QUESTION:
Dear Dr. Heller,
My daughter has turned 16 and was diagnosed years ago with chronic depression, ADD and bipolar. She has been on numerous "cocktails", NEVER been able to interact with peers without a disaster, very sexually dominant, DEPRESSED, spinning way out of control and a danger to herself and others mostly because she doesn't seem to be aware of anything beyond what she is fixated on!!
She stopped taking her meds 2 months ago and prior to that NEVER continuously. We cannot enforce it without intervention from child abuse agencies (She knows the system and is very smart and a master at divide and conquer). We attended our 20th CSE meeting at her school which is truly trying to help this girl. Someone mentioned BPD and I have been trying to get someone to listen to me because I have researched this andit fits her to a "T" but then again so does adolescent behaviors so its hard to tell.
Her current meds are Depakote 500 mg , BuSpar 15mg, Wellbutrin 20 mg in the morning, Depakote 500 mg, BuSpar 50 mg at night. She is always talking suicide and has been hospitalized a number of times as well as inpatient at treatment centers. Presently we are trying to get an intake at the Northeast Parent Child Association in Schenectady, NY .
I apologize for the long read but I am driven because I know she can be helped and feel better about herself. Its just that I'M not the one to do that. She says she wants help but she is all over the place. Any guidance you can offer or direction would be appreciated. I am checking the library tomorrow for "Walking On Eggshells" and "The Angry Heart". However, I'm afraid to let her read anything because when she sees it she becomes it. She feeds off everything (not necessarily the good stuff) and LIVES what she reads. So I'm not sure if it will hurt her instead of help her. Any thoughts?
Thanks so much for your time, and "the adventure continues...."
ANSWER:
If she fits the BPD as strongly as you imply she needs to be treated for it. While
BuSpar is sensational for the generalized anxiety disorder (particularly the
"cognitive component"), it does nothing for the BPD. Depakote is a reasonable
option, but the percentage of my patients who do well on it is small. Wellbutrin is
essentially useless for those with the BPD unless it's being used to treat the
hyperactive type of ADHD or the occasional patient who feels passionless on SSRI
medications like Prozac.
To me the BPD is the most crucial aspect of an adolescent's treatment. If not
successfully treated medically, nothing else will be of much use.
The following three sections will be of assistance to you:
http://www.BiologicalUnhappiness.com/AskDoc/q1.htm
http://www.BiologicalUnhappiness.com/20a.htm.
http://www.BiologicalUnhappiness.com/HowBPD-Y.htm
