Q. Doctor,
I am emailing you to get some ideas for myself and my parents on what to do about my younger brother. He has recently been diagnosed with borderline personality disorder. He was previously diagnosed with bipolar disorder at the age of 17 (he is now 18). I questioned this diagnosis, having been a Psychology major in college and after much research, my parents took him for a second opinion which resulted in the BPD diagnosis. Now, however, they do not know what to do for him. He avoids responsibility at all costs. He won't go to high school (he has at least one more year to go), he can't seem to hold down a part-time job (even at only 10 hours a week), he brags about all the psychiatric hospitals he has been to (apparently his friends think that is cool), he claims to have a drug problem, and enjoys playing the victim so as to avoid any consequences for his actions. If they confront him about his lies, he acts even harder to prove he is right and that he does have problems that he has to escape from. They have tried counseling, medications, group therapy, and specialized institutions to help him. But he enjoys all of the negative attention, and behaves more outrageously to get this attention each time. My parents are fed up (and broke) and do not know what else to do. I told them that I would try to help, but even though I am a Psychology graduate student, I do not know what to do. Please, please give me some suggestions on what we can do for my little brother!!
A. This is obviously a very bad situation, with more than just medication necessary.
The right medications will help significantly, and he needs all his diagnoses made and treated. The "screening test" section of my website www.biologicalunhappiness.com may be of some use in this regard. A way needs to be found for him to take the medications as well, as individuals with this profile often avoid taking their medications.
The "tough love" philosophy may also be necessary. Enabling him is a huge problem. Counseling for the family may be helpful, learning how to avoid enable him.