Need opinions about Dr's wanting to immediately prescribe meds

[FireWalker]

My DD made 3rd suicide attempt in a year this past weekend. Hospitalized 3 days and now moved to an in-patient facility. (we are grateful for this because after 2nd attempt they released her before the 72 hr hold was even up)!  Both the psych dr. at the hospital and now at the new facility tried to prescribe Zoloft right off the bat.  She refuses to take these meds because she has been prescribed various meds in the past and say they make her feel really weird.  Upon refusal this morning the Dr then said, ok, then I'm putting you on a 14 day hold.  (this is good too, because we are told they have an excellent CBT & DBT program)  We want her to go thru these programs and finally have her in a place that offers them. This is the first time she has been in a place like this and has not even seen a psych dr regularly because we couldn't get her to stay on track.  (she's 21 - we don't have much control)

My question is how to handle it if the Dr keeps pressing for her to take meds? My husband and I both agree that the meds haven't helped in the past. She herself says they don't motivate or do anything positive for her.  Anyone have experience with demanding NO meds? and still able to seek treatments in a similar facility/situation? She was just moved to this facility last night and met the Dr. this morning.  My husband & I hope to meet with this Dr later today when visiting hrs begin noon-8pm.  We don't want to jeopardize her getting the CBT/DBT therapies just because she won't take the meds.  Opinions?

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

[Rapt Reader]

Hello, FireWalker &  and the Parenting a Child with BPD Board... .

I don't have any experience with my son (he is 37) not taking his meds since his BPD diagnosis, but I'm curious how your meeting with your daughter's Dr. went? I'm thinking that after you meet and talk with him/her, you will have a better handle on how the treatment works, and if her getting CBT or DBT is dependent upon her taking medication.

Also, I'm sure the program has experience with others who are like your daughter, and has some sort of way to help them get better. I'm so glad she's getting treated, and that it seems it is a safe and productive place. Please keep us in the loop, FireWalker... .

[qcarolr]

I too hope you were able to meet with the pdoc . I so understand the frustration when our kids can deny access to their parenst . Can u share information about your DD'so prior medications with the doc ? My DD 28 did not have a good response with many meds. She also was not compliant long enough to really see the effectiveness.  Or she was mixing street drugs, pot, alcohol. She has had success recently with Prozac for depression and her anxiety disorder. Being in jail most of this year has allowed her to experience the benefits. She has access to cbt in jail. I can see so much improvement for her.

Looking forward to hearing how your visit went.

Qcr

[jellibeans]

firewalker

When my dd was younger she also said that the meds didn't help her. In fact it was hard to get her to take the meds. She often tried to fool us and also hide her meds. I really believe this is part of the illness... .the denile that anything is wrong with them... .they don't need meds. This period of time was the most unsettling for my dd. Overdosing repeating or running away from home and cutting. Shear hell. Even when she took the meds she would tell us they didn't help. This was a while back and thankfully she now is compliant with taking the meds and she also actively participates with her own care. I am not here to push the drugs and when my dd was younger I was against giving her meds but the sad truth is she needs them right now. One day she might not need them but right now she is unable to control her impulses and her mood. Starting meds in a hospital setting is the best way to proceed but she needs to be on board with the treatment plan. That goes for the therapy part too... .how much is she looking for help? If she is suicidal then she is not in the right mind set to get the help she needs and that is why meds are probably a good choice at this time.

[theplotthickens]

Good question.  My experience is that it takes time to find the right meds.  SSRI's like Zoloft and Prozac made my daughter irritable and angry, and increased her thoughts of suicide. 

It is always an option to refuse one CLASS of medications, such as SSRI's, because your daughter has been made worse by them, but to be open to other classes of medications.

Does your dd have anxiety, and has it ever been treated by a medication such as Buspar?  Had your daughter ever been tried on a mood stabilizer such as Lamictal?  Has an anti-psych for aggression ever been tried, such as Risperdal or Seroquel?

I wouldn't give up on meds as a whole, give your child's history, but would make sure that your dd's wishes are respected.   Nobody is in her body but her, and SSRI's do make many people feel worse.  Maybe she would be open to a 2-3 week trial of another class, depending on what symptoms she needs to manage.

All the best.  Remember: there are answers.  Keep seeking them. 

[FireWalker]

Well ... .thanks for all your replies and input ... .it's been a daunting 2 weeks.  I was SO, SO sure the system was going to work for us this time around, but here's what's happened.  If your child is over 18, the system does NOT work. At least in San Diego. DD attempted suicide on a Sunday morning, taken to hospital and put on 72 hr hold. Monday morning she refuses meds, Tues morning she refuses meds.  We found another local program at nearby hospital with excellent results and numerous referrals by both her therapist and several others I called (Sharp Mesa Vista if you are in San Diego area) and they accept our Ins! Woohoo - very important these days btw. Tues night the on-duty psych dr agrees to transfer her to Sharp MV per our request ... .Wed morning, new hospital psych ward, 8:30 am, new Dr doing rounds sees her, she refuses meds, he says ok, no problem,  issues 14 day hold.  Whew, sigh of relief for me & husband ... .(we now think we have time to research 30 day programs for CBT & DBT, get her signed up in time - these programs our very full - hard to get into quickly). DD furious, causing havoc in psych ward. As Expected. oh well.  DD given/reads patients rights (neither me or my husband informed of this brochure).  Come Friday morning, a social service worker from hospital calls and suddenly informs us she has requested court hearing to be released -that btw is taking place in 15-30 minutes - so we can't possibly be there in time to be present.  In CA, any patient put on 14 day hold (also known as a 5250) may request hearing before a judge to be released. 

we plead with social service worker to advise judge to not release her, this is her 3rd suicide  attempt in one year.  Judge also sees recommendation from on duty Dr.  Lo & behold, we get a call 15 minutes after hearing (which takes place in side office in psych ward btw) Judge ordered 14 day hold to stay in place. Whew, relief again.  Meanwhile, we have her signed up to begin very next outpatient DBT program, which doesn't start until Oct 28,  3 weeks away, but can also get her into outpatient CBT program in next 7 days.  (none of these programs available for in-patient!)  Why?  All of a sudden, Monday morning we get a call from our DD, psych dr has released her... .This is Monday morning after Friday hearing... .are you kidding me? ARE YOU KIDDING ME?  DR. does not return calls ... .social service worker only guesses that he released her because she wouldn't take meds & there were more severe psychotic cases that needed a room/bed in that ward.  Long story short now... .we picked her up Monday afternoon.  she snuck out Monday night at 1am... .came home at 2am... .slept... .left again Tues afternoon ... .(a week ago) ... .and we haven't heard from her or about until this morning ... .her ex-bf called to tell us she is in LA (an hour away) and has been doing meth for a week and he guessed heroin as well.  She won't call us or return calls/texts.  She is still signed up to begin intensive DBT 4 days a week starting Oct 28.  Not sure she'll be back in SD by then.  We have younger 13 yr old daughter at home and both my husband & I agreed today that neither of us wants to risk driving to LA to get her and bring her back home, only to have her take off again.  We are wits end ... .WHEN DO YOU JUST GIVE UP AND LET THINGS HAPPEN AS THEY WILL?  My husband & I both agreed today that extreme measures to rescue her are pointless at this point.  Even if we get her home, it's only Oct 20 and her DBT class doesn't even start until Oct 28.  Not like we can chain her up ... .  WHAT TO DO?

[nzmum]

  Firewalker

WHEN DO YOU JUST GIVE UP AND LET THINGS HAPPEN AS THEY WILL?   ... .  WHAT TO DO?

this all sounds just dreadful!     

Possibly a good time to take care of yourself, your H and D13 ?

BP-DD21 is surely classed as an adult in the USA (?) and making some wrong choices for sure but maybe it has to be worse for her before she will accept help etc? 

So perhaps letting her do her own thing for a bit may help in the long term? As hard or unsafe as it may be.

It certainly would not be a case of you giving up though as if she comes to you for help (like the rest of us) you'll be there waiting!