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.
 

[CC43]

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

Hi Butterfly,

You've come to the right place.  Many people come here looking for answers and advice, while others seek an outlet for their thoughts and feelings, because living with BPD can be challenging.

When I found out the diagnosis for the pwBPD in my life, I searched the internet to learn more, because I had never heard of BPD.  The first thing I read is that it's treatable.  That was a huge relief to me.  A challenge though is that there's no magic pill, though medications can help with anxiety, depression or other co-existing conditions, which seem to be common.  Medications might help stabilize your daughter, but they don't deal with the underlying issues of overwhelmig emotions, negative thinking, volatile relationships and unstable sense of self.  That's where therapy can really help, provided that your daughter does the work of therapy.  Therein lies the rub:  therapy won't help much unless your daughter actually does the work.

I highlighted an interesting comment from you, which is the observation that the changes in your daughter seemed to happen overnight.  While that could happen, especially if there were a traumatic event or major disappointment in her life (e.g. a first break-up), my sense is that many parents here have observed that their kids have always been wired to be extra-sensitive and potentially "difficult."  Nevertheless, I think that sometimes it's hard to differentiate between what constitutes "normal" teenage behaviors from BPD.  After all, most teens experience super-sized emotions and changing feelings about their identity at some point--I think that sort of thing is part of growing up.  It's perhaps for that reason many doctors won't diagnose BPD until adulthood.  Having said that, I personally wouldn't consider recurrent cutting or suicide attempts as "normal" teenage behavior.  My guess is that your daughter has been a danger to herself or others, in order to land in a residential treatment facility.  That's how the pwBPD in my life ended up, multiple times.  Fortunately for her, she decided to take therapy seriously, and she turned her life around pretty quickly.  Though she still struggles, particularly with interpersonal relationships, her life looks much, much better today than it once did.

Though I imagine you've been through so much and have probably cried your eyes out, I think you have some reasons for hope.  First off, BPD is treatable--therapies like DBT and CBT can help your daughter learn how to handle her big emotions better.  Second, your daughter is very young--she can learn these skills before her negative thinking patterns and emotional reactivity become too ingrained.  She'll be getting some extra support in learning better coping skills and increasing her mental toughness!  I think there should be no shame in that, just as there should be no shame when people seek support to learn better eating habits or get physical therapy.  Third, she has your support.  I believe that the support of a loving parent (such as one who seeks advice here) is invaluable--in fact I think you are your daughter's greatest ally in the treatment journey, even if she says she hates your guts and blames you for everything.  Trust me, that's not her talking, that's BPD.

My advice?  You need to focus on self-care first and foremost.  I know that sounds counter-intuitive, but you are no good to your daughter if you are a basket case with stress and worry.  Right now your daughter needs Calm, Happy, Rational mom, not a stressed-out mess of worry, guilt and exhaustion who can barely function.  Here we call that living in a FOG of fear, obligation and guilt, which clouds our judgment.  You need to focus on self-care so that you can think straight and not get sucked into your daugher's seemingly unending drama.

My other advice?  Think in terms of baby steps.  Changing how someone thinks and behaves typically doesn't happen overnight.  If your daughter's life looks really dysfunctional right now, my advice would be to look for progress in baby steps.  For the pwBPD in my life, the first baby step was probably getting up in the morning and going to bed at a reasonable hour.

All the best to you.