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Dr. K
Dr. K, Psychiatrist
Category: Mental Health
Satisfied Customers: 357
Experience:  15 years clinical experience in all areas of psychiatry. Holistic and practical approach.
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Im sure my daughter (age 28) has BPD but has never been diagnosed.

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I'm sure my daughter (age 28) has BPD but has never been diagnosed. She appears quite normal to the doctors and has been prescribed both Adderall in college, for attention deficit (not Hyperactive) and recently Zoloft since she has been getting progressively depressed and angry. She lives by herself, one town away from me. Her father, I'm sure, has the same thing and is also an alcoholic. She witnessed a lot of serious arguments and trumoil growing up between her father and I which were rarely physical and she was always acting out and demanding attention, both positive and negative, which I always felt was because of our fighting. She was alone until she was almost 6 years old and we had another daughter J who appears to be fine except for a bad temper, which is mostly directed at her older sister. E has resented J from the day she was born, yet alternately acts like she "owns" her, and has always been fascinated by J's curly hair, patting it, pulling it and smelling it! J would always haul off and punch her as soon as she did it because E just couldn't stop doing it and E would always be so surprised and say thta J was wrong and she was right, she nver understood or acknolledged that she was in any way to blame and it has been that way with her always! E was and still is a temper tantrum thrower. No matter where she is she will act out, in public and in front of anyone. She has and still does cross that boundry where others will not. Everything is black adn white to her, if you are not with her you are against her. Also, she has always had an eating problem, she only eats certain foods her whole life. She eats hamburgers, hot dogs, baked beans, french fries, applesauce, cranberry sauce, mixed fruit, waffles, pancakes and has been to a nutritionist and she does try chicken and beef and lettuce but not really. She has done that becasue of peer pressure from the boyfriends who have come and gone through her life. I am her best (and only) friend and her worst enemy, lately more often her enemy, because I try andoffer her help and suggestions, yet she accuses me of criticizing her and wishing her harm (not to mention that I'm the one responsible for all her problems and I need professional help and i favor J, and I'm just waiting and hoping she fails and will be happy when she is gone, etc., endlessly!)! I've had her to Alateen which she never wanted to go back to and to counceling twice, mostly for eating and she has gone once herself. She would never do the exercises or keep the journals they suggested and just stopped. She is in total denial (I have never suggested that she has BPD for fear of her temper tantrum and accusations that I would be happy if she is crazy!) but as far as suggestions for her to get help. She and her sister had a knock down dragged out fight recently and of course I am against her and I support J (E almost threw a basket out of her 15th floor balcony) and then J's laptop causing J to try and stop her and restrain her. She always acts agressively toward J and I and tries to say she didn't and then dramatically falls or throws herself down and says we did it to her. She is therefore not at fault and we are!

My question is how can I get her help. I thought I cna sepak to her primary doctor who is treating her for depression (zoloft whcih seemed to help with the frequency of her outbursts and she seemed happier for a longer period of time, more stable) as well as Adderall which she needs for work (she is always onthe verge of being fired and has been twice before because of her inefficiency). By the way she has a college degree from a big East college so is very smart and manipulative. If I tel her primary doctor and he tells her she will be more than furious with me, it actually scares me what she may do! I don't feel she needs to be committed, although I do feel she is getting worse. She is currently not speaking to me but I expect she will soon enough, I hesitate to tell her anything to rile her up. Should I tell her I think she has BPD? Her sister J and she are no longer talking and I am not encouraging their relathionship anymore as is always ends in disaster! When she is speaking to me again should I tell her I think she has BPD? I'm pretty frank with her as far as suggesting she get help, etc. (which she hates) should I stop doing that? And finally when she tells me she doesn't want to speak with me, I usually email or call & leave a voicemail and just ask her how she is doing or if she needs anything. Should I do that, or just stop contact with her until she calls me? I don't want her to feel I've abandoned her, even though she yells aat me because she told me not to call her!!! I just want to do the right thing by her and her sister. I am still married but I keep my husband out of it because he is just as bad as she is and he blames me to for antoganizing her. We live in the same house but do most everything separately. Please advise.
Submitted: 3 years ago.
Category: Mental Health
Expert:  Dr. K replied 3 years ago.

1st, I assume by BPD you mean borderline personality and not bipolar disorder.

 

I don't think telling her you think she has BPD is going to be the best idea. If anything, just barely suggest it. In other words, "I was reading this article about BPD and it reminded me a little bit of you...just thought I would mention it." Even this can backfire because she may take it as an insult if she's in denial that she is just fine.

 

The main treatment for BPD is psychotherapy and she doesn't sound too keen on that. One way to get her some help is by starting with a family therapist. This sends her the message "let's work on our relationship together" instead of "you have a problem...go fix yourself."

 

There is a great book you should read: Stop Walking on Eggshells: Taking Your Life Back When Someone You Care About Has Borderline Personality Disorder by Paul T. Mason and Randi Kreger . You may also want to consider finding support for youself; http://www.nami.org/ could help you find a local support group. No matter what professional advice I give you, it will be invaluable for you to hear how other parents' handled similar situations.

 

Good luck....let me know if you need more info.

Customer: replied 3 years ago.
Thank you, XXXXX XXXXX mean Borderline Personality Disorder and I already ordered the book you suggested and I'm waiting for delivery! I appreciate your answers, but I do want to know what you think about talking to her primary doctor - we share the same one and I will be seeing him on Tuesday and wonder if I should tell him my concerns and ask him not to say anything to her? Thanks again.
Expert:  Dr. K replied 3 years ago.

If the doctor has a good relationship with her...and might have better luck encouraging her to see a therapist, then go for it. And if you just want some feedback from him for yourself, and trust that he won't say anything to her, go for it. Otherwise, there's not much to gain...it's not as if he can offer her any other treatment for it. Is there a particular outcome you're hoping for by taking to the primary doctor?

Customer: replied 3 years ago.
Thank you again, I guess your suggestion to go to therapy together is the best option - if she agrees, but I just think our doctor should be aware that she has the disorder since he is prescribing her adderall and zoloft. I can't help but think she doesn't have ADD and I also think her taking adderall makes her more crazy acting. I do think she needs the adderall for her job performance mostly because SHE thinks she needs it. I guess it does enable her to focus, which is her biggest problem at work, she was fired from two jobs previously and is having problems with her supervisors in her current job regarding her inefficiency. I'm sure she would be fired if they could easily replace her, meanwhile I think it is the cause of much of her anger and frustration and rages. So my reason for talking to her doctor is to let him know my concern that she has a borderlie personality disorder and with the medication he is prescribing for her and also to ask him encourage her to get treatment - she told me when he started her on zoloft he suggested she also go for counseling if she felt she needed it.Thanks again!
Expert:  Dr. K replied 3 years ago.

People with BPD often have substance abuse; and stimulants can increase behavior problems in someone who truly doesn't have ADD. Now that you've told me that, I think it's important that you do consider telling the doctor.

 

Now, if he listens to you and stops the adderall, this will obviously make her very mad at you. And I can't say from here that she doesn't have both BPD and ADD...so I don't want to recommend stopping it immediately. Many GPs make patients see a psychiatrist to confirm diagnosis when they are prescribing stimulants...he could basically make her do that if she wants the medication continued. This could upset her...and I don't know if she's the type who would just go find another GP...sadly, it's not hard for people to find docs to prescribe whatever they want.

 

But remember, you shouldn't avoid telling the doc just b/c it will make her mad. Tough love is important...even if she doesn't understand it at the moment.

 

However, he could also potentially just listen to your concerns and note them. Then down the road if there seems to be problems with the adderall...he can reconsider whether to prescribe them. Perhaps you can also remind him to tell her that the best treatment for depression is meds with counseling and that she should do it...not just "if she thinks she needs it." I like telling patients that psychotherapy/counseling has been proven to work by studies using sophisticated brain scans. It may be more "palatable" for her to think she needs counseling for depression...rather than BPD...

 

I hope this is helpful...anything else I can answer?

Customer: replied 3 years ago.
Thank you very much for all your help I will talk to her doctor and hope we can keep it quiet. I don't care that she gets mad at me (nothing new!) but I just want to handle it so that she will get help. I do like our docotor and think he will be on board and if not the suggestion of both of us going is great since she is always telling me I'm th eone who needs help! :) Thanks again for you advice.
Expert:  Dr. K replied 3 years ago.
Glad to be helpful. Take care.
Dr. K, Psychiatrist
Category: Mental Health
Satisfied Customers: 357
Experience: 15 years clinical experience in all areas of psychiatry. Holistic and practical approach.
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