granddaughter has just been diagnosed with possible BPD

[nanof2]

Hello,  my granddaughter who is 15 has just been diagnosed with BPD.  She came to live with us at the age of 8, her dad (my son) has mental health issues and we believe he was mentally abusive. Her mom abandoned her at 2 1/2 and has been in and out of her life, until last June when she told my granddaughter she no longer considers her, her daughter and wants nothing more to do with her. We are struggling through self harming, suicidal attempts, threats, etc.  To say we are walking on egg shells all the time is an understatement.  My nerves are shot, my anxiety is at an all time high. 
Just last night she was standing talking to me and i went to rub her back and she shrugged me off, okay, she doesn't want to be touched right now, i'm okay with that, my husband walked by and hip bumped her, and she huffed and gave him a dirty look.  He looks and says 'sorry" I said to him, " she doesn't want to be touched right now"  what she heard was me laughing at her and sarcastically saying " she doesn't want to be touched" she stomped off and I called her back and she ignored me.  I know when she gets like this i need to leave her be for a while.  I will text her to see how she is doing.  If she responds i know I'm good to go and see her up in her room.  So i sent her a text, no response, i sent her another one later letting her know her medication is in a cup on the counter, (because she can no longer be trusted with her meds) and still no response.  So i didn't sleep well worrying she wouldn't take her medication out of spite.  Missing one dose might not be a big deal but i don't know that for sure.  By this morning I'm a little mad and stressed because watching what i constantly say is extremely tiring.  She get's up and you never know what kind of mood she will be in so i don't say anything until i can figure it out.  Then she is texting me from school, asking me what my problem is?   From things I've read i can't very well say she is being over sensitive and needs to learn to take a joke.  So i tell her I'm having a bad day (because one wrong word from me and she will have a meltdown at school and every day is filled with stress waiting for that phone call from school).  She then calls me a liar and says she knows I'm angry at her and she would like to know why.  I keep telling her it's nothing, then the phone calls come, she's crying and asking why I'm upset with her, and she doesn't understand why when all she was telling me was she didn't want to be touched right then and there.  So now I'm trying to talk her down, and tell her i know she didn't want to be touched and I'm okay with that, her body, her choice, i was just letting her Papa know not to hip bump her because she didn't want to be touched, then she wants to know again why I'm so upset with her, she keeps asking over and over to the point i finally say, it's because i don't know what to say to you anymore.
Everything i say she takes to heart and is upset, so i find it easier not to say anything.  Then she says fine don't talk to me then, i have to go to class and she hangs up.  Now I'm left here feeling like the worse person, because again I've said the wrong thing, i worry she will self harm, and go into a depression when we have had 3 good days in a row, might not sound like much but when just after Christmas my days and weekends were spent running her back and forth to the hospital almost everyday.  To say I'm exhausted is an understatement and I'm so stressed it's affecting my work and sleep.  Everything i have read says not to take it personally, but it's so hard when I'm the one person who has always been there for her, I'm the one she comes to for comfort and I'm the one that takes her abuse. 
I'm at a loss and I've read so many self help articles, my head spins.  Is it just me or does everyone feel like this.
Sorry if the font is big, i couldn't figure out how to make it smaller.

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

[nanof2]

Hello,  my granddaughter who is 15 has just been diagnosed with BPD.  She came to live with us at the age of 8, her dad (my son) has mental health issues and we believe he was mentally abusive. Her mom abandoned her at 2 1/2 and has been in and out of her life, until last June when she told my granddaughter she no longer considers her, her daughter and wants nothing more to do with her. We are struggling through self harming, suicidal attempts, threats, etc.  To say we are walking on egg shells all the time is an understatement.  My nerves are shot, my anxiety is at an all time high. 
Just last night she was standing talking to me and i went to rub her back and she shrugged me off, okay, she doesn't want to be touched right now, i'm okay with that, my husband walked by and hip bumped her, and she huffed and gave him a dirty look.  He looks and says 'sorry" I said to him, " she doesn't want to be touched right now"  what she heard was me laughing at her and sarcastically saying " she doesn't want to be touched" she stomped off and I called her back and she ignored me.  I know when she gets like this i need to leave her be for a while.  I will text her to see how she is doing.  If she responds i know I'm good to go and see her up in her room.  So i sent her a text, no response, i sent her another one later letting her know her medication is in a cup on the counter, (because she can no longer be trusted with her meds) and still no response.  So i didn't sleep well worrying she wouldn't take her medication out of spite.  Missing one dose might not be a big deal but i don't know that for sure.  By this morning I'm a little mad and stressed because watching what i constantly say is extremely tiring.  She get's up and you never know what kind of mood she will be in so i don't say anything until i can figure it out.  Then she is texting me from school, asking me what my problem is?   From things I've read i can't very well say she is being over sensitive and needs to learn to take a joke.  So i tell her I'm having a bad day (because one wrong word from me and she will have a meltdown at school and every day is filled with stress waiting for that phone call from school).  She then calls me a liar and says she knows I'm angry at her and she would like to know why.  I keep telling her it's nothing, then the phone calls come, she's crying and asking why I'm upset with her, and she doesn't understand why when all she was telling me was she didn't want to be touched right then and there.  So now I'm trying to talk her down, and tell her i know she didn't want to be touched and I'm okay with that, her body, her choice, i was just letting her Papa know not to hip bump her because she didn't want to be touched, then she wants to know again why I'm so upset with her, she keeps asking over and over to the point i finally say, it's because i don't know what to say to you anymore.
Everything i say she takes to heart and is upset, so i find it easier not to say anything.  Then she says fine don't talk to me then, i have to go to class and she hangs up.  Now I'm left here feeling like the worse person, because again I've said the wrong thing, i worry she will self harm, and go into a depression when we have had 3 good days in a row, might not sound like much but when just after Christmas my days and weekends were spent running her back and forth to the hospital almost everyday.  To say I'm exhausted is an understatement and I'm so stressed it's affecting my work and sleep.  Everything i have read says not to take it personally, but it's so hard when I'm the one person who has always been there for her, I'm the one she comes to for comfort and I'm the one that takes her abuse. 
I'm at a loss and I've read so many self help articles, my head spins.  Is it just me or does everyone feel like this.
Sorry if the font is big, i couldn't figure out how to make it smaller.

I guess my question is how to deal with the sudden mood changes loving one minute, raging the next then all apologetic after that. 

[livednlearned]

Hi nanof2,

What a loving person you are, and so kind. I'm touched by how big your heart is, and your GD is lucky to have you in her life.

I've read that caregiver burnout for BPD carers is among some of the highest, even compared to family members with dementia. Not taking things personally is different than feeling overwhelmed by confusing behaviors and how relentless they can feel.

When my stepdaughter came to live with us at 19 the best word I could find to describe her is relentless. I can only imagine what it is like to be her.

Are the medications for mood stabilization? It seems positive that your granddaughter received a dx for BPD, since not all clinicians will diagnose it in teens. Does she accept her diagnosis?

A book I found really helpful in understanding SD26 was Loving Someone with BPD by Shari Manning. There are some good strategies and skills in there for commonly occurring BPD behaviors. I also found Buddha and the Borderline (a memoir written by someone who has BPD) helped me make sense of SD26 a bit better. Together those books gave me an aha moment. I realized that SD26 regulates her emotions through other people. And she doesn't seem to have naturally occurring boundaries so I had to learn to build those into our relationship.

Do you think the school where she is understands her special needs? We've had members on this board whose teens had accommodations to help them with mood regulation and if there are sensory issues, accommodations for those too. Or are they treating her like a regular student with behavioral issues?

[nanof2]

Hi livednlearne,
Thank you for your kind words.  I might need to back up, her psychiatrist feels she is bipolar with BPD traits but on the high scale of BPD,  nobody is willing to give her a clear diagnoses due to her age.  My GD has always been an answers type of kid and not having a straight answer bothers her.  She thinks she can never live a normal life, i asked her to define normal.. .. She has tremendous support at school, she is especially close to her guidance counselor at school, to the point my GD doesn’t believe what I tell her regarding certain things Ive found out or researched but if her counselor tells her then it is like the gospel.  I can tell her the sky is blue and she will tell me i dont know what im talking about, once her counsellor does then it’s true.  She runs hot and cold to extremes.  I have to stop and really think about what im saying to her because one wrong word and we have a meltdown.  She has had a few hospital stays to have a break, they were initiated by her psychiatrist.  Last Sunday night was the first night i have had a full nights sleep since well before Christmas as she was in a good head space but yesterday down we go.  Ive learned to bite my tongue and not engage when she feels like arguing.  When she says very hurtful things to the point i feel like crying i walk away, go in my bedroom and close the door.  Then later on or the next day she wants to snuggle and says shes sorry and doesn't know why she said those things.  She says she can see and feel her self doing it but cant seem to stop herself.  To say I’m  on a mental rollercoaster is an understatement.

She is medicated,  she is on an anti-depressant and a mood stabilizer .  She takes them at night because for 5 weeks she wasn’t sleeping she was maybe getting 2 hrs all night every night.  She was suicidal all she did was think about it and the different ways.  She said the only thing that stopped her was knowing how sad i would be if she did it.  She has just had her first session with a mental health therapist, so I’m hoping in time this will help.  Im glad she is getting the help and support she needs but i feel everyone forgets about me.  Ive looked for maybe a support group in my community hut there is nothing.  I don't know a lot if people where i am as we have only been here a year, but I’ve still thought of maybe trying to get one started. My therapist said she cant believe there isnt already one because there are a lot of kids with mental health and the parents could probably use the help. 

My exhaustion is so extreme its hard to focus at work and day to day.  Now that she is going in a low ill be checking on her a couple times a night to make sure she is okay. She didnt self harm for 10 days and then yesterday she did.  I think with the pressure if exams and assignments it did her in.  So I’m back to checking her room everyday and confiscating everything.  Ive heard so much advice on that i don't know which way to turn. Some say don't take it all some say lock everything up.  She no longer has access to meds so we are safe there. 

I wish there was a right answer to all this, but that would be too easy

[livednlearned]

I wondered about the dx only because there is such reluctance for psychiatrists to evaluate for BPD in the teen years, although apparently that is changing.

I'm starting to understand why psychiatrists might wait. My stepdaughter (26) was recently diagnosed autistic after getting bits and pieces of different diagnoses including bipolar, psychotic depression and of course anxiety. Her stress at 16 was extreme enough to cause auditory hallucinations reported by teachers.

SD26's brother is autistic but he presents in such a different way that everyone overlooked it in SD26. A year ago her new psychiatrist told her she didn't meet the criteria for bipolar, and she worked with the second of 5 psychologist to evaluate for autism.

If you think of autism as differently normal, or people who have vulnerable nervous systems, it makes sense that they might be more susceptible to developing BPD traits because on top of any real trauma, there is a chronic invalidation due to sensory differences. And in girls it's even more likely because there is thinking that the double x chromosome offers some protection, which minimizes some of the strength of the traits that often lead to early diagnosis.

It's hard sometimes to see what is autism and what is BPD, but it is definitely not just autism, and it's the BPD emotional lability and all that goes with it that present the biggest challenges for her (and others who love her).

Not suggesting that your GD is autistic, only to say that I'm now beginning to realize why a diagnosis might take some time. I think they know something big is happening but they aren't entirely sure what, so they look at the things that can be medicated to see if that helps, and then wait to see what else persists that might be something comorbid.

I completely understand the exhaustion and needing support. I'm so glad you reached out so you aren't going through this feeling alone. Sometimes just sharing what you're feeling can help with people who get it. Have you looked at the NEA-BPD Family Connections program? During Covid they started to offer more online for people who don't have the program where they live. I found that to be a huge relief. They tend to be volunteer-run by peers, often parents, and offer workshops on skills, including the same ones we reference here, like emotional validation, SET (support, empathy, truth).

In those groups you'll hear a lot about self-care. I know it's tempting to get on the emotional roller coaster with GD, but she really needs you to stay grounded. She hasn't yet learned skills to help her self-regulate so she'll either blow out her emotions and return to baseline when they've run their course, or she'll find her way back to level ground by following your lead.

Right now you're trying to figure out what is driving her behavior so it's crisis time, plus she's going through puberty. It would be a miracle if you weren't exhausted and doing everything in your power to keep her safe. Sometimes the key is not what we do, but what we say and how we say it. You are locking things up because you love her and want her to be safe. How does she respond to that?

A silver lining here is that she has tender cycles where she expresses regret. How do you respond to her when she shares this with you?

[CC43]

Hi Nan, we understand how exhausting it is trying to avoid triggering a pwBPD. When I read your post, I couldn’t help but wonder if your granddaughter is projecting. I mean, when she asks, “Why are you mad at me?” it sounds to me like she might really be asking, “Why am I mad at you?”  She likely has negative emotions and is thrusting them back at you. Your seemingly minor interaction might just have been a trigger. But her stress and anger could come from somewhere else, maybe school, or a disappointment, etc.

I experience this frequently with the pwBPD in my life. She will face a disappointment or treat someone badly.  She’s then “primed” with negativity. Then someone makes an innocuous or neutral comment, but she interprets it as threatening and exhibits a trauma response. She will either be avoidant (flight mode) or aggressive (fight mode); typically her flight will be followed by a fight. When in fight mode, she’ll often project her feelings and blame the people closest to her, usually her parents. “You’re disrespectful to me” or “You’re bullying me” are typical accusations.  Not coincidentally, often these accusations describe her recent behavior towards a friend or relative, but she doesn’t apologize or take responsibility. Her guilt festers in her, and her unresolved bad feelings emerge as projections onto her parents after a minor, unrelated interaction. Does this ring any bells?

[nanof2]

Hi CC,
Some of it does ring a bell.  She does feel slighted very easily, so me walking away from her, she is probably feeling like I've abandoned her, as i said in a previous post her mother left her at 2 1/2 and has been and out of her life inconsistently until last June when her mother broke it off for good. It was the only thing i could think of doing with out escalating the fight or show her how much she is hurting me.  Some of the self help things I've been reading say don't cry in front of her, because i have to be strong for her, because in the end it's not about me it's about here, which i understand.
 Now her best friend has a gf and spends a lot of time with her gf,  my GD says she likes the gf and they get along but her friend never has time for her and she thinks they are talking about her when she isn't around, when she called her other friend to make plans my GD was told she couldn't because she had some family things going on over the weekend, so to her that means(i'm assuming) they don't want to spend time with her because she has done something, or they are making excuses not to hang out with her, then she won't talk to them for days and she stays up in her room.  When i go and see what's happening, she says nothing.  I say to her, i can see something is bothering her, does she want to talk, I then get the eye-roll and a big no and to leave her alone.  a couple hours later i go back up again, to see if her mood is any better and she is usually sleeping.  so i leave her and she may come down afterwards, but still doesn't want to talk.  When GD comes down stairs i will say something like i see you had a nap, you must have been pretty tired, do you feel better.  I will get an eyeroll and get I'm fine.  I'll ask her if she wants to help with dinner, no, after dinner want to play a game, no.  then she starts to fire up and the please leave me alone, I'm fine.  and stomps up stairs.  a couple hours later she will usually come down stairs when I'm in my room reading and she will sit and ask what I'm reading and ask how may day was and pretend nothing has happened.  this is where i get stuck.  I want to ask her if she needs or wants to talk, but on the other hand i worry about setting her off again by saying the wrong thing.  I've tried, the phrase I see so and so are busy this weekend, that must make you feel left out, do you want to do something with me?  Wrong thing apparently because now she is mad again and says i don't feel left out, why would you say that.  I've always made sure i validate her feelings and i never make her feel like everything is all in her head and she needs to snap out of it.  She is hurting inside and i wish i knew why and doesn't have the coping skills yet to help herself.  She is just now starting to learn some, but they take time and practice.  All i can do is watch and see what triggers her, which i'm still learning.

[nanof2]

Hi Livednlearned,

My GD's psychiatrist still suspects she has bipolar, as i just found out 1 1/2 ago it runs in my dads side of the family.  I never knew this.  Apparently my dad was bipolar.  as a child did i notice anything out of the ordinary, not in the least, but i wasn't looking for anything as being a child.  My parents divorced when i was 12.  I recently asked my mom if she knew and she said this was the first she heard of it.  She also told me she never saw him take medication for anything other than migraines.  So i was a little angry this was kept from me because this is an important medical condition i should have been aware of.  Anyway this is where her bipolar DX is coming from.  Then with her moods being all over the map and her having abandonment issues, along with the self harm, suicidal thoughts and mood swings, (which i thought were traits of bipolar.)  this is where her psychiatrist is getting the BPD Dx, i know she can't be formally DX'd until she is at least 18 because of teenage hormones.  So she is being medicated for both to be on the safe side.  I've had one specialist say she is being over medicated, but if these meds are helping her to sleep at night in stead of staying awake and and having suicidal thoughts, then i don't think she is over medicated.  She was on a med in the morning but he took her off that one, to see if her suicidal thoughts slow down.  My GD has told me she is sleeping sometimes she wakes up but doesn't stay awake, so that is a good thing. Maybe it was that one med she was taking. 
You asked me when she expresses regret how do i respond, i usually give her a hug and i tell her i know she is hurting, does she want to talk about what caused her to be so angry, sometimes she will and sometimes she won't i assure her i will always love her no matter what I'm hear to listen if she needs to vent.  I also say maybe we can think of something to do to better express her anger.  She says she will think about, then says she loves me and walks away. 
i always feel whew another crisis diverted.

[CC43]

Nan,

The way you described your GD's behavior regarding her friends, feeling left out and acting moody is EXACTLY the sort of behavior my diagnosed stepdaughter exhibited at her age.  It seemed to me that my stepdaughter's issues initially manifested as social challenges in her teens, but as she aged, her dysfunction began to spill over into all areas of life:  relationships, studying, working (or lack thereof) and daily routines (or lack thereof).

What I observed is that my stepdaughter seemed overly "sensitive" to perceived "slights" by her peers, mainly other girls, starting in high school.  Rather than do her own thing or hang out with other friends, she'd withdraw and become very moody.  She would spend hours isolating in her room, doomscrolling on social media, which only added to the FOMO and sleep deprivation.  Then she would lash out at her family for seemingly insignificant reasons.  Like if you asked, "How are you?" she perceived it as insulting, abusively judgmental, controlling or "bullying."  We were walking on eggshells trying to figure out how to avoid triggering an outburst from her.  She would often say, "Don't poke the bear."  I'm sad to say that this approach may have given her too much freedom (to make bad decisions).

My stepdaughter's issues progressed as social relationships became more complicated.  In younger grades, friend groups tended to be bigger:  everyone got invited to the birthday party.  Parental supervision and support were nearly constant.  However, as my stepdaughter advanced in age and encountered more adult scenarios--friends with romantic relationships, rooming groups at college, living away from home the first time--she was simply ill equipped to handle the complexity, pressures and responsibilities.  In a nutshell, I think she was facing adult-level challenges with the emotional skills of a young girl.  Her moods became darker, and her raging outbursts more extreme.  She started using marijuana daily, which in my opinion nearly completely destroyed her thinking and habits, and therefore her entire life.  Her relationship with her family became a battlefield, and she went nuclear, threatening suicide or attempting suicide when she felt attacked--even if we weren't the ones "attacking" her.  She lost all her friends, even her besties; she quit school multiple times; she couldn't hold a job; and she cut off contact from family members until she had no choice but to come back and ask for money/lodging.

My stepdaughter had to hit bottom (twice) before agreeing to get help and remain committed to a treatment program.  It is devastating to see a loved one be so self-destructive, especially someone who shows so much promise in many areas.  I hope that you are able to get appropriate therapy and medications for your GD, without her having to hit rock bottom.  But the sad part is, with this illness, I think that untreated people with BPD are resolutely convinced that everyone else is the problem, not them.  They want everyone to adapt to their needs.  Hence the phrase "walking on eggshells"--we are the ones changing to make their life manageable, and not the other way around.

The upshot is that my stepdaughter got a definitive diagnosis and started with intensive therapy and medications (for her mood/anxiety).  Though she has had relapses, right now she's headed in the right direction and regaining control of certain aspects of her life, even though she hasn't resumed contact with her mother and siblings yet.  It took several horrible years to get to this point.  I just hope that for you, the utter misery doesn't last that long.  This is a confounding illness, and it's hard to know what to do.  That's why this website recommends self-care.