Desperately Seeking Feedback About Our DS29

[radioguitarguy]

Here's a quick synopsis of our situation... . 29DS admits he has BPD and has been thru DBT... . debilitating anxiety, 2 pack a day smoker, morbidly obese(330lbs), on methadone for almost 3 years but wants to begin a slow taper... . facility says "no" unless he stops the pot smoking... . says that pot is the only drug that helps with his anxiety... . part time job delivering the morning newspaper for almost a year.

As most of you know, there is no such thing as a "normal" day. 75% of the time over the last 6 months he's appeared to be in a relatively good frame of mind. Over the last week he's been depressed, crying jags almost every day, and here's the one that scares me the most... . falling asleep standing up. The other night he spilled cereal all over the kitchen floor and broke a glass when he nodded out. I came out to the kitchen and told him to please go downstairs and lie down so he doesn't hurt himself, and then I went back to bed. Then it happened again. About 6 or 7 months ago when it happened, he fell down a short flight of stairs and dislocated his shoulder, which I heard about when he called me sobbing into the phone.

I expect that if "something" isn't done, I will be calling 911 for an ambulance sooner than later. He adamantly states he's not doing drugs. If he was(and they do random drug tests) the clinic would begin a fast taper and kick him out of the program. Short of checking him into some type of residential treatment center, which financially we can't afford, I feel scared and helpless. He has so many issues and has become so very overwhelmed by them all, he doesn't know what to do... . 2 packs of cigs a day, pot, methadone, morbidly obese(335lbs), debilitating anxiety... . I feel so sad for him and, of course, I want to fix it but I know I shouldn't. He just woke up and has missed the clinic so he won't have his methadone today or tomorrow. He's currently into panic attack mode and crying and there's not a thing I can do but drive him to the ER if that's what he chooses.

Does anyone have any words of wisdom for me?

RGG

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

[jellibeans]

Dear radioguitarguy

I want to welcome you back... . I have not seen you on the board for a while. I am sorry things are not good with you ds... from your post I get the impression he is slowly killing himself. I aked my dd16 recently about smoking. She told she really did care if it was bad for her because she didn't see any future for herself.

Your sd is stuck in a pattern of destructive behaviors... . the think the key is how do you break that cycle? Is your ds living with you? Maybe you could help him with a new diet?

[pessim-optimist]

I am so sorry RGG... . I think that at this point, your son wants to get better and feels trapped and doomed... .

You can't fix him, at the same time - do you think he would be open to your guidance for solving his issues one at a time?

I am not sure about this, but I think your son may be suffering from sleep apnea (periods of no breathing at night and resulting lack of oxygen in the brain and disrupted sleep) because of his heavy weight. Falling asleep during the day is often a side effect of sleep apnea... .

He definitely needs to lose weight - that would be a life-saving priority... . My mother had a successful stomach-reduction surgery, and is now close to a 100lb lighter. She feels much better and many of her difficulties went away. Do you think that might be an option?

Pot would be my next target... . Perhaps there are some anti-anxiety medications that he hasn't tried yet?

I am hoping today will go ok for you and your son, if he needs to go to the ER, that's a good option to keep him safe... . let us know how it went when you can, ok?

[Reality]

radioguitarguy:

It seems that anxiety can be a main driver of BPD for some people.  I agree with others that the weight issue needs to be targeted, with outside help.  Maybe Weight Watchers.  The group meetings are social connection and are non-judgmental.  I think the psychology of that approach is a sound one.  An idea.

I remember your son is very creative.  Is he playing his music?  Writing songs? 

He is fine 75% of the time.  Very good.  Part-time job.  Very good. 

Exercise can be a life-changer for people with anxiety, although the job would probably help with that. 

This is a brain disorder, but habits can have a huge effect.  Just heard a psychiatrist say that it is 30% genetics and 70% habits.  Habits change the brain. 

Thinking of you, your family and your son,

Reality

[qcarolr]

I am so sorry things are so hard and scary right now. This really sounds like a medical problem. is ds willing to see a doctor about the sleep on his feet? Perhaps even a neurological evaluation to start. It is so easy to assume this is drugs or weight or BPD... .

Please let us know how you are doing.


Qcr

[jeb]

Although my situation is very different with  my dd25, there are a couple of issues that I would like to address.  Others have suggested sleep apnea and my ex had that and had to have surgery but now what they usually prescribe is what my friend uses; a CPAP which is a mask that you wear at night and forces more oxygen into the system.  He could undergo a sleep study; where they hook you up to electrodes overnight in a facility and then a definite diagnosis can be made. Here in Canada as long as your primary physician refers you it costs nothing.

With respect to smoking pot, I find it interesting that for my son too much weed sends him into a panic attack; although he still uses recreationally in small amounts and not every day (as far as I know), I can't complain because he is doing fine in all other aspects of his life.  I am from the Woodstock generation when just about everyone was getting high. However I suffer from a great deal of anxiety over my daughter and my psychiatrist has put me on a regimen of anti-anxiety meds and although I have been on them for about 4 years now, I am careful to stick to the prescription and not overuse them.  This has helped immensely with my anxiety. It is still there but manageable most of the time.  Also what I have not done but know would also help with my anxiety is regular exercise; was doing it but got out of the habit.  Maybe your son could start by just walking around the block and gradually increasing the amount each day.  With his weight I don't think most doctors would recommend a strenuous regime.  I wish you luck in your dealing with his and your situation.

[chooselove]

I'm wondering about narcolepsy with the sudden falling asleep.  He might have sleep apnea as well, which would be depriving him of the REM sleep he needs for well being, not to mention the risk to his health in other ways.

Ah the weight.  So true that a good diet will help but first one has to be able to stop using the food to fight emotions and that is so difficult without a lot of support and a program he can get started on. Usually just a few days of good eating makes will power less of an issue. But those first few days are trying.

There is a very inexpensive prescription drug (really cheap!) called low dose naltrexone and it has been successfully used to treat anxiety and other health conditions.  It increases the levels of endorphins in the brain and creates a sense of well being (also helps with pain).   It's helped a lot of people, including some I've known personally who swear by it. But it cannot be taken with opiates.

Be aware, too, that marijuana can bring on panic attacks in some people. It's quite common.

I hope you are doing things to alleviate any anxiety, too, in the midst of all this.  Sometimes I wonder about the stress of living and coping with BPD's and how will manifest in our lives.

[Thursday]

Hi RGG-

Sorry to hear about your son's recent cycle back to the depths. I've seen this many times with my BPDSD22... . she's doing well now but there is always a nervous feeling that something will snap her back to blackness. Blackness for us sees her unable to motivate herself, full of self-loathing, and in her worst moments a bad addiction to benzos. She has now been clean for 3 years.

Your son's falling asleep standing is very worrisome. Sleep apnea has already been mentioned. Also narcolepsy. I think there is likely also diabetes/blood sugar issues (everyone I've ever known to doze off unexpectedly had one of the issues already mentioned including diabetes and high blood sugar from improper eating even when they use their medications) and also the pot smoking itself can create drowsiness. The falling asleep while standing or walking down stairs sounds more ominous though... . maybe a seizure disorder. Obviously, all of these mentioned conditions require a medical work-up. Obviously, this is very serious. He could have broken his neck when he fell down the stairs.

As others have mentioned, anxiety can be exacerbated by pot smoking. Sure he claims he needs it and for most human beings, claims that it's no biggie are accurate IMHO... . I'm sure he is the loudest about that but I call a very loud BS when this comes from someone, anyone who is doing so poorly in their life. For your son to be doing anything besides trying to get better (and this includes following protocol for being weaned off of methadone) it's all BS. I admit here, loudly, I think prolonged "methadone treatment" is BS. People with mental illness and drug addiction need to be clean and sober if they are sincere about living the life in front of them without substance abuse.

If his mental state is to blame and you can't afford inpatient hospitalization you will need to start working NOW on finding an alternative and doing what is required for him to qualify OR sell something to pay for his treatment or borrow money. It is a sad proposition, this lack of resources for people who have severe mental illness.

There are, actually, at least one free options that seems like good option for your son. I believe my SD is doing better from her involvement with AA, which has given her a place to belong, a community who accepts her no matter what and gives her a place to shine, awards to win (the coins) and most importantly, a system for identifying maladaptive behaviors and a way to correct them that is simple and straightforward. It also provides a go to person for the lost soul (the sponsor) and an important key to this is that someone is not YOU or anyone else your son has involved in his maladaptions. The sponsor can be really clear and has BEEN IN A PLACE OF KNOWLEDGE and thus the sick son can't say, well, you just don't know... .

AA is a real option for your son. He will need to get to a place where he desires sobriety over the way his life is now. My SD got to that point after getting caught drinking and driving  and we took away her car. Because she couldn't get to her dealer she went through a withdrawal from her benzos and had a seizure in front of her Dad in a public place. She was then hospitalized and diagnosed and came clean about her drug use. We let her come home and gave her a reset lecture- go to an IOP, continue with school, be clean, go to AA everyday, walk to work, do better or you cannot live with us anymore and we will not support your lifestyle anymore. About a month later she came to her Dad and admitted that she was still using (fearing another withdrawal seizure she had switched drugs to opioids) and we gave her then, the choice to do another IOP and live in a sober house at our expense OR figure out how to live without our support. She didn't like the idea of the sober house but she liked the idea of trying to figure out how to live on her own even less so she made a choice to go to sober house and to work the program. I believe she went into sober house resisting but knew she was there and the culture of sobriety was then all around her and rewards came from digging in, so she dug in. It is a part of her nature to not want to be on the outs with who she is around.

And she was ready for AA... . she wanted to have change. She was having to jump through a lot of hoops to get her daily drugs and it was getting harder and harder. We were on to the stealing and had everything locked up. She and I were at total odds with one another and I was watching her like a hawk and holding very firm to my boundaries. I'm sure her surrender to AA was a real readiness but I don't know if she could have gotten there without both my boundaries and her Dad's newly resolved boundaries (and seeing how sincere her Dad finally was... . the seizure was the bottom line for him after years and years of enabling her, spoiling her, catering to her, allowing her etc. etc. etc.) This has been hard behavior for him to change but he could see that she would have no reason to change anything until he changed first.

So, hard line here RGG- what do you need to change that might help your son? Are you allowing him the space to continue with current behaviors that might keep him from seeking help for himself?

I can't begin to know all of the details of your story and how my feedback and my story might or might not fit with your scenario. But my question above is a place to start. Don't let yourself get to a place where your son has damaged himself beyond repair and then have to ask yourself, had I done x would it have made a difference?

Your love for your son sounds strong. Strength and inner resolve is critical in a situation such as this.

Best to you and your son,

Thursday

[radioguitarguy]

Thank you all for the feedback and advice but after I had posted this, he came clean about the "falling asleep" thing. Yes, he is an excellent singer/songwriter but he's lost his voice to cigarettes. He told me his only passion in life was to be able to write and play music and if he couldn't do that, there was no reason to live. He attempted suicide last Thursday evening by taking some Klonopin which doesn't mix well with the 105mg of methadone he's taking daily. He apparently only took enough to make him nod out on his feet. I am now working with him to explore "other" avenues for quitting smoking and he tells me little by little some hope has returned that he will find a way to quit.

A quote from "Thursday"... . "If his mental state is to blame and you can't afford inpatient hospitalization you will need to start working NOW on finding an alternative and doing what is required for him to qualify OR sell something to pay for his treatment or borrow money. It is a sad proposition, this lack of resources for people who have severe mental illness."

"Thursday" with all due respect, I take exception to your, "what I need to do" statements. My wife and I have been supporting him both emotionally, lovingly, and sometimes financially since he was 18. Sure we walk that "supporting vs enabling" tightrope all the time but I'm not going to drop him off with a duffel bag full of clothes in the middle of the city and tell him, "good luck to ya." He's on Medicaid and is trying to get his SNAP benefits back. I prod him day after day to follow through. He just doesn't seem to want to do the work. He's going to be 30 in June and this may sound harsh, but I'm not going to do the work for him. I'm not emptying my IRA and 401K for someone who doesn't want to take SOME responsibility for improving their life. He's bright and creative. He knows what his resources are. He knows all about AA and other support groups. His reply is, "They're not for me." My wife and I have always been willing to talk and advise in any way we can. I agree with you "Thursday", If the only way to taper down your methadone is to stop smoking pot... . stop smoking the damn pot! Sure, people with mental illness and drug addiction need to be clean and sober to live a better life but at 30 years old, or any age for that matter, you can't MAKE them do that. They have to WANT it and many know exactly what they need to do to get it!

We choose to let him live with us under certain conditions which we're consistent with. My wife and I need to take care of ourselves and we do. Our oldest son and his wife just had their first child a month ago and we're proud grandparents for the first time. We have no guilt when it comes to how we deal with our ds30. We can't live his life for him. We are always there for him and he knows that.

[qcarolr]

radioguitarguy - what a relief to know what was happening with your DS. A big step for him to be able to talk with you about his distress at losing his voice for his music. I will pray that this will continue to motivate him to move into a more positive direction with his life.

We each have to find our place of balance with our struggling kids. You and your wife know your DS better than anyone. Sounds like you have done a lot of work over the years to take care of your lives so you can be there as needed for your DS.

The boundaries and choices we make, even when the best we can make, do not erase the distress and pain. My hope for myself is to learn how to integrate the pain within the moments of joy so I can find some daily peace in my life. It is working for me right now, today.

qcr

[Thursday]

rgg-

I apologize for my "what you need to do" statement. Of course you do not want to bankrupt yourself to get him help and it sounds like you have made sure he has assistance.

I understand your not wanting to

drop him off with a duffel bag full of clothes in the middle of the city and tell him, "good luck to ya

Sometimes our kids with BPD have no reason to push themselves forward because they will accept a meager sort of life rather than put themselves in an uncomfortable situation. I don't know if your son needs a push out the door or maybe another sort of push because I don't know your exact situation and frankly it's none of my business.

It is a tightrope walk, loving without enabling.

Stopping what might be keeping them trapped in their own miasma is a leap of faith and it feels all wrong but at the end of the day I want to know I've done everything I can do, even if it sucks to do it.

Again, sorry for my intrusive statements.

thursday

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

[peaceplease]

Radioguitarguy,

I am just seeing this thread now.  My dd is in methadone treatment, and I can always tell when she is doing benzos.  She nods off.  It is so obvious, as it is almost like she is hypnotized and trying not to doze off.  I have learned to spot when she is on them.  There is a big difference when she is just very tired and when she is on benzos.  

Benzos and methadone are a lethal combo!   My dd dropped a dresser on her, burned holes in good furniture that I gave her, burned holes in carpet of her bedroom when she lived with me.  Also, she was fired from her job for nodding off at her cash register.  I would not be surprised if she was on Xanax then.  I was away on vacation, so I don't know.  They fired her two days later, after co-worker complained.  She asked for drug test, but they said that she was give many chances already.  Boss told her that drug test would not matter.  She was fired for sleeping at register, not for being on drugs.  I have no faith in drug tests.  I know that she will get someone else's specimen.   People will sell clean specimens.  Yuck!  Sorry, I am on my soap box here!

Methadone has a long half life, so missing one day would not out him in withdrawal.  He would not feel like doing much, but that is the worst of it.  If he missed the clinic, why would he not be able to dose the next day?  And, why would they not taper him, if he is smoking pot?  What is the rationale for that?

Is he prescribed the pot?  Funny, my dd says that is the only thing that helps with her anxiety.  However, she is so full of it, saying that her Effexor does not work.  I counted her pills, and she did not take them!  However, she lied to my face and told me that she took them.  I did not tell her I knew it was a lie!

Are you certain that your ds would be kicked out of methadone treatment if he tested positive?  That is money they are not getting.  My dd lost her privileges about six months ago. That is the only sanction for testing positive.  They test for THC, too.  My dd would always go and smoke pot after her drug test.  But, now she just goes everyday.   She loves her pot too much.    Sorry, for kinda hijacking.

[radioguitarguy]

Hi Peaceplease... .

Thank you for responding. Regarding the clinic, when they go to get dosed on Saturday, they are given their Sunday dose which they are required to own a lock box to carry it in because the clinic is closed on Sunday. He was OK on Saturday but started to get a bit uncomfortable on Sunday.

The more I think about it, the more I think that methadone clinics are a sham. This clinics policy is if you're smoking pot, we will not taper you. The only reason I can think of is so they can continue to receive the money they charge for the methadone. He feels like he's being held hostage because 

[radioguitarguy]

Peaceplease... . Sorry I accidentally hit the send button. To continue, he feels like he's being held hostage because HE IS! There is absolutely no reason if they're trying to do what's best for the individual, to keep them addicted to the methadone. No, he has not been prescribed the marijuana.

About 6 months ago, he had taken a Xanax the night before and when he showed up at the clinic the next morning, he was still nodding out. They refused to dose him and had an ambulance take him to the ER. THAT was a fun day! NOT! He has been prescribed anti-anxiety meds and anti depressants, but factor in the methadone, he was a walking zombie. One of his first prescribed anti anxiety meds was Thorazine! Good God... . he was a mess! After that debacle, he was prescribed other meds for anxiety and he just got sick and tired of feeling like he was underwater all the time and simply quit taking them. Not advised by the way. Now it's just his pot that he leans on for his anxiety issues.

Thanks for your concern "peaceplease"!

RGG

[Reality]

Just wondering if pot causes anxiety?  I think it can trigger panic. 

Reality

[qcarolr]

DD was allowed to smoke pot under her medical mj license when she first came back home in 2011. She did give me some insight into how to monitor use to avoid paranoia. She absolutely avoided edibles - cookies, brownies, candies, etc. - because 'you do not know how much is in there and once in your stomach you can't stop it'. She can feel the calming effects and stop smoking. I have observed this calming effect. The meds just put her out so she only takes at night (trazedone with melatonin).

In reality, when she is really overwhelmed, she has over used it. Or she was using meth (away from home) and taking the edge off. I was ignorant and blind with denial about the meth use at that time.

qcr