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Dr. L
Dr. L, Psychologist
Category: Mental Health
Satisfied Customers: 1153
Experience:  Psychologist, Marriage and Family Therapist
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I believe my daughter, 20yrs old, has hpd. How do we cope

Resolved Question:

I believe my daughter, 20yrs old, has hpd. How do we cope as a family and how do we draw boundaries but take her attempts of serious attention seriously
Submitted: 1 year ago.
Category: Mental Health
Expert:  Dr. L replied 1 year ago.

Dr. L :

Hello,

Dr. L :

I would like to help you with your question.

Dr. L :

I am sorry that your daughter has this diagnosis.

Dr. L :

The first thing I want to recommend to you is that you learn all you can about this...knowledge is power and that is your first step in providing appropriate support and care to her.

Dr. L :

Please see:

Dr. L :

I would also recommend that you consider talking to a physician or psychologist about your daughter so that you can set those appropriate boundaries, while attending to her needs.

Dr. L :

A suicide attempt is very serious and I am glad that she survived. At the same time, I must encourage you never, ever to dismiss any talk she makes of suicide. We always want to take talk of suicide seriously. The consequences of not acting are not something you would want to face.

Dr. L :

I see you have entered chat. Can you tell me what you worry about with this diagnosis? Have you instituted boundaries in the past?

Dr. L :

At 20 years old - and away at college - there are going to be many things happening in her life that you will have little ability to help her with. What is she asking of you?

Dr. L :

Is she seeing a psychologist?

Dr. L :

I see you are typing. I will wait for your reply.

Dr. L :

Thank you.

Customer:

Thank you for answering my question. Her college is only four hours away, so there have been times that we've dropped everything to go there to deal with whatever the crisis was. She has not been officially diagnosed with HPD, currently she is seeing a counselor at the college she attends for depression and is on a anti depressant. The first anti depressent she was on was wellbutrin.

Dr. L :

Who prescribed the wellbutrin?

Customer:

She is also in a relationship where it appears that she is extremely dependant on him. They've had several breakups by him, as he has stated to us that he cares for her, but is overwhelmed with the relationship. She recently had surgery in December to have her gallbladder removed. It was shortly after that, that she had the suicide attempt because her boyfriend broke up with her. Ive researched HPD as much as I can, and she seems to fit the characteristics.

Dr. L :

Do you think she is histronic?

Dr. L :

How did she attempt suicide?

Customer:

Yes, based on the characteristics that i've read. I now have been revisiting things that she has displayed when she was home, but nothing serious had ever happened

Dr. L :

I'm not thrilled that she is seeing a therapist at college...the reason being is that these are usually graduate students and not licensed professionals. I encourage you to find her a psychologist who is licensed and has expertise with depression.

Customer:

She tried to OD on some pills that she had received from the surgery she had recently had. So my husband and I caught he in the act after her boyfriend called us. (this was over christmas break) So we took her to emergency, then they admitted her to a treatment center.

Dr. L :

From my 30 years of experience, I would say that her being a bit overly dependent on BF is pretty normal for a 20 year old away at college. I wonder what impact the surgery - and the meds given - had on her mental health. It could have been quite hard on her emotionally - being vulnerable, physically weak, etc. I would say that this contributed to her emotional level.

Dr. L :

What happened in treatment?

Customer:

Yes, I've been working on that, but right now she has not really been interested in seeking help outside of her school. It's been difficult

Dr. L :

Do you think she was serious about the suicide? Or despondent about the bf and so forth?

Dr. L :

What's her issue with not seeking help beyond the school?

Dr. L :

The anti-depressant is probably a good idea. But I would want to be sure that she is getting med checks to make sure it is working and that the dosage is right. These things take monitoring...

Customer:

I not sure if she was serious about the suicide. I'm leaning towards being despondent about the bf. I think her issue is that she is afraid to really get help. I had an appt. set up for her here when she was home, but she was a noshow. I agree about the emotional instability, she lost both of her grandparents about two years ago, only two months apart from one another. And I feel she really hasn't grieved their death. She still really won't talk about them. Then she has been having this medical issue, with her gall bladder and had to have surgery, and didn't do well in school at all. And she is normally an A student. she finished the semester with a 1.9 and it dropped her gpa to a 2.7. She really freak about that. So sometimes I feel it's just severly emotional issues, then I think she is histonic

Dr. L :

Thanks for the additional information.

Customer:

Yes. the school counselor did refer her to a psychologist and he changed her meds to something other than the wellbrutrin. Not sure of the new name of this one. She's only been on this one for less than a month. It's been hard to manage since she is away at school, so I feel a little helpless and have to rely on what she tells me since I can't ask the psychologist personally.

Dr. L :

I feel for you mom! You are absolutley right that trying to manage this from a far is difficult..but the truth of the matter is that she needs help with this. When someone is depressed they are typically incapable of taking the necessary steps to get the help they need. So..let's look at some of the issues you present...

Customer:

ok

Dr. L :

New medication. Typically, anti-depressant medication takes about 6 weeks to start working. If she is taking Lexapro or Celexa these have a faster "up-take". That she had to get off one med and on to another makes this process a bit longer. A psychologist cannot prescribe medication. So..I am assuming that she saw a psychiatrist. I ask you to verify this as a psychiatrist is likely only to be involved with the medication...and not with therapy. Having said that, what she needs is to be seen by a psychologist with expertise in depression. The folks she is seeing at the college will not have the expertise she needs. However, if she is unwilling to go outside the school...then that may be better than no therapy. Still....please try to get her to see someone with higher credentials. Her reluctance may be more about low energy than anything. Maybe bf or roommate could help here.

Dr. L :

And ... you can talk to the psychologist. What you would need is your daughter to sign a Release of Information form. This would give you the ability to talk directly to the therapist. I would ask your daughter to do this so that you can stay on top of the bills, medicine, and so forth.

Dr. L :

You wrote that you think she is afraid to get help...tell me more about this.

Customer:

ok. thank you. She does tend to listen to him and he does talk to me and her dad, so I think he wouldnt have a problem with helping us to get her to see someone else. And I believe you are correct that she is only seeing the psychiatrist for the meds.

Dr. L :

As to her grandparents dying. This could, in my opinion, be a very critical piece of the puzzle. If she has pushed away her grief...attempted to gone on with life without grieving...it is very reasonable that her current depression and despondency is related. I am going to encourage you to get her several very good books as a way to open her eyes to what she might be feeling:

Dr. L :

Remembering With Love. Messages of Hope for the First Year of Grieving and Beyond

Dr. L :

The Remembering With Love Journal

Dr. L :

Fire in my heart, Ice in my veins

Dr. L :

All these are available on Amazon or at your local bookstore.

Dr. L :

One way to present these to her is to simply say...I have been thinking about grandma and grandpa and I wanted you to have these books.

Customer:

Well, I'm not sure how much she really wants her dad and I to know. She constantly states that she wants to protect her privacy. Not sure if that is just he way of trying to show she is being responsible, or if she is trying to protect us from something she may think we will be mad at. When she was in the hospital for the suicide attempt, we went for our family session, and she stated that she didn't want to upset us, and so many people depend on us, she wanted to protect us from worrying about her. Her dad and I work in the ministry. So we have many people that seek our cousel

Dr. L :

Each of these books is unique...and each will provide her with support.

Dr. L :

I understand...here is how I would respond to that:

Customer:

Thanks for those books, I will certainly take your advice on how to present to her

Dr. L :

Yes. Honey you are absolutely right. Lots of people depend on us and seek our counsel. But not one of those people is more important than you. God has given us the ability to minister to these people and we do that. Yet our love, our devotion, our support are nothing if we cannot be there for you.

Dr. L :

No burden you have is too great for us.

Dr. L :

We will respect your need for privacy.

Dr. L :

And...at the same time...we want you to know that we will always be here ready and waiting for you.

Dr. L :

The issue is that you will worry no matter how much or how often she protests that she wants to protect you.

Customer:

Thx, we did express that to her and I've continued to try to reinforce that when I speak with her. She called me late last night, about 1am to tell me that she didn't feel good, she was very upset. I stayed on the phone with her and she calmed some. Then I called a few hours later, and she said she was perfectly fine, and had a very upbeat attitude as if the hysterical phone call we had hours earlier hadn't happened.

Dr. L :

So...all you can do is to be there in whatever way she allows you into her life. That you have a good relationship with bf is very, very fortunate.

Dr. L :

That may be the meds working...it could be fatigue...it could be confusion on her part.

Customer:

Ok. I will continue to try to encouarge her to seek a more professional therapist. And I will also speak with her bf.

Dr. L :

Sometimes things do seem dark/scary/horrible when we are tired and out of sorts...and then the comforting words of support from a loving person changes the situation.

Dr. L :

Still...it could be the hpd....

Customer:

Ok. She has been saying that she is always tired and doesn't understand why. I wasn't sure if it was her depression or something else.

Dr. L :

And...I do want to encourage you and your husband to consider a few sessions with a psychologist as a way to take care of yourselves. You need to be strong for her...and making sure that your head is in a good place would be important to this goal.

Dr. L :

Likely the medication. Her body is trying to adapt...and that isn't easy since she has switched medication.

Customer:

Yes, that's what's so hard. In my heart I just wish is was only depression bc that seems more managable, but I feel it's both and/or HPD. That's scares me so much, b/c the things that i've read speaks of how hard HPD is to treat.

Dr. L :

You might tell her that so that she has a better idea of what is going on.

Dr. L :

As to her grades...how about a tutor? That can help immensely!!! Most schools offer this for free...

Dr. L :

The thing that is important to remember is that she is 20 years old. At 20...the brain is still changing dramatically! !

Dr. L :

What might help you is to read: The Whole Brain Child by D. Siegel. This is EXCELLENT. And will likely prove beneficial in understanding that some of what is happening is due to immaturing and a brain that is still evolving.

Dr. L :

The current literature says that from age 12 - 27 our brains are undergoing tremendous reconstruction...so much so that we are impulsive, take unnecessary risks, can't make good decisions, etc. Some of this describes your daughter!!!

Customer:

Thanks, XXXXX XXXXX considering therapy for all of us as a family. She has a 12yr old sister who looks up to her and had been trying to understand what's going on with her sister. The last time I mentioned family therapy, she wasn't so open to it, but that may have changed now. In terms of her grades, she had been seeing a tutor for a few classes. I think she struggles with having a turtor, b/c she is usually the tutor. But I've tried to encourage her that she has had a lot going on, and it's okay to have a turtor for now.

Dr. L :

Please consider getting this book. Also...the grief piece is likely a factor as well. Get the books...I know they will be helpful.

Customer:

Thanks, XXXXX XXXXX get all of the recommended book tonight.

Dr. L :

You are doing an excellent job here Mom! Keep up the good work...I can understand how exhausting this...and I do think going to therapy is the right move to make at this point. The more you can arm yourself with knowledge...the better you will be able to handle this.

Dr. L :

Keep hopeful!!!

Dr. L :

Is there any more I can help you with tonight?

Customer:

Thanks so much for your help and input. I'm feeling a little more at ease.

Dr. L :

Please know that we can chat again in the future. Just post a new question directly to me and I will be notified.

Customer:

No thx, I will start searching for the books.

Customer:

Great. Thx so much, God bless and have a wonderful evening. Thx again

Dr. L :

I'm very glad you are feeling some relief. It really helps when you have something concrete to do...rather than worrying.

Dr. L :

You are very very welcome.

Dr. L :

Take care!

Dr. L, Psychologist
Category: Mental Health
Satisfied Customers: 1153
Experience: Psychologist, Marriage and Family Therapist
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