Coping strategies required please

[DesperatelyHoldingOn]

I have an adult step-daughter (will be 29 later this month) whose life, in her own words, is just a series of car crashes. I have only known her for 4 years but it seems that her problems go back to her teens. I don't wish to drip feed, but it would take hours to relate anything like a full history.

Briefly, she appears incapable of making rational decisions, she lies, she has poor if any impulse control or judgement and has relied on others to pick up the pieces for her when things go wrong. She is resistent to seeking professional help.

She is currently unemployed, in massive debt (the "bank of dad and step-mother" having closed its doors to all but small but essential bail outs such as paying her train fare to attend her grandmother's funeral) and has just finished a "relationship". She is in deep crisis and near total meltdown. She currently lives in a flat-share a hundred miles away from us. She has asked to come and visit us next week and we have agreed and sent her the fare.

Her younger sister is going to visit her today so we will have further information on elder sister's frame of mind later tonight.

Our situation: I am currently undergoing treatment for breast cancer. I had a mastectomy last autumn and had my final chemotherapy treatment 2 days ago. At the time of her visit I will still be trying to ride out the side effects of that treatment. I face a further 15 - 16 months of other treatments. My MIL passed away just under 3 weeks ago and her funeral was the week before last. I have an adult godson who has just been diagnosed with numerous skeletal tumours and suspect lymph nodes (precise diagnosis awaited following a biopsy earlier this week). This morning I received an email from an uncle in America to tell me that my other uncle is in ICU and unlikely to recover.

Please, can anyone advise me on how to cope with the next week?

Both my husband and I are physically and emotionally exhausted by the events of the past year or so. He will be at work for 2 days of my step-daughter's visit so I will be on my own with her. I realise that she probably has deep rooted mental health issues that cause her to be as she is and I do try to sympathise. At the same time I can't help being very angry at the effect her actions have on my husband and my other step-daughter.

Can anyone help me?

Wow that's too much for anyone to cope with in one go. I really want to say to you 'focus on yourself to get better' but that sounds impossible

Yes your SD does sound like she has a deep rooted mental health problem. From my limited knowledge I wonder whether Borderline Personality Disorder is not a very likely cause. Does she agree that there is a problem? Is she having any treatment or support?

It sounds to me like you are setting very sensible boundaries and that is very important. You can't solve this for her. At the same time your anger is normal and justified so don't feel bad for feeling it.

She may not be able to help how she is, but she can still make choices, seeking treatment is one of them.

Do you really need to be alone with her for two days? Is there no one else she can go and visit?

Thank you for responding, madmouse. I have seen you on other threads and I know you have a wise head on your shoulders.

I will have no choice but to focus on myself to a certain extent. I will be coming out the far side of the chemo side effects tunnel but I will still be even more fatigued than normal.

I'm not qualified to diagnose DSD1's mental health issues. Having said that BorderlinePD did occur to me as I have a cousin who has that. My better non-qualified suspicion is Bi-Polar. DSD2 also suspects the same thing and came to her conclusion not knowing I was also leaning in that direction. DSD1 does seem to cycle between deep lows and extreme highs.

Does DSD1 agree that there is a problem? Only to the extent that she knows her life has really gone tits up this time. But that's not the same thing as accepting personal responsibility for her situation. She is not currently having any treatment and, as I mentioned in my OP, has so far been resistant to any suggestion that she needs professional help. My husband has insisted that she register with a local GP (having moved only a couple of months ago, she was still registered at her old location) and that as soon as her records are transferred over she must make an appointment to discuss counselling. She says she has now registered but whether she will seek counselling remains to be seen.

I agree that she has choices. She simply seems incapable of making the right ones.

Yes, I really need to be alone with her for 2 days. DH already had 2 weeks off work due to his mother's death. We live in a fairly rural location and DSD1 doesn't know anyone else locally. She has no money so I can hardly drop her off at a shopping centre to amuse herself for a few hours. She has also lost contact with many of her old friends and the couple she has left also live some distance from her.

I also feel a bit guilty because until I appeared on the scene both her dad and sister (DH was widowed in 2006) were accustomed to tiptoeing around her "drama queen" (their phrase, not mine) outbursts and then picking up the pieces - usually financially. I was the one who started noticing inconsistencies in her stories and the one who reminded her dad that he'd actually already previously given her the £5,000 for her wedding when she rang up saying she needed it urgently.

I don't want to be the evil step-mother. I try to support my husband and DSD2 in their efforts to cope but otherwise I tend to keep my mouth shut around DSD1. I'm afraid that if I start, she will hear some things she won't be able to cope with either.

I just can't see the way through next week at the moment.

Don't feel guilty - my DSM set boundaries to stop my troubled brother upsetting my father time and again and I'm so grateful for that.

If she has nowhere else to go, can you schedule some time out of the house for you? Seeing friends, having a massage or beauty treatment, bit of sitting in a cafe with a book?

I'm not sure I know how to set boundaries for other people. But it breaks my heart when I see DH nearly reduced to tears following a phone call from DSD1. The biggest hug in the world seems so inadequate but it's really all I can offer.

I do have a hospital appointment on Friday for an echocardiogram which I need to have before starting Herceptin in a couple of months (once I get my radiotherapy behind me). As it's a half an hour drive one way to the hospital and then who knows how late the clinic will be running I could be gone for at least 2 or 3 hours. Having said that, I feel I should offer to take her with me. I'm not at all sure she would want to come but I think I would feel worse just telling her I'm off for a few hours and leaving her alone. She hates her own company which is another factor.

I will be having regular naps. I have tolerated the chemo far better than I could ever have hoped for but one cummulative effect is utter fatigue. I simply hit a wall at least once and sometimes twice a day and must go to bed for a couple of hours. I will NOT feel guilty about succumbing to those while she is here.

Speaking of naps... I may disappear now for a couple of hours. I slept very poorly last night, waking every hour. That's a temporary side effect of one of the anti-nausea drugs I have to take for a few days following a chemo treatment.

I can't thank you enough, madmouse. Just having someone to talk it through with is helping.

I'm going to be '''''''selfish''''''' (not!!!!) on your behalf and strongly suggest you do not offer to take her with you to the hospital. Give yourself some space. She may hate her own company but she lives 100 miles away and will be alone more often.

Actually, being "selfish" about the hospital appointment may well be possible. I've just checked the appointment letter (and put it in my diary now!). The appointment is at 14h15 and the letter says it can take up to 45 minutes. DH is a teacher so will be home by 16h00. I could well be an hour later than that especially if I treat myself to a small supermarket sweep and a coffee on the way home. I will make sure she is aware of this. I'm pretty certain she would choose to stay home as it's really her dad with whom she wants to spend time.

I think what I am most worried about is if she asks me direct questions about what she should do. I suppose I must just enforce the message that we do all love her and want to help her but that this time she must take steps to help herself. No one else can put her life back together for her. We can encourage her in the right directions but she has to start accepting responsibilty for her own life. At this point it is obvious to the rest of us that this must begin with seeking professional help. We must all try to help her see that as well. I will be as kind as I can be but I will be firmly on message.

Let's hope this visit proves to be a turning point for her.

But you're still leaving it up to her to choose and I think that it should be your choice x

You're doing the right thing though by saying we will support you if you choose to turn things around but you have to do it. Maybe you and/or your dh can offer to go to her doctor with her to lay all the problems on the table together.

I know you're right, madmouse. I will do my best. Given that the GP is also over 100 miles away, accompanying her to an appointment would be problematic. But, I suppose that if it comes down to the wire something could be done.

We've just got off the phone with my godson. They still can't identify what type of cancer he has - unable to locate the primary tumour. However, he is now in the orthopaedic hospital. They have cancelled all other operations for Tuesday and will spend the entire day working on him. They will remove as much of the most dangerous spinal tumours as they can and then erect scaffolding around his entire thoracic spine to stabilise it. They expect him to be up and walking by Friday! When he has fully recovered from this operation he will start on a course of chemotherapy. The operation should give them sufficient tissue to identify exactly what they are dealing with.

We've just got off the phone with DSD2. Her visit with DSD1 was a bit up and down but she thinks DSD1 was in slightly better shape when they left her.

DSD2 has also told DSD1 that she will take a day off work and accompany her to see the GP for the initial appointment. I hope DSD1 takes her up on that offer as frankly none of us trust DSD1 to be completely open with the GP on her own.

One step at a time.