Mother looking for advice ...

[ButterflyBaby]

I've never really posted in a forum before, so excuse if my thoughts are a bit scattered.

My daughter began showing BPD traits over a year ago. She is currently 15. In the beginning, every medical professional we met with diagnosed her with bipolar disorder. She began therapy and medications immediately. After a year of changing therapy, changing medications (many times) and a PHP program, I had to make the choice and send her to a residential treatment facility. She spent 60 days there. During that time the on call psychiatrist agreed that she was misdiagnosed and was not bipolar, but had BPD. She would not formally diagnosis her because of her age. Fast forward to today and she is currently doing and IOP program and I have been told the same thing, "We agree she has BPD but we won't label her at this age". Unfortunatly the IOP is not working and it looks as though she will need to go back into residential treatment.

My question is, are there any parents whose children have been given this diagnosis during the teen years (or younger) and did it make any difference in the treatment they received? Nothing seems to be helping her and I don't know if medical personal would take a different approach if she were properly diagnosed.

I just feel like my child is a completely different person these days.  And it happened what seems like overnight.

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

[Pook075]

Hello and welcome to the family.  I'm so sorry you're going through this and I'm going to try to be brief here.  I went through the exact same thing with my daughter, who's now 27.  She was first diagnosed bipolar and it switched to BPD. 

A criteria of being diagnosed BPD/NPD is that you're 18 years old.  Why?  Because sometimes, kids can grow out of it and doctor's don't want a life-long diagnosis if it's not necessary.  Once it's on your chart, it's almost impossible to remove.  So doctors and psychiatrists are very careful what they actually place into writing for minors.  Bipolar doesn't have that same criteria though, so it can be diagnosed at any age.

For what it's worth, my kid is diagnosed BPD/Bipolar/ADD.  I don't know if I agree but in the grand scheme of things, it actually doesn't matter.  Here's why.

You mentoned that the treatment hasn't worked, which means you're looking at this like the flu or a broken arm.  For that stuff, there's logical steps to get the patient better.  Take the meds, get some rest, eat a balanced diet and waalaa...the patient is cured.

For mental illness, it takes complete buy-in from the patient to actively change.  You have a rebellous teen who's mentally ill, who likely resents you and resents her care team even more.  Of course she's not getting better, she's not trying to get better because she sees "the problem" as all the people who's telling her what to do.  Until she actually realizes that the problem is inside her, the best therapists in the world aren't going to make a bit of difference.

My kid was particularly stubborn and it took a series of terrible choices for her to finally realize that she needed to change.  That happened when she was 23 and both her partner and her best friend cut her off.  They were right in doing so, my kid did them both wrong and got caught doing it.  But it was devestating and she was suicidal for weeks.

This might sound horrible, but betraying the friends and having her heart ripped out was the best thing that ever happened to her in life.  That was the thing that actually made her realize, "Hey, I destroyed both these relationships because of what I said and how I acted."  She had nobody to blame but herself, and it was the first time she actually started working in therapy.  Within 12 months, she was a different person entirely.

My kid is still mentally ill and she still has bad days.  She has learned to manage it though and let go of those deep, dark thoughts that send her spiraling.  She also understands relationships a lot better now and how to treat people; especially those she's close to that do a lot for her.

I've lied, I didn't keep this short after all.  But I wanted to give you the full picture of the path your kid is on.  Medicine can help somewhat and therapy let's her get out some emotions.  Those are surface-level fixes to a much deeper issue though.  It's like taking Tylenol for a broken arm- maybe it helps with the pain for an hour or two, but the problem remains.  More Tylenol doesn't fix anything.  Dealing with the root problem does.

One last thing.  As a parent, you'll try working harder than your child to "fix her."  You'll think, "If I just tell her enough times, she'll get the picture and this will all work out."  But that's only pushing her further away because she feels like you don't understand her and are rejecting her.  There's so much more we can talk about, but know as an intro that this is not your fault, you can't fix this, and you're going to learn quite a bit about affirmation and boundaries while you're here.

Please ask the tough questions or let us know where we can specifically help.  Again, my heart breaks for you!

[Notwendy]

Did a diagnosis of BPD make any difference in the treatment they received? Nothing seems to be helping her and I don't know if medical personal would take a different approach if she were properly diagnosed.

I just feel like my child is a completely different person these days.  And it happened what seems like overnight.

I think a main question is- if they officially diagnosed BPD- would it lead to specific treatment that could be more effective?

Note- we are all lay people here with our own experiences, so these are not professional opionions. I think you know that but I wanted to make this disclaimer.

There isn't a specific medicine for BPD. Medicine can be used to help some associated symptoms. In the case of my BPD mother, she took medicine for anxiety- and so "anxiety" was the diagnosis on her chart. Her medical team was aware of her BPD, but as a diagnosis, it would not have changed the choice of medicine to treat her because there isn't a BPD medicine.

There are certain therapies that have helped pwBPD and other disorders. DBT is one of them. If there is a history of trauma, then EMDR helps with that. However, in a 15 year old, how much of her cognitive and emotional development at 15 to work with these therapies is a part of the decision. If there's a history of trauma, she may be too young for EMDR. So the benefit of having BPD on her chart may be lessened if she's too young for full participation in these therapies.

They may also feel she's too young for this diagnosis to be official on the chart, since she's still maturing. The therapists can be aware of it, without it being on her chart yet. Since she's young, they may be incorporating therapies into age appropriate approaches with her.

With a sudden change in her behavior, I assume they have looked for and ruled out other causes, medical, events that cause emotional trauma, bullying, abuse, and substances. This isn't to blame parents- even with good parenting and monitoring, kids today can be exposed to the internet, cyberbullying, through peers. Sometimes none of these are factors, but I assume they've looked at these to rule them out.

Since she is a minor, I also assume her treatment plan includes family therapy and meeting with you as parents. If BPD is being considered, you can go ahead and learn about it without having a definite diagnosis at this time. It can help to have your own personal therapist for support as you navigate this situation.