Advice, DD under 24 watch

[Parents! Get help here!]

Our DD, 19 (w/bipolar II and BPD) attempted suicide yesterday AM at home, by taking many prescription pills... . I was at work and she'd called a friend to say goodbye, and the friend called me at work and then 911. My son got home before me and saw a video she'd made and apparently put on my computer. He watched the first few seconds ( a goodbye) and then deleted it. Poor kid... . didn't know what happened that morning until he called me. I am so upset that he had to discover that.

She was in the ER yesterday, and was transferred to another hospital last night to ICU, where she is under 24 hr.watch. I saw her today. She is regretful and said that we've done everything we can, and that is is her fault.

She gave clearance for my DH and I to talk to the Drs (thankfully) and I did talk to the psychiatrist today. He said this was serious and obviously planned and that she will be medically stabilized, and then transferred to their behavioral health unit, but if no bed opens up she will go to another hospital's unit. They will adjust meds... . her lithium was shown to be sub-therapeutic, according to the Dr.

He then said that that would likely be for one week or so only, and that after that he feels she needs a plan... . IOP or PHP, which, as he explained to me is essentially an intensive outpatient program. He rec'd it be DBT based. He also seemed to say that we need to advocate for this, especially if she is transferred to another hospital. I'm a bit confused at to how this gets put into action... . ?

I am very nervous about her coming home after a week and then being left to go to this outpatient program while I am at work unable to monitor this.

Has anyone has success or have advice on the steps after a suicide attempt and new routine for an adult child living at home?

Who do we let know about this? What is helpful? I have let my immediate family know, and will let her best friend's (the girl DD called who called 911) parents know as they are dear friends of ours.

Any advice or thoughts at all would be so welcome.

[LittleThings]

Our DD, 19 (w/bipolar II and BPD) attempted suicide yesterday AM at home, by taking many prescription pills... . I was at work and she'd called a friend to say goodbye, and the friend called me at work and then 911. My son got home before me and saw a video she'd made and apparently put on my computer. He watched the first few seconds ( a goodbye) and then deleted it. Poor kid... . didn't know what happened that morning until he called me. I am so upset that he had to discover that.

She was in the ER yesterday, and was transferred to another hospital last night to ICU, where she is under 24 hr.watch. I saw her today. She is regretful and said that we've done everything we can, and that is is her fault.

She gave clearance for my DH and I to talk to the Drs (thankfully) and I did talk to the psychiatrist today. He said this was serious and obviously planned and that she will be medically stabilized, and then transferred to their behavioral health unit, but if no bed opens up she will go to another hospital's unit. They will adjust meds... . her lithium was shown to be sub-therapeutic, according to the Dr.

He then said that that would likely be for one week or so only, and that after that he feels she needs a plan... . IOP or PHP, which, as he explained to me is essentially an intensive outpatient program. He rec'd it be DBT based. He also seemed to say that we need to advocate for this, especially if she is transferred to another hospital. I'm a bit confused at to how this gets put into action... . ?

I am very nervous about her coming home after a week and then being left to go to this outpatient program while I am at work unable to monitor this.

Has anyone has success or have advice on the steps after a suicide attempt and new routine for an adult child living at home?

Who do we let know about this? What is helpful? I have let my immediate family know, and will let her best friend's (the girl DD called who called 911) parents know as they are dear friends of ours.

Any advice or thoughts at all would be so welcome.

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

[mama72]

I am so sorry, LittleThings. I don't have any great advice, I am sure others here will have some. Have you been able to talk to her personal T about what to do now?

Our stories are similar in multiple ways, so I follow your posts. You are a caring mother and your daughter is lucky to have you. Your input has really helped me.

Praying for you, your DD and the entire family. Keep us posted and stay strong.

[Thursday]

LittleThings

So heartbreaking. Sorry this is going on for your DD and for you.

My only thoughts, after hearing your apprehension about going back to work and leaving her to "cope" with the next step are to meet her IOP or PHP counselor/therapist.

The man who ran my SD's IOP was open with us about her. He wasn't sharing her thoughts with us, he shared HIS thoughts about her with us. And he was very, very insightful, his being a recovered addict himself and with AA as a part of his life for many years he had a real handle on the personalities of the people who were seeking his help. Hopefully, the facilitator for your daughter's IOP will be similarly enlightened and able to help you with a plan or at least maybe he/she can give you some suggestions to alleviate your understandable angst.

Can you ask around about available IOPs or PHPs and find out who seems to be the most highly recommended? We participated in what was available to families during SD's IOP and that helped us get the lay of the land, so to speak. It was just once a week (during work hours but there was availability to attend an evening group, even though SD was a part of the morning program. ) and there would be interaction between the facilitator, the clients and the family, then they would send the clients out of the room and we met with the therapy person as a smaller group with other parents and grandparents and siblings. There was easy contact with the main person as well as two other's who worked with him, filled in when he was on vacation etc. and they were both as in tune with their clients as he was.

This was our first experience with a therapy person actually having a clear picture of who SD was (she, at the time was an active addict and all of her cuteness and silliness was easily SEEN by this man and he knew about it, what it covered, how she used it... . because he had seen it all before but most importantly... . he knew why she was there and how to help her get better... . ) and it was soo refreshing and helpful to know that finally her therapist understood a way to help her.

Best wishes for you and your family... .

Thursday

[LittleThings]

Thank you both for your kind and hopeful thoughts.

I have not spoken with DDs regular/personal therapist (no clearance there), but my therapist (same office) has alerted her T of recent events.

I know we will need some new limits here at home, as DD is addicted to the internet and isolates herself in her room most of the time. It is her comfort, her haven from the heartless world as she sees/feels it.

She has taken up smoking cigarettes and eating junk as well and has gained a lot of weight and hasn't taken care of herself physically. She may have been drinking some the wine that we have in the house, and Dr. wonders whether she's been taking her meds faithfully. If you saw her graduation pictures, you would not recognize her at all.

She really has very few healthy coping mechanisms.

My DH and I will be asking many questions... . please chime in with any essential questions we need to ask. This is all new territory.

[LittleThings]

I visited my DD again yesterday, along with my son and her Gpa (my father). It was a bright, sunny day and the all around feeling was positive.

Her best friend (who'd called 911) was there along with her boyfriend visiting, and they left within 10  minutes.

We were all chatting and then ended up watching the last couple of innings of an exciting MLB game together in her room.

I told her briefly some of the things the psychiatrist told me... . especially about the outpatient program. I've tried to leave my baggage at the door and focus on the present and future.

She seemed very chatty, almost giddy and had been watching lots of cooking shows all morning. She is not allowed to have anything at all in the way of objects... . nothing from home... . toothpaste, cell phone, books, teddy bears, flowers, etc. Hasn't showered in days. She is off all meds at the moment. My DH had been there in the AM and said she'd expressed the desire to exercise and to cook.

Good news, I think, is that they will keep her there and wait for a bed in the behavioral unit. The psychiatrist had said they have a DBT based IOP/PHP there as well for transition to. Wouldn't this be great for continuity sake?

I do wonder if her mood right now is one of pure relief... . that she has lots of attention now, and people are there for her and taking care of her. In the scheme of things, I know this is helpful right now, but she is again, going to need to learn to take care of herself, and to be self motivated to work at getting better... . professionals can only pull the strings for so long. Is this a "honeymoon" phase?

I will remain hopeful that this event has changed the scenario for the better. Perhaps she's seeing that the current way hasn't been working and is now willing to listen and try new, better ways. We have to figure out how to help make it stick.

Thank you for reading.

[qcarolr]

LittleThings - sounds like a very positive visit with your D. I hope the hospital is able to transition her into their program and she continues to be open to the treatment plan they offer her. Can you ask about the family component of their program?

TLC's - Tiny Little Changes. It takes loads of patience to allow things to change over time, while keeping your D safe as her emotions will go up and down.

Please find ways to be kind to yourself during this time.

qcr

[LittleThings]

Thank you qcarolr.

At yesterdays visit she expressed uneasiness with DBT. In her words "they will tell me all the things i am doing wrong and it can make you feel a lot worse before you get better... . like really, really depressed. I don't think I can do group therapy, I'm not sure I can open up if I don't trust the person... . well, if they convince me I can trust them, then maybe... . "

She also said, "I feel like I can't wait for these meds to work, I need to do this on my own." I think that was a positive comment in the realm of needing to take responsibility. Not sure.

I just said that it's a therapy that tries to help you learn news ways of thinking in order to help you. Like in regular T, if you said " I cut yesterday", they might say "How were you feeling when you did that?"

But in DBT they might say, "OK, now try this instead." I've only read some of Valerie Porr's book at this point, so I'm not well versed in DBT.

I would like to think that the hospital would promote this therapy as a non-threatening and very positive option. I feel that maybe I should say no more, and perhaps talk to the Dr. and let him know her reservations... . ?

[jellibeans]

Dear Little things

I just wanted to let you know I am thinking of you. I do hope things get better for your dd.

So is she on new drugs or not drugs right now? Not sure I understand that right. I do think you could be right about her taking her meds. My dd tends to overdose when there is a chance of losing her friends... . she has very few but if she is in a fight with one she does tend to act out to get attention and sympathy.

keep us posted... . hang in there

[LittleThings]

Thank you jellibeans.

They restarted her meds as of Sunday... . Lithium (upping the dosage), Cymbalta, and Latuda (new on the market). She's been taking all of those, but when she was admitted to the hospital, they didn't give her anything for about 4 days. Also takes a med for sleep, used off label... . can't remember which, but it's non-narcotic.

From what her friend said, she was pushing her away saying she shouldn't hang around with her and that she was no good.

I'd noticed her sleeping more, eating more, and talking in a flat tone... . very depressed. She went to her once a week job, but turned around and came home. She told the girl she was supposed to work with she "couldn't do this anymore."

She said she'd gone to her regular T, but they didn't talk much. T asked her if she wanted to go to the hospital, and she'd said no.

How many times has your DD overdosed? What has happened after?

[jellibeans]

Dear littlethings

my dd16 overdosed 7 times until (all within about 8 month span) she was put in a RTC for 2 months to help stabilizer her... . after getting out she was really kind of weak and fragile through last summer but a lot better. She started at a new school last year and has struggles a bit there off and on. She had one overdoes at exam time on Dec 2013 but bounced back pretty fast. Overdosing became a real habit for her and RTC really seemed to help break that. She doesn't want to return to a RTC so she tries to control herself better. She still struggles a lot but is so much better than a year ago.

I noticed with my dd that often her meltdowns came when she stopped taking her meds... . or changed meds so this is really a hard time for your dd. All you can do is hold on and get through it. Have you seen any improvements on the new meds? ARe they sure about the bipolar part? hang in there... . I hope things improve for you and your dd.

[LittleThings]

Overdosing as a habit... . oh my. I cannot imagine coping with that. How have you done it?

I am seeing that this visit to the behavioral health unit is somewhat more than a bandaid, but not that much more. The psychiatrist met with my DD and took only a few minutes to look at the meds and then lower her Lithium and add in Depakote. I have no clue why, or what he is thinking as I haven't spoken to him, and hear from staff I would have better luck getting hold of/talking to the social worker.

I did call her, and In 2 messages to each other, I presented the first psych's recs for IOP/PHP and then she replied that it was a good idea and she'd present some options to DD. If I hadn't mentioned it, I'm not sure it would have come up! This is frustrating. There was mention of her being discharged Friday. I'm not ready!

Again, as my DH spoke of this to our DD in his visit this evening, she is trying to avoid group therapy at all costs. She spoke of getting another part time job because she feels as if she needs to pay her way here at home. (some day we hope she gets back to her college education, however slowly) I think she just wants to go back to the same T who I feel is really not very effective. She's been going to her for a year and a suicide attempt isn't exactly progress, nor is staying in bed all day.

How, how, how do we negotiate for change?

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 little things

We all do the best we can... . we all ride a roller coaster of sorts... . the ride just gets a bit easier when we gain a better understanding of this disorder and learn tools to help communicate with our children. There really isn't a magic pill... . My dd just got a new P this month and his advise to me was simply to hold on and hope she grows and matures and gets through these tough times. My dd has learned some coping skills and that has helped her make some better choices... . really that simply.

My dd was on depakote for a while... . I think for mood. I find it odd that they lowered her lithium when you stated it was not at a theraputic level... . the times my dd has gone into an inpatient hospital setting was always interesting... . meds were changed... . new DX given... . I kind of felt like we were going through a fast food window with her.

Her P was the one the was able to finally stablizier her with the meds she is on now. Also her T has been working on dealing with a trama from her past. She has told me of a rape that happened in 8 th grade but I really didn't know if it really happened. Talking with her more and more I am coming to believe that something did happen to her. She kept it from us and even now won't tell us who the boy was for fear that I would go to the police. It would make a lot of sense since during this time is when her behavior really got bad and continued into high school.

I am not sure how you find the help for your dd in the situation you are in... . some of that has to come from her given her age. When we found this new T for my dd then things started to change. Before this she didn't like her T and hated going. Finding a T your dd is comfortable with is very important. This new T does DBT therapy and that has helped my dd learn coping skills. We are celebrating her one year anniversary from being released from her RTC soon and when I look back over this year it is better than the year before. Only one overdose compared to 6 the year before.

Can I ask you is this your dd first suicide attempt? Do you know what triggered it? Hang in there little things and keep fighting for your dd to get the help she needs.

[LittleThings]

Yes, it is does feel like we are going through a fast food window! This was her first attempt. She was in the unit for SI a year ago.

Not sure what triggered the attempt for sure, but I do know she'd had 3 job interviews with no results, and her current relationship may have been becoming unstable. She had dyed her hair orange, gained a lot of weight from eating junk, was smoking cigs and sleeping all day. Becoming more and more depressed. Some cutting began again. No money to speak of. I believe she is confused about her sexual identity.

It is puzzling about the Lithium. No continuity w/what the first P said. I had even asked him to document his recs!

Ultimately, what our DD needs is to learn some coping skills in order to make better and better choices.

She is comfortable with her current T, but I can't see why after an entire year, she still cannot take care of herself (in our home). We have really tried to let her figure things out and keep things level and non-confrontational. Nothing really improved.

DD maybe amenable to individual DBT, but I need to ask the SW again about this. My DH and I would

like to see her try a new T... . simply because of where she is a year in w/current one. DD has said that her T "does DBT", but this worries me in that I am not sure why the T hasn't tried it yet, and not sure if she really has the right training. This T did not really agree w/Dx. DD has lots of secrets, and what I'm hearing is that it's hard for her to trust someone enough to open up.

Under what circumstances did your DD enter RTC? Is this something that is open for any age?

Thank you so much for your input.  There is so much valuable info!

[jellibeans]

After several months of my dd running away from home, cutting, failing school, and the many overdosing... . two in the same weekend that I was not even aware of we insisted she get help and she was no long safe at our home. She was taken to the ER and then to a RTC. RTC is not something that is available easily and it is hard to get insurance to pay for it. The private route is better but extremely expensive.

Your dd would have to want to go and there would have to be a real concern that she was unsafe at home. I am sure there are programs for your dd age but I am not sure of one. There is a link to the right that talks about RTC... it is near the bottom of the sidebar. Read that and see if it helps.

What does your dd P think about what is going on? What has he/she suggested? My dd really has a hard time talking about things that have happened in the past. So much shame involved it is hard for her but when she found this new T things really got better. Finding the right T is so important and one familar with BPD. Does your dd go weekly to her T? There might be an out patient place she could go to during the day. My dd went to a place after she got out of RTC that was how she was able to finish school. She went everyday and wasn't too happy about it but it was a good transition.

What state are you located in... . maybe someone here will have a suggestion for you. You could ask a new question about that too. I am sorry things are not going well for you but hang in there.

[qcarolr]

little things - just a quick thought. Maybe the P is tapering off the lithium and replacing it with depakote. They are both mood stabilizers. Depakote needs to be increased slowly to minimize side effects. If it helps then maybe bipolar is part of your D's issues.

My DD, nearly 28 now, never got any benefit from the many mood stabilizers she tried. What has helped her is an anti-depressant/anti-anxiety medication. Then she is more stable, present and self-reflective. She has never persisted long enough with a T to build the trust needed to be vulnerable and make progress.

I hope things stabilize for your D and you can find a good path for her treatment.

qcr

[LittleThings]

Yes, they took her off the Lithium, and using Depakote as the mood stabilizer.

I was on the phone with her SW who said she first objected to the IOP, and insisted she see her regular T 3x/wk, but the regular T said she wasn't comfortable taking her right out of the hospital, and didn't have the time in her schedule right now for that many visits. I think it was fantastic that the SW and her T worked together, and later in the day our DD agreed to do the IOP!  It's 3x/wk 9-1:00. She is there right now. (as far as I know) I need to ask of she will sign consent for us to participate.

She also has some info for support groups for her gender issues/conflicts. We know she is questioning where she fits in. Currently dresses more masculine and quite messy, but sometimes she'll wear makeup and pay more attention to her appearance. We know about it and don't really judge, but we are not able to pay for any surgery. It's also not an excuse to do nothing with her life. She did express wanting to have her breasts removed a couple months ago.

We aren't sure if her conflicts are a part of her illness(es).

I know she was rejected by the leader of a group of girls in middle school, and she had to do anger management during recess for a while. She cried alone in her room a lot, without us even knowing about it. We found out much later.

Perhaps this therapy and being in a group will help! Being optimistic.

[jellibeans]

little things... . so happy to read things are coming together for your dd. I hope things continue to improve further and your dd gets the help she needs. This is a very tough time for her and she must be so confused and suffering some deep hurts from middle school.