" arguments we used to have. Right now she is receptive of the treatment she is getting as an inpatient because the other alternative is going straight to jail. I am hoping her lawyer can convince the judge to order RTC. She has signed out of every other rehab situation after turning 18, except where it was rehab/therapy or jail.

I thank you again for responding, and will keep you and your daughter in my thoughts and prayers also. This is a wonderfull website, where I have discovered that I am not alone, as I have felt for so many years.

[susan21024]

Thank you Eclaire5... .this site has really helped, just knowing I am not alone with this. I have read so many similar stories to my own, and my heart goes out to each one of the parents and their children.

Yes, while our stories may differ, knowing there are other parents who can relate to the episodic "chaos" that seems to be prevalent with a BPD son or daughter, helps me know I can be proactive in seeking appropriate help for my daughter and our family.

[Reality]

Susan21024,

There are many stories of late diagnosis of BPD, as you know.  Of comfort is the emerging recognition of the importance of early intervention. 

Many people have found Valerie Porr's book, Overcoming Borderline Disorder, to be very helpful.  The chapter on Mentalization is my favorite.  The book is available on Kindle, if you need that access.  Shari Manning's book is often recommended as well.  I think it is called How to Love Someone with Borderline Personality Disorder. 

Having family members use the DBT skills makes a significant difference to the family dynamics, as you will have gathered.  There are useful skills for all relationships.

It is good that you have found help here already. 

Reality

[MammaMia]

Susan

Welcome to BPDF.  I am pleasantly surprised to earn your therapist suggested this site.  That is wonderful!  I recently recommended it to my new internist who has a brother with BPD.  She did not know about this forum and was thrilled to learn of it.  This tells me that BPD is still a mystery to many, even professionals in the medical field.

I am so sorry to hear of your troubles.  The important thing is that you have gotten treatment for your dd and she is now aware that she has a problem.  That is huge.  Thankfully, her child is with you which is a blessing.  Like so many other mental disorders, perhaps she has not hit bottom as yet.  :)enial is a powerful tool.

My 39 yo son has BPD, and he is currently in meltdown, so I can relate to your concerns and fears ... .but your dd is safe temporarily.  BPD is a parent's nightmare.  Those of us with adult children suffer terribly because of the current legal system.  This has to change. Most pwBPD are not responsible enough to seek care on their own or even admit they are seriously ill.

Please keep us posted.  We are here for you and truly do understand what you are going through.  You are not alone in this battle.  We are an army of BPD warriors fighting to save our loved ones.  

Please take care.

[peaceplease]

susan21024,

My uBPDd is 29, and has had various diagnosis from different psychiatrists over the years.  First, one said Major Depressive Disorder, Anxiety, and ADHD.  Then, suspected bipolar.  Next psychiatrist said bipolar.  Then next one said ADHD.  The one she saw recently said Depression and Anxiety, and not ADHD.  She determined that from a dementia screening?  I know the screening as I am a nurse, and my daughter told me the three questions that she asked.  I think that she believed that my dd was drug seeking, so she did not give the ADHD diagnosis.  She did not want to prescribe her Adderall.  For that, I was happy, as my dd is on methadone for opiate addiction.  I wasn't impressed with the psychiatrist, though.  And, my dd still managed to get her Adderall from her primary doctor.


As far as my dd ever getting an accurate diagnosis from a psychiatrist, that would be hard.  They only see her for a few minutes and are writing a prescription.  Having an official diagnosis of BPD is not so important to me, as long as they can giver her the right treatment.  And, I don't see that happening.  It is just here is a prescription .   She needs a good T that is knowledgeable about BPD to recognize that she fits the criteria.  However, I don't know how honest my dd would be.

I  don't know that my dd will ever get the right treatment.   She is not motivated to get better.  She openly tells people that she is bipolar and jokes about it.  Although, she is not any meds for bipolar.    Right now, my dd is ready for a major meltdown.  The methadone and Adderall combo is making her quite manic.   

It is great that you are seeing a therapist.  That really helped me, and I was fortunate to finally find one that specialized in BPD.  That was a few years ago.  I am going to find another therapist, as I need a tune up, now.  I am searching for the right one.  My former T was an intern going for her doctorate.

I have accepted that my dd may never get the right diagnosis or treatment.  She does not cut, but, she is an addict.

I am glad that you found this board.  It is a great support!