When all motivation is gone

[MidnightRunner]

My story in a nutshell: 14-year-old DD has been struggling with chronic suicidality and depression for over 6 months. She has been in and out of inpatient hospitals, day treatment programs, IOPs, and has a team of therapists working with her to try to get at the "root" of her distress. She either lacks the introspection to examine the root of her misery or she is, as she claims, simply "born this way." Next week she is scheduled to start cyber school and next month, a long-term DBT course. But she simply has no motivation to get better. She has admitted as such. She has stopped caring about her appearance or schoolwork and she answers, "I don't care" to virtually anything anyone says. The only saving grace is that she does have great friends whom she keeps in touch with and sees on the weekends. She also loves music and animals and we're doing our best to get her involved in activities that revolve around these interests. She has moments where she seems like her old self. But the moments are usually short-lived.

So where do we go from here? How do you move forward when your child is stuck and simply doesn't care to get better? My husband and I have discussed residential treatment. He is not for it and neither is our DD's therapist. I have mixed feelings about it. But I certainly don't want to invest thousands of dollars in RTC if my daughter doesn't have any motivation to get well. I don't think that simply being in RTC automatically makes you better. Our daughter also doesn't want to go to RTC. She wants to be home. But she also feels that she is "holding on" to a life that she has no interest in living. I'm just so heartbroken. I feel like every avenue we pursue takes us back to the same hopeless place.

Tomorrow we will be meeting with her psyD. I don't know whether it's worth discussing treatments such as TMS or ECT... .has anyone else had success with these treatments? I feel like if we could just dial down the level of crisis in her mind we'd have a better chance of DBT making some real inroads with her. Her primary therapist also thinks that we should develop an agenda for her that carves out time every day for certain activities like playing piano, getting outside, doing schoolwork, etc. She will not motivate herself to do anything so he feels some structure needs to be put in place.

I know I'm all over the board with my thoughts here but I figured I'd throw out what's running through my head and see what sticks. Thanks for listening.

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

[JustYouWait]

MidnightRunner -

I feel your pain.  We have a similar situation with our DD18, recently diagnosed BPD.  In and out of hospitals, self-harm, etc., etc., the whole gamut.

We currently have her in a RT Center, hoping it works.  We were at the end of our ropes, and felt sure that even though she didn't want to go, the other choice was her inevitable death.  I apologize for being so blunt, but that's what I, her stepmother, her bio-mom, and stepfather all agreed upon, as did her therapist, additional therapists, and every single doctor who treated her over the last 2 years.

My situation seems slightly different than yours in that the parenting team and the professional care team were all on the same page.

May I ask why your DH isn't on board?

Cost certainly is a massive factor, especially considering that there are no guarantees. 

Also, welcome here.  You are NOT alone.

[MidnightRunner]

Thanks for your response, JustYouWait. The feeling right now among her treatment team and us, her parents, is that we have a plan for moving forward (with cyber school + DBT) that we haven't even started yet so we don't want to jump to RTC without at least giving the plan a fair shot. Plus our DD is kind of all over the board emotionally. There are times when she's much more stable and a bit more optimistic. The hope is that with some changes in her treatment approach we might be able to build on that stability. Who knows? Everything about children with BPD is so unpredictable that I have no preconceived notions that our plan will work. Still, we feel we want to exhaust every option before making the decision to send her  to RTC, which would require sending her out of state. The financial commitment (to say nothing of the emotional toll) would be huge and it's not something we would want to undertake if she hasn't bought into the idea of wanting to get better. There are no easy answers here. Just hopeful watching and waiting. Thanks for your response.

[JustYouWait]

Thanks for your response, JustYouWait. The feeling right now among her treatment team and us, her parents, is that we have a plan for moving forward (with cyber school + DBT) that we haven't even started yet so we don't want to jump to RTC without at least giving the plan a fair shot. Plus our DD is kind of all over the board emotionally. There are times when she's much more stable and a bit more optimistic. The hope is that with some changes in her treatment approach we might be able to build on that stability. Who knows? Everything about children with BPD is so unpredictable that I have no preconceived notions that our plan will work. Still, we feel we want to exhaust every option before making the decision to send her  to RTC, which would require sending her out of state. The financial commitment (to say nothing of the emotional toll) would be huge and it's not something we would want to undertake if she hasn't bought into the idea of wanting to get better. There are no easy answers here. Just hopeful watching and waiting. Thanks for your response.

Everything you say is true.

Also, this quote:

"Plus our DD is kind of all over the board emotionally. There are times when she's much more stable and a bit more optimistic."

Yup, sounds like BPD.  We have that, as well.

I hope this works for you and your daughter.  DBT helps a lot of BPD people. 

Keep posting here.  You are not alone.