My daughter is a revolving door

[anybodys guess]

My life has not been the same since last August. My 16 yo daughter was diagnosed with anxiety last September and put on Zoloft.  Didn’t help, got worse. Then in November tried to OD and then put on Lexapro and Hydroxazine. Didn’t help, got worse.  Then started cutting. First of January,Hydroxaine removed and  Abilify and Trazadone added.  Nothing gets better and now is tested for disorders.  Tests showed BPD, bi polar 2 and ADHD, so then she has a med change and is put on Tegretol, Clonidine and Trazadone. Nothing gets better.  so now new psychiatrist gets her off Lexapro, Abilify,Tegretol,Clonidine and starts Lithium and only Trazadone for sleep  Today he started Concerta for ADHD.  Oh, and she also has Hashimotos Disease of the thyroid.  Has only half of her thyroid now  She is anxious, defiant, impulsivity is off the charts, and is now claiming to be bi-sexual.  Also has a fear of falling asleep on her own.  We have considered that she has endured some form of trauma but states that nothing has happened, but how can a normal, happy girl go from being ok one day and then opposite another? She goes back and forth between wanting a boyfriend to wanting a girlfriend and on a weekly basis.  It is exhausting to even watch.  I am praying the diagnosis of ADHD is the problem but I won’t hold my breath.  She is extremely intelligent and it is hard for me to believe someone could have all these disorders and meds don’t help.   Any feedback ?

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

[KateCat]

I have Hashimoto's thyroiditis, and that makes me wonder whether it might not be playing a big role in her turmoil. (Especially since you mention a change in August of last year). When the body begins to produces antibodies that will eventually destroy function of the thyroid gland, all kinds of mental and physical imbalances can occur. Sometimes people swing from being hyperthyroid to hypothyroid pretty quickly during this time, kind of like a mind and body whiplash.

I think it couldn't hurt to start learning more about Hashimoto's. It's a common disorder, but it takes a little while to begin to understand its effects and its treatments. Ultimately it's pretty treatable, but a little tricky sometimes.

I'm sorry for your family's ordeal with all this.

[lbjnltx]

Hello anybodys guess,

Welcome to the site and the Parent's Board, glad to see you here!

The revolving door/BPD rollercoaster is quite a ride to go on and doesn't seem to stop to let you off.  The medication rollercoaster can be frustrating too.

There are  constant chemical changes from different meds in the past 8 months. I can imagine her mind/body is in a constant state of flux with so much change. Have you considered saying "no" to any further changes (within reason)?  What affect does her thyroid condition have on her chemical brain balance?

Antidepressants and mood stabilizers can help to some degree, sort of level the playing field a bit and they don't cure any of the core symptoms.  Therapy can help with the core symptoms in conjunction with meds.

The lack of a sense of identity is one of the traits of BPD.  Sexual preferences are part  of ones identity, couple that with being at the age when sexuality is being explored and she becomes very exploratory in her options.  My d dabbled with this too at 14 and 15 and it leveled itself out and she made her choice to be heterosexual.  She also had long term inpatient care to help her be grounded in who she is and her values. 

Has your d been participating in any kind of therapy?  If so, what kind?

How are you taking care of self and relating to your daughter currently?

I look forward to your reply.

lbjnltx

[livednlearned]

Hi anybodys guess,

I wanted to join KateCat and lbjnltx in welcoming you to the site. This is such a compassionate and helpful community with lots of educational resources and peer support.   

Your post reminded me so much of a book that was recently reviewed here about BPD and adolescence. Do you know the book Borderline Personality Disorder in Adolescents: A Complete Guide to Understanding and Coping When Your Adolescent Has BPD? It's the second edition, and is written by an MD named Blaise A. Aguirre. I've only read the sample so far, but what I did read included the frustration parents feel when their child's disorder is treated with drugs that don't solve the core challenges, including the impulsivity and other features of BPD. It's common, it seems, for teens with BPD to be diagnosed ADHD and/or bipolar.

Here's a review of the book: https://bpdfamily.com/message_board/index.php?topic=274101.msg12597754#msg12597754

Some of the drugs you mention are pretty intense to be on, and also very intense to go off, like Tegretol for one. Have any of the psychiatrists discussed DBT or therapy to address the BPD?

Please tell us more when you're comfortable doing so, and check in to let us know how things are going for you. We're here for you.

LnL

[hypermic]

Hi.

Very sorry for what your going through.

Accurate diagnosis is very important. For this post I am going to concentrate on the  ADHD and BPD elements of the diagnosis.

In regards to Concerta for ADHD, please allow the medications a few days. In fact the doctor may have to increase the dosage or switch to another stimulant- sometimes this is required.

If she also has BPD, Concerta may not control all her emotional symptoms or may perhaps worsen some aspects. It is not uncommon for doctors to also prescribe a low dose atypical anti-psychotic in combination with a stimulant medication for dual diagnosis ADHD + BPD. If she also has BPD, she probably needs specific therapy, and extensive social support  to overcome her problems.

People with ADHD tend to be impulsive all the time, continuously where as people with BPD tend to be more impulsive when upset or under stress. People with ADHD + BPD tend to extremely impulsive people, more impulsive than the average person with just BPD (at least according to what I have read about this).

Here are some symptoms of ADHD, you may wish to specifically read about ADHD in females however, as the disorder can present somewhat differently in females to males. ADHD is a lifelong condition, while hyperactivity often diminishes with age, the other symptoms start young and can last a lifetime.


* Very disorganized. Has great difficulty with tasks, especially household tasks and "boring" tasks. Tends to go off on tangents  and not complete tasks. Tends to make careless mistakes with tasks or do a poor job in regards to the quality of the task, tends to rush tasks. Easily dis-tractable, may often zone out or miss what people are saying to them.

* Tends to forget appointments and obligations. Frequently loses and misplaces things. Puts everything off until the last moment. Procrastinates all the time. Very poor time management skills.

* Lives in the immediate world, with an inability to sustain action towards future, medium and long term goals. Has great difficulties with motivation towards things that do not bring immediate rewards. May have an addictive personality.

* Knows what to do, but has problems doing what they know they should be doing- even if they have said they want to.

* Markedly impulsive in many areas of life, including when calm and not under stress.

* When they feel comfortable to talk they tend to be over-talkative. People with ADHD may tend to interrupt others, intrude upon others when they are busy, even sometimes finish other people sentences as they are speaking or interrupt them mid sentence. Even when calm they may often say things which they probably should have kept to themselves.

* Some other common characteristics: prone to boredom, explosive tempers, hyperactive or restless, constant fidgeting is common, especially in children with ADHD.

Does the above sound like your daughter? Or do you think all her problems are more fundamentally emotion and stress related?

If your daughter has both disorders, she needs treatment for each disorder she has. Some research indicates people with ADHD as children are much more likely to develop BPD later in life if exposed to traumatic experiences, than people without ADHD as children.

Accurate diagnosis is critical for your daughters future I'd say. Read up all that you can.

In regards to her sexuality, its not uncommon for teenagers of her age to be confused in the way you describe, every more so with all the problems she seems to have.

TIP: With doctor approval, I suggest trying Melatonin for sleep problems.

[rationalmind]

Welcome to the board!  I have an 18 year old daughter with undiagnosed BPD.  I think everyone was afraid to make the diagnosis as she was under 18, but she officially has ADHD, Depression, and PTSD.  I didn't find the ADHD meds to help (though she may have met criteria as a child).  It's so hard to sort out when a lot of the symptoms of the disorders overlap. For example, is poor impulse control related to ADHD or BPD?  I think when meds are not working or not completely working the BPD diagnosis is more likely. Just my two cents.  Therapy is the most important, along with meds to treat symptoms (depression/anxiety/impulse control) but our kids are often resistant to it. I know my daughter is more accepting of meds than therapy (easier and less painful) but it's only recently after a long inpatient stay that she recognizes "I'm so F**ed up" compared to others