I think my 23 year old daughter has undiagnosed BPD

[WatsonCM]

When my daughter was young my husband and I noticed she had some issues.  She would fly off in a rage at around 8 or 9 years old and wouldn't back down.  If the t.v. was on when she went to bed she would scream at us to turn it down even though you could hardly hear it.  If you were chewing gum she would yell at you to spit it out.  She couldn't tolerate certain things.  We would even trick her with the t.v. volume off to see if she still complained about the noise and she would.  She had problems with all of her friends they were always being mean to her according to her.  We tried everything to stop her behaviour from counsellors to books. Nothing worked.  By the time she was a teen it got much worse.  She would want something and if told no then would scream at me for literally hours trying to get her way.  This would happen a few times a week.  At first I would argue back and ground her or take privileges away but it never worked.  Finally I just stopped responding to her when she was like this.  It drove her crazy that I wouldn't engage.  It was the only way I could cope.  When we went to counselling she was very good at snowing the counsellor so needless to say they never fully saw the extent of the problem.  As an adult she has been diagnosed with anxiety.  Although she does have the anxiety disorder I don't think that is the only problem.  I think she has had BPD since childhood that was not treated which led to anxiety.  The hard part for me is that she depends heavily on me for support but I have to be really careful that I don't say the wrong thing to her or she will go off on me.  It is getting exhausting.  She is on medication but the medication is making her incredibly tired and has contributed to her gaining almost 100lbs.  She has PCOS on top of this and is on medication for that.  Now the doctor wants to put her on more medication for her weight.  She isn't taking any responsibility for her own health.  Her doctors are not coordinating her treatment and looking at her whole being.   If I were to say anything I am being a bad parent.  It's getting really hard to maintain this fake relationship with her.  It's turning into a superficial relationship where she can say what she wants but I can't.  Anyways that's the basics of my dilemma. It's a viscous cycle.   

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

[Sancho]

Hi WatsonCM and glad you have posted here. There are some things that really do tick the bpd box - especially the not being able to take 'no' for an answer. The inflexibility of the BPD mind just can't accommodate anything other than what they are processing.

But without a diagnosis it can be difficult. For example you mention the 'noise' issue when she was young. A relative of mine who has always been easily irritated by things such as people  breathing etc found out the other day she has a condition called 'Misophonia'. This illness is quite debilitating because the normal range of sounds is so irritating. My relative struggles with friendships, workplace environment etc, and this diagnosis has really explained a lot of things.

There are other sensory processing problems too that are often 'hidden disabilities' - that is, we don't see them, only the behaviour that is generated by the difficulties with the internal processing.

My dd was hospitalised a couple of times and put on drugs that caused extreme weight gain. While she definitely was diagnosed with BPD - and she certainly ticks the boxes there - I think they missed ADHD and if she had been treated for that her story would have been different - maybe?

Having read your post a couple of times, the thing that stands out is the early history to do with sound irritation. It is very specific and I think worth a focus of investigation.

Is there a way you can get this investigated?

[WatsonCM]

I don't know that it would be possible.  As she is an adult, she won't let me be a part of her treatment.  She has her councillor wrapped around her finger.  The counsellor doesn't challenge her to cognitively try and help herself.  The counsellor enables her to use excuses of why she doesn't have to try.  She is only getting a biased take on what is going on with her.  There is so much back story to her condition and my daughter is not looking within herself for the causes of her illness but trying desperately to place blame with others.  It's almost to the point where she won't even talk to me about whats going on.  For instance the medication is making her gain the weight but she also won't alter her lousy eating habits or be more active to counter balance the effect of the medication.  Because of the weight gain she has PCOS.  The only way to alleviate PCOS is to keep your weight in check.  Now she is on medication to prevent diabetes.  Also the doctor wants to put her on weight loss medication.  I'm not saying she should be a skinny little thing.  Only to try a holistic approach of a healthy lifestyle to try and manage things without drugs.   Her anti depressants make her tired all of the time.  Everyone is saying that its fine for her to sleep 3 hours a day.  How about changing medication and or doctors to see if there is a better way.  She is a great kid.  She is a full time college student, straight A's all her life and just generally a beautiful person.  It's sad because with the right help and diagnosis I think she could do a lot better.  I even contemplated contacting her councillor and telling her of my thoughts.  But that would be such a breach of trust in my daughters eyes.  I think the only thing I can do at this point is learn to set boundaries with her and not allow myself to live her mental illness.   It's hard because she is only 23...still a child but not if you know what I mean.  I wish this had of all come down while still a minor.  At least I could have made sure she was getting the proper help.  It's hard to see her go through this.  She doesn't want to take responsibility for her conditions..take a pill for what ever ails you and call it a day.  Even though the medication seems to be exacerbating her condition.   I get it that she may have to stay on medication her whole life but at least try to mitigate the effects of it.  All of this while walking on eggshells when talking to her.  I can't ever say how I feel unless I say exactly the right thing.  Otherwise I'm a terrible mother.  It's difficult dealing with this type of illness.  You are always worried about saying the wrong thing and setting her off.  It's exhausting.

I just looked up Misophonia and it could have been an issue when she was young.  But it doesn't explain the hours long rages she would go on and the problems with friends.  I think there could have been a few things going on for sure.  Any of the counsellors we tried therapy with didn't think she had a problem.  Just normal parents trying to raise their kids.  I don't think they believed my husband and I on how bad things really were.  All they ever suggested is time outs etc.  It was incredibly disruptive when she was raging, to the point that we couldn't go on holidays much because of her outbursts.  We even had neighbours who came to the door to see if she was being abused.  Meanwhile we would be outside in the back as she was carrying with her rage in her room.  It was a crazy time.  I think though under the circumstances we did pretty good with her.  For the most part we managed to give both our daughters a pretty stable and loving upbringing.   When she was diagnosed with anxiety she had had a few very bad panic attacks.  They didn't take a history or do a physical or any counselling first they just put her on drugs.  They have never been interested in getting a family history or even a physical history.  Her GP, counsellor, psychiatrist, and gynecologist have never worked together on a health plan for her. I they should be and being that she was so young when the panic attacks happened I think they should have involved the family to get an accurate history.

[BrokenMomof3]

That sounds a lot like my daughter. My 26 yo daughter would cry at the top of her lungs as an infant if I tried bottle. She would latch on my breast every hour literally for 9 months. She had separation anxiety from her dad too. Later in her pre-teens she had similar issues with the friends. She was left with none by her 16th bday. She was diagnosed with depression and anxiety, when she first started telling that she has something on her nose. She believed there was a bird in her bed too. Anyway the depression medication kept her going. Her behavior was so bad (totally opposite to her upbringing) so we tried to get her off the meds. She had an episode.  Then with the help of meds she completed her undergrad.

She worked for 2 years. She began to complain about her dad's voice during the Covid. So it became impossible to keep her  at home.  So she went to grad school 50 mi away from home. Just then she was diagnosed with OCD, when she started obsessing about her body hair. The new med for OCD again put her in psych ward. She was diagnosed with MDD this time. Psychotic drugs got her out of this mess and she was back at school with old depression med.

Now the third time she has decided to get off the depression medication. She is now being delusional, convinced that her younger sister is dead.

Her head strong behavior, fits, rages, name calling etc points to the BPD but her delusions point to the MDD. She seems to be functional otherwise.

I can really use some help, if someone can guide me what to make of it and how to talk to my adult daughter to seek help.

[Sancho]

Your response and the reply above highlight just how difficult, how frustrating and painful it is to try to help adult children with these conditions.

The clinicians see how children for short periods of time. They respond to the answers they are given. (I don't know but I suspect that many clinicians don't have any experience of sharing life with a person with one of these conditions).

We know our children because our life journey has been with them. We can observe the effects on their day to day life of medication etc and we know how they can distort the facts of that journey.

It is normal for children to separate from parents and to be able to interact with health professionals on their own. But our children often lack the rational capacity to do this and are acting/speaking through the nature of their illness.

I think the following statement you made is really important:

I think the only thing I can do at this point is learn to set boundaries with her and not allow myself to live her mental illness.

I can't agree more. Also my experience is that when I stepped back, accepted I could not do more, dd eventually came to relate to me in a better way (a lot of the time; I mean I still get the abuse etc, but I don't take in on board - most of the time!)

It is worth remembering that many people with BPD experience a lessening of symptoms in their 30s. Your dd has a lot going for her and she could come through this in the long term.

It is really, really difficult to see all this happen, but you have done everything you can and there is not a way - at this point in time - that you can have input. Your love will be there - and it might be what makes the difference in the long term.

[WatsonCM]

I agree so much.  I think the most important thing for parents is to take care of our own mental health.  If we aren't stable we won't be any help to our kids.  We can't fix this we can only support them.  But it's a fine line between support and enable.  I've been enabling my daughter I fully admit this.  This was my breaking point.  I think in a round about way these kids have the motto "misery loves company"...maybe not consciously or maliciously...but with their twisted thinking they want to pull you into their illness.  That's not good.  It's for their professionals to deal with the process of fixing them.  I think we get lost in the role of parents..not knowing how to make things better.  But we don't have the expertise to do this.  I'm recognizing my boundaries and limitations as a non professional in her life.  If she wants my help I will try and point her towards people that can help her.  But until she asks for that help it's up to her.  They are adults and ultimately are responsible for their own lives.  This has been really hard to get to this point. I am a fixer by nature .  It's been and will continue to be hard for me to let go but I'm trying.