Our 15 year old is showing Borderline Personality Traits

[Ready2Bchanged]

Our 15 year old adoptive daughter is showing borderline personality traits.  She has just finished her 7th inpatient stay in a psychiatric hospital, in addition to a six month intervention center stay for self-harm and suicide attempts in the past 2 years.  They released her from the hospital today and she has been sent to a respite center until Sunday.  To say that we are exhausted would be an understatement.  We are working with the state to have her sent to residential treatment. 

What have you found to be the best treatment options?  We have been involved in individual therapy, WRAP around, and recently DBT.  She was removed from DBT as she was hospitalized 2x in the five weeks of treatment.

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

[Kwamina]

Hi Ready2Bchanged

I am very sorry that your daughter is having these struggles. I can only imagine how difficult it must be for you see her go through all of this and engage in self-harm and even suicide attempts.

Doctors are often very hesitant to diagnose teenagers with BPD, but when the signs are clearly there, it does seem wise to acknowledge the possibility and get your child targeted treatment. Perhaps you can benefit from a thread we have here about early signs of BPD in your children. Here's an excerpt:

Doctors are often very reluctant to diagnose young children with BPD, partly because the brain is still developing. Having said that, I think looking back many parents of now adult children with BPD will probably be able to identify certain early indicators of possible BPD traits in their children. Regardless of whether it was 'officially' labeled as BPD or not. Blaise Aguirre, MD, examined the notion of not being able to diagnose adolescents with BPD and raises some very interesting points:

• The idea that we have to wait until 18 to diagnose a personality disorder [makes] little clinical sense and flies in the face of current evidence.



• In our clinical experience most adult patients with BPD recognize that their symptoms started in adolescence (or earlier).



• Personality evolves in children. Parents often recognize that their children can have very different personalities from each other.



• Psychiatry has been comfortable diagnosing most other DSM conditions in younger people.



• No other medical or psychiatric condition would wait to get until someone was 18 to get targeted treatment.

If you are interested in reading more, you can find the thread here:

Early signs of possible BPD traits in your children

Dialectical Behavior Therapy (DBT) has been proven to be effective for many people with BPD. Do you feel like she acknowledges her issues and/or understands what's going on with her? Do you feel like she's willing to work on her issues?

It's unfortunate that your daughter was removed from DBT. There are people with BPD who have learned to better manage their difficult thoughts and emotions through hard work and as a result have improved their behavior. Your daughter is still very young and though BPD is quite a difficult disorder, there definitely is hope

[lbjnltx]

Hi Ready2Bchanged,

I'm glad that you are here asking about treatment options for your adopted d15.  I'm sorry that she is suffering so and engaging in self injury and suicidal thoughts/attempts.  I know this is so very difficult to wrap your head around and deal with.  How old was your d when you adopted her?

My daughter was dx with traits of BPD at age 12 and also engaged in self injury and suicidal ideation, hospitalized once (though there were 2 other times she needed stabilizing and there were no beds available).  She was first dx ODD at 11 and also received the dx of MDD (major depressive disorder) while inpatient.  Does your d15 have any other dx?  RAD? (Reactive Attachment Disorder)

Since the State is involved in placement what are the limitations for RTC placement... .within your state or is out of State an option?

At 13 yrs old we placed our daughter in an RTC in Utah, Falcon Ridge Ranch.  Her therapist there was awesome and the treatment program was a true fit for my daughter.  My d had over 2 years outpatient (DBT mixed with CBT) with little progress so while we had the power to do so we chose long term inpatient care.  It still remains the best choice we made to get her the help she needed.  Over 4 years has passed since she graduated the program and she is still doing very well.

Here is a list of the treatment aspects of the program that she experienced as the most beneficial:

Heavy family involvement and commitment through the entire process

Positive Peer Culture (accountability and support group therapy)

Equine Therapy (on site... .not occasional)

Individual Therapy (CBT and Mindfulness mix)

Program tailored to fit her needs

Peer mentoring

Gender specific RTC

Long term stay (9 months or more)

24/7 therapeutic environment

Transitional aspect before graduation

Behavior Modification programs with Levels don't seem to work well for people with BPD.  The peer accountability carries a lot of weight with teen girls and it is important because peers have our children's ear before all others.

I hope some of this helps you begin to weigh the options you have.  There are hundreds of programs out there... .narrowing it down to 1 was hard and completely necessary.  I resorted to a form I created with a criteria to help weed through them all.  I hope you have many options to choose from as well.

I look forward to hearing back from you and walking by your side as you make these important choices.  We are all here for you.



lbj