Diagnosis of underlying issues

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If you were diagnosed with BPD, bipolar, or autism as an adult how long did that take and what was the process?

DD attempted suicide yesterday by overdose. It is not the first time she's done it but it is the first time she's admitted it early enough to get help. Physically, she is fine, thank god. All the tests in A&E showed the medications she had taken hadn't caused any serious issues.

The on-call mental health team wants to push for her to see a psychiatrist to diagnose what is causing her depression, anxiety, and suicidal tendencies.

This is brilliant news to us. It's what we've pushing for since her early teens. We've always been convinced that depression and anxiety are symptoms of something bigger and this is why medication never helps.

DD herself thinks she has BPD and/or autism.

However, I cannot help feeling like we are going to be let down again. She's seen CAHMS, Mind, and various other local mental health charities. We've offered to pay for private counseling, online counseling, etc. We've tried Citalopram and Sertraline. She always gets signed off before making any progress due to a lack of engagement or missing too many appointments. She cannot speak to people and it takes her months to learn to trust someone new. She gets signed off her medication due to missing appointments before it has a chance to work. They will not give her a new prescription without her attending regular appointments.

I can manage to get her to 60-70% of her appointments with serious planning, constant reminders, bribes and outright begging but there are times when a literal rocket shoved up her backside could not move her from her bed. And once she is at her appointments I cannot make her speak. On top of this, I work full-time and she cannot go to appointments on her own so we are limited as to when she can attend.

Is a psychiatrist the answer we have been waiting for or are we going to be let down again?

The psychiatrist will diagnose her which means she can be offered the correct treatment. Psychological and pharmacological treatments are very different for each of the diagnoses you mention. This means she can be put on the correct pathway. Whether or not she engages, as you say, is a different matter but you will at least understand the underlying problem.

Thank you.

Will she only need to see the psychiatrist once or will it be an ongoing thing she needs to attend regularly?

I understand that a diagnosis will not magically allow her to engage but I live in the hope that once gets the right type of treatment, be it medication or therapy or a combination of both, she will find it easier or at least be offered more patience and understanding when she's unable to.

I often feel like her missing appointments (or rather canceling at the last minute) and refusing to answer her phone is viewed as a lack of effort on her or my part, and that's why she's just signed off; when it's not. It isn't that she/we can't be bothered. There are days when she physically cannot leave her bed. The house could burn down around and she still wouldn't be able to get up and leave the house.

Autism often goes hand in hand with extreme empathy which would explain much of her behaviour to date.

Sorry I don't have answers. My Autism assessment was one online meeting (Covid) and sending in questionnaires.

Previously I had a wrong BPD diagnosis and was put through so medication that never helped.

I hope you get somewhere this time.

It depends.

Sometimes things are clear cut and a diagnosis can be made in one session due to presentation and previous notes.
Sometimes it might take several sessions.