Son with substance abuse and BPD

[Toute Heure]

Hi. I have a 15 year old son who has been diagnosed with BPD. Also, major depression, anxiety and substance abuse.  I am a divorced mom and have another son, age 12, living with us.  It has been a very difficult year.  My son has had several inpatient hospitalizations for suicidal ideation and self-destructiveness.  He was pretty high functioning up until a few months ago when he just fell apart.  Now he has completely given up. He is so miserable, so empty, every minute of every day.  He doesn't care about anything at all.  He sees no future, hates life, hates himself, and can not envision ever feeling differently.  He has been turning to drugs, mostly mj but other things as well.  He is not hostile or aggressive but sad, irritable, and angry inside all the time.  He's actually pretty sweet and helpful, but he tells me straight up, he is going to use drugs again because it is the only thing that makes him feel better and he can't take it anymore and I should just leave him alone.  I have had him with private therapy, psychiatrists, multiple outpatient programs for psychiatric and for chemical dependence.  He spent a few weeks at an adolescent transitional unit but they discharged him because he tried to escape.  He is home now and at a full day DBT program but he I think he will stop cooperating soon.  Before his last hospitalization he stopped going to school, was doing drugs daily, shoplifting and not following my rules (curfew, etc.).  He is cooperating now but tells me he can't go on like this much longer. He has zero motivation to not use drugs and he thinks DBT is stupid, doesn't work, hopeless.  According to him, therapy is a waste of time.  I don't know what to do.  I have been advised by one therapist to send him to residential rehab and by another that that would make things worse.  A psychiatrist suggested wilderness therapy but another thought that was a terrible idea. Plus, I can't really afford it.  I want him home where he belongs but if he reverts to the chaos of drug use, stealing, not coming home, etc. I don't think I can manage it. 

I don't know any of you but if you are also on this board, I am sorry for you and hope to offer support.  I hope we can help each other.  I look forward to "meeting" you.

thank you.

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

[PaulaJeanne]

Hi mimmadreama,

I so relate to your story. My pwBPD is my 21 yr old daughter.

At 15, 16 she was like your son. the problem with most of the rehab & all of the wilderness therapy is they don't have dual diagnosis programs for adolecents. Sending a pwBPD to a rehab, with all of its rules, contracts, punishments, etc... . that doesn't work for BPD. Tough love doesn't work.

It sounds like you have a good relationship with your son. Even though he's not doing what he's supposed to, he is talking to you truthfully. I just purchased Valerie Porr's book on Overcoming BPD. I really wish I had found this book when my daughter was 15. I would have never done half the things I did to try to help her, and I would be about $100k richer from the money I spent on ineffective residential treatment. I also would have been able to maintain the good relationship if I'd only understood her motivation back then.

All of us here are on a tough journey. It's really hard to deal with the drug use, the stealing, and the not coming home (that one always scares me worse of all). Glad you found this board.

[Kate4queen]

I sympathize with you greatly. My BPD son first started showing similar issues at age 16, anger, rage, depression, drug use, irritability.

I wish I could tell you how we got through those days but it was a bit of a struggle. I reached out to his school and counselors and got him therapy which meant he could just about keep going but it was very hard for him. I tried to be a good sympathetic listener.

All I can say is that 16 was about the worst stage of his depression, as he's grown older, he's balanced out a bit.

Hang in there, get as much help for him as you can and don't forget to take care of yourself.

[Elbry]

 

Hello Mimmadreama and welcome to the family!  You will find lots of support and advice here.  I am sorry to hear of your struggles, and I wanted to tell you, you are not alone.  SO many of us share your story.

My BPD daughter just turned 15 and the last year has been hell.  3 suicide attempts, 2 crisis unit stays, 3 hospitalizations, lots of cutting, school refusal, drinking, marijuana use, irritability, moodiness, outbursts, screaming, crying I could go on and on. Like your son, my daughter was not hostile or aggressive, at least not to others, all her anger and hostility was at herself. It can be so very hard to make a decision about what kind of treatment to get for them especially when they do not cooperate with anything.  We had that problem too.  She wouldn't engage in anything.   We did individual therapy, in-home therapy, and DBT group. I made the difficult decision to send her to Residential Treatment after her last suicide attempt, but by the time I made the decision and the paperwork was processed, she couldn't go because she was too stable at home.

I guess my only advice to you is, don't give up, and as someone else said, take care of yourself.  Dealing with this is exhausting and it can drain so much energy from you.  I can also tell you it can get better.  My DD is on her 3rd therapist, but this one she IS engaged with and is actually talking to.  She is finally engaging in DBT group.  She hasn't cut (that I have found and I check her body) in 4 months.  She passed a drug screen.  I'm still holding my breath a little bit, because I'm traumatized by the suicide attempts, but right now she is doing really well.  The other day she posted an anti-suicide video on FB and a comment about how it was almost her and how she is "so so sorry".  That is a far cry from what she used to post!

Hang in there.  We are all here for you if you need to vent or need advice. 

[Toute Heure]

Thank you PaulaJeanne, Kate4queen and Elbry for reading and for the empathy.  I am also thinking about RTCs or therapeutic boarding school... . maybe.   I don't know. I want him home, if I can, but I also want him safe.  There is so much conflicting information about structure, behavioral contracts and consequences, but also that strict rules and tough love don't work. I don't know what's right.  It seems so hard to send away a vulnerable boy who, even at his worst, wants at least 20 hugs a day.  PaulaJeanne... . you though the RTC was useless?  Also, I wonder if any of you had your children classified at school as emotionally disturbed?  My son can barely function or think about school work.  Do your kids manage to get through high school?  Thank you.  Mimma

[griz]

Hi:

I am sorry that you are going through all of this.  I have been there as well and your son sounds much like my DD at 15.  School was horrible for her and it was very much a trigger for her.  She had given up on life and spent her life either sleeping.  When she was awake she would self harm and talk about wanting to kill herself all the time. And yet with all of this going on she still needed the hugs too.  When I look back I don't know how I can possibly still be alive but we parents somehow manage.

At the age of 16 I had my daughter classified in school as emotionally disabled.  This did help somewhat but in the end we had her home tutored because no matter how hard she tried she just couldn't do it.  From 15-17 DD wanted no part of therapy, DBT or anything of the sort.  We forced her to go until she finally quit, refusing to go back.  Her DBT therapist told us that she was not ready to accept help.  She told us to keep a close eye on her and let DD know that when she was ready she would be waiting for her.  It took till almost 17.5 years old and one day she came and asked me if she could go back to her therapist and DBT.  This time she was "ready and willing" to do the work.

Over the past year and a half she has done the work and is a much better place.  She still goes to therapy every week but she also just finished her second year of college and is transferring to a wonderful University.  Life isn't always peachy.  She has her struggles and I believe she always will.  I pray often that she keeps moving forward in her life.

I know how difficult things are for your right now. Yes, we have all been there and it is a very dark, lonely and scary place but I do believe that things can get better.  Your son is still young, I believe maturity also helps our children.  Take care of yourself

Griz

[Toute Heure]

Hi Griz,

Thank you for your thoughtful response. I am so happy for you that it seems like your daughter is on her way to a better life.  You give me hope. 

Take care,

Mimma

[Kate4queen]

Thank you PaulaJeanne, Kate4queen and Elbry for reading and for the empathy.  I am also thinking about RTCs or therapeutic boarding school... . maybe.   I don't know. I want him home, if I can, but I also want him safe.  There is so much conflicting information about structure, behavioral contracts and consequences, but also that strict rules and tough love don't work. I don't know what's right.  It seems so hard to send away a vulnerable boy who, even at his worst, wants at least 20 hugs a day.  PaulaJeanne... . you though the RTC was useless?  Also, I wonder if any of you had your children classified at school as emotionally disturbed?  My son can barely function or think about school work.  Do your kids manage to get through high school?  Thank you.  Mimma

My son only finished high school by doing the last year at the 'alternative' high school where he only had to go in one hour a week to see his tutor, get his assignments for the week and he worked on them at home. If this option hadn't been available I don't think he would've graduated, he was just refusing to go. So look into alternatives in your state, and talk to the school district. Does he have an IEP? That can help a lot.

[Elbry]

My daughter has been out of school since since last October, she just can't handle it.  We tried homeschooling but that failed because it is not structured enough, I am not tough enough on her to get her to do it and she is not motivated enough.  Right now I am working with the Superintendent's office, with the person who handles things for disabled children and my DD will be getting back in school under a 504 due to emotional/psychological illness.  It's one step down from an IEP, but it means the school will make accommodations to make it possible for her to be educated.  This is awesome news for us because in the past it was seen that she was acting out and I was supposed to punish her enough to force her to go to school.  This puts the burden on the school instead of on me.  And IF the 504 accommodations do not work, she will go up to an IEP.  Try calling your superintendent's office and asking to speak with whoever is in charge of special needs if the school itself is not helping enough.

[Elbry]

Forgot to ask... . does your son have a case manager?  My DD's is SO very helpful in getting this sort of thing organized for me.

[Toute Heure]

What is a case manager?  I have heard/read people talking about case managers but who are they?

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

[Elbry]

A case manager is exactly what it sounds like. My daughters works for the same agency as her med manager, her first therapist, the crisis stabilization unit and they run the crisis hotline and do crisis intervention for the hospitals.  She manages my daughters case and does all needed referrals, makes appointments, goes to meetings with me with whether it be with the school or team meetings with her care providers.  She also handles all insurance prior authorizations etc.  So instead of me having to make all kinds of phone calls and play phone tag trying to organize things I just make one call to the CM and tell her what our needs are and she organizes everything for me and then just calls me back. 

[Elbry]

When my DD's therapist quit, her CM found her a new one.  And when it was time to look for residential her CM handled all that as well.  I highly recommend having a case manager.

[Toute Heure]

Sorry... . I'm sure I'm being dense, but where do these case managers come from?  It's a government service? or private?  What kind of agency are you referring to?  thanks!

[Elbry]

It's no problem Mimmadreama you are not being dense, you just don't know.  The CM we have works for a private Psychiatric services facility.  They have everything from Psychiatrist, counselors, a variety of groups like DBT, crisis stabilization units, an adolescent RTC, crisis hotline and case managers.  What kind of services does your DS currently have?  Perhaps one of his providers would know where to go or if he would be eligible for case management.   

[PaulaJeanne]

I found RTC to be useless in treating my dd because it was all based on drug use, which I believe is a symptom of mental illness, not a cause of mental illness. If you could find a dual-diagnosis RTC, that would be fine, but I couldn't find one.

My dd is in a DBT program now - outpatient. She goes twice a week. It seems to be effective, but she really wanted to do it. She's 21 now. At 15 or 16, I doubt she would have made the commitment.

Best to you all.