Challenging Times...Searching for Peace & Basic Compliance with our 14 year old

[MonaLisa4]

Hello.  On good days, our 14 year old started calling me Mona Lisa.  Most days I am just M. 

Our daughter's emotional challenges began in 5th grade.  She is soon to be a 9th grader.

Body image has always played a part.  Early on, we thought she was experiencing anorexia.  Yet, there were inconsistencies.  More behavior related.  Mistakenly we were advised to walk away from anorexia.  Let it disappear.  In those days, it was believed that she exhibited signs of factitious disorder.  The need to be "anorexic" or to have a "concussion", which surfaced next.

That school year, she qualified for a 504, which helped us get a McKay Scholarship for 6th at a small Catholic School.  Our therapist at the time told us to focus on the social, which again backfired.  It gave our daughter a way out of academics.  Her academic work effort hasn't been the same since 4th grade.

At the new school, her histrionic tendencies surfaced.  The positive attention of being the new kid kept her flying at first.  She made the Cross Country team, switch to the JV basketball team, joined the Chorus, and landed a spot in the school musical.

Somewhere that fall, when normalcy set in, she didn't get the lead part that only 8th graders typically get, the excitement of her 12th birthday ended, the attention seeking turned to threats of self harm.  She was trying to choke herself with her hands.  When it was necessary to bring the therapist into a meeting, for our daughter was taking up to much Admin and teacher time, she reached out to the student population and girls started to get very upset, which stirred up parents.  It was necessary to try medication.  Prozac was the start.  We kept her home for 2 weeks, but it wasn't enough time.  She wasn't ready to go back to school, so we had to give up the scholarship.

We tried a co-op at a local Church.  Our daughter was responding to a new therapist who was guiding her on thinking and she was effectively using the right words.  Just as she made a big leap of fitting in, she was booted out.  Some ridiculous story.  Our guess is that the Church found out about her past at the private school from someone in the community.  My husband worked from home and had our daughter home school and travel with him as necessary for his business.

During the summer leading up to 7th grade, our daughter's behavior drastically changed.   She stole jewelry and money from a neighbor, clothing and money from her big sis, and was more impulsive in nature.  A recommendation for a new psych report led to the belief that she exhibited signs of bipolar 1.  We got a 2nd opinion that felt it was the bipolar 1 and borderline.

Our first trip to Wolfson's ER coincided with the 2nd opinion results.  We had tried to return to our public home school, and the self harm began again, which led to crisis team calls.  Our daughter's first hospital stay as a transition to abilify began ended up being a good two weeks.  By Thanksgiving she had been bakeracted and had another Wolfon's stay.  She was refusing to go back to her old school, which led us to the middle school by my elementary school at the time.  Our daughter went straight from the hospital to the new school.  Received an IEP that day and direct entry to their school's behavior unit.

7th and 8th grade were intensely rough years with far too many hospitalization.  The final hospitalization was in a DBT treatment program in GA.  6 weeks residential/3 weeks day program.

As our daughter returned this past Thanksgiving, she wouldn't return to the behavior unit.  We tried to find another way, yet it was the only way to move forward.  So this past January, she faced it and made progress.  She was able to keep it together at school and joined a local youth Chorus.

Then corona hit.  She was released from the behavior unit, and was accepted to a Communications Academy close to us for high school.

Corona has been hard for every teenager but it's getting increasingly more complicated.  No matter the efforts we make, my husband and I are seen as the enemies

We are concerned about her body image once again.  Her energy is fully focused on her appearance and needing to be "perfect."  Her eating habits and hydration are out of sink.  With being on lithium, we have been watching her levels to make sure she isn't reaching toxicity.   We had an EKG done on her this past week and have a follow up with a cardio doctor tomorrow.  She has been experiencing chest pains and her anxiety is super high. 

We can never seem to get the medication right, and we are dealing with a lot of behavior.  Her age is a trigger word.  She hates being 14.  Thinks of herself more as a late teen or in her 20's.  She tries to dress in provocative clothing and has begun cutting her shirts.  Asking her to change is not accepted.

Finding some common ground and basic rules is challenging.  We are working with a team of doctors and therapists.  We are inquiring about EMDR, for we feel like something must have happened when she was in residential or with a boy on social media.  Words like babe and daddy are viewed only in a sexual context in her mind. 

We feel like we are losing the fight.  We have at least 5 weeks before high school starts.  We have an older high school daughter as well, who we want to protect her junior/senior years.  Our youngest daughter will either come to the high school with the communications academy where I am now teaching or our older daughter's school.

Achieving a basic compliance is essential.  Sorry to be so long winded.  If anyone has any ideas, please know I am grateful.  We are maxing out medical bills and getting nowhere.  High school has the potential to be a great change for our youngest, but she holds strongly to the belief that nothing can help her. 

Thanks for your time.

MonaLisa4

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

[FaintTheGoat]

I’m so sorry you and your family are struggling through this.

My ddwBPD is 16, and since her symptomatic behavior didn’t fully emerge and become harmful (and self-harmful) until she was 14 - but looking back there were probably tendencies I just didn’t recognize.

I’m in no way in a position to provide clear guidance for you, and in fact am only back on the BPDFamily message board because I need help and support from this community as our and her struggles have continued and previously effective approaches are not really helping.

When we first started hearing “BPD” it was after misdiagnoses including bipolar, depression, ptsd, and anxiety. It took countless self harm incidents, eventually  identifying dozens of bizarre Karpman triangle narratives from her, three suicide attempts and hospitalizations, and two RTCs before we finally had clarity that the pattern indicated BPD - and then we struggled to understand how treatment (and our family’s interactions with her) needed to vary for BPD compared to bipolar or anxiety.

After consuming as much material as humanly possible and being inquisitive with treating professionals, I still don’t feel confident that there’s a solid tool kit for parents of teens with BPD. There is a ton of literature for those with the diagnosis, but it’s really a tricky spot as a parent, when your key responsibilities include keeping your child safe, setting and reinforcing boundaries and rules, instilling a sense of care and respect for self and others. Man, it’s hard.

Then you couple the perception that parental abuse or neglect is a causal factor for BPD- it’s doubly hard.

Daniel Lobel’s book “When Your Daughter Has BPD” helped the lights come on for me. I found it after reading “Stop Walking On Eggshells,” “I Hate You! Don’t Leave Me” and as much material as I could find. Lobel’s book made me not feel crazy after months of not understanding why everything we and professionals were trying wasn’t working. So many of the vignettes seemed very familiar.

I encourage you to read that book if you haven’t, and be kind to yourself. This message board can really be a great source of support and anecdotal information from other parents- which I’ve found, in the absence of much more formal sources of parental guidance for those managing with teens with BPD - it’s a big help.

The big light bulb for me throughout Lobel’s book - which I soon started hearing from psychiatrists and mental health professionals familiar with BPD - was that it’s behavioral. No medication cocktail or amount of medication will cure BPD. My daughter has been in DBT, and we’ve essentially worked on some key Approaches that seem to help - validate the valid (but not the invalid) - use “SET” (especially when she is frustrated or angry or upset - Clarifying to her that she always had my SUPPORT, and that I won’t support choices or behavior that’s harmful; expressing EMPATHY for her emotions and acknowledging that she’s entitled to feel any emotions and that she meanwhile isn’t entitled to act out on those emotions in harmful ways; and communicated that I TRUST her to resolve the problems she is confronting and manage those emotions safely and responsibly and within appropriate boundaries).

I’ll be thinking of you and your family and praying for you all.