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Author Topic: Is it BPD? What about LENS/TMS?  (Read 428 times)
LMLB
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What is your sexual orientation: Straight
Who in your life has "personality" issues: Child
Relationship status: Married
Posts: 2


« on: January 17, 2022, 01:54:58 PM »

Hello! I'm new here; my 17YO daughter has been having issues for a little over a year. She was initially diagnosed with Generalized Anxiety (we thought perhaps exacerbated by the pandemic, online school, and the sudden loss of her beloved dog), but as time has gone on, she's had increasing problems with depressive episodes.

About two weeks ago her therapist and the psychiatric PA we see for meds consulted and determined that she 'might' have BPD and could benefit from DBT. The psychiatrist agreed, but stopped short of an actual BPD diagnosis. Over the last year we have tried CBT and two different SSRIs, none of which have helped much (the SSRIs quite possibly made her worse). She currently takes meds for anxiety and recently started a mood stabilizer. She has done two stints in PHP and is currently doing IHP. We have a DBT intake appointment this week so are hopeful that this will help, although DD is concerned about the amount of time it will take.

My first question is: How does one know whether it is BPD or something else? She becomes very depressed when triggered (mostly by problems with her SO, who is also unstable), and has thoughts of self-harm and suicide when this happens. She seems to have fear of abandonment (again, primarily with the SO), and experiences 'splitting' to a certain degree, although perhaps not as pronounced as I have read about with BPD. The only emotion that seems to become really intense for her is sadness; she never rages or becomes manic. She is irritable at times, but mostly when she is being forced to do something she'd rather not (school, PHP, IHP). She has mentioned feeling bored, empty and hopeless, and has experienced dissociation (she is on medication for that, too, which has been a double-edged sword--although it has eliminated the dissociation, she now has no way of escaping the emotional pain). So, she seems to have a lot of symptoms of BPD, but no official diagnosis (maybe due to being under 18?), and she does seem to be missing some of the major hallmarks of the disorder (anger, rage, projecting, risky behavior, etc.). Her 'episodes' are definitely cyclical and always seem to happen right before her period; she usually stays 'down' for the duration of her cycle and then improves about the time it stops. She's on BCPs to see if we can help to regulate her that way, but so far it doesn't seem to have done anything and might possibly be making her mood worse (she's only about a week into her 2nd pack of pills).

My other question is about either TMS or Neurofeedback Therapy; if you can share any success stories about your teens who experienced improvement with either of these, I'd love to hear them; also, whether or not you were able to get the treatment covered by insurance.

Sorry so long, thank you for reading!
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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
chinchilla_dad

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What is your sexual orientation: Straight
Who in your life has "personality" issues: Family other
Relationship status: Estranged
Posts: 33


« Reply #1 on: January 17, 2022, 02:31:06 PM »

It's important to remember That all personality disorders Are on the spectrum with varying degrees of severity And borderline in particularly is very complex And often comorbid With many other things That makes diagnosis difficult.  I'm not sure if you were aware of the four subtypes of borderline But my wife ended up having Quiet BPD In which All of the rage and anger That is typically directed outward in A more classical case of borderline Is directed inward at themselves.  Depressive borderline is also like that.  DBT in CBT Do take a lot of time and effort And I have been doing it myself For a little while And have already starting to see results But it's a slow daily grind That takes dedication Which can be Challenging for someone who is unstable  There's nothing else I am aware of That actively targets the cause whereas everything else just treats symptoms.

It does sound At the surface that it could be BPD And her treatment team is going to need timeTo go through differential diagnosisAnd rule out things like Bipolar, Complex PTSD, Major depressive disorder, etc.  And yes, Typically You're not supposed to diagnose Until the person is 18.  I also feel my wife Was worse During her period.  I'm interested to know how your daughter is taking all of this.
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LMLB
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What is your sexual orientation: Straight
Who in your life has "personality" issues: Child
Relationship status: Married
Posts: 2


« Reply #2 on: January 17, 2022, 04:17:27 PM »

Hello, thank you for all the information and for asking about my daughter. She is taking it about as well as can be expected; I think she is at least somewhat hopeful that DBT will help her, but I know that, especially when the intense sadness sets in, it is extremely difficult for her to see the light at the end of the tunnel. She tells me that she feels like she has been this sad 'forever,' and that even if DBT does help, she 'can't wait that long.' I think this is when I see the most marked example of Splitting in her--in those moments, everything is terrible, always has been, and always will be. Those are also the most terrifying moments for me as her mom.

I am glad you have seen some improvement with DBT; I hope we will have similar results!
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chinchilla_dad

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What is your sexual orientation: Straight
Who in your life has "personality" issues: Family other
Relationship status: Estranged
Posts: 33


« Reply #3 on: January 17, 2022, 04:45:05 PM »

Well I hope you were coping well enough as well.  as strange as it sounds Keep your fingers crossed That if she does in fact have borderline that they find Something like Bipolar or another mood disorder because they can at least treat that with meds.
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