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Elliott, LPCC, NCC
Elliott, LPCC, NCC, Psychotherapist
Category: Mental Health
Satisfied Customers: 7662
Experience:  35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
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Son suffers from depression, BPD?. He is trying very hard to

Customer Question

Son suffers from depression, BPD?. He is trying very hard to work at jobs but unable to work. Depression and lack of experience have slowed him down and a really bad sleep pattern keeps him tired during the day. Constant anxiety and fear of failure. Has gotten and lost many jobs. Is he avoiding working or can he not work because of his condition? Can neuro- biofeedback help? How can I help him without enabling?
Before this disease took over he was a great worker. Worked when he was 13-14 as a dishwasher. Was cheerful, now at 27 he seems to be unable to hold a job or even attend classes.
Submitted: 1 year ago.
Category: Mental Health
Expert:  Elliott, LPCC, NCC replied 1 year ago.

Elliott, LPCC, NCC :

Seeking expert counseling is a sign of strength. A personal relationship with a caring professional is proven clinically effective.

Elliott, LPCC, NCC :

Dear friend,

Elliott, LPCC, NCC :

I believe that I can help.

Elliott, LPCC, NCC :

What makes you think that your son has Borderline Personality Disorder?

Elliott, LPCC, NCC :

If you can type a response to my question and then click REPLY, we will be able to have a very useful dialogue and I will best be able to help you in this situation.

Elliott, LPCC, NCC :

Bioneurofeedback is not a mainline treatment for depression. If you are talking about the depression from BPD then the best approach is often Dialectical Behavior Therapy.

Elliott, LPCC, NCC :

I am not sure, from what you have said thus far that your son has Borderline PD.

Elliott, LPCC, NCC :

Here are the diagnostic criteria for BPD. Tell me if they fit?

Elliott, LPCC, NCC :

For your enlightenment and information here are the official criteria for BPD from the psychiatric diagnostic "bible", the DSM-IV.


BPD – DSM-IV


1. Frantic efforts to avoid real or imagined abandonment.


2. A pattern of unstable and intense interpersonal relationships characterised by alternation between extremes of idealization and devaluation.


3. Identity disturbance - markedly and persistently unstable self-image or sense of self.


4. Impulsivity in at least two areas that are potentially self-damaging, e.g. spending, sex, substance abuse, reckless driving or binge-eating.


5. Recurrent suicidal behaviour, gestures, or threats, or self-mutilating behaviour.


6. Affective instability due to a marked reactivity of mood, e.g. intense episodic dysphoria, irritability or anxiety, which usually lasts for between a few hours and several days.


7. Chronic feelings of emptiness


8. Inappropriate, intense anger, or difficulty controlling anger, e.g. frequent displays of temper, constant anger or recurrent physical fights.


9. Transient, stress-related paranoid ideation or severe dissociative symptoms.


Anyone with six or more of the above traits and symptoms may be diagnosed with Borderline Personality Disorder. However, the traits must be long-standing (pervasive), and there must be no better explanation for them, e.g. physical illness, a different mental illness or substance misuse.

Elliott, LPCC, NCC :



Since you are not at the computer at the moment I shall save this chat and exit. Come back to me later and we shall continue, hopefully as a two-way dialogue.

Elliott, LPCC, NCC :

Warm regards,

Elliott, LPCC, NCC :

Elliott, MAE, LPCC, NCC, CCMHC

Customer:

ok, when can we do this monday ?

Elliott, LPCC, NCC :

Hi there. Are you on line now?

Elliott, LPCC, NCC :

I will be available Monday morning after 8AM CDT.

Elliott, LPCC, NCC :

Due to the way the computer system is set up, experts cannot guarantee an exact time. We are automatically obliged to serve any clients according to their position in the queue at the time. If you are online and I am not with some one, I can take you immediately, which is, of course what I would like to do.

Elliott, LPCC, NCC :

Hope to talk to you Monday morning, unless you catch me before then.

Elliott, LPCC, NCC :

Warm regads,

Elliott, LPCC, NCC :

Warm regards,

Elliott, LPCC, NCC :

Elliott, MAE, LPCC, NCC, CCMHC

Customer:

Will try again on Monday.

Elliott, LPCC, NCC :

Just checking. You are still offline. I shall check back later.

Customer:

Thanks for clarifying the BPD symptoms. Hoping you will be available today. According to this definition he does not fit the bill. But this chronic depression and anxiety continues. Extreme sensitivity to criticism and inability to keep a job. Has a great resume and gets job offers but after the 1st day he is no longer able to stay on. He stays up at night due to anxiety and then goes to work sleep deprived. That plus his lack of experience makes him slow at work.

Elliott, LPCC, NCC :

Hello.

Elliott, LPCC, NCC :

I am here now.

Customer:

Thank you very much. We are parents of a young 27 year old. As a child he was a happy child with lots of possibilities. Extremely bright and went to a private prestigeous school but a shadow fell over him as a teenager. He changed. Depressed and unable to function. He works with his depression now but we can't seem to help. He is trapped in time, in his room, trying to be normal at times but has anxiety at jobs. He has a very nice girl friend.

Elliott, LPCC, NCC :

I did not think he had Borderline Personality Disorder, but does seem to be suffering from depression, which includes lack of sleep and low self-esteem, and also makes it difficult for him to concentrate and focus on his tasks on hand. It is also making him irritable and this is where it may seem he cannot take criticism.

Elliott, LPCC, NCC :

Is he seeing a therapist?

Customer:

Yes, now he is. We as parents want some tools to deal with a difficult personality. We loved and spoiled him as a child. He was the star but if you hear him talk we were very mean to him and that is why we need to give him money. That is his reasoning.

Elliott, LPCC, NCC :

Do you give him money? Isn't this a form of extortion? Does giving in to his demands help? You said that you spoiled him. Now he is 27. Do you think you are enabling his behavior?

Customer:

I know it sounds like the garden variety problem but we need to some help. The only time we give him money is when he baby sits the dogs for us and takes care of the house. Otherwise we don't give any money any more. He is required to do chores. Mow the lawn, paint the house etc. But my husband feels we are enabling him by not kicking him out of the house. We sent him to be with his sister in New York city and he got mugged, muddled through some jobs, did poorly and begged to come home.

Customer:

From a streak of brilliance in his youth he has slowed down and depression has almost slowed his mental capabilities. His judgement is poor at times. How can we empathize but maintain our position that he work?

Elliott, LPCC, NCC :

It is not the garden variety problem. It is a problem that needs attention.

Elliott, LPCC, NCC :

What do you think is the source of his depression? Does it run in the family? Was there some life-changing events that precipitated this?

Customer:

Yes, it runs in the family. Also a trauma when he was 11 or 12 yrs. old. Yet he remained a very happy, cooperative child till he reached 15-16. He was very open and honest to me. When the depression hit nothing made him happy. At times he could put on a happy face at weddings etc. but most of the time he lived in a shadow. No real cause.

Elliott, LPCC, NCC :

What was the nature of the trauma when he was 11 or 12?

Customer:

I want to be therapeutic and say things that appear that I understand at the same time be firm. I mirror him when he seems upset that seems to alleviate his anxiety. what other tools are there?

Elliott, LPCC, NCC :

Who else suffers from depression and what do they do about it? How has if affected your family?

Customer:

You know mirror, repeat what he has said by saying, 'I understand you are saying that.....'

Elliott, LPCC, NCC :

I'm sure he appreciates your empathy but that is not fixing him. I'd like to know more about the trauma, and about the depression in your family. Who has it and how has it affected your family life, collectively and individually?

Customer:

When the kids were little, Jon thought playing paint ball would be fun. They all bought masks and guns and played in a heavily wooded area. Jon had mowed lawns to buy his equippment. According to the children playing a boy who was not a part of the game entered the play area. The children were playing in a hollow wooded area and the spectators were on the edge on a hill area. This boy who came into the play area was hit in the eye. Jon was also very upset. The next day the police officer called our home and said they were going to pull Jon out of class room and speak to him about the incident as the father of the injured boy had complained. My husband answered the phone and without thinking much about it agreed that the police interogate Jon in the school with no parent present. By the time I called the school the police had already spoken with Jon. Then we had deposition in which the attorney grilled Jon and me. I was in tears but Jon had a stoic blank face. After the settlement we were moved Jon to a private Christian school. He was easily accepted and became the star pupil. His girl friend now was his class mate.

Elliott, LPCC, NCC :

This incident does not appear to be one to cause long-term trauma. What about the family history of depression? What about his relationship with his father?

Customer:

TO some degree we all suffer from it. But we function well. HUsband a retired editor, I am an ER nurse. I decided to seek antidepressants after menopause. We can endlessly go over the past. What other people can slough off as nothing to worry about seems to have put this young's life on hold. I need to know how we can move on and help him move on also. TOOLS to work with that is what I need!

Elliott, LPCC, NCC :

What do you mean by tools?

Elliott, LPCC, NCC :

I do have an excellent workbook that I would call a tool. It can be very helpful:

Elliott, LPCC, NCC :


I do not think that asking your son to leave the house will be helpful to him. He must abide by the rules, however.

Customer:

Husband says, maybe he needs to move out and that he is manipulating. I say he does not seem to function in the real world and who in their right mind would want to live like he does. Cocooned in his room and avoiding the world. Therapeutic tools to help him mature. He seems to be caught in a time warp, emotionally not developed. Face the knocks of the world.

Customer:

Cannot face the hard knocks of the world. I thought biofeedback would help him take charge of his own mind. How to calm down when faced with anxiety.

Customer:

How would this book help us/me deal with him? Please explain.

Elliott, LPCC, NCC :

You would sit him down with the book and go through the lessons/chapters, one by one.

Customer:

When your mind is not under your control and feels trapped then one feels a victim of your own poor judgement and yet not know that your judgement is poor.

Elliott, LPCC, NCC :

What is his therapist doing for him? Is he taking medication?

Customer:

He would never sit down with me and go through the book. I can't even get him to read a paragraph.

Customer:

Yes he is on meds.

Elliott, LPCC, NCC :

What meds?

Customer:

Meds. mean he can get up and carry on a conversation. When he came back from New York I immediately knew he was not on meds. He was suicidal and so depressed. I got him on meds immediately. But the meds not enough. They don't help him function.

Elliott, LPCC, NCC :

What meds are they?

Customer:

Generic Lexapro q day. and Klonipin 3 xday.

Elliott, LPCC, NCC :

Are these drugs making him somnolent and affecting his ability to function properly?

Customer:

We think Klonipin is but he talked his doctor to give him this.

Elliott, LPCC, NCC :

It is addictive, you know.

Elliott, LPCC, NCC :

And makes a person sleepy.

Customer:

Yes I know it is addictive. But if the doctor gives it to him we have no recourse.

Elliott, LPCC, NCC :

Is he getting any psychotherapy?

Customer:

Psychiatrist are so quick to write the scripts. They don't want to make the patient unhappy.

Elliott, LPCC, NCC :

He needs a psychotherapist who will TALK to him, not just an uncaring doctor as this one seems to be.

Customer:

Yes. he is seeing a therapist now, 2 sessions, so far.

Elliott, LPCC, NCC :

It will take some time.

Customer:

Yes the psychotherapist talks to him. He does not devulge what they say.

Elliott, LPCC, NCC :

Hopefully he is a competent one.

Elliott, LPCC, NCC :

Give it some time.

Elliott, LPCC, NCC :

Are you depressed because of this?

Customer:

It is a woman and I have no knowledge of what goes on. I feel very guilty about how he suffers. He was my beautiful baby. The star of the family. The smartest boy who would grow up to be adoctor. I feel like I failed with him, but I have not given up. I pray for wisdom and would love to go to a retreat with him, my husband to some place we can afford. Maybe Costa Rica, Thailand, Bali anywhere where care is affordable.

Customer:

Being on the inside I know what goes on in psychiatric facilities and what most psychiatrist think of their patients. There is a lack of compassion and empathy in that profession more than in other profession. Compassion fatigue!

Elliott, LPCC, NCC :

What kind of care do you expect? He needs to be motivated and not allowed to stay in his cocoon doing as he pleases. He needs to be motivated and not treated as if he is beyond help. Having compassion for him means encouraging and even prodding him. If he does not have to be self-reliant then he will not be.

Customer:

Exactly, how do I do that? I have an appointment. Please can we talk later?You have made me think and I need to mull over this.

Customer:

Tomorrow AM ?

Elliott, LPCC, NCC :

How about some positive feedback for all of the time I spent with you? That would be an act of good faith on your part, and show JustAnswer that I am actually making progress in their terms?

Elliott, LPCC, NCC :

I will still get back with you.

Customer:

OK.

Elliott, LPCC, NCC, Psychotherapist
Category: Mental Health
Satisfied Customers: 7662
Experience: 35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
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