What Has Happened To My 12 Year Old Daughter?

QUESTION:

Dear Dr. Heller,

I have a daughter who turned 12 in September.  She Started her period in January of last year.  She is bipolar and has ADD.  Since she started her period she has had terrible mood swings.  She is very destructive at times.  She has started hitting me recently.  She is very disrespectful to her father and I.  It is a constant battle around the house everyday. 

She is on 5 different meds.  She was kicked out of school recently.  The other night she started hitting me again.  This child is 5.1.  She loses her temper and she is very strong.  I call the law on her to let her know that it is not all right to hit anyone.  She is now on 6 months probation.  If she gets into any kind of trouble she will go to juvenile hall.  I love my daughter very much.  But I feel like I'm becoming a victim in my own house.  She said that we go by her rules.  She always tells us she wishes that we where dead.  She keeps repeating that we are going to get what's coming to us.

She is very interested in sex.  She goes to therapy.  I don't know how much more I can take of this.  When she calms down she is a wonderful and loving child.  But if she doesn't get her way it is hell around her.  She is very smart - she has been an A and B honor roll student all her life.

Please help.

ANSWER:

She almost certainly has the BPD, since it begins at puberty.  In my experience BPD and ADD are 50/50 - meaning half with ADD have the BPD, and half with BPD have ADD.

I acknowledge that she's on 5 medications but they are obviously not working.  A comprehensive medication and therapy approach is needed that does work.  The screening test I use for my patients may be helpful to you regarding discovering treatable diagnoses. 

The entire BPD section of my Website will be helpful as well.

There are many "Ask the Doctor" answers that will be of enormous help to you, the most significant in the FAQ section.  http://www.BiologicalUnhappiness.com/AskDoc/First-Do.htm and http://www.BiologicalUnhappiness.com/AskDoc/q6.htm are likely to be the most helpful.