Bpd, bipolar II, or both

[busymind79]

We are really unsure of what's going on with my DD15 lately. She does meet all criteria for BPD, but is undiagnosed. Right now her paperwork says mood disorder unspecified, rule out bipolar. Also BPD tendencies.

We have noticed recently that my dd seems to go through fairly long cycles of hypomania. She will go days or weeks at a time in a very outgoing, frantic and irritable mood. However the BPD also seems to be there with its rapid cycling highs and lows. For example, she will be in a great mood in the morning super happy, can't wait to get going, wants to talk about the day and wrestle with her brother. By the time she gets home from school she is super irritable. She talks nonstop about everything that happened at school. Everything was always the greatest or the worst ever. Everybody is horrible or the greatest. Play by play is quickly given about everything. Then she isolates herself to her room and texts with her friends or cries or listens to her music. When she comes out, it's because she suddenly has to go somewhere or get something. Right now. She will inevitably get extremely angry or upset and end up in her room for the rest of the night. This is pretty much every single day during this manic state. Even when she does want to watch a show with us in the evening, it's extremely unpleasant and almost always ends badly. She talks about how stupid everyone on the show is or how wronged they all are and how terrible someone is. Eventually someone either asks her to wait til commercials to talk or just stops responding to the rants and then all hell breaks loose. We are horrible parents, her little brother is a loser, nobody listens to her, we all think we are better than her. Than she storms off to her room and won't come back out. 

I almost prefer the depressed state. Even though she gets very sad and suicidal, the BPD is calmer and her tantrums are less chaotic. We are trying to get her to take her meds again, but she says that she hates that they take away her high periods and just leave her with the lows. The psych wants to add another mood stabilizer that works better for the depressed state. If I can get her to agree to take them she would be taking two stabilizers, one for the mania, one for the depression.

Does anyone have a child with both disorders? 

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

[livednlearned]

Hi busymind79,

That must be hard for your DD15 to experience only the lows, and not the high periods when she is taking her medication. What medication if any was she prescribed?

Hypomania is not easy to live with. I think it would explain more if doctors referred to it as intense irritability, which more accurately describes the behavior to laypeople.

How long ago did she receive the dx about mood disorder unspecified? Did the psych recommend any therapy or DBT to help with some of the behaviors?

[busymind79]

She received a major depressive diagnosis about 10 months ago after her first suicide attempt and hospitalization. She was put on Prozac. Then the diagnosis was changed to mood disorder unspecified about 4 months ago after her 4th suicide attempt and fourth hospitalization. She was changed to lithium. She spent 5 weeks in a DBT inpatient center and BPD tendencies were added. She suddenly went off the lithium about a month ago and wouldn't say why other than she didn't like it and wasn't going to take it. She also refuses to use any of the DBT skills she learned saying they are stupid and don't help. She does see a therapist twice a week.

Today was the first time that I heard why she stopped the lithium. I wouldn't want to only feel the lows either! I just wish she had said why, because we could have added proper meds then. Now the doctor wants her to restart the lithium and add lamactil. I read about the combo and it sounds like it addresses her exact concerns. Unfortunately, she was extremely pissed when we left the psych office today because the doctor had been quite argumentative and condescending to her and refused to answer questions she had about the meds. It's going to be tough to convince her to give it a shot, and I am nearly positive I will never be able to get her to go back to that dr office again!

[Rapt Reader]

Gee, busymind79, I'm sorry that your daughter is feeling so negative right now about her Dr. and her medications... .

Have you ever researched Neurofeedback Therapy? Do you think that your daughter would ever consider that? My own adult (38) son was diagnosed with BPD in April 2013 (but he also had been diagnosed with ADD, Clinical Depression, Social Anxiety, Suicidal Ideations and drug addiction, prior to the BPD). The DBT he learned in the Dual Diagnosis Center that diagnosed the BPD was the start of his road to recovery, but it's been the Neurofeedback Therapy that has made the biggest difference for him.

His story is linked to in my signature line (and here: My Son's Recovery-In-Progress Story), and he has really loved the NFT and is still going to the Sessions (besides Out-Patient and Psychiatric Therapy). For some reason, once he learned what it was and met the NFT Therapist for her free consultation, he was interested and has never balked at it. And it has really made the difference for him: He is now almost 26 months clean and sober (from a multi-year Heroin Addiction), and wouldn't be diagnosed with anything at this point except the Social Anxiety that is much better than before, but still present.

Just wanted to throw that out there... .If your daughter would consider NFT, and if you have a Neurofeedback Therapist near you, I would highly recommend your checking that out if possible, busymind79 

[meantcorn34]

I am also diagnosed with bipolar II. I experience hypomania ranging from euphoria to agitation. The euphoric part is wonderful and I don't blame your daughter for not wanting to lose it, but she needs to weigh that in relation to the agitation and depression. That takes maturity that may be quite a reach for one so young. I have heard many others complain about lithium making them feel flat. I have been on lamictal for nearly 15 years. Along with an antidepressant, my moods are stable. It took quite a bit of trial and error to find the right combination.   

Personally, I would not see a doctor who was condescending - even if your daughter was being difficult. A psychiatrist trained to work with adolescents should be better than that.

I feel for you and your daughter. It's hard to manage when your brain just takes off like a car with no driver. I used to think something or someone must have caused my mood swing. It took me quite a while to realize that feelings are not necessarily reality and to manage my illness rather than the other way around.

Hang in there. Hope it's not too bumpy a ride.