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Elliott, LPCC, NCC
Elliott, LPCC, NCC, Psychotherapist
Category: Mental Health
Satisfied Customers: 7664
Experience:  35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
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My son is 36 and very irresponsible, although he does not

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My son is 36 and very irresponsible, although he does not live with me I take care of all his bills. He pays me 2x per month. I suspect he may be BP, only one real incident of what I could call psycotic. He had a blow to the head, no real damage, but his behavior prompted me to take him to the hospital. He was verbally abusive to me and was not himself. He did see a psychatrist whom he convinced that he was OK, but he seemed manic to me. I feel at this time in his life he should be mature and should make better decisions, he seems to be at standstill. He has angry outburst when I try to talk to him about doing better. His apartment is a wreck and can't not keep a car or a drivers license, tickets and accidents. I walk on eggshells with him and can't see it getting any better. I am afraid if he is BP something could happen that I cannot prevent. Looking for suggestions. Donna
Submitted: 4 years ago.
Category: Mental Health
Expert:  Elliott, LPCC, NCC replied 4 years ago.
Seeking expert counseling is a sign of strength. A personal relationship with a caring professional is proven clinically effective.

Dear *****na,

The very phrase, "walking on eggshells", is often associated with a personality disorder called Borderline Personality Disorder. It has some of the symptoms of Bipolar Disorder (mania and depression). Both can have occasional brief psychotic breaks, and both can lead to reckless behavior (driving, spending, sex, gambling).

The sudden outbursts of anger, easily triggered perhaps when he feels you are not supporting him or abandoning him in some other way, As with other personality disorders (especially in the category called Cluster B: narcissistic, antisocial, histrionic, and borderline) he could be adept at manipulating others, including the psychiatrist.

The official "bible" of mental health diagnoses, the DSM-IV manual describes BPD in this way:

"A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

1. frantic efforts to avoid real or imagined abandonment. Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.

2. a pattern of unstable and intense interpersonal relationships characterized by alternating 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, binge eating). Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.

5. recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior

6. affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).

7. chronic feelings of emptiness

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

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

Concerning the head injury, it is possible but not likely that the head injury could have cause the BPD. Here is what one physician has to say about it:

http://www.biologicalunhappiness.com/AskDoc/2004/Can-a-Childhood-Head-Injury-Cause-the-BPD/

I suggest that you find a therapist in your area who deals with personality disorder if you think this is a possibility.

You can go to www.psychologytoday.com and click FIND A THERAPIST, then click your state and city.

In the left hand column, after the list pops up, under issues find personality disorders and read carefully what the therapists have to say. Some may specialize in personality disorders and these are the ones to see. The best form of therapy for BPD are not drugs (as with bipolar disorder) but with Dialectical Behavioral Therapy.

For more information about BPD I highly recommend this book which you can purchase at www.amazon.com or elsewhere, or download to your computer as a Kindle book (you don't need a Kindle device) and could be reading it in five minutes from now.

Stop Walking on Eggshells: Taking Your Life Back When Someone You Care About Has Borderline Personality Disorder by Paul Mason MS and Randi Kreger

I wish you great success in getting him the treatment that he desperately needs.

Warm regards,

Elliott Sewell, LPCC, NCC, CCMHC
Elliott, LPCC, NCC and other Mental Health Specialists are ready to help you
Expert:  Elliott, LPCC, NCC replied 4 years ago.
Dear *****na,

Thank you so much for your generosity. I wish your son and all your family my best wishes.

Warm regards,

Elliott Sewell, LPCC, NCC, CCMHC

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