Friends, Family & Carers Forum

[Che]

Hi,  I'm new here but am absolutely desperate.  My daughter is now 26.  

She has had undiagnosed BPD for many years.  I took her to a Psychologist when she was 17 who discussed with me that my daughter had BPD and I agreed as I had already researched this.  My daughter said, at that time, that she did not want to know what was wrong with her as she would ‘act out’ the symptoms and I said (very kindly) you couldn’t do that more if you tried.  This Psychologist turned out to be very unstable herself (long story) and so I found my daughter another one. My daughter has had counselling on and off, more off in the last 2 years, as she found a Psychologist that she could relate to.  I also had counselling for many years in order to try and help both my daughter and myself.  It has been a very hard and long road but I really thought that she was improving.  We have all been through much trauma and violent outbursts, property destruction, etc. etc.

My daughter meets most of the DSM diagnostic requirements for BPD but her therapist does not appear to have given her this diagnosis.  My own counsellor said she was reluctant to give people labels, especially one like BPD, and would rather manage the behaviours.

I am really at my wits end after the last awful outburst.  I cannot tell her she has BPD but how is she going to get the treatment she so clearly needs without knowing that what is wrong with her.  She is beautiful, bright, funny and has a lot of pride.  I love her with all my heart and soul but she is destroying my health.  My husband really has had enough and is not able to be as patient and understanding as I am and often escalates events through lack of empathy.

I'm not sure what, if there is anything, I can do next.

[Janna]

Hi @Che and Welcome!

I'm sorry to hear about the troubles you are having with your daughter. It sounds as though you have all been struggling for quite some years. It's great that your daughter has engaged in therapy with a psychologist and counsellor, but I noted in your post that you didn't mention that she has been to see a psychiatrist. Counsellors are not allowed by law to make a clinical diagnoses. Psychologists can make an assessment and diagnose, but they generally refer onwards to a psychiatrist for a full clinical diagnosis and should do so for further and complimentary management.

I have noted in my experience that clinical psychologists and even psychiatrists are reticent to come forth with a diagnosis. I believe that it is because they need extended contact with a patient in order to make a diagnosis with accuracy. Many mental health disorders overlap e.g. depression can be a symptom of many disorders, but it can also be a stand alone disorder. In many respects I admire those who err on side of caution when it comes to making a diagnosis as the fallout of this can be catastrophic for both the individual concerned and their family, particularly if it is wrong. I have a friend who recently saw a counsellor for family issues in relation to her father-in-law. After two sessions the counsellor came to the conclusion he was a narcissist. This completely spun my friend out, who rang me that evening in a hysterical state screaming "OMG, he's a narcissist". From that moment on the family matter exploded into an interfamilial war as she chose to protect her two young daughters from their narcissist grandfather by breaking contact.

I would highly recommend taking your daughter to a psychiatrist for an assessment with a view to getting her on medication or into more appropriate treatment/therapy. Perhaps the psychologist she has seen can write the referral and provide a concise clinical history. Another more hard line approach would be to involve the police if she becomes violent or destructive of property. Although this is not something any parent wants to do, sometimes it is necessary and can make the person realise how unlawful and inappropriate their behaviour is. Additionally, you would be showing her that you have boundaries that should not be crossed. I called police on my 15 year old son to protect us and himself and all that happened was that he was forced to undergo a mental health assessment in hospital. However, he has never lost control to that magnitude since because he knows what Mum is going to do. You have to remember that mental health issues are not a licence to be violent, abusive or destructive and you do not have to tolerate this behaviour. As parents we tend to stretch our boundaries in order to accomodate their troubles, but sometimes this backfires because we are not setting limits on what is and isn't acceptable.

Best of luck

Janna

[Former-Member]

Hi @Che

@Janna really said it all - her post was spot on. I like you have a daughter diagnosed with BPD and possible bi-polar (the jury in still out on the latter but she has severe mood swings and is on mood stabilisers). My self and husband have suffered the same as you have with much trauma, violent outbursts, verbal abuse and destruction of property. Like @Janna did with her son - we called the police on our daughter when she physically assaulted us and destroyed property. We eventually had to put an AVO on her as she was becoming dangerous. This needs to be done to set clear boundaries as mental illness is not excuse for violence or abusive behaviour.

A lot of my daughter's mental health issues stems from low self esteem and past sexual and psychological abuse from partners and friends. And she so far has refused therapy as she won't part with the money. So we are in a similar situation to yourself. All we can be is there for her to pick up the pieces. It's soul destroying to watch and if we don't detach and try and lead a life for ourselves the ongoing stress is detrimental to health.

[Che]

Hi Janna,

Thankyou for your reply.  I cannot facilitate my daughter being referred to a Psychiatrist.  She is 26, and although still living at home, an adult.  I am going to encourage her, when appropriate, to see her Clinical Psychologist again.  She is usually high functioning, she works part-time and is coming to the end of a Pyschology degree but does not seem to recognise or acknowledge that she has a mental illness.  She already takes an anti-depressant.  I would find it very hard to involve the police.

[Che]

Thank you Overthe edge for your reply.  It is so hard and I mourn for the life she should have.  She is beautiful, smart and funny and I want her to have the opportunity to live a full life with healthy relationships.  I am fortunate in that I am in a position to pay for all her health care costs.  I have worked very hard over the last 10 years to maintain and facilitate her relationships with her siblings and have seen great results.  They all know that she has undiagnosed BPD and support me and their sister, in that they won't abandon her, even when her behaviours have been at their most challenging.  Having said that, it is still very hard for her younger, but adult sibling, who also lives at home.  I can't detach, but am trying to also lead a life of some sort.  I think I have reached the stage where I need to see a Counsellor again, unfortunately the wonderful person I saw for a few years retired and I'll need to find someone I can connect with, which as I'm sure you are aware can be very hard.

[AndrewM]

Hi @Che,

Sorry to hear the situation with your daughter. It sounds to me like you are managing the best you can at the moment. It's difficult when we are unsure of the situation - today could be ok, we wake up tomorrow and it's a mess. It really makes it difficult for use carers to know how to behave and cope, and therefore manage the situation effectively. But as I said it sounds like you are doing everything you can and I can tell it comes from a place of love and caring. So much so it hurts, and I understand that. Stay strong though and make sure you look after yourself regularly.

I have a recently diagnosed BPD 34 year old son. He has been difficult for 15 years, and has had drug and alcohol issues. Although verbally abusive, thankfully he has never been violent. His mum and I are divorced and I now live in a different state after AVOs were ineffetive with her (she sadly grew up with a violent father and this caused major problems in our marriage). For my understanding only and not placing blame (unhelpful), I believe this is part of why he has these problems. Our other son also has similar problems, although not so bad. Their attitude to their mum is sadly not good. So she sounds similar to your husband and will often escalate things rather than improving them. This results in him leaving her home and simply "exisitng" in the world - with no money, little food, sleeping rough etc.

I would love to take him in, but I am interstate and in the country with little services, let alone BPD treatment - plus my partner (who he has included in the abuse) has diagnosed Bipolar - so that is a big consideration. So my support is largely phone and finance.

It's interesting to note that when my partner was first diagnosed, she mentally crashed overnight and stayed in a dark place for a month or so. It was a challenging time. The reason I'm saying this is because she said she could cope simply not feeling well, but to then be actually diagnosed is a shock. The bright side is that she has responded really well to medication and treatment and is beginning to get her life back together and importantly we are still strong. I cancategorically say that in the case of my partner and Bipolar, a diagnosis has helped, in fact it probaly saved her life.

For my son and for me, a diagnosis has without doubt also helped. He went through a similar time as my partner, and even though I could sense the relief he felt, his risky behaviour escalated. But the really nasty abuse did not. In fact it is has lessened markedly so far. A diagnosis has meant that I can now deflect some of his behaviour onto the illness and not the person. In my view this is an important coping mechanism, and I no longer have the racing heart, sweats and depression his abuse caused. The flip side to a diagnosis is that behaviour standards still need to be maintained, and a diagnosis does not mean they have an excuse for it. I would also argue that a diagnosis allows carers, supporters and sufferes to better identify and focus on treatments (and medication if required) which specifically target the illness.

I've gone on a bit and don't mean to hijack your thread - but this is a glimpse of my experience and I hope there's something in it that gives you some hope for improvement.