DD16 - possible borderline personality disorder

[tarapinn]

My DD has been struggling with mental health issues and self harm for a few years now. She has recently taken an overdose and her sleep patterns and diet are awful.

I know there is 'something' wrong with her but despite 4 different therapists (all for short term) where she just could not engage, mainly because she sees herself as having so many issues she didn't really know where to start, she herself now believes she has BPD.

She has never engaged with me before about all her problems but a couple of weeks ago we sat in the car for three hours where she poured her heart out and said she'd been reading up on this disorder and truly believes she has it. She was so articulate and mature during this conversation, it was like talking to someone else.

Having since googled it, I am horrified and anxious all rolled into one. But she's right, she ticks every single box. It looks like a life sentence to me, and I'm so scared for the future. But what do I know?

We had a major incident on New Year's Eve where her stepfather accidentally threw away a drink of hers. She went completely irrationally mad, he said something sarcastic and she just couldn't cope. She ran into her room sobbing, and when I went up she had been cutting her arm really badly. She was screaming and hitting me to get out of her room. It seems like she can't cope with anything negative said about her or around her.

Can anyone else relate to this? Do any of you have BPD? Is anyone a parent of someone with it? How easy is it to get the diagnosis? Is there any treatment for it? I'm really struggling with this possibility but don't know if that is unfounded or not.

She herself would like to be referred to a psychiatrist to seek a possible diagnosis but even the private ones have a four month waiting list. It is breaking my heart and I don't know what to do for her anymore

Hi, I can talk about this with some degree of authority because I was married to someone who has it. Try not to panic, you can recover from it but the person with bpd needs to get a therapist trained in dealing with bpd. And they need to stick with the therapy program until they are recovered. You can get medication for it but that will even out the symptoms at best. It’s a personality disorder that can be co-morbid with other things but a psychiatrist needs to diagnose. Talk to gp as soon as you can and get the ball rolling. Best of luck and take care.

I heard that psychiatrists don't like to diagnose BPD before age 18 at the earliest as the personality is not fully formed.

Also it's not a diagnosis I would actively seek as it carries a major stigma amongst many HCPs.

I think yes to seeing a psychiatrist but let them come up with ideas, don't suggest a diagnosis to them as the real diagnosis may be completely different & hopefully more curable etc.

Why do I say this??

Well, I was misdiagnosed with BPD in 2011 by a psychologist who failed to realise I was going through a psychotic episode & only had a couple of BPD 'traits'.
It was the nurse at the DBT clinic who recognised I was actually acutely psychotic & that I no longer scored for the BPD criteria.

TL:DR I was put on anti psychotics & diagnosed with Schizoaffective disorder mixed type instead.

BUT while I had the BPD diagnosis I found I was treated like a leper by the mental health team & that's how they missed the psychosis.
Once my diagnosis changed to schizoaffective their attitude changed & they could not be nicer.

A friend's daughter has sadly suffered badly with BPD & had not found the mental health team helpful, however there is hope should your daughter ever receive a BPD diagnosis- this young woman was also referred for DBT (Dialectecal Behavioural Therapy) & 2 years after completing the course has not self harmed once.

I'm a clinical psychologist on an adolescent inpatient unit and I work with LOTS of you g people with an "emerging personality disorder". Try not to panic! Look into DBT - this is the gold standard treatment. I'd be hesitant to get a diagnosis at her age, but lots of the treatment elements will be helpful. Where (roughly) do you live? You would need a diagnosis to get NHS treatment, but you'll likely find a private therapist who can do some of the work without the formal diagnosis.

Walking on Eggshells is also a book I've heard recommended.

I'm sorry you are both going through this. I don't have much to add but I was diagnosed with this when sectioned when I was 27. I was only sectioned for a very short period of time. I was a difficult patient and am fully recovered now holding down a good job and I have previously had happy relationships. My personal view is that I didn't have it. I was a pain and didn't cooperate so I feel the BPD label (and histrionic which I was given as well!) is often given to difficult female patients!!

I would also agree she is possibly a bit young to be diagnosed with this. Teenagers go through a lot.

The self harm is of course an issue but I wouldn't focus on the label of BPD.

The sensitivity to criticism I can relate to. I found CBT to work well for that. Just continue to support her and let her talk to you and as you are doing, get professional help. I wouldn't focus on the label too much and read too much into it as the description can be alarming.

Good luck.

I've seen several people on here talking about having it but no longer having it impact them - it IS treatable unlike other PDs if the person with it wants to be treated and is willing to engage.

You could probably get her a zoom spot earlier and might be better with a psychologist who treats this in teens rather than a psychiatrist who's primary role seems to be to prescribe medication. They will start her on DBT (therapy) which is designed for this. But also they will be able to diagnose after they have spent some time with her.

My niece supposedly has this and is lovely 90% of the time. I'm not sure she has, I think it could even be ASD. But teenage girls can also be so extreme and unhinged because their brains aren't fully working and they have hormones bouncing around. Apparently many teens are also functionally sociopathic for a few years too - no empathy, selfish and entitled etc etc. Then they grow out of it. Thank god. I'm sure maa as my teens doing an online test would get a diagnosis of this though.

Also it's easy to tick boxes for BPD but it's the extremes of behaviour that matter and that's hard to gauge on a self test. It could be many things, ASD or even ADHD or depression. They can mimic each other and there's a lot of overlap sometimes. Is she exceptionally dishonest and manipulative? That seems to be one of the main differences.

In the meantime get her out into nature and into a hobby that doesn't rely on looking good, isnt insta worthy and gets her spending time with normal kids who won't put up with any nonsense but will be kind snd supportive. If she thinks this about herself she's probably terrified and with zero self esteem and getting some balance is important.

The reason BPD is a stigma of a diagnosis is that sufferers are labelled very often unfairly by HCPs and others as 'attention seeking' and other negative labels.

You only have to look at threads on here about people with BPD to see how much prejudice there is.

Like I said I definitely would not actively seek a diagnosis for this especially at just 16. Get help for your daughters problems but don't go looking for a label that is hard to shake off.

Definitely be looking at other neurodiversities too. Lots of overlap. The adhd foundation has lots of info on adhd, which is overlooked in girls & women. Even if it is something else, the strategies for dealing with adhd would be helpful, I think.

Teenagers can't be diagnosed with personality disorders. At least not by anybody competent and ethical.

It is far, far more likely to be complex trauma.

What's the situation with her dad? You mention a stepdad.

Thank you so much for your informative and helpful replies.

I have had another long chat with her tonight and we talked about the fact that there are so many different things that this could be and it might not necessarily by BPD. I think she has known that something is wrong with her (fucked up in her words) since year 9 and she just wants an answer to it all. She has felt 'shit' most of her life that she can remember but it all went horribly wrong from Year 9 . She had peers who were similar to her (drug and alcohol use and self harm) but most of those have now grown out of it and maturing in the usual way nearly 17 year olds do. But she is getting worse.

Her dad left when I was pregnant with her. He has remained in her life and spent the usual every other weekend and one night a week with her and ds19 but this has dwindled as she has got older. She has many, many issues with her dad and his style of parenting - he tries his best but is very intense and there have been so many 'family chats' about small things. She feels he does not ever acknowledge her feelings about things but just tries to say everything is OK. She has a stepmum who took on the strict parent role growing up and dd has said she was petrified of her as small child. Consequently both her and ds were alway good children for them. Always on their best behaviour and never put a foot wrong. So now, her dad doesn't know her at all. And if she is even remotely stroppy he will get angry and tell her off.

She has known her stepdad since she was 18 months old and we got married when she was 4. She doesn't particularly get on with him now but he is a constant in her life and no matter what shit she throws at him and insults she has said, he continues to engage with her when she is up for it, but it is very much on her terms. We have had 2 more dc together who she gets on with but doesn't do much with due to the age difference.

She has said in the past that she feels her stepmum 'stole her dad' and she thinks that he loves her more than her.

I have also read about the stigma of a BPD diagnosis and will take on board your comments about not mentioning it at the beginning, but rather waiting to see the professionals take on her.

She is not particularly manipulative or dishonest. But she takes risks and puts herself into very vulnerable positions after consuming a lot of alcohol. She has so many visible scars all over her arm. She over reacts to the smallest of things. She says she often feels empty inside. She hates anyone being nice or compassionate to her. She cannot let anyone see her without make up. She has dyslexia and is now struggling with A levels. She seems to just hate people. Has two friends, both with their own issues.

We live near Oxford and I am looking at the Priory and will call them on Monday.

I still feel anxious for her future but I guess until she knows what is wrong, we can't do much. I will support her however I can though.

Be careful with her, or you, suggesting this as a diagnosis.

It has a huge stigma, even amongst professionals. I’ve met young women still in their teens with this diagnosis, and there are stuck with a diagnosis that means they are not taken seriously when in distress and constantly told they need to learn to “self soothe”

Someone displaying the same behaviours and mood swings, but with a diagnosis of bipolar would be treated completely differently.

@wibblewombat

Definitely be looking at other neurodiversities too. Lots of overlap. The adhd foundation has lots of info on adhd, which is overlooked in girls & women. Even if it is something else, the strategies for dealing with adhd would be helpful, I think.

I second this. So many girls and women are misdiagnosed with BPD when in fact they are autistic or have other Neurodiversities.

Autism presents differently in women.

She sounds very like my DD who was diagnosed with autism at age 5. At her age I agree with other posters that it may well be a spectrum condition and that's what I would steer her towards first.

And as @HarrietPotterska just said, maybe DBT skills could help. There are workbooks available online that are actually quite user friendly and have exercises in that can help distract from the urge to self harm, as well as ones that you could help work through with her.

It is not a substitute for sessions with a trained DBT therapist obviously, but there is a huge waiting list (in the area I live in anyway).

There is a book called “The DBT workbook” with exercises in, and could be really helpful for anyone who struggles with emotional regulation.

Also free mood tracking apps - which could be helpful to see if there is a pattern to her moods and to see if there any specific places or people that seem to trigger to trigger her.

Agree with others, specifically about adhd and autism. You may have to really research on your own then present what you find as even professionals have no idea of the misdiagnoses that occur as a result of these.

Offen what happens is that girls get extremely good at masking their conditions and then melt down because they are exhausted. This is then diagnosed as BPD.

Good luck to you and your daughter

I struggled with everything you say your DD does, and I was misdiagnosed with BPD. I actually have ADHD which is managed now (any wonder no treatment ever helped?!) but had had a trauma at a young age which meant my other symptoms were overlooked as they didn't necessarily present the way ADHD is normally seen. As other posters say, definitely worth a thought. I really struggled to get help with a BPD diagnosis as I was just considered attention seeking all the time, but I was really hurting and struggling at the time.

I agree with many other previous posters about looking into Autism and/or ADHD.

Girls present these two neurological developmental disorders so differently to boys and are often misdiagnosed with personality disorders, anxiety or depression when it's actually ADHD/Autism.

when did she start drinking alcohol.
is she aware it is adversely affecting her.
is she willing to give it up.
could you try to get her to help you more in the house, doing tasks together. that can be therapeutic, being actively occupied, with simple tasks, done together or for/ with you, not requiring much mental input, not agonising, analysing, just doing. she could gain confidence through that, and a sense of calmness. and self-esteem, value, of contributing to the running of the household, maturing, growing into adulthood.
i know it's easier said than done.
all the best to both of you.

The exercises in this book at be helpful - complete de workbook online, in particular there are suggestions of what to do instead of self harming
adoeci.com/sites/default/files/grupos/dbt-skills-workbook.pdf

I agree with others. I wouldnt want a BPD diagnosis put on her at that age. It can affect any other medical treatment . Being a self-harming and female can get someone a personality disorder diagnosis without proper assessment.

Talking to a qualufied childrens psychotherapist can be useful if you're able to. That way she can just talk without it being about getting a diagnosis.

Hi,
Well done for exploring beyond sticky labels. As a family therapist I agree with this angle. Here's a few thoughts in case useful:

1. LIFECYCLE challenges for teens: this is when relationships with safe and appropriate male role models become really important. You have an emotionally intelligent daughter who has the same in her Mum. What resources do you have around you on this, who would be happy to be someone she could talk to about boys and get a male opinion you would trust? Perhaps someone could put some effort into building up a relationship with this in mind?

Perhaps you've seen this video my Dad shared with us girls. The main message being: having everyday fun with a safe trusted male influences your development as a confident female around men.

1. FUN: what does she and your family enjoy doing together? Photos/vidoes of fun times. Check out jibjab.com for funny vidoes to create and send

1. YOUR OWN REFLECTIONS/STORIES/LESSONS: Reflecting on own teenage journey can help. Especially funny stories. Who were your safe males and female role models? Take regular time out together having some fun so the stories and worries come out naturally.

1. STEP FAMILY SUPPORT:

• I ran family therapy for Janen-Newman in Sydney. They're family therapists and step parents themselves. Its very popular in Australia:

BOOK: STEP FAMILY LIFE: www.fishpond.com.au/Books/Stepfamily-Life-Margaret-Newman/9781876451523

FORUM: STEPTALK..COM: www.steptalk.org/

KIDSLINE: kidshelpline.com.au/teens

HER DAD: Fathers often find relating to a maturing daughter tricky. Did they have fun together when she was tiny? Or since?

SEE: fatherly.com - www.fatherly.com/parenting/how-to-raise-happy-teenage-daughter/

This is a little funny, but maybe not possible:
www.fatherly.com/news/dad-lets-daughter-makeup-trend/

1. EMPOWERMENT: Watch movies together and find role models that fit with her talents. Some examples:

• www.image.ie/life/25-empowering-movies-thatll-make-you-proud-to-be-a-woman-112565
• brightside.me/article/15-inspirational-movies-about-extraordinary-women-59155/
• Netflix-The Queens Gambit.
• The good Liar ();

See also: www.myvirtualacademy.com/blog/advice/positive-adult-role-models/

Check out Greta: www.britannica.com/biography/Greta-Thunberg

Do you touch base with your ex regularly on this?

Stay Strong You Great Mum! Keep letting us know how you go hey?