Q. My daughter is 13 now. As I look back my daughter has problems functioning socially since she was very young. By the age of 3 she had gotten rid of 2 baby-sitters who could not take her constant yelling and crying. She would cry for hours until she finally fell asleep. I would only have a baby-sitter over 1 to 2 nights a week and I would work the 7pm to 7am shift so it would not be during the day. In kindergarten and 1st grade she would never use the bathroom in school because she was afraid to get up during class time. She would never look anyone in the eye and would insist on having her bangs long so that no one could see her eyes. She still doesn't drink fluids in school as she doesn't want to have to get up out of class. I had her see a psychologist when she was in 4th grade for shyness but after he put her in a group for shy kids and she wouldn't talk to them and started bad mouthing them and the psychologist he felt that she didn't need any help. She doesn't have any friends at school. She has a way about her that makes people uncomfortable. She likes to be the center of attention. But when someone pays attention to here she will put them or someone else down. I think she thinks this is cool and people will like her but in reality it pushes them away. When we go for walks or a ride in the car she becomes angry at people and will say nasty things about them using foul language. If I try to talk to her about this she will become very angry yelling at me and denying she used any foul language, then she will become very sad. She shows little respect for her father or I at times. One example is a couple weeks ago Airtram was issuing my family free trip vouchers at the Atlanta airport due to a mix-up in flight. While they were doing this in the terminal in front of 100's of people she was yelling I hate Airtram I want Continental. This was very embarrassing and my other daughter had to pull her away to try to keep her quite, but when she came back she started up again. 2 months ago she had a couple scratch type marks on her legs I asked her what happened and she told me she was trying to write her boyfriends name on her leg with a razor. She will also take the razor and try to shave off pimples. One other thing that worries me is that she loves to play with matches. She will light books of matches, take string and light them candles, hair, bottles, paper.
I love her dearly. I used to think her problem was extreme shyness. But am worried. I would love for her to see another psychiatrist, but, she refuse and she is very stubborn. I am writing you to see if you might think her problem is BPD. I don't really know what to do or where to go but thought I might start here. Sorry I know this is long but I thought you might need to know a little about her.
A. The BPD is extremely likely. I suspect she's been depressed for a long time, with social phobia and possibly also with panic and/or the generalized anxiety disorder. Based on what you wrote, she shows features of many problems. She should be very responsive to medication, particularly Prozac - although I'm sure she'll need more than just Prozac. She needs the diagnoses made and treated. No matter how difficult she makes it for you, you are her parents and you need to get her diagnosed and treated.