Borderline personality disorder

[Oddcat]

I posted this in chat initially but think it’s better here .

We haven’t had a diagnosis but I strongly suspect my dd 21 has BPD , she ticks every single box and I am really struggling with her mood swings and violent verbal outbursts .

She admits she needs help but won’t go to the gp because ‘they’re rubbish ‘ . She suffers with bad periods , I suggest different ways to help with this but she rejects everything.

I’m exhausted and also dealing with elderly parents, my dad has recently had a heart attack and is today having a biopsy for suspected prostate cancer. My mum is agoraphobic and needs extra care.

I am thinking of sending dd to a rehab in Thailand ( cannabis use) she is keen to go but last night had another meltdown and said she doesn’t want to go.

I’m at my wits end.

I'm horrified reading your stories!

You will struggle to find individual private therapists offering DBT. That's because it is designed to be delivered by a team of therapists, rather than 1 to 1. That's the structure of the therapy. Reputable training providers (such as British Isles) won't take you on the course unless you are joining as established team or part of a new set up. I would also say, you won't find many DBT therapists who have full accreditation. That's because to achieve it you have to jump through a lot of hoops, practice wise. It's very different to say a CBT accreditation. You want to be checking that the therapist has completed the intensive training course and is practicing within a consult group, supervised by a psychologist.

It sounds like all this is pie in the sky where you live, but it might be useful for your journey forwards.

I practice in Leeds; there is a city wide DBT programme that people can self refer into. There is also a full DBT programme within the substance misuse service, along with a DBT skills based programme run by the personality disorder service.

DBT is usually undertaken as a group therapy. My psychiatrist referred me to a psychologist who has DBT experience as uses it as an informed approach in my therapy but can't class it as "proper" DBT as I'm not undertaking it as part of a group.
It's something that's becoming more commonly offered as an inpatient therapy but is not yet offered more mainstream.

There are DBT workbooks available on Amazon which both my specialists recommended as a back up to my therapy sessions - this could be something to look into as a first step?

I have to say that I'm about 8 sessions in to the therapy and I haven't really learned anything that is not common sense to most people but to me suffering BPD/EUPD it has been helpful.

I found CAT (cognitive actuality therapy) to be helpful when I first got diagnosed, it helped me make sense of my diagnosis and why my brain acts the way it does, but I have treatment resistant depression and anxiety which is complicating things hence the next lot of therapy. CAT is definitely worth looking into - I'm not sure if you can self refer but a good psychiatrist should be able to arrange this.

I hope your daughter gets the help she needs, it's a horrible illness to suffer with but it can be made more manageable.

Restless if I send you a link via pm would you be able to tell if they’re legit or not ?

When you say therapists should work in a team , can you explain how it should work please ?

It’s a bloody minefield and I am desperate to get my Dd the correct treatment, she will lose all confidence ( not that she trusts many doctors as it is) and I will have no hope of getting her to engage if the treatment is not carried out correctly.

Sorry for all the questions, I just want to get this right.

@Oddcat I have no idea how to look at pms on the mobile site. I'll try work it out!

In brief, DBT is made up of 3 components over about a year. The first is skills training programme. Typically this will involve a small group of people who are receiving the therapy spending a few hours each week together, along with two members of the DBT team. In our team there is 5 of us, and we rota around teaching the different skills modules to the group.

There will then be a weekly one to one therapy session. The client gets an hour to work through whatever issues are coming up with their assigned therapist, who they work with for the entire year.

The third part is telephone coaching. Clients should be able to contact their therapist (or an on call therapist from the team) to be coached in effective behaviour, rather than destructive behaviour.

Hope that all makes sense? Just shout if not

Gosh , the therapist that I found doesn’t mention anything like that.
Would it be bad form to put the link for her on here ?

I'll get on my desk top tomorrow and get back to you @Oddcat. If the offer isn't very similar, it's not DBT. The therapist may have experience in DBT and therefore be able to offered DBT informed treatment, and some standalone skills training, but the two aren't the same. The evidence base for DBT starts to fall away when the programme isn't followed as designed

I’d be really grateful, I’m worried that the wrong treatment will be more damaging than no treatment at all.

@Oddcat of course, leave it with me.

Restless your advice is invaluable, thank you for posting. My DD has an added complication in that BPD is not recognised in northern ireland or so the hospital staff told me. I queried it over and over and over and they said it's not. My DD's friend who was in hospital with my DD is being referred to a Unit in England.

DD's friend is considering going to the Unit in a country where she doesn't know one single person.

@LakeIsle48 I am sorry to say your daughter has been absolutely fobbed off there! Unless NI has for some reason decided to abandon both the DSM and ICD (it hasn't!) then they cannot deny its existence as a diagnostic category with an evidence based set of treatment options. That is appalling! Unfortunately it doesn't surprise me that you've come across this attitude. This group of people come across some absolutely awful stigma, even amongst mental health professionals, I am ashamed to say.

@Omzlas it's called PMDD I think

Restless thanks for clarifying that. The nurses used to say it. Obviously I just believed them.

I wish it wasn't called BPD. My daughter hated those words. The words caused her significant damage. She doesn't like EUPD either.

Had quite a good chat with Dd today and she has said she’s happy to get a diagnosis here , she has even agreed that Thailand might not be the best place for her to go .

Oddcat thats great. See your GP and get a referral to mental health services. Strike while the iron is hot. I hope things start to change for your DD. She didn't ask for this illness and she must be in a lot of pain.