View Full Version : My daughter is in the hospital


Ravenstar
03-16-13, 11:03 PM
Hi all....

*sigh* 3 days ago my daughter (14) attempted suicide and went to emerg.. and was sent to a children's mental health inpatient ward. I've been trying to get her help for about a year now.. we've been in counselling, she's in an 'alternative' school program... but her behavior doesn't seem to be improving.

The Pdoc who saw her at emerg suggested she may be either bipolar or borderline...(?) and she is most definitely majorly depressed and now suicidal.

I'm so tired and heartbroken. It's been a HELL of a year and a half.

2 weeks ago she was diagnosed with ADHD, they put her on Concerta.. and then this... did the Concerta trigger this suicide attempt? They took her off the Concerta at the hospital.. but put her on Zoloft. I'm so confused.. what I've read about bipolar is that neither of these medication are good for them, without a mood stabilizer. And how do you tell if it's bipolar? or Bpd? Could she be both ADHD and bipolar? or BPD?

I'm home alone and going through everything in my head.. two things have occurred to me; first, I feel weirdly relieved... because I know she is in a safe place and for the first time in years I'm not walking on eggshells in my own home or worried about where she is, and secondly.. WOW, I ignored or missed a lot of signals over the years. I feel like the worst mom ever. (I have pretty severe ADD - inattentive)

I love my daughter more than anything.. some days I don't like her too much though. Her constant extreme mood swings and risky and abusive behavior is taking it's toll.

I'm just wondering... how do we get a definitive diagnosis? and being ADD myself I feel so flippin' INADEQUATE to deal with this..

I'm scared to death and don't know how to navigate this, at all. I meet with her clinical team on Monday... and I know she needs me to be her advocate... any words of wisdom would be much appreciated

mctavish23
03-16-13, 11:13 PM
First of All, HUGS.

I don't practice on the net, but some possible things to consider are whether or not

Bipolar runs in the family/ extended family (on both sides). Also, keep in mind that

"cutting" is an ADHD (adolescent female) manifestation, and that all cutting / SIB, does

not instantly mean Borderline Personality Disorder, especially with 14 year old girls; all

of whom act that way to some degree.

Good Luck and hang in there. The good news is that she's okay.

tc

mctavish23

(Robert)

Ravenstar
03-16-13, 11:38 PM
Thank you so much.. yes, she was cutting too.. last year, not for the last six months but cut again during the suicide attempt (first tried to hang herself... didn't work, then the overdose).

I don't know about the history on her fathers side of the family though.. other than he had clinical depression and died of an overdose. My side has anxiety, depression, ADHD... and at least one NPD. (her great great grandma) and one Paranoid Schizophrenic (her great great uncle - too far removed I would think)

Ya.. the hardest thing is trying to separate the adolescent female DRAMA from the illness (whatever it turns out to be) Gaaahhh!

14 is a tough age, even for the healthy.

Twiggy
03-17-13, 03:15 AM
Not to be intruding, but do you know what's bothering her?
What is it causing her to want to kill herself? There has to be a reason behind the depression.

sarahsweets
03-17-13, 06:01 AM
I am so very sorry. I wish I could get in her head to help you but I can only speak of myself. I am BPII and ADHD. I attemtped suicide and also engaged in cutting as a teen. I firmly believe that it was a combo of trauma and undiagnosed BPII that contributed to thodse behaviors. Has she has any sort of trauma in her life?

Gadfly
03-17-13, 06:24 AM
My thoughts are with you.

I tried suicide twice in my twenties.

Bird's Mom
03-17-13, 06:25 AM
Hi all....

*sigh* 3 days ago my daughter (14) attempted suicide and went to emerg.. and was sent to a children's mental health inpatient ward. I've been trying to get her help for about a year now.. we've been in counselling, she's in an 'alternative' school program... but her behavior doesn't seem to be improving.

The Pdoc who saw her at emerg suggested she may be either bipolar or borderline...(?) and she is most definitely majorly depressed and now suicidal.

I'm so tired and heartbroken. It's been a HELL of a year and a half.

2 weeks ago she was diagnosed with ADHD, they put her on Concerta.. and then this... did the Concerta trigger this suicide attempt? They took her off the Concerta at the hospital.. but put her on Zoloft. I'm so confused.. what I've read about bipolar is that neither of these medication are good for them, without a mood stabilizer. And how do you tell if it's bipolar? or Bpd? Could she be both ADHD and bipolar? or BPD?

I'm home alone and going through everything in my head.. two things have occurred to me; first, I feel weirdly relieved... because I know she is in a safe place and for the first time in years I'm not walking on eggshells in my own home or worried about where she is, and secondly.. WOW, I ignored or missed a lot of signals over the years. I feel like the worst mom ever. (I have pretty severe ADD - inattentive)

I love my daughter more than anything.. some days I don't like her too much though. Her constant extreme mood swings and risky and abusive behavior is taking it's toll.

I'm just wondering... how do we get a definitive diagnosis? and being ADD myself I feel so flippin' INADEQUATE to deal with this..

I'm scared to death and don't know how to navigate this, at all. I meet with her clinical team on Monday... and I know she needs me to be her advocate... any words of wisdom would be much appreciated
First of all, you are not the worst mom ever. I know exactly how you feel. My daughter was hospitalized in October of last year after a cutting episode. Her symptoms sound very much like your daughter's. I understand your relief and don't feel guilty about that. Know that she's in the best, safest place to be right now. Hopefully they will be able to make a diagnosis and get her stabilized on the right meds before she's released. That was the problem with our daughter and unfortunately she wasn't on the right meds when they sent her home. But we eventually found a great psychiatrist and got her on the right medication and she's stable and happy only 5 months later. There is hope, and you are doing all the right things. When you meet with her team on Monday, make sure you tell them about ALL of her behaviors with the mood swings, risky behavior, etc. I'm not a doctor, but her symptoms are so much like my daughter, and she was finally after 2 years diagnosed with bipolar II. However, the diagnosis doesn't really matter, it's finding the right medication to treat the symptoms.

Fuzzy12
03-17-13, 07:51 AM
Raven I'm so, so sorry. This must be truly heart breaking for you. Huge hugs to you and your family!!!

The Pdoc who saw her at emerg suggested she may be either bipolar or borderline...(?) and she is most definitely majorly depressed and now suicidal.

I think, one of the differences between borderline personality disorder (BPD) and bipolar disorder (BP) is that in BP the mood swings are usually not caused by a trigger and are episodic in nature whereas in BPD they are more reactive to external causes. I've been diagnosed with BP II but I sometimes wonder if I'm not BPD as I seem to over react to little triggers. As in, I feel disproportionally bad if something negative happens but I also feel disproportionally thrilled if something good happens.

Another difference is the black and white thinking in terms of relationships in BPD. BPD patients tend to glorify a person they like but then vilify them to the extreme in response to a small perceived slight or disappointment.

Also, if you look at the family history, if there are cases of BP in your family, it's likely that your daughter has BP as well.

But then keep in mind that ADHD and BP are often co morbid. One diagnosis doesn't rule out the other.

2 weeks ago she was diagnosed with ADHD, they put her on Concerta.. and then this... did the Concerta trigger this suicide attempt? They took her off the Concerta at the hospital.. but put her on Zoloft. I'm so confused.. what I've read about bipolar is that neither of these medication are good for them, without a mood stabilizer. And how do you tell if it's bipolar? or Bpd? Could she be both ADHD and bipolar? or BPD?

Stimulants can induce mania in BP patients and anti depressants can make them more suicidal, especially in children and adolescents. I'm 34, but my anti depressants made my mood swings a lot worse and whenever my mood crashed it was accompanied with considerably increased suicidal ideation.

I'm home alone and going through everything in my head.. two things have occurred to me; first, I feel weirdly relieved... because I know she is in a safe place and for the first time in years I'm not walking on eggshells in my own home or worried about where she is, and secondly.. WOW, I ignored or missed a lot of signals over the years. I feel like the worst mom ever. (I have pretty severe ADD - inattentive)

You are not a bad mom. Your post alone shows how much you care. It's so easy to miss the signals. My parents never suspected that there was anything wrong with me (they still don't believe it). I was very good at hiding my mood swings. In retrospection it's always easier to interpret signals. I, myself, missed a lot of signals that could have pointed to a BP diagnosis long ago. I recognise them only now though for what they were.

Your daughter is in a safe place now and that's the most important. It seems like you've tried very hard to provide support and get her the required help in different forms. I think all that we can do is to keep trying out different treatment options (like counselling, CBT, medication, etc.) till we find something that works. I'm so sorry that you and your daughter have to deal with this. Neither of you can be blamed in any way. I hope that with the help of your clinical team you can find a good solution.

Huge hugs again!!! :grouphug:

Lunacie
03-17-13, 08:52 AM
Not to be intruding, but do you know what's bothering her?
What is it causing her to want to kill herself? There has to be a reason behind the depression.

She's 14 - it could be hormonal shifts, it could be stress from starting high
school, it may not be something that's easily identified, or a combination.

My now-15 year old granddaughter is really struggling with depression lately.
High school is harder than middle school, her friends are doing things that
make her uncomfortable, her back is messed up and chronic pain triggers
depression. She's also had her first couple of migraines, and living with me
she knows what her life will be like with that pain. It would depress anyone.

Amtram
03-17-13, 09:40 AM
As awful as it may be that she had to be hospitalized, the good thing is that she's someplace where they will take her condition seriously. They will keep her there and observe her responses to medications and have her talk with counselors, and behind the scenes there will be office staff fighting with insurance providers to say that the doctors will say when she's ready to go, not some call center operator.

Yes, this kind of thing is highly heritable - but don't blame yourself. Or your husband. Stuff happens.

Talk to the doctors and ask them why they prescribed a medication. Sometimes it's because it treats specific symptoms a patient has shown, not to treat a whole diagnosis. If you ask the doctor why this medication, what changes do they hope to see, what symptoms it's supposed to address, what other symptoms concern them, why treat this symptom before this other one, they will tell you. Then you'll be able to help with her treatment by observing whether the desired changes are happening - from the point of view of a parent, not a clinician who just met the patient.

You might also want to ask the doctors if you can get help for yourself, beyond whatever you might already be getting. You might benefit from attending a support group for parents of suicide survivors, or parents of children with depression or mood disorders. Take advantage of every resource that's available to you.

Ravenstar
03-17-13, 09:43 AM
Thank you all so much,

hmmm. everything seems to bother her. I think she has been depressed for a couple of years. Whether there was trauma?, I suspect there might have been something (a triggering event maybe?) about a year and a half ago when she started cutting, but she's not talking. Now it's seems it's like life in general, and teenage life in particular. and %#@* I HATE facebook.

I should probably keep a mood journal on her - because with my ADD I'm not going to remember details and I certainly won't remember time frames. I still get confused when spring arrives because it feels like christmas was 2 weeks ago...

If she is bipolar - she cycles fast, like hours sometimes. I have seen her okay one minutes then talking incessently, kind of giggly and hyper the next, then within a couple of hours she is raging - her anxiety is through the roof. She hides her feelings well.. too well though, and I can never figure out where she is at. She hasn't been sleeping well for the past 2 years - either up every two hours or she crashes for an entire day.

ODD... holy crap she can't deal with any kind of authority. She rages if things don't go her way and I have holes in my walls. She is having problems with friends... she seems to go through them pretty quickly - but I'm not sure about the b/w thing. She has a hard time forgiving if someone has hurt her (or she thinks they have). It's like she has no sense of past or future... just the NOW.

She's self-medicating with pot and who knows what else. She feels worthless and hopeless - I don't know where her self-esteem went... her reaction to anything is way more extreme than I've seen in other kids her age. But... she doesn't lie (she'll 'omit' then tell me later sometimes) I don't know if that means anything, maybe? She's shoplifted, but doesn't steal from me or family (just stores I guess.. has a court date coming up for that *sigh)

She seems to be at the mercy of her emotions to me, but ya, I'm not inside her head.. I can only tell the docs what I see - only she can tell them how she feels.

It's hard.. and scary. and I think she's been struggling for longer than I've been aware of.

(If there is bipolar it must be on her dad's side..(?) or undiagnosed on mine... i don't know of any relative that has it)


What scares me the most is that they won't figure this out, or she'll fool them and they will send her home before she's ready. She has no idea how sick she is... the second day in hospital she asked me 'why do I have to stay here?, I'm not crazy, I want to go home'... and I said to her... 'honey, I know you're not crazy - but trying to kill yourself isn't exactly healthy - we need to find out why you feel so bad and help you feel better'.

I think I need to see my own counsellor though... my anxiety is through the roof and although I work well in 'crisis mode' (hyperfocus) this is going to affect my ADD and I'm going to get all unbalanced again... that won't help anyone.

Labels... tough one, I guess the only reason for a label is for treatment purposes... but I'll just be grateful for whatever works. From what I understand bipolar is mainly a physical thing (meds first) and BPD is more psychological (counselling, DBT, etc..) I could handle just ADHD... but even at my worst I never seriously considered suicide - so I'm at a disadvantage there.

HUGS!!! and thanks!!!

Ravenstar
03-17-13, 09:46 AM
Thanks, yes I think it's important that I know what they expect and why they have prescribed anything so I can monitor her reaction. The zoloft.. I would think.. is for the depression. Could make her manic though - it takes a few days to kick in, doesn't it?

They have family programs I think, I find out tomorrow how they involve family in the treatment plan.

Fuzzy12
03-17-13, 09:51 AM
Not to be intruding, but do you know what's bothering her?
What is it causing her to want to kill herself? There has to be a reason behind the depression.

Just wanted to add. The difficult thing with depression or BP, is that there doesn't have to be a concrete reason. It could be hormonal like Lunacie said, and usually it's very difficult to pinpoint maybe even for the person themselves.

When my mood crashes and I get suicidal, there isn't always a reason. In fact, usually there is not. It's one of the things that make it so upsetting. I keep screaming at myself "Nothing is wrong. Everything is fine. Stop being so depressed" but it doesn't help. I know that everything is fine, but it doesn't make a difference to how I feel. This is what makes it scary. If there was a reason, you could work on the cause of your depression or try to solve the underlying problem. But if you don't know the cause or reason yourself? It makes me feel as if I'm so out of control and beyond reason that nothing can save me.

daveddd
03-17-13, 09:52 AM
self injury is an attempt to regulate emotions that we(adhd) cannot regulate on our own

zoloft takes about 4-6 weeks to kick in for depression

although for the impulsive self injury, it has been shown to work in as little as a week

independently from helping depression

dresser
03-17-13, 09:59 AM
I will talk with the big guy, stay strong, I send hugs N love.

daveddd
03-17-13, 10:03 AM
Thank you all so much,

hmmm. everything seems to bother her. I think she has been depressed for a couple of years. Whether there was trauma?, I suspect there might have been something (a triggering event maybe?) about a year and a half ago when she started cutting, but she's not talking. Now it's seems it's like life in general, and teenage life in particular. and %#@* I HATE facebook.

I should probably keep a mood journal on her - because with my ADD I'm not going to remember details and I certainly won't remember time frames. I still get confused when spring arrives because it feels like christmas was 2 weeks ago...

If she is bipolar - she cycles fast, like hours sometimes. I have seen her okay one minutes then talking incessently, kind of giggly and hyper the next, then within a couple of hours she is raging - her anxiety is through the roof. She hides her feelings well.. too well though, and I can never figure out where she is at. She hasn't been sleeping well for the past 2 years - either up every two hours or she crashes for an entire day.

ODD... holy crap she can't deal with any kind of authority. She rages if things don't go her way and I have holes in my walls. She is having problems with friends... she seems to go through them pretty quickly - but I'm not sure about the b/w thing. She has a hard time forgiving if someone has hurt her (or she thinks they have). It's like she has no sense of past or future... just the NOW.

She's self-medicating with pot and who knows what else. She feels worthless and hopeless - I don't know where her self-esteem went... her reaction to anything is way more extreme than I've seen in other kids her age. But... she doesn't lie (she'll 'omit' then tell me later sometimes) I don't know if that means anything, maybe? She's shoplifted, but doesn't steal from me or family (just stores I guess.. has a court date coming up for that *sigh)

She seems to be at the mercy of her emotions to me, but ya, I'm not inside her head.. I can only tell the docs what I see - only she can tell them how she feels.

It's hard.. and scary. and I think she's been struggling for longer than I've been aware of.

(If there is bipolar it must be on her dad's side..(?) or undiagnosed on mine... i don't know of any relative that has it)


What scares me the most is that they won't figure this out, or she'll fool them and they will send her home before she's ready. She has no idea how sick she is... the second day in hospital she asked me 'why do I have to stay here?, I'm not crazy, I want to go home'... and I said to her... 'honey, I know you're not crazy - but trying to kill yourself isn't exactly healthy - we need to find out why you feel so bad and help you feel better'.

I think I need to see my own counsellor though... my anxiety is through the roof and although I work well in 'crisis mode' (hyperfocus) this is going to affect my ADD and I'm going to get all unbalanced again... that won't help anyone.

Labels... tough one, I guess the only reason for a label is for treatment purposes... but I'll just be grateful for whatever works. From what I understand bipolar is mainly a physical thing (meds first) and BPD is more psychological (counselling, DBT, etc..) I could handle just ADHD... but even at my worst I never seriously considered suicide - so I'm at a disadvantage there.

HUGS!!! and thanks!!!

there doesnt have to be any trauma

especially at her age, it wouldnt trigger behavior like that

borderline behavior (extreme emotional dysregulation) can be helped greatly with meds (usually ssris,lamictal or atypical antipsychotics)

daveddd
03-17-13, 10:34 AM
[QUOTE=daveddd;1459910]there doesnt have to be any trauma

especially at her age, it wouldnt trigger behavior like that

without strong biological underpinnings i should say

keliza
03-17-13, 01:59 PM
I'm so sorry to hear your daughter attempted suicide, but really glad to hear that she survived and is in a safe place now. Big hugs to you.

Your daughter reminds me a lot of myself at her age. 14 was when I made my first attempt, and I had a lot of issues at home, rage, depression, self-injury, insane emotional lability (no ability to control my emotions or emotional responses to events in my life). To some extent, mood swings, abnormal sleep schedules, etc. are normal for teenagers. But major depression, self-harm, and suicide attempts are clearly not. There's something going on here, a lot more than "teen angst", and I'm glad that you recognize that and are focused on getting her the help she needs. You're already doing better than my family did. They spent years writing it off as being a moody teenager. It wasn't until college that I was diagnosed with bipolar disorder, even though I had been having major depressive and manic episodes for over 5 years at that point.

I want to clear something up about self-harm, because generally people who are outside of the behavior seem to have a lot of thoughts and opinions about what it is and isn't. I don't really know what you think about it or where you believe it came from, but I want to be clear - self-injurious behavior doesn't have to be in response to a major trauma. There might not be any event in her life that triggered her to start doing this. Or maybe there is. But there doesn't have to be, is my point.

Self-harm also doesn't equate to suicidal thoughts or impulses. Some people who SI (self-injure) do it because they want to live, not because they want to die. For many people who do it, SI is the only way they know how to get a grip on the world spinning around them. It's a maladaptive emotional release valve, like steam pouring out of a kettle, lowering the pressure inside. It's a way to cope with things beyond your grasp - you can't control the feelings you have, or the events in your life, but you can control this. It's a way to validate your pain - putting it on the outside where you can see it, instead of on the inside where you can't. Making it real, physical, tangible. There are many myriad reasons why people engage in SI, and virtually none of it has to do with being a 14 year old girl. I just wanted to make sure that was clear.

Anyway. Fuzzy did a great job in breaking down some of the key differences between bipolar disorder (BD) and borderline personality disorder (BPD). I also wanted to mention that personality disorders cannot be diagnosed before the age of 18. It is part of the diagnostic criteria, because teenagers are still developing who they are as a person, their personality is still forming. You cannot tell if it is truly a disordered personality or not, because being a teenager is kind of like living with a personality disorder at various times - the personality is still fluid, still morphing, not set. Can a person have symptoms of BPD before the age of 18? Of course, yes. But it cannot actually be diagnosed as BPD until 18+.

Whether she has bipolar disorder, BPD, major depression and anxiety, PTSD, whatever is going on, she's going to need a combination of medication and therapy to work through it. Every single one of those disorders responds best to a combo of both, it's never an either/or situation. Bipolar disorder has stronger genetic roots than BPD, usually, but that's like saying an oak tree has deeper roots than a Japanese dogwood. They're both trees, they both have roots. The way you treat them is different, but they both require both meds and therapy.

Bipolar disorder tends to respond best to mood stabilizers such as Lithium, Depakote (which they won't give her because of risks for ovarian issues), Lamictal, atypical antipsychotics (Seroquel, Risperdal, Abilify, etc.) and the like. Front-line antidepressants like Zoloft, Wellbutrin, Prozac, etc. tend to cause manic flips in about 50% of bipolar patients, but if matched with a mood stabilizer, they can be effective for some people. CBT is a great form of therapy for people with BD, because it helps them learn how to change their cognitive schemas and behavioral issues that contribute to depressive episodes. Ongoing therapy is an important maintenance aspect of bipolar disorder, as it is a life-long condition.

On the other hand, BPD isn't particularly responsive to most medications. Some people get some relief from antidepressants or mood stabilizers, but it's often very marginal and mostly placebo effect. BPD is best treated by a specific kind of therapy called dialectical behavioral therapy (DBT). DBT is a form of therapy created specifically for BPD, and has been shown to be very helpful for the disorder. BPD cannot be cured and the person will always struggle with it, but they can live a much less chaotic, more centered, stable life with the right therapy.

I've gone on and on, I'm sorry, but I wanted to give you as much potentially useful information as I could. You are not a bad mom and you probably did not miss any major glaring signs that your daughter was going to attempt suicide. Sometimes it just happens, nobody sees it coming. Not everyone talks about it before they attempt, or does the other kinds of things that loved ones are told to look out for. Some things you just can't see coming.

What's important is that she's safe now, and you can move forward together. Please seek therapy for yourself too, this is a lot to handle and you're going to need help along the way.

daveddd
03-17-13, 02:22 PM
naltraxone is also another medication being used for situations like your daughters



but trust your doctors

and like you said, dont get to wrapped up in a specific label

a lot of what they thought is wrong, and a lot of what they didnt know they are starting to find out

if she receives a BPD dx for some reason, medication is being shown to be more and more useful

daveddd
03-17-13, 02:30 PM
labels can be a big mistake

Ravenstar
03-17-13, 06:24 PM
Thank you both so much... visited today, she has put up her 'front' again, all 'happy, happy nothing's wrong'.. I don't think she knows she is doing it though - and I hope the staff can see through it. Weirdly, they had her on the Zoloft for 3 days then took her off it again yesterday(?), I guess I'll have to ask pdoc about that.

She did admit to some visual hallucinations today (the walls sparkle, I guess) and paranoia. She's trying to tell me stuff... as she can.

Yes, when she first started cutting it really freaked me out but I learned a little about it and realized that it was a coping mechanism, and I tried to just help her with harm reduction and not being judgmental about it.. then she stopped for quite a while.

I appreciate the kind words and information.. thanks!!!!! and no, this isn't just teenage angst, but you are right - she is where she needs to be, and she's safe.

I sure wish there wasn't such stigma around mental illness... makes it so much harder. I know I will have to help her with that also... they've already told me they have to inform her school because of safety issues (and I would think so they can help her too).

She said to me today, "hey mom, I didn't realize this was a psych ward".. I said, "it's a children's mental health ward".. "psych ward", she says...

Why do they hide their pain?

deadmau5
03-17-13, 07:37 PM
This sounds like a rough situation, your daughter must be really suffering to attempt ending her life. I dont get why they would put her on Zoloft, why not something like ABILIFY that acts as an antipsychotic and helps with depression in like a week instead of a month.

Twiggy
03-17-13, 08:25 PM
I agree with deadmau5.

Ravenstar
03-17-13, 08:26 PM
LOVE grumpy cat... :)

They put her on it for 3 days then took her off of it (?) SO weird.

Yes... she must be suffering but if you saw her today you'd have NO clue. Smiling, joking around... being her sweet sarcastic self. *sigh*

I'm SO afraid she's going to pull the wool over their eyes. Oh well.. see new pdoc tomorrow.

Sandy4957
03-17-13, 08:39 PM
Sorry to hear what you and she are going through Ravenstar.

If it's any consolation, I was pretty unstable at her age, swinging wildly here and there. In my case, it was probably primarily due to my mother being borderline personality disorder, and as a result, I didn't know how to exist in the world.

But after a year or so with a GREAT psychiatrist in college, I became pretty darned AOK. The thing that did it was talk therapy.

My money's on some sort of trauma, or drug use causing the sudden change, I'm sorry to say. :( Drug use makes for a hugely heightened sense of drama... :(

Good luck with you both.

keliza
03-17-13, 10:12 PM
Thank you both so much... visited today, she has put up her 'front' again, all 'happy, happy nothing's wrong'.. I don't think she knows she is doing it though - and I hope the staff can see through it. Weirdly, they had her on the Zoloft for 3 days then took her off it again yesterday(?), I guess I'll have to ask pdoc about that.

She did admit to some visual hallucinations today (the walls sparkle, I guess) and paranoia. She's trying to tell me stuff... as she can.

Yes, when she first started cutting it really freaked me out but I learned a little about it and realized that it was a coping mechanism, and I tried to just help her with harm reduction and not being judgmental about it.. then she stopped for quite a while.

You reacted SO WELL to finding out about her self-harming behavior. Seriously, big kudos to you. I love that you took the time to learn about it and help her in a way that was positive and supportive for her. I could have only dreamed of such a reaction. My mother's first reaction was to first freak out completely, and then second was to do a total about-face and pretend that it never happened. Not very helpful for me as a teen, as you can imagine.

If she was having visual hallucinations, that might be why they took her off the Zoloft after 3 days. Zoloft can cause a manic switch in half of patients with bipolar disorder, and visual hallucinations and delusions of persecution (paranoia) are both symptoms of mania. Mania isn't always euphoric, sometimes it's irritable, anxious, and scary. So it's possible that they took her off the Zoloft because it was causing those symptoms or making them worse. But ask them, they ought to tell you what their reasoning was behind it.

I'm SO afraid she's going to pull the wool over their eyes. Oh well.. see new pdoc tomorrow.

I want to tell you to both A, have faith that these trained professionals have been doing this for long enough that they will be able to see through her facade, but also B, make sure they know that she is a skilled faker. Some people can put on a show and you'd never have a clue, so letting the doctor know that isn't a bad idea. They're used to it, but it never hurts to mention it again to make sure they know who they're working with.

Ravenstar
03-17-13, 10:55 PM
^^^ yes, absolutely! I totally freaked out last year when I discovered the cutting.. but then I saw how that affected her. It's like when a little kid falls down and scrapes their knee.. and looks at you to see how to react. If you scream and make a big fuss then you teach them to react that way... but if you are cool and calm - they stay calm too. (am I freaking out? Oh yes! But I am also the grown up, and I need to be her stability... sooo, I only freak when she isn't around)

and now I need to suicide proof my home.. and just thinking about that chokes me up...

Thanks for the advice.. :) I agree and you can bet I am going to make sure the clinical team knows she is an oscar-winning actress - it's how she has survived so far in the real world - but it's not helping her now. Part of her 'grandiosity' when manic is thinking she is smarter than the grown-ups, and she IS wicked bright. I am writing everything down that she tells me... because she gives little hints and subtle clues that sometimes can get missed. I downloaded a mood journal too, so I can chart what I observe.

I didn't know about the mania causing hallucinations and paranoia.. good to know.

I'm nervous about the meeting tomorrow...

HUGS to all of you!!! Your kindness and care means so much.

anonymouslyadd
03-17-13, 11:00 PM
I'm sorry for what your daughters gone through, her pain and yours.:grouphug:

evilfeline007
03-17-13, 11:25 PM
According to the DSM-IV, borderline personality disorder cannot be diagnosed in adolescents (though the traits may be identified a precurse a diagnosis once in adulthood).

I will say that pdocs thought I had BPD, but I actually have ADHD.

Sounds like your daughter has lots of stuff going on, they may all be related or not.

The best thing you can do is be supportive to your daughter and inform yourself about all the disorders she may or may not have.

dogluver358
03-18-13, 03:22 AM
I have a little bit to add that I don't think has been brought up yet,and you can skip the parts about me if you wish, and everyone has given you such good advice. Just wanted to offer you a listening ear if you ever need it, hugs and well-wishes. And you're a great mom for taking such good care of your daughter and knowing when to get help. Mine brushed my problems/symptoms under the rug. And I especially want to thank you for how you handled it when she started cutting.

I started cutting at 13 to cope with things. I would feel so upset or out of control, I used it as a way of coping and it helped me "calm down" if that makes any sense. When people notice the scars now, I get a little embarrassed actually, particularly in front of doctors. Most people who aren't doctors don't comment on them. Instead of cutting, I eventually moved on to scratching my arms.

One thing that set me off as a teenager was a drug called Accutane. It was pulled off the market for sometime and I don't know if it's back on the market. But I started getting really depressed and having mood swings. I had one episode of trauma related to a guy I met online through a friend and that didn't help. As I got older the mood episodes worsened and I cycled back and forth between up and down and everywhere in between. I was finally given a correct diagnosis of bipolar as an adult.

I know some doctors are even hesitant to label a young teenager bipolar sometimes too. For the same reasons as BPD. It's sometimes blatantly obvious, but sometimes it's mood swings related to hormones. Childhood bipolar is a pretty controversial diagnosis, though she's not a child...she's a teenager.

I don't know if it's been brought up, but do these mood episodes coincide with her cycle? I was diagnosed with PMDD as a teenager because I would only get suicidal and such around the time of my cycle. If not, I'm sorry for bringing it up.

Whatever her diagnosis, just please be sure you're making aftercare planning/discharge planning ahead of time before she gets discharged. That is very important. Make sure they update you on her progress and let you know when she's close to being discharged so you all can meet with someone and plan for that. She will need aftercare.

And make sure they know she can be a good actress so they don't send her home prematurely, as hard as it is and as much as no one likes knowing their family is in the hospital. But she's at least in a safe place.

The first time I was in a psych hospital, I did everything I could do and said everything they wanted to hear just to let me go. And once you say certain things, they do let you go. I ended up back there a few days/a week later because I needed to be there. So just let them know what you observe.

Also, I know it's too early yet to be thinking of discharge planning and aftercare, but see if they have an PHP (Partial Hospitalization Program), which is a day program at the hospital. It's a step down from inpatient, but she'll still be monitored everyday, see a psychiatrist and a therapist everyday and participate in groups and have an opportunity to share what is going on with people around her age. It might help her open up more, at least to someone. And after PHP, there's IOP (Intensive Outpatient) which is a half-day program.

Sorry to ramble. Just wanted to add a few things. When the time comes (and insurances are very picky about keeping people inpatient), if you don't feel completely comfortable with her at home/school yet, you can ask for PHP or IOP as a step-down program. I did it. It gives you time to adjust instead of being jolted back to reality and it helps in that it's more therapeutically orientated. The hospital is more for keeping someone safe who is a danger to themselves. The outpatient programs are more intensive with the groups and activities to learn to cope than the hospital, at least in my experience.

Bird's Mom
03-18-13, 07:31 AM
I have a little bit to add that I don't think has been brought up yet,and you can skip the parts about me if you wish, and everyone has given you such good advice. Just wanted to offer you a listening ear if you ever need it, hugs and well-wishes. And you're a great mom for taking such good care of your daughter and knowing when to get help. Mine brushed my problems/symptoms under the rug. And I especially want to thank you for how you handled it when she started cutting.

I started cutting at 13 to cope with things. I would feel so upset or out of control, I used it as a way of coping and it helped me "calm down" if that makes any sense. When people notice the scars now, I get a little embarrassed actually, particularly in front of doctors. Most people who aren't doctors don't comment on them. Instead of cutting, I eventually moved on to scratching my arms.

One thing that set me off as a teenager was a drug called Accutane. It was pulled off the market for sometime and I don't know if it's back on the market. But I started getting really depressed and having mood swings. I had one episode of trauma related to a guy I met online through a friend and that didn't help. As I got older the mood episodes worsened and I cycled back and forth between up and down and everywhere in between. I was finally given a correct diagnosis of bipolar as an adult.

I know some doctors are even hesitant to label a young teenager bipolar sometimes too. For the same reasons as BPD. It's sometimes blatantly obvious, but sometimes it's mood swings related to hormones. Childhood bipolar is a pretty controversial diagnosis, though she's not a child...she's a teenager.

I don't know if it's been brought up, but do these mood episodes coincide with her cycle? I was diagnosed with PMDD as a teenager because I would only get suicidal and such around the time of my cycle. If not, I'm sorry for bringing it up.

Whatever her diagnosis, just please be sure you're making aftercare planning/discharge planning ahead of time before she gets discharged. That is very important. Make sure they update you on her progress and let you know when she's close to being discharged so you all can meet with someone and plan for that. She will need aftercare.

And make sure they know she can be a good actress so they don't send her home prematurely, as hard as it is and as much as no one likes knowing their family is in the hospital. But she's at least in a safe place.

The first time I was in a psych hospital, I did everything I could do and said everything they wanted to hear just to let me go. And once you say certain things, they do let you go. I ended up back there a few days/a week later because I needed to be there. So just let them know what you observe.

Also, I know it's too early yet to be thinking of discharge planning and aftercare, but see if they have an PHP (Partial Hospitalization Program), which is a day program at the hospital. It's a step down from inpatient, but she'll still be monitored everyday, see a psychiatrist and a therapist everyday and participate in groups and have an opportunity to share what is going on with people around her age. It might help her open up more, at least to someone. And after PHP, there's IOP (Intensive Outpatient) which is a half-day program.

Sorry to ramble. Just wanted to add a few things. When the time comes (and insurances are very picky about keeping people inpatient), if you don't feel completely comfortable with her at home/school yet, you can ask for PHP or IOP as a step-down program. I did it. It gives you time to adjust instead of being jolted back to reality and it helps in that it's more therapeutically orientated. The hospital is more for keeping someone safe who is a danger to themselves. The outpatient programs are more intensive with the groups and activities to learn to cope than the hospital, at least in my experience.
This was key for my daughter too. When she was released from the hospital, she went right back to school and of course within 2 weeks was back to where she started. The IOP was a lifesaver because her pdoc could monitor her meds and behavior every day. She was also good at putting on a facade, but at the IOP that's harder to do. That's where they ditched every med and decided to start over with bipolar meds. That's where she got better. She also learned a lot of coping skills to deal with her bipolar.

ConcertaParent
03-18-13, 09:05 AM
One thing that set me off as a teenager was a drug called Accutane. It was pulled off the market for sometime and I don't know if it's back on the market. But I started getting really depressed and having mood swings. Wow, I didn't know that Accutane has been pulled off the market. I remember the dermatologist prescribing it a long time ago and I expressed my concerns about reading so many complaints about bad side effects.

Ravenstar
03-18-13, 09:09 AM
Thank you for sharing a bit of your story... looking into any correlation with her periods is a good idea. Being ADD I may have missed that... the mood journals should help.

I'm lucky that here in Canada I don't have to fuss with medical insurance, other than make sure I have her health card with me (whew!) She's at probably the best children's hospital in Eastern Canada (it's a teaching university as well) so I'm taking some comfort in that. It's an hour away but they don't have facilities for adolescents where we live. I will ask about what kind of outpatient programs they have too... thanks :)

I remember hearing about Accutane. It's hard with kids because they react differently to drugs than adults do... many doctors won't prescribe Prozac to under 18's either. I guess it can cause psychosis (?) in kids.

She's always been sensitive.. to food dyes, tags in her clothes, certain fabrics drive her batty, perfumes in lotions, etc... so I wonder about autism spectrum stuff too.

Today I will make sure they hear me about her ability to 'appear' well... it's obvious to me she isn't remotely close to being well, or not a danger to herself, no matter what she says or acts like.

I grew up with undiagnosed ADD, and a dysfunctional [read NPD whackjob] (grand)mother. I didn't get the help I needed either though I'm sure everything I did as a teenager was a scream for help... I won't do that to my kid. I'm also sure my own issues have contributed, so I'm thinking family therapy might be needed as well.

I'm not so good with structure, ya know?

SquarePeg
03-18-13, 09:37 AM
Hi Ravenstar, what a sad post along with the other parents and poster who have been through the same.

I haven through an awful patch with my daughter who was suicidal a few weeks back. She was diagnosed adhd last year (at 17). Because, in my opinion, hers was a late diagnosis, she hid her symptoms from herself which caused her anxiety from about the age of 12.

she wasnīt able to confront the fact that she was struggling at school when she had previously done well and everyone called her bright. In her head she had no problems but her grades told another story. She began to get anxious about everything and fearful of everyday situations.

We have gotten used to her pre diagnosis rages and temper and walking on eggshells with her and therapy sessions with a psychologist helped her confront her problems, then she was diagnosed by a psychiatrist and put on concerta.

she has been doing well on this but out of the blue she crashed and felt suicidal for no reason, this was such an awful feeling for her as she is used to being able to associated some reason with feeling depressed but this was for no reason at all.

she actually begged me to take her somewhere and I got an emergency appointment as I was scared she would kill herself. She admitted to the doc she had self harmed. THe doc gave her zyprexa and my daughter said if it didnīt work by the next day she didnīt know if she would be able to cope. Anyway it did work but she couldnīt stay on it as she had bad side effects.

It seems she has passed that crisis this time. The doc said it was too early to give a diagnosis or treat her for depression. She was supposed to stay on the tablets for a month. BTW she has always had very irregular periods and I am wondering if this has an effect.

Well on to me, I was also diagnosed adhd last year and self harmed as a teenager. It wasnīt to kill myself but as a release. When feelings of helplessness built up inside me and I didnīt know what to do with myself I cut myself. Itīs like transferring the inner torment and making an external problem.
Later I was to become suicidal though and was lucky to have very good therapy. I have never been on antidepressants.

You sound like a great caring mum and I know what itīs like to feel helpless as a parent. I hope your daughter gets the treatment she needs very soon.

I know my daughterīs problems will resurface and I am keeping a vigil on her but I need to not question her.

Keep strong, I know it can seem never ending, you pass one hurdle only to be faced by another challenge. Please keep us updated.

daveddd
03-18-13, 08:03 PM
forgot to add this to post yesterday, it may or may not interest you

http://www.ncbi.nlm.nih.gov/pubmed/22889337

dogluver358
03-18-13, 08:26 PM
Oh, I'm sorry about the insurance part of my post. I didn't even check that you were in Canada and they have a different health system there. Whoops....that's what I get for posting at I think 3 or 4 in the morning. :)

keliza
03-18-13, 11:49 PM
Thank you for sharing a bit of your story... looking into any correlation with her periods is a good idea. Being ADD I may have missed that... the mood journals should help.

I'm lucky that here in Canada I don't have to fuss with medical insurance, other than make sure I have her health card with me (whew!) She's at probably the best children's hospital in Eastern Canada (it's a teaching university as well) so I'm taking some comfort in that. It's an hour away but they don't have facilities for adolescents where we live. I will ask about what kind of outpatient programs they have too... thanks :)

I second what was said about looking at how her cycle plays into it. I was diagnosed with PMDD when I was a teenager, before my accurate bipolar diagnosis. I honestly don't know if I actually have/had PMDD, or if it was just a manifestation of bipolar disorder, but I always had SEVERE mood swings around the time of my period. I mean suicidal thoughts, violent outbursts, getting into major physical altercations with other people, destructive behaviors, etc.

At first they put me on birth control, and that did help the mood swings, but I was not on it for very long. I have migraine with aura and I passed out on 3 separate occasions, and they were very concerned about the risk of stroke with a combo pill and migraine w/ aura, so they took me off of it. I couldn't tolerate the mini-pill, so I just dealt with it.

Now that I am on mood stabilizers for bipolar disorder, I do not have the PMDD-like mood swings around my cycle. I get a little cranky, yeah, but NOTHING like before. Now I'm just normal hormonal cranky, not "If I had a crowbar I'd beat you unconscious with it" cranky. That's why I don't know if it was actually PMDD related, or if it was because of the bipolar disorder. I don't really care, honestly, I'm just glad that I don't feel that way anymore!

I'm also really glad to hear that you don't have to battle with insurance companies regarding your daughter's current and continued care. That must be a huge relief to you. In the states it's nearly impossible to get adequate mental health care. They HAVE to accept you into inpatient if you're in crisis mode, but after the 72 hour hold (or even less sometimes) they can dump you right back out and have no concern about your continued care. It's really disgusting, honestly. But I won't get into all of that political stuff! I'm just glad you don't have to deal with it, that allows you to focus on her and your wellbeing.

dvdnvwls
03-19-13, 01:32 AM
She said to me today, "hey mom, I didn't realize this was a psych ward".. I said, "it's a children's mental health ward".. "psych ward", she says...

Why do they hide their pain?

Sounds to me like she was just "calling it like it is". It IS a psych ward. Being willing to admit that, is (in my eyes anyway) a good thing for her and for you.

Ravenstar
03-19-13, 10:33 AM
Had session with pdoc and therapist... *sigh* he says he thinks she is cluster b (tendencies) and that's where the emotional dysregulation is coming from... so basically he is telling me she is borderline. He seems reluctant to label her, which I get - she is still very young. BUT... the kid I'm seeing in the hospital is NOT the kid I see at home (not much anyway) and they are missing her hypomania altogether (had to point it out to staff twice this week - they think that's how she is 'normally'.. umm.. no)

He also wants to test her for any learning disabilities. Okay.

He's not prescribing any medication at this time... I kinda disagree with this but am willing to see what affect the therapy has (intensive DBT right now) I feel she may still need a mood stabilizer or something, for a little while anyway. I'm going to try to talk to the therapist and clue her in to the fact that they aren't seeing my kid as she is at home.

I read a little on this disorder... wow, most of it says it stems from child abuse... I've never abused her. Made mistakes as a parent? Oh ya.. had a hard time with structure and consistency, yup (ADD, remember?) It also says it has a high co-morbidity rate.

What do I have to do? videotape her at home so they can see how bad it is?

I've been trying to get this kid help for over a year now (myself too - can't do this in a vacuum - obviously family therapy is needed too)

Sorry.. frustrated today. and scared...

Ravenstar
03-19-13, 10:35 AM
^^ you are right.. need to call it as it is. She has to accept the fact that she is sick.. no sugar-coating. Thanks :)

Lunacie
03-19-13, 11:40 AM
We did video tape my g-daughters Autism meltdowns to share with the
therapist and the p-doc.

keliza
03-19-13, 12:30 PM
It's not just that her psychiatrists don't want to label her as borderline, it's that they can't label her as borderline. She's too young. They can say for now that she has cluster B tendencies, and then later look back on it and say, "Yeah, that's when we began seeing the borderline issues pop up." But they cannot, as per the DSM, diagnose her as borderline until at least age 18. Some psychiatrists want to wait even longer, into the early twenties, to give the individual's personality full opportunity to solidify before they call it disordered.

BPD doesn't have to stem from abuse, it's just that they are often related. Nobody is entirely sure what causes BPD. It seems to be more related to environmental influences than axis I disorders, but there is always a genetic underpinning to it as well. Everything has some sort of genetic basis, it's just how much is genetic and how much is environmental.

I think it's really important that you keep stressing to them the differences between the child they see in the ward, and the child you see at home. If she's behaving in a very different way, it's good for them to know that. They need to know who they're dealing with. But if she has BPD, medication may not be a good route for her. Mood stabilizers don't do anything for BPD in most cases, and they can come with a host of nasty side effects. No point in putting her on them with that risk if they won't help. Of course, it's also hard to know if they'll help or not unless you try them.

daveddd
03-19-13, 02:22 PM
Had session with pdoc and therapist... *sigh* he says he thinks she is cluster b (tendencies) and that's where the emotional dysregulation is coming from... so basically he is telling me she is borderline. He seems reluctant to label her, which I get - she is still very young. BUT... the kid I'm seeing in the hospital is NOT the kid I see at home (not much anyway) and they are missing her hypomania altogether (had to point it out to staff twice this week - they think that's how she is 'normally'.. umm.. no)

He also wants to test her for any learning disabilities. Okay.

He's not prescribing any medication at this time... I kinda disagree with this but am willing to see what affect the therapy has (intensive DBT right now) I feel she may still need a mood stabilizer or something, for a little while anyway. I'm going to try to talk to the therapist and clue her in to the fact that they aren't seeing my kid as she is at home.

I read a little on this disorder... wow, most of it says it stems from child abuse... I've never abused her. Made mistakes as a parent? Oh ya.. had a hard time with structure and consistency, yup (ADD, remember?) It also says it has a high co-morbidity rate.

What do I have to do? videotape her at home so they can see how bad it is?

I've been trying to get this kid help for over a year now (myself too - can't do this in a vacuum - obviously family therapy is needed too)

Sorry.. frustrated today. and scared...


Yes. Same thing I've been helping my sister with for 7 years. She has had it 22 years. About since 11


The neurological. (non abuse version). Of bpd. It's a severe form of ADHD.

I've gone through a ton of stuff with sister. We have found med combos that help

She self harmed. Suicide attempts. Bulimia. All of it



The learning disability he is interested in. Expressive language and poor internal narrative???


I'll let you know what's helped my sister after work



She also has brief and often hypo manic episodes as do I. It's part of emotional regulation. It can later turn into bipolar

Ravenstar
03-19-13, 03:28 PM
oh wow... really? I don't think they understand this as well as they think they do. I do see the borderline tendencies... now that I think about it, but I also see the adhd (pdoc says no ?) and the hypomania for sure (starts talking rapidly, gets giggly, can't sit still and it comes out of nowhere - lasts about an hour then she's off on a rage or depression, or just very restless)

Her internal narrative must be awful - she's so down on herself. She's very bright though and when she actually did anything positive shows a lot of talent for writing and song lyrics.

The way she treats friends though.. borderline. off and on and off and on - very reactive to any little thing. hate/love and serious trust issues. No ability to think things through rationally - she just REACTS like everything is negative.

Impulsive.. yes. But she is also depressed underneath it all.

Thanks, I'm deeply interested in whatever you have.

I think there will have to be HUGE changes in how we interact too. Right now we probably set each other off in negative ways... bad interpersonal habits.

I'm VERY emotional today... guess it finally hit me. Wondering if it's a good idea to visit or not. (?)

and HUGS!!!! everyone, you are really helpful.. thanks for being here

Hawutwut
03-19-13, 04:20 PM
So sorry to hear your are both going through this. I can only try to imagine how incredibly difficult and heart-wrenching it must be. I wish and hope and pray for the best outcome.

keliza
03-19-13, 04:51 PM
oh wow... really? I don't think they understand this as well as they think they do. I do see the borderline tendencies... now that I think about it, but I also see the adhd (pdoc says no ?) and the hypomania for sure (starts talking rapidly, gets giggly, can't sit still and it comes out of nowhere - lasts about an hour then she's off on a rage or depression, or just very restless)

I will tell you that something that only lasts an hour, as bizarre as it may be, is not hypomania and not indicative of bipolar disorder. The fact that it only lasts an hour, instead of days or weeks, is strongly indicative of borderline personality disorder.

That is one of the delineations between the two disorders, is how fast the person "cycles" through moods. Bipolar disorder generally has long, arcing mood swings that start a bit slower and last for days, weeks, or months. Borderline PD has abrupt mood shifts that are intense, often negative, sometimes giddy and energized like mania, but very short. Everything you've described sounds like borderline PD to me... disclaimer being that I am not a professional, just a career mental health patient.

The beautiful thing about DBT is that it is a therapy aimed at the disturbed cognitive schemas a person with borderline PD has internalized, and helps to change them. The negative internal dialogue your daughter has can be helped immensely by DBT, if she applies herself to it genuinely.

daveddd
03-19-13, 05:00 PM
the only reason i mentioned to not worry about labels to much is for that reason

they think BPD, they think of the old model that is "incurable", untreatable and whatever

in actuality the treatment methods are just failures, so is such a large amount of research of this particular symptom cluster, unfortunately google is overrun with the old abuse model, and it can take years to find it all

your dealing with a biological temperament at the core

an overstimulated nervous system, in oversimplified terms, everything is intense, senses emotions, and empathy(especially negative emotions, and that is an important part as well)

those cluster b tendencies are defense mechanisms against these powerful feelings

medication doesnt fix those, but until you fix the underlying temperament, its nearly impossible to stop "defending " against it, hence your high rate of failure in treatment

oops got to go, ill finish later

dogluver358
03-19-13, 06:54 PM
The neurological. (non abuse version). Of bpd. It's a severe form of ADHD.

She also has brief and often hypo manic episodes as do I. It's part of emotional regulation. It can later turn into bipolar

I don't want to derail the thread, but I feel I must point something out here. BPD is NOT a severe form of ADHD. And no one knows whether it's neurological or not or for sure what causes it. And BPD cannot turn into bipolar. They are two separate and distinct disorders whose symptoms sometimes overlap. Can you have both? Possibly. But BPD is a PERSONALITY disorder whereas bipolar is a MOOD disorder. There are two primary different treatments. BPD with therapy and bipolar with medication. Sometimes meds are used in BPD to help with severe symptoms and sometimes therapy is also helpful to people with bipolar. But those with BPD require therapy and DBT to get better and those with bipolar need medication to get better.

My friend did have BPD, but she also had concurrent major depressive disorder. The BPD was treated with intensive DBT therapy and the depression with medication. her symptoms have improved so much since first starting therapy that she now graduated vet school, is married and has a full-time job. So it's not a hopeless picture. Does she still have periods where she dislikes you and then likes you? Yes, but it's not as severe. One needs to find a treatment team to help...a good therapist, psychiatrist, etc. And especially how to set boundaries with the person with BPD.

daveddd
03-19-13, 06:58 PM
I don't want to derail the thread, but I feel I must point something out here. BPD is NOT a severe form of ADHD. And no one knows whether it's neurological or not. And BPD cannot turn into bipolar. They are two separate and distinct disorders whose symptoms sometimes overlap. Can you have both? Possibly. But BPD is a PERSONALITY disorder whereas bipolar is a MOOD disorder. There are two primary different treatments. BPD with therapy and bipolar with medication. Sometimes meds are used in BPD to help with severe symptoms and sometimes therapy is also helpful to people with bipolar. But those with BPD require therapy and DBT to get better and those with bipolar need medication to get better.

My friend did have BPD, but she also had concurrent major depressive disorder. The BPD was treated with intensive DBT therapy and the depression with medication. her symptoms have improved so much since first starting therapy that she now graduated vet school, is married and has a full-time job. So it's not a hopeless picture. Does she still have periods where she dislikes you and then likes you? Yes, but it's not as severe. One needs to find a treatment team to help...a good therapist, psychiatrist, etc.

Like I said. I went through this for 7 years with my sister and tons of different doctors

I know what I'm talking about

And the temperament DOES. Lead to bipolar far more often than the general population


It's definitely not two unrelated things

The severe emotional regulation leads to defense mechanisms


Defense mechanisms are the definition of a personality disorder

daveddd
03-19-13, 07:05 PM
SeverAl studies have shown the neurological connection

So not to be rude but that why I mentioned having to dig deeper than google

daveddd
03-19-13, 08:51 PM
to better explain, without this sounding like just my opinion

the first post in the thread is by someone who is a, ADHD specialist for 20 or 30 years a believe

he stated self injury is a manifestation of ADHD, self injury is not a neurological symptom. Its a defense mechanism against a neurological symptom (inability to self regulate emotion, per russell barkleys model of ADHD)

this defense mechanism would be a cluster B tendency

enough of these (black and white thinking,splitting,rapid mood shifts, etc) will garner you a DX of a personality disorder


but without the ability to self regulate emotion, (that IS a neurological symptom), there would be no need for these defenses

so without getting the neurological symptoms under control, it would be nearly impossibly for therapy alone to work, especially in a young person (due to lack of self awareness which is an executive function , per russell barkley)

Ravenstar
03-19-13, 10:31 PM
I like Dr. Barkley.. watched a couple of his videos.

When I visited today she was upset that her pdoc said she isn't adhd.. she said.. "so why can't I focus then?" You can be both adhd and borderline I think. I don't think I agree with him either. I told her that we would put that aside for a little while but look at it again later if she was still having a lot of problems focusing and paying attention.

I do see the oversensitivity in her..she's been like that since day one, and the defense mechanisms - ya (and LACK of self-awareness - she's 14) If you watch carefully, every so often, you can see the terror behind her eyes.

So how does one get the neurological symptoms under control? I feel like she isn't going to be able to make sense out of anything if she is just reacting all over the place because of her emotional dysregulation and she going to have emotional dysregulation because of her thinking patterns.. it seems like a circle that just keeps going round and round. We need to stop the *******' merry-go-round and give her a chance to breathe.

Interestingly, she is now getting agitated... you can feel the anger building in her. I saw it tonight when I visited. Yesterday she was a little manic, but okay - but today... Oh I know this feeling - she's building up now.

I probably sound cold but I've learned to observe in a detached way or I get pulled into her rollercoaster of emotions all the time. And that, my friends, is crazyland. I think she might just blow on the ward... and I hope she does (she's safe there), because all they've seen so far is the sweet compliant little girl... and that's not the reality.

She's getting frustrated, and comfortable... a recipe for an explosion.

I think.. and I'm no doctor, that they might find a correlation between mood disorders and personality disorders at some time. I know they've seen some brain abnormalitites with borderlines.. so it's not JUST maladaption - there are some physical differences and I've spoken with quite a few BPD's that are also bipolar. There is some co-morbidity. Does my daughter have it? I don't know... I think at this point we are really just narrowing things down.

I'm trying to find some of the positive stuff - because on the net the hatred towards BPD's is pretty severe, and the attitude that they are hopeless too - that really hurts. The idea that they are hopeless. But she is very young, so I hope we can catch some of these tendencies and defenses before they become 'set'.

But... and this makes me so sad and afraid, she has to accept she needs help, and she has to work hard at her therapy. But.. like any typical teenager... she thinks she knows everything.

I beat myself up today... after I read for the 15th time that child abuse or neglect causes this... it really sucks to think you messed up your child. The guilt is horrible. Maybe I did...(?) but I don't get a do over... I have to deal with the here and now. We have to work from where we are now.

You guys are awesome and I can't tell you how much I appreciate all your posts and support... thank you from the bottom of my heart... this is one of the hardest things I've ever gone through, and most people do not get it.

keliza
03-19-13, 10:49 PM
Like I said. I went through this for 7 years with my sister and tons of different doctors

I know what I'm talking about

And the temperament DOES. Lead to bipolar far more often than the general population


It's definitely not two unrelated things

The severe emotional regulation leads to defense mechanisms


Defense mechanisms are the definition of a personality disorder

I would like to see any kind of scientific evidence, psychological studies, reputable scholarly publishing, ANYTHING at all that indicates that BPD is a severe form of ADHD, or that BPD turns into bipolar disorder. Because neither of those claims is true, at all. I'm sure you've been through hell and back with your sister, but if it's not substantiated by reputable science, it's simply not acceptable to broadcast as a fact.

BPD is a personality disorder, on axis II. Bipolar disorder and ADHD are both axis I disorders, neither one is related to an unstable personality. Having an unstable temperament does not lead to bipolar disorder any more than it leads to ADHD. Are there personality factors that contribute to both illnesses? Yes, there are - because personality in some way, large or small, factors into ALL mental illnesses. Certain personality types (higher on neuroticism, for example) will struggle more with their illnesses. But it does not mean their neurotic baseline CAUSED those illnesses. That is a faulty leap to make.

I'm not trying to derail the main focus of discussion, which is Raven's daughter and the help she needs. But I feel like this is really important to call out, because if you spread misinformation in a place like this where people come desperately seeking information, it's not just a casual discussion about the origins of mental illness - you're misinforming a parent about her child's condition. That's not okay.

Let's stick to what has been shown in the literature to be true, not our own personal conjecture about what we think is going on.

daveddd
03-20-13, 05:49 AM
I would like to see any kind of scientific evidence, psychological studies, reputable scholarly publishing, ANYTHING at all that indicates that BPD is a severe form of ADHD, or that BPD turns into bipolar disorder. Because neither of those claims is true, at all. I'm sure you've been through hell and back with your sister, but if it's not substantiated by reputable science, it's simply not acceptable to broadcast as a fact.

BPD is a personality disorder, on axis II. Bipolar disorder and ADHD are both axis I disorders, neither one is related to an unstable personality. Having an unstable temperament does not lead to bipolar disorder any more than it leads to ADHD. Are there personality factors that contribute to both illnesses? Yes, there are - because personality in some way, large or small, factors into ALL mental illnesses. Certain personality types (higher on neuroticism, for example) will struggle more with their illnesses. But it does not mean their neurotic baseline CAUSED those illnesses. That is a faulty leap to make.

I'm not trying to derail the main focus of discussion, which is Raven's daughter and the help she needs. But I feel like this is really important to call out, because if you spread misinformation in a place like this where people come desperately seeking information, it's not just a casual discussion about the origins of mental illness - you're misinforming a parent about her child's condition. That's not okay.

Let's stick to what has been shown in the literature to be true, not our own personal conjecture about what we think is going on.

ok if you read my post, you would see i tried explaining that severe ADHD, can cause BPD symptoms (just like the ADHD specialist in the thread said)

you will rarely find a PD without an underlying axis 1 or temperament

ive had this argument with you before, you do it a lot

you stick to your wikipedia definitions, and strict DSM criteria, anyone who knows me knows spreading misinformation is the last thing i do here

yes i was typing from my phone and my autocorrect and dyspraxia made things come out wrong

thats why i clearly tried to rephrase what i meant

daveddd
03-20-13, 06:06 AM
it would take hours to back up what i mean

but this is the basic idea
http://www.ncbi.nlm.nih.gov/pubmed/21812103

daveddd
03-20-13, 07:58 AM
It's the same reason that Ritalin thoroughly helps a specific subgroup of "odd,cd,and anti social personality disorder" with ADHD And does nothing for others

Just think in terms of gender presentation

english-ice
03-20-13, 09:28 AM
Sadly my father who was my best friend, my hero and the greatest person I have ever met took his own life 3 years ago after jumping from a bridge after a long battle with depression, and now looking back on it possible ADD.

Its a horrible thing to go through as he attempted to do it 8 years before he finally did but I found out and stopped him,and the worry was always in the back of my head after that he would do it again someday , and sadly for me he did.

My thoughts are with you at this time , and I'm here to talk if you need. x

Zaashy
03-20-13, 10:18 AM
Ok their is too much of text going on here to read, but she should be on a mood stabilizer.
When I went on Risperdal, the pain stopped and I could function.

daveddd
03-20-13, 11:17 AM
Yes. Risperdal. Is an atypical anti psychotic

Good to see someone with a smart doctor

Ravenstar
03-20-13, 11:42 AM
have to look that up... side effects?

my kid is freaked out about weight gain...(she saw me gain a LOT of weight on my anti-depressants - which I am off now) and I sure wouldn't want to start an eating disorder on top of it all.

But if she can't regulate enough to do the DBT... I guess we will wait and see. I have two studies to bring to the pdoc (i hope he is one of those doctors that doesn't resent proactive parents/patients)

Her great aunt wants to go visit her - I don't know if that's a good idea. My kid is already embarrassed.. it's her favorite aunt but she's so fragile/reactive right now and these problems are hard for me to understand much less my aunt.

I'm also concerned with reinforcing attention for a suicide attempt... might not be a good idea to do that. I've been trying to downplay that myself and focus on the feelings that precipitated this and her options for managing the feelings - not the action itself.

saturday
03-20-13, 11:53 AM
Geodon is another atypical antipsychotic and is less likely to cause weight gain.

dogluver358
03-20-13, 11:54 AM
:grouphug:

Amtram
03-20-13, 12:17 PM
he stated self injury is a manifestation of ADHD, self injury is not a neurological symptom. Its a defense mechanism against a neurological symptom (inability to self regulate emotion, per russell barkleys model of ADHD)



Actually, just as an aside, there may indeed be a neurobiological basis for self injury. I just ran across an abstract (http://www.ncbi.nlm.nih.gov/pubmed/23303052) that found white matter abnormalities in skin picking that might also be related to trichotillomania.

This doesn't mean that it's necessarily a symptom of anything else or comorbid with anything else, but it could suggest that we don't automatically assume that someone who self-harms does it strictly for psychological reasons and can therefore consciously control it with therapy. Meaning that therapy can help, but assuming that once the behavior is curbed, it's cured, is a mistake.

Therapists and psychiatrists often know what kind of signs precede the onset of certain self-harming behaviors, and ongoing exercises needed to prevent them from starting up again. Ravenstar (and any other person who has a loved one in this situation) should find out about this so that action can be taken before mood and behavior get out of hand.

It's no guarantee, because people who are self-harming and/or suicidal are often very good at hiding what's going on. If the people around them learn how to recognize when that hiding is happening, though, it increases the likelihood that they can seek help for their loved ones.

daveddd
03-20-13, 12:22 PM
have to look that up... side effects?

my kid is freaked out about weight gain...(she saw me gain a LOT of weight on my anti-depressants - which I am off now) and I sure wouldn't want to start an eating disorder on top of it all.

But if she can't regulate enough to do the DBT... I guess we will wait and see. I have two studies to bring to the pdoc (i hope he is one of those doctors that doesn't resent proactive parents/patients)

Her great aunt wants to go visit her - I don't know if that's a good idea. My kid is already embarrassed.. it's her favorite aunt but she's so fragile/reactive right now and these problems are hard for me to understand much less my aunt.

I'm also concerned with reinforcing attention for a suicide attempt... might not be a good idea to do that. I've been trying to downplay that myself and focus on the feelings that precipitated this and her options for managing the feelings - not the action itself.


I would hope your doctors don't mind a little research on ur own


The best one I've had likes it. And gives me things to research

Yea gedeon. Is one as well. Should of remembered that one my doc has a gedeon scale in his office

Amtram
03-20-13, 12:24 PM
Ravenstar, from what you're saying, you seem to be handling things as best you can. Communicating with your daughter and the hospital staff is really important. Have you discussed with them what you see regarding her hiding her problems from them, and what you see that indicates her emotional building up from doing this?

Come to think of it, they may know exactly what's going on, and are observing her very carefully so they can document the progression. It sounds like something sadistic, but if you think about it, having documented evidence of her emotional and behavioral patterns might be important not only in her treatment, but also in the inevitable fight with the insurance companies about what help she needs. . .

daveddd
03-20-13, 12:29 PM
Actually, just as an aside, there may indeed be a neurobiological basis for self injury. I just ran across an abstract (http://www.ncbi.nlm.nih.gov/pubmed/23303052) that found white matter abnormalities in skin picking that might also be related to trichotillomania.

This doesn't mean that it's necessarily a symptom of anything else or comorbid with anything else, but it could suggest that we don't automatically assume that someone who self-harms does it strictly for psychological reasons and can therefore consciously control it with therapy. Meaning that therapy can help, but assuming that once the behavior is curbed, it's cured, is a mistake.

Therapists and psychiatrists often know what kind of signs precede the onset of certain self-harming behaviors, and ongoing exercises needed to prevent them from starting up again. Ravenstar (and any other person who has a loved one in this situation) should find out about this so that action can be taken before mood and behavior get out of hand.

It's no guarantee, because people who are self-harming and/or suicidal are often very good at hiding what's going on. If the people around them learn how to recognize when that hiding is happening, though, it increases the likelihood that they can seek help for their loved ones.

Yes good point

It's what I'm trying to do, when you recognize a pattern. A lot of times it is what it is. And as much as we would like to believe doctors are current. Most aren't


The ADHD. And cluster b tendency thing has been found quite a bit

It's why I said she shouldn't worry about labels and their outdated definitions

keliza
03-20-13, 05:09 PM
have to look that up... side effects?

my kid is freaked out about weight gain...(she saw me gain a LOT of weight on my anti-depressants - which I am off now) and I sure wouldn't want to start an eating disorder on top of it all.

But if she can't regulate enough to do the DBT... I guess we will wait and see. I have two studies to bring to the pdoc (i hope he is one of those doctors that doesn't resent proactive parents/patients)

Her great aunt wants to go visit her - I don't know if that's a good idea. My kid is already embarrassed.. it's her favorite aunt but she's so fragile/reactive right now and these problems are hard for me to understand much less my aunt.

I'm also concerned with reinforcing attention for a suicide attempt... might not be a good idea to do that. I've been trying to downplay that myself and focus on the feelings that precipitated this and her options for managing the feelings - not the action itself.

All of the atypical antipsychotics (AAPs) have a similar side effect profile, but some are more likely to cause certain side effects than others. The side effects are usually weight gain, lethargy/hypersomnolence/sedation, insomnia, potential for difficulties with insulin regulation/blood sugar levels, tics or movement disorders (tardive dyskinesia being the main concern), muscle pain/tremors, sun sensitivity, etc. Risperdal is pretty strongly associated with weight gain, so are Seroquel and Zyprexa. Geodon is typically less frequently associated with it, also Abilify has less weight gain in general than some of the others.

These are pretty strong drugs, not the kind of stuff you want to be on unless you have to, but she might have to. That's really up to the doctors to evaluate and decide. I personally think that doing research shows that you are a good patient advocate, but some doctors don't see it that way. They get a god complex and they view patient research as the patient not trusting their medical opinion, which is stupid and egotistical, but it happens. But I would definitely say keep researching and keep asking questions, whether the doctor likes it or not.

Perhaps as far as her great aunt visiting her goes, you could ask her doctors what they think. They might have an insight about it from experience that none of us do, as far as whether it is a generally good idea or not. You're right, there are a lot of variables surrounding it, so it's not a clear-cut yes or no.

keliza
03-20-13, 05:13 PM
ok if you read my post, you would see i tried explaining that severe ADHD, can cause BPD symptoms (just like the ADHD specialist in the thread said)

you will rarely find a PD without an underlying axis 1 or temperament

ive had this argument with you before, you do it a lot

you stick to your wikipedia definitions, and strict DSM criteria, anyone who knows me knows spreading misinformation is the last thing i do here

yes i was typing from my phone and my autocorrect and dyspraxia made things come out wrong

thats why i clearly tried to rephrase what i meant

I will stick to research and psychiatric literature, thank you (but not Wikipedia, unless it is properly cited). I value the science on the subject over conjecture and personal anecdote. It's too easy to fall into "person who" reasoning when you start taking personal anecdote as fact.

daveddd
03-20-13, 09:54 PM
you can disagree

its not personal anecdote though

the number one authority in the world on personality disorders ,(theodore millon) has stated personality disorders were based from a biological temperament since the 1970s

Fuzzy12
03-21-13, 10:36 AM
Raven, how are you and your daughter doing? I hope things are a bit better?

:grouphug:

Ravenstar
03-21-13, 11:18 AM
A millions phone calls yesterday... they are gearing up to release her I guess. They want to give her a pass for the weekend (one night here I think) but.. I came down with the flu yesterday (SERIOUSLY bad timing) but seems they want to go ahead with it anyway (?).

I didn't go visit last night, just slept and drank a gallon of orange juice and dosed with Neo-citran.

I'm not ready to have her home...

I have an appointment at the hospital tomorrow with her occupational therapist to discuss the pass and outpatient treatment. And then with the entire treatment team on Tuesday. The must think she is stable or they wouldn't be taking these steps.

I told the therapist I didn't believe my kid was actually grasping the severity of the situation.. she's meeting with her today for a session... I've avoided triggering her in the hospital but think I may have to set some limits before she gets out. I'm not giving her her cell phone back.. and facebook is off limits until I see some improvement (as well as a strict curfew) and she's gonna freak over that... but I think she should know now before she gets out.

I've always been a pushover but it's not working for her and she can't go back to how it was before...

I'm just not ready and I feel like they've worked with her, but not enough with me to prepare for this.

keliza
03-21-13, 01:09 PM
I'm not surprised they're releasing her at this point. Psych hospitalization is for crisis management, so if they feel the crisis has passed and her life is no longer in danger, they will let her go. Unfortunately that means a very unstable person who is no longer at risk for seriously hurting themselves, but still not ready for the "real world" yet, can and will be released.

We've struggled a lot with my cousin being repeatedly hospitalized for his issues because they release him when to us he is clearly NOT ready... but because he is not in crisis, their job is done. And in the U.S. we don't have much in the way of support services immediately following hospitalization, especially not for low-income individuals. So that means he gets out, barely stable, floats around for a few weeks, backslides because he has no plan for long-term mental health treatment and medication management, then he ends up in the hospital again. I feel like it would be cheaper on the state's part to pay for better long-term outpatient care than to keep paying for repeated hospitalizations that he is clearly unable to pay for... but what do I know.

Anyway, my (long-winded) point being that the function of the hospital is only crisis management. Everything else is going to have to happen on an outpatient basis - setting her up with a long-term therapist and psychiatrist in the community, therapy for yourself so you can get help on how to best manage the situation, etc. Careful, close monitoring and treatment outside of the hospital setting. This is truly better than the old model of institutionalization, where a person could end up in the state psych hospital for months, years, or forever. But it is a lot harder on families.

I think setting these boundaries with her while she's still in hospital is a good idea. Let her know what she's coming home to ahead of time. And then if she does totally flip her lid, she does it in the hospital setting, where they can witness it. Although I'm curious about why the cell phone and Facebook are being taken away? The curfew I get, but those other things? Are they somehow related to the fact that she tried to kill herself, or is it just a matter of wanting to monitor everything she says and does? Obviously you don't owe it to me to answer that, but I'm just curious because it sounds like she's being grounded for trying to kill herself.

Fuzzy12
03-21-13, 01:18 PM
I hope you can find a treatment plan that works for both of you. When one person in the family is in a crisis, the well being of the other family members often gets ignored. This must be taking a huge toll on you too. I hope you'll feel better before she comes home.

I agree with everything Keliza said (as usual) and yes, it's a pity that this means that too many people get released before they are ready to face the real world again.

I was wondering about the facebook and phone thingy too. I'm curious about the reasons as well. Do they have a depressing effect on her? Or does she spend so much time on them that she gets isolated from real people or her family?

In general, I think (unless facebook, etc is affecting her negatively), it would be good for her to get socially active again and be in touch with her friends.

Ravenstar
03-21-13, 03:02 PM
The phone and facebook... She doesn't seem capable of handling the social drama of teenage life. She also has 'friends' who are assisting her in her very destructive behaviors.. drugs, heavy partying, she knows some girl who lives with a bunch of other drug addicts in a house with no adults around (and I can't get the address or I'd be calling the police) - she runs away and stays there when she is mad at me or flips out over some drama she had with people on facebook. There's a girl in her alternative school who was put out on the street by her boyfriend to hook and she's been seen with these people. Another boy who is doing meth... *sigh* Another who is probably schizophrenic and suicidal/psychotic from time to time (weirdly, I really like this kid - he's smart and funny and he cares about my daughter) Some of her 'friends' are in and out of juvenile detention, some are hanging around with much older kids - even adults. This suicide incident is just the tip of the iceberg... the daily behavior over the past year has been extreme... and her choices in friends and activities is highly self-destructive and I've had no way to enforce any boundaries with her.(though she doesn't see it that way) She's not going to get better if she keeps heading down that road. At least I think some of her therapy team are getting an idea - the talk therapy wasn't really working with her... I have to have hope that we can really address the problems now in a way that is effective.

She is addicted to her phone.. I took it away a few months ago for about 4 days and she was climbing the walls - just like a junkie. (I have a lot of experience with addictions and I know withdrawal when I see it) If I let her on the computer all she does is go on facebook and then I'll see her ramp up... and she takes it out on me, and then she's off again to use drugs. She has dropped all activities to the exclusion of her bloody texting and facebook - she can't even read anymore, or draw or do any of the things she used to enjoy.

I might be willing to allow her on if she is working hard on her DBT, as a sort of reward - but it will have to be in short bursts as I see how well she applies her new skills. The same with the phone... she will have to show me it won't be a trigger for her or be the ONLY thing she does. Life is more than just social stuff, and I think she uses that as a distraction from herself, and her illness.

She is also a caretaker... and is always trying to help her 'friends' who are in crisis (talk about the blind leading the blind LOL okay, not funny, but sometimes you just have to laugh at the ridiculousness) It's a great trait and I do validate that she is a caring friend, but I've also tried to tell her you can't help anyone if you are having problems...you have to take care of you first - it's like trying to save someone from drowning but you don't know how to swim. *sigh*

All teenagers seem to have this intense drama in their social lives but her reaction is plus a thousand... and she doesn't have the skills yet to calm herself or see things realistically. Her drug use is a serious problem and probably one reason why the pdoc didn't want to put her on anything at the moment (I'll find out tomorrow when I talk to the therapist.)

In Canada she can legally leave home at 16.. that gives me a year and a half where I have any real legal authority. I also can not force her to take treatment (yes, even now) - it has to be voluntary, only the courts or a doctor can 'form' her.

Ya.. I'm freaking out today.. sorry guys. I feel so unprepared, but I've been doing as much research and soul-searching as I can so I can help her help herself when she comes home. I need to also work on my own boundaries and taking care of myself.. really hard.. really really hard. She keeps me very off-balance.

Ultimately it's up to her though to grab onto the help and do the work, and want to fight for her life... as a parent that bites because I know she isn't mature enough to see things clearly yet, and her self-awareness is pretty slim. I just don't know.

hmmm... the friends that really care about her, she pushes them away. The good kids, you know?(not perfect, just regular teenagers) Maybe that has to do with her self-esteem... it's like she doesn't feel worthy to hang out with them..and if they challenge her to be better or treat them better she shuts them off and avoids them..and then she calls them 'boring' or something like that...


so flipping complicated...

MellyFishButt
03-21-13, 03:29 PM
I have been watching this thread since it's start. Each new post brings about a sense of urgency and struggle and I feel for you terribly. I am so sorry Ravenstar, this is very rough. I was a pretty wild child myself and put my folks through some hell too. The positive is that I am great friends with them now, so all is not lost. <3

The more you speak about her every day life, the more she appears to be histronic or borderline. The addiction to drama - Facebook, friends in need, high risk environments, etc. Do you know if she's at all promiscuous? (I am so sorry to ask this but it could be helpful in determining patterns of behavior.)

Ravenstar
03-21-13, 04:28 PM
Whatever else she may have I think the pdoc is right about the borderline tendencies... she seems to have a hate/love thing with her sexuality, impulsiveness might not help there.

Funny, a boy she was seeing last year (her age) and was very much 'in love' with, and her were not yet sexually active... but I'm not sure about her behavior in the last couple of months. I suspect she might be, but from what I do know the motivation would be more for acceptance (or drugs?) than because she liked any one guy. She hasn't mentioned anyone 'special' in quite a while. except.. just the last month this old boyfriend..

She hasn't had a steady since him. Nice kid actually... and he just started to get back in touch with her.

She said they were talking about getting back together - but I wonder if that didn't add to this. Maybe she's scared of a 'real' relationship. She doesn't open up with me enough for me to figure out what she's thinking.

Thank you, and yes... I feel very stressed with the urgency of the situation, and I was a bit of a wild child myself (can't fool myself about what goes on out there - I lived it)

At least they don't say this is untreatable anymore... :)

keliza
03-21-13, 04:40 PM
That does make sense now that you explain it that way. I can understand wanting to keep her away from those negative social influences, especially when she is currently incapable of self-regulating and handling those issues in a mature way.

I do want to warn you that she is probably going to start going to greater extremes to try to see her friends, since you're removing her abilities to contact them via other means, like Facebook and her phone. She's probably going to harass you and treat you like crap and tell you that you're ruining her life and making her ignore her friends... she might try to run away, sneak out at night, skip school, etc. in an attempt to spend more time with them.

Right now she probably feels like they're the only people who "get her" because they have issues too. I know it doesn't make much sense to you, that she ditches the "good kids" who care about her and wants to spend time with the kids who are into the self-destructive scene... but I've been her, at 14, in a way, and I can about guarantee that she feels like those "good kids" simply do not understand her. They're nice, but they don't get her, and spending time with them makes her feel even more alienated because she feels like everyone is speaking a different language. They're all connected to the world in a way that she doesn't feel like she is, and that makes her feel even worse. At least the messed up kids, they get her, she feels like they understand the place she's in right now. That's something she values, as destructive as it is to her and those around her.

I was in a rough crowd back in the day. I dated a drug dealer, skipped class a lot, did drugs, a lot of my friends were in and out of juvie, getting arrested, going to alternative schools, into drugs and drinking and all of that. So while I don't pretend to know exactly what your daughter is thinking, I do understand why someone would identify with a group of people who don't seem to be good for them. And to my mother's benefit, she did not make me stop hanging out with them. But she did try her best to supervise as much of the time we spent together as possible. They could come over to the house, while she was there. We could go out to a movie, but she would be there to pick us up 15 minutes after it ended. I hated it then, but I get it now. She was trying to give me what I wanted - my friends, the people who made me feel understood - without allowing it to turn into something that would seriously hurt me.

Of course I snuck out, partied, dated a boy she would have never approved of, did drugs, all of those things. You can't totally shelter kids, they'll find a way no matter what you do. But she did try to give me fair, careful limits as much as possible.

daveddd
03-21-13, 04:58 PM
Hey ravenstar sounds like your doing your best, hang in there

I didn't mean to derail your thread at all and my way with words may not be to good


The only advice I wanted to get across is that both me and my sister had neurological disorders (genetic ADHD from both parents) with strong cluster b traits

What I mentioned wasn't just an opinion of mine. It came from a ton of research and directly from pdocs mouths

The best help we both got was from doctors with that POV when categorical reductionist doctors didn't help


So just a different view. Hopefully whatever ends up happening is for the better

Ravenstar
03-21-13, 05:15 PM
I appreciate all points of view... thank you both.

Yes, I will have to find a way to work with her.. and I did the same thing, hang out with the rough kids.. probably for very similar reasons. Maybe the therapist, my kid and I can make some safety/boundary agreements.

My toughest thing is I don't have a car at the moment and she takes advantage of that... we'll work with what we have though.

And I'm already the evil hated mother (read much more colorful words) who is ruining her life!, well... until she wants a sandwich, a new pair of shoes or a cab home from wherever she's been at 2am. :) I've learned not to take it too personally... or I'd go nuts.

Sometimes it's just harm reduction... hopefully we can move forward from there now.

keliza
03-21-13, 11:35 PM
Yes, I will have to find a way to work with her.. and I did the same thing, hang out with the rough kids.. probably for very similar reasons. Maybe the therapist, my kid and I can make some safety/boundary agreements.

I think this is a really fantastic idea. Family mediation with a therapist who is an objective third party may be really helpful for you and your daughter, as far as your relationship with one another, communicating concerns, fears, expectations, and boundaries between each other, etc. This way you can talk about your reasoning with your daughter (not that you have to reason with her, since she is in an unreasonable state of mind, but I mean as far as explaining why you are doing what you're doing) and the therapist can help "referee" those discussions and help BOTH of you communicate better with each other.

We did family therapy for a while, my mom and I, when I was your daughter's age. I actually appreciated it a lot at the time, because it made me feel like there was another adult there to listen and make constructive comments and observations about BOTH of our behavior, me and my mother. Sometimes the therapist helped explain my mother's reasoning to me in a non-emotionally charged way that my mother could not. And other times, the therapist told my mom she was being unreasonable with me, and helped us together work out a more reasonable, respectful plan of action that we could both be happy with.

That is how, for example, we worked out my curfew, who I hung out with and when, the boundaries for hanging out with certain groups, etc. One specific example of mediation was that my mom wanted to make me show her my arms and legs every day to make sure I wasn't self-harming. The therapist told her that was intrusive and disrespectful to me - it didn't matter that I was 14, I deserved more personal space and respect than that. My mother NEVER would have accepted that from me, but she was willing to listen to what the therapist said, since she was the expert.

I think that kind of family therapy/mediation might be very good for the both of you. It's always good to have an objective referee there to make sure BOTH of you are being heard, understood, respected, and both feel like you have an active role in her treatment and pursuit of a positive lifestyle.

I think you're doing such a great job with all of this, I just wanted to tell you that again. You're open to all kinds of advice and suggestions, in constant dialogue with her care providers, trying to provide the best environment and treatment plan for her. I tip my metaphorical hat to you, truly.

Zaashy
03-22-13, 05:23 AM
Since you a proactive mum, I think what would help is finding a 24+ female adhd or bpd person in your area to speak to her. Maybe ask a local support group counselor or look through if there a facebook page for bpd members. I wish I could speak to someone who went through what I'm going through because going through it alone is horrible and normal
people don't get it.

daveddd
03-22-13, 07:29 AM
ravenstar

i was looking through my stuff for a couple things for you, in case you want them for future reference, and knowing you have ADHD(genetic reasons)

notice (especially in the first article) the distinct profiles between what is thought to be the neurological BPD (adhd related) and the personality disorder only model

if i could paste textbook pages, id have a ton more

i want to share this, because believe me if it would have been brought to people in my life's attention in my teens, things could have been very different for me




http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3202232/


http://www.ncbi.nlm.nih.gov/pubmed/17289404


http://www.ncbi.nlm.nih.gov/pubmed/17289404

http://www.ncbi.nlm.nih.gov/pubmed/15951086

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3214601/

Fuzzy12
03-22-13, 08:07 AM
The phone and facebook... She doesn't seem capable of handling the social drama of teenage life. She also has 'friends' who are assisting her in her very destructive behaviors.. drugs, heavy partying, she knows some girl who lives with a bunch of other drug addicts in a house with no adults around (and I can't get the address or I'd be calling the police) - she runs away and stays there when she is mad at me or flips out over some drama she had with people on facebook. There's a girl in her alternative school who was put out on the street by her boyfriend to hook and she's been seen with these people. Another boy who is doing meth... *sigh* Another who is probably schizophrenic and suicidal/psychotic from time to time (weirdly, I really like this kid - he's smart and funny and he cares about my daughter) Some of her 'friends' are in and out of juvenile detention, some are hanging around with much older kids - even adults. This suicide incident is just the tip of the iceberg... the daily behavior over the past year has been extreme... and her choices in friends and activities is highly self-destructive and I've had no way to enforce any boundaries with her.(though she doesn't see it that way) She's not going to get better if she keeps heading down that road. At least I think some of her therapy team are getting an idea - the talk therapy wasn't really working with her... I have to have hope that we can really address the problems now in a way that is effective.

She is addicted to her phone.. I took it away a few months ago for about 4 days and she was climbing the walls - just like a junkie. (I have a lot of experience with addictions and I know withdrawal when I see it) If I let her on the computer all she does is go on facebook and then I'll see her ramp up... and she takes it out on me, and then she's off again to use drugs. She has dropped all activities to the exclusion of her bloody texting and facebook - she can't even read anymore, or draw or do any of the things she used to enjoy.

I might be willing to allow her on if she is working hard on her DBT, as a sort of reward - but it will have to be in short bursts as I see how well she applies her new skills. The same with the phone... she will have to show me it won't be a trigger for her or be the ONLY thing she does. Life is more than just social stuff, and I think she uses that as a distraction from herself, and her illness.

She is also a caretaker... and is always trying to help her 'friends' who are in crisis (talk about the blind leading the blind LOL okay, not funny, but sometimes you just have to laugh at the ridiculousness) It's a great trait and I do validate that she is a caring friend, but I've also tried to tell her you can't help anyone if you are having problems...you have to take care of you first - it's like trying to save someone from drowning but you don't know how to swim. *sigh*

All teenagers seem to have this intense drama in their social lives but her reaction is plus a thousand... and she doesn't have the skills yet to calm herself or see things realistically. Her drug use is a serious problem and probably one reason why the pdoc didn't want to put her on anything at the moment (I'll find out tomorrow when I talk to the therapist.)


hmmm... the friends that really care about her, she pushes them away. The good kids, you know?(not perfect, just regular teenagers) Maybe that has to do with her self-esteem... it's like she doesn't feel worthy to hang out with them..and if they challenge her to be better or treat them better she shuts them off and avoids them..and then she calls them 'boring' or something like that...


so flipping complicated...

Raven, till this day I can't hang out with the nice kids. I like and appreciate good people very very much but I need something more stimulating. All my close friends haven't exactly been the nicest people around, but they were always interesting and fun. I didn't like the drama but I liked the stimulation. My husband always wonders why I never keep in touch with the nice friends, I've made over the years.

I'm sorry, I know this doesn't help you, but I was just thinking, I could really relate. I was wondering if maybe she could join some clubs where she could meet like minded people that share her interests but aren't a bad influence. Maybe she could replace her unhealthier interests with something positive like a hobby or sport.

Ravenstar
03-22-13, 08:27 AM
Thank you all!

Yes.. we need mediation.. and from what I've read BPD's need tons of validation so working on how I communicate with her... they want to set up in-home DBT instead of us going to the clinic. I find out more today. But, I'm going to insist on family therapy as well. Before they were just seeing her.. I was kind of out of the loop. Not sure how that's supposed to help really - other than my kid having privacy to work on some issues, which I completely understand. She will still have her therapist for that.

I see the OT today at 11

A mentor is a great idea. There is a girl in my apt. building who is bipolar (18) in remission, who wants to support her but yes, finding a BPD who could coach/support her a bit is an awesome thing. Sort of a big sister.

Thanks for the articles! I still think ADHD may be a possibility, and there is a correlation with comorbidity... and since I struggle with ADD.. who knows, keeping my mind open. With BPD and adolescence there aren't a lot of studies yet... but the ones there are do point to about 2/3rds getting better with treatment by the time they are in their early 20's. However.. there's a lot of stigma and myths attached to it to and a reluctance to diagnose adolescents.

There's no quick fix for this.. and the suggestion so far is about 4 - 5 years of treatment.

I still gravitate to the unusual in friends too... 'regular' people bore me. Could be the ADD lol However, I do avoid the really toxic ones now, but that comes from self-awareness and knowing that some people just aren't good for me. I think finding that balance is important...maybe that's a good topic for therapy? and if it's stimulation.. maybe riskier sports could help? She's stopped outside interests but that is something we will be working on. Thanks!

Wish me luck today!

daveddd
03-22-13, 10:03 AM
Thank you all!

Yes.. we need mediation.. and from what I've read BPD's need tons of validation so working on how I communicate with her... they want to set up in-home DBT instead of us going to the clinic. I find out more today. But, I'm going to insist on family therapy as well. Before they were just seeing her.. I was kind of out of the loop. Not sure how that's supposed to help really - other than my kid having privacy to work on some issues, which I completely understand. She will still have her therapist for that.

I see the OT today at 11

A mentor is a great idea. There is a girl in my apt. building who is bipolar (18) in remission, who wants to support her but yes, finding a BPD who could coach/support her a bit is an awesome thing. Sort of a big sister.

Thanks for the articles! I still think ADHD may be a possibility, and there is a correlation with comorbidity... and since I struggle with ADD.. who knows, keeping my mind open. With BPD and adolescence there aren't a lot of studies yet... but the ones there are do point to about 2/3rds getting better with treatment by the time they are in their early 20's. However.. there's a lot of stigma and myths attached to it to and a reluctance to diagnose adolescents.

There's no quick fix for this.. and the suggestion so far is about 4 - 5 years of treatment.

I still gravitate to the unusual in friends too... 'regular' people bore me. Could be the ADD lol However, I do avoid the really toxic ones now, but that comes from self-awareness and knowing that some people just aren't good for me. I think finding that balance is important...maybe that's a good topic for therapy? and if it's stimulation.. maybe riskier sports could help? She's stopped outside interests but that is something we will be working on. Thanks!

Wish me luck today!

good luck

you are right for any of these things there is never a quick fix, its a life time of adjustments

Fuzzy12
03-22-13, 10:19 AM
Fingers crossed!! Best of luck Raven.You and your daughter deserve all the luck you can get!! :grouphug:

Ravenstar
03-22-13, 02:19 PM
I am livid...

So.. I go there thinking that I'm just going to meet with the therapist... and set something up for a home visit over the weekend and find out about the discharge and therapy plan for next week... and they spring on me that they want to send her home with me after the meeting...(full discharge) not only that but they've ALREADY TOLD HER she's going home. So she's all upset about me saying... umm.. I'm not ready.. this is news to me. I need more time. CRAP! I've been sick in bed for 2 days.. and YES, I told them when I got sick.

The meeting didn't go well.

I look like the bad guy.

I'm so angry.... I'm supposed to go get her at about 5pm. If she comes out I will NEVER get her back in...(except in handcuffs) are they STUPID?

They bought her ********.. and I TOLD them the first, no second day, she was there that she would play the game because she wanted out.... I TOLD THEM what she told me.. that she'd say whatever they wanted to hear to get discharged.

I can't believe these 'professionals' were snowed by a 14 year old... and now they are going to dump this mess THEY CREATED in my lap so they can open a bed? My kid is freaking out.. I watched her ramp up.. and the ******* therapist asks me what do you think she's feeling and I told her, "She wants to rip your face off right now" and my daughter looked at me and gave me the "bingo" face.

I said - if she is coming home then we need to set a couple of boundaries first.. for her AND for me... the therapist says.. well this isn't going to be fixed overnight - it's going to take time.. and I just wanted to scream, "okay then.. YOU come stay with her without any limits and watch her disregard all the 'techniques' you've shown her in the last few days, go right back to what she was doing before and then crash and burn".

They set both of us up to fail... and I will SUE their asses if something happens because of this. *sigh*... and if I react at all they can justify themselves and say.. oh, it's the mothers fault.

aaaaaaarrrrgh!!!!

sorry - just have to vent.

keliza
03-22-13, 05:47 PM
Wow, I'm really sorry to hear that the meeting went so UNLIKE what you were expecting. They weren't kidding about wanting to discharge her fast. Sounds like no matter where you are, U.S. or Canada, they're gonna play the "how fast can we free up this bed" game. The suck thing is that in that game, everyone loses.

I ditto the idea of finding her a "big sister" type mentor who has been where she is and can help her out. If nothing else, someone she can look at and see, "They've been through this, they made it out alive, I can make it too." I wish I would've had someone like that when I was her age.

Big hugs. I know you don't feel prepared at all, but you're a great mom and I can tell you're trying really hard to do the best for her. You can only do the best you can. Setting all of those limits is good. Finding a good therapist and psychiatrist in your area who will work with you both is the next important step. Don't feel like because she's coming home early, all of your plans for change are out the window. It just means you'll have to implement them faster. You can still do this. Every day will be hard, but you'll also learn more as you go.

You've got this. And all of us are here for you the best that we can be - to vent, to bounce ideas off of, anything.

Amtram
03-22-13, 08:07 PM
That IS crazy. Did they put you in touch with any kind of a support group? There has to be something out there for parents of kids who self-harm and/or have suicidal ideation. They would be in a good position to help you manage your way through the system and avoid being treated like this. It sounded so much like it was going to be helpful when you started this thread - this is not at all the way it should have turned out.

dogluver358
03-26-13, 07:26 PM
How are things going?

sarahsweets
03-27-13, 04:54 AM
I hope someone here who is from canada can offer you some tips with regard to the legal responsibility the hospital has in discharging her.

dvdnvwls
03-27-13, 05:08 AM
I hope someone here who is from canada can offer you some tips with regard to the legal responsibility the hospital has in discharging her.

(Might need to be from Ontario specifically - most aspects of health care are under provincial jurisdiction. I don't know if there are any federal laws about this.)

keliza
03-28-13, 04:23 PM
Raven, I hope things are going as well as they possibly can right now. I am sure you are extremely busy with taking care of your daughter and yourself, but just so you know, I (and I'm sure everyone else here) thinks about you and your situation often. I hope at some point you are able to update us on how things are going. Big hugs.

shaggy935
04-03-13, 12:37 PM
Those who have ADD are sensitive to all types of medication and food. The wrong medication or anything she may eat or drink can make the problem much worse. So, to know what medication helps her it must be taken alone. A lot of medication may work/help in the first few days but make her worse afterwards so she has to be monitored closely. Then just do a trial and error with other medication. From my experience, I've been through hell and back all by myself, from a nutrition standpoint I know what works and does not work. The most important thing is for her not to have any dairy intake, there is a protein called casein in dairy that would make the problem multiplied by a million. But there is a protein called Whey protein it is sold in powder that can calm her down. A multivitamin every couple weeks, not daily. An Amino Acid complex take every week. I would advise you to stay away from antidepressants, because if it is not the right one it would make things worse, she will feel drugged and more out of control.

Lunacie
04-03-13, 12:46 PM
Those who have ADD are sensitive to all types of medication and food. The wrong medication or anything she may eat or drink can make the problem much worse. So, to know what medication helps her it must be taken alone.

A lot of medication may work/help in the first few days but make her worse afterwards so she has to be monitored closely. Then just do a trial and error with other medication.

From my experience, I've been through hell and back all by myself, from a nutrition standpoint I know what works and does not work. The most important thing is for her not to have any dairy intake, there is a protein called casein in dairy that would make the problem multiplied by a million.
But there is a protein called Whey protein it is sold in powder that can calm her down.

A multivitamin every couple weeks, not daily. An Amino Acid complex take every week. I would advise you to stay away from antidepressants, because if it is not the right one it would make things worse, she will feel drugged and more out of control.

Thank you for sharing your experience, but I have to make it clear that you
only know what works for YOU and what does not work for YOU.

Not everyone has a problem with dairy/casein. For those who have cormorbid
Anxiety and/or Depression, a antidepressant can be very helpful. You have
to be cautious with ANY new medication, but there's no point in avoiding a
whole category that could be helpful.

dvdnvwls
04-03-13, 03:16 PM
The most important thing is for her not to have any dairy intake, there is a protein called casein in dairy that would make the problem multiplied by a million.

Dairy products are great for me. I know they aren't great for everyone. Please don't state your preferences in a way that makes it sound as if your preferences are important to everyone with ADHD. They simply aren't. Casein has no effect on ADHD. Casein does apparently have an adverse effect on your body - but it's just you.