Q. Dear Doctor,
I've got an problem and need somebody who can help me. My girlfriend she is now almost 16 years old, heard last week she has borderline. At home she has a lot of problems. It is there a very unstable situation with drinking problems and so on. Also a lot of fights about the most stupidest things. When she was a little child, her mother started to drink a lot, and didn't gave the love a child need. It wend well, but now she started drinking again and everything is going wrong. My girlfriend has been to foster parents, and there she began more relaxed, but she wanted to go home again, because she didn’t feel really home there. Now, the organization won't want to help it anymore because the think the situation at home is quite stable, and there is no need for her finding another home for a while. Although she wants to go out of the house.
After a fight home, she began to scratch herself with a razor. Although it started with scratches what's she has got now on her arm aren't scratches anymore. Deep cuts all over her arm.
I really don't know how to help her with this. I really want to do what's good for her. She now has got some medication (Prozac), but that won't change the situation at home. She thinking a lot of killing herself by cutting her arms. In her depressive mood the only thing she is thinking about is how the kill herself, and I cannot talk it out of her head. It looks a big wall around her, and nobody is able going through that wall and have influence on her. It makes me worried and upset. What do you think what is the best for her. Her psychologist has sent her to social work. But do you think she must go to an clinic or something?
A. I'm glad she's started treatment, and Prozac is indeed an important part of the treatment. Cutters generally need more medication than just Prozac, Tegretol being the most successful addition in my experience. Like everyone else she needs all the diagnoses made and treated.
Her home situation is unlikely to change. Once the medications are working, she needs to understand the pathology in the home and that it's possible for her to "break the chain" of family dysfunction. There is nothing more powerful than hope.
I would encourage her to read as much from this website as possible to help give her that hope.