Sharing teen's "diagnosis" with her

[Imhermom]

Hi All,
Our 16 year old daughter is almost finished with a great, DBT-focused residential treatment program in Utah. She says it saved her life: she's stopped self-harming and our whole family is doing better communicating. Not to overdo how great things are: we are a work in progress, for sure. My husband and I are still working on our own dynamics and how we contributed to our unhappy family. Our daughter will more than likely be coming home in a few months.

So here's my question: Should we tell our daughter that one of the diagnoses she has received over the past year is BPD? She thinks she is bipolar. She does not identify with BPD: she has told us that having lived in such close proximity with others who have been diagnosed with BPD, she is clear that this diagnosis does not fit her. Thus far, we have just listened when she has discussed her diagnosis. My husband is in favor of using 'radical honesty' and telling her about this diagnosis--he thinks it will help her to deal with her issues and does not want to be dishonest. I have felt that the diagnosis is less important at this age and stage of life--and that the main thing is that we have all been learning DBT skills and working on our own issues. Unfortunately, my daughter has a negative association with what it means to have Borderline Personality Disorder. (It's a long story... .there was someone that was briefly involved in our lives athat was affected by BPD... .and my daughter despises this person and would probably not like to identify with her.) After one psychiatrist gave this diagnosis, I asked my husband to wait and let my daughter just do the work without the label until she's older. He has respected my wishes thus far, but she may have figured things out. One day in Skype Family therapy, she announced quite purposefully that she's bipolar, and does not have BPD. My husband is also getting impatient because he feels that all of this is unnecessary subterfuge.

So what do we do? As we prepare for our daughter to return home, do we put away the BPD books? Do we share honestly with our daughter that BPD is one of the diagnoses that was suggested, among others? My husband favors radical honesty. I'm not sure. My feeling is that if my daughter identifies as bipolar for now, that's her choice at this point. It is not necessarily going to change any of the counseling or ongoing treatment she receives as we will be working with a DBT Family clinic upon her return. On the other hand, now that she's 16, and she is much more stable than she was before going to an RTC, it might be that she could handle this information. Whatever we decide, I want it to be in my daughter's best interest.

Of course, I don't want to be in conflict with my husband about this: but he's agreed to let me check in with her current therapist and clinical director. I also thought I would ask in this forum, and I thank you in advance for your support and advice. Don't worry, I know that ultimately we will make a wise decision.

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

[mybabygirl23]

i personally don't think the labels are as important as the treatment. I realize she is 16 so technically a child, but i would recommend letting her doctor talk to her about these type of issues and as parents we should continue to love and support.

[cbm419]

i personally don't think the labels are as important as the treatment. I realize she is 16 so technically a child, but i would recommend letting her doctor talk to her about these type of issues and as parents we should continue to love and support.

I am not an expert in parenting a BPD but read your story and agree with this. Regardless of whether she is told or not, I wonder if it is received to her by her parents, she may find a way to resent you for either choice. A resentment that could provide an impediment to the whole familiys healing and recovery processs.

 My experience with a BPD partner was a lot of darned if you did darned if you don't.  If I, theoretically, became the messenger deliverer for his diagnosis, he may quickly deny it and shut down on me, and the subject might become taboo and toxic. Would be a major roadblock in our entire relationship, not least of which supporting his treatment.

If I were to not tell him (and keeping this secret would be tough when the BPD traits emerge into acute episodes,  let's be honest), and it ever slipped out, or I supported his active denial of the diagnosis until it was "the right time", I could just as easily have that held against me. And until that right time, having a secret of this magnitude spinning inside the parental unit seems like potential dysfunction in the making. It may deter the parents from employing the tactics and suggestions they are learning to embrace to help their daughter. That is, to somehow covertly support her BPD treatment. I might speculate in current or future group therapy post her inpatient stay, she'll get exposure to overt instances of the parents "subterfuge" and put two an two together.  So making it all work without telling her surely isn't  impossible, but sounds like adding a complicating factor to an already very difficult situation.

The OP already alluded to some concerns on keeping the secret in the parents body language over skype, over hiding their books and I would extrapolate that hiding this site or any digital resources employed ((which teenagers can be sly in monitoring, without question). My BPD partner, while undiagnosed, would be greatly triggered if I ever pushed the topic upon him, tho he was textbook. Once when busy and distracted he was able to paw thru my email and saw I was on this site. By the next day he had read my posts and was LIVID. He was not high functioning - very low in fact. And I was quite good at securing privacy where need be. But like any other human, I was rushing around dealing with an unrelated work matter, and got sloppy. Happens to the best of us!

Just sharing my own experience. as many on this site say, a diagnosis isn't a cure or treatment and mostly a label that guides recovery.

[Imhermom]

Is this the right place to reply to responses? I'm not sure, but I appreciated both perspectives, though they were quite different. It's fodder for further reflection. Thank you so much for taking the time to reply!

[Yepanotherone]

Imhermom, which RTC is your daughter attending in UTAH ?

[Kat816]

Hi there,

I don't think it is important to tell her it's BPD.  The best news is she got help and is on the mend. Why jeopardize this.  Biploar and BPD have some of the same issues and she seems to connect BPD with someone she does not like so she won't put her self in that category.

Yes you want to be honest but sometimes a little white lie makes it easier to hear and deal with.

I wish you all the best for your family and know we all have difficult times. If life were a straight path we would be there in no time without stopping at the bumps in the road to teach and help us learn along the way.

[jellibeans]

My daughter also likes to think she is bipolar... .not sure why that DX is better in her mind but that is her belief. I am not really sure putting a label on it changes anything. I would not go out of my way to tell her but I would be honest if she came to me with questions.

Focus more on treatment and let her therapist and doctor be the one to handle this topic. I just don't know what would be the benefit and how your approach would change by telling her... .I guess is something you can look at. I am glad to hear your daughter is doing so well. You must be happy she will come home in a couple of months.

[livednlearned]

You must be so proud and relieved that she is doing better and your family is healing and working to iron out dynamics in favor of a healthier family. So nice to hear your good news   

It's funny with diagnoses. My son diagnosed himself with depression in middle school after seeing the criteria for it in health class, and was eager to see a psychiatrist/therapist to help him overcome it. But when it came to taking medication, suddenly S15 felt everyone was ganging up on him, and rejected the medication and the labels for the very thing he felt he suffered from.

He has a good psychiatrist who told me this is common and encouraged me to be patient, so I was and eventually S15 came around and now he is taking an active role in his treatment, at least for depression and ADHD.

In terms of your D, I would leave the books where she could find them and maybe add some, like Beyond Borderline -- a series of essays from people who are in stages of recovery. Or Buddha and the Borderline, written by a woman who was dx'd as an adolescent, and even had a CBT therapist who disagreed with the BPD dx. The author went through DBT and characterizes herself as being somewhat different from the "typical BPD" patient who externalizes and rages (she was more of an internalizer). If your D's mind is open, she may see that there are many different ways for BPD to present.

(On a side note, it's so interesting to me that bipolar is considered a preferred dx. I remember how manic-depressive labels were characterized when I was growing up (i.e. crazy), and now it seems almost as normal as depression. I wonder if Carrie Fisher's characterization of it has anything to do with it... .maybe one day the same will be true of BPD).