Q. My almost-17 year old daughter scores 100% on every bpd scale. She has been in a highly structured boarding school setting performing GREAT with no set-backs for 18 months. Recently, she abused a privilege she had earned and ended up running away (looking for the old criminal friends) carving "scared" into her arm, and other acting out behaviors. We were all shocked, even the well-seasoned staff of the 28 year old school. Her school stay will now be extended, but we can't keep her there past her 18th b-day. My question is: do teens who exhibit CLASSIC BPD signs necessarily end up adults with BDP? Are we increasing her chances for coping in the adult world by catching this now, and treating it with structure and accountability? (Her school is excellent and was recommended by a psychiatrist who spotted all the bpd stuff... but they use NO drug therapy). You place a huge emphasis on drug therapy. Are we doing her a disservice not using drugs? She is learning coping skills but will this approach serve her well? Also, no one has ever talked to her about BPD... they address each symptom directly.
A. Yes, they do.
I agree with you completely about treating the BPD now.
I disagree totally with the staff's concept about avoiding medication. The BPD is a medical problem. She'll have enough problem coping with the medications working, to ask her to do otherwise is almost impossible.
I want to make it clear I'm not against counseling and structured programs - I am a huge supporter of both. My experience has been they don't work that well without the right medications, and they work dramatically better with them. Regarding not telling her the diagnosis - how would you feel if when you were 18 that you had your diagnoses withheld from you, and that in fact the adults in your life were dishonest by omission in that regard? How do you think she'll feel?