Mom4hope Introduction

I am new to this online community and to the world of Bipolar.

This school year started with a diagnosis of Bipolar 1 for our now 13 year old daughter (a 7th grader). A second opinion was something we sought, and that came back with a diagnosis of Bipolar and Borderline Personality Disorder.

The 2nd diagnosis results came back as our daughter experienced her first extended hospital stay in a behavior unit . Part of what extended the visit to 15 days was a change over from Prozac and a medicine that decreased urges (can't remember the name) to abilofi. Throughout the course of the fall which contained more ER visits, a baker act, another 5 days in the behavior unit, things transitioned to an addition of buspar to the abilofi (she takes 20 mg of buspar per day and 15 mg of ailofi per day). The day after she got out of the 5 day stay in the behavior unit, she started at a new middle school, eligibility was determined for an IEP with the exceptionality of EBD, with a direct placement into a behavioral unit, in her new school setting.

Our daughter's early issues began early in 5th grade, as she appeared to have anorexia. After seeking out a specialist, we soon realized that it was more behavior and had a first psych eval which felt she exhibited factitious disorder and an unidentified neurological issue.

By the end of 5th grade, she had a 504, we shifted to 6th grade at a private school, and then had to pull her out half way as self harm talk began, quickly followed by the initial medication.

Through virtual school and summer, she was able to complete her 6th grade coursework.

7th grade has grown to an even greater roller coaster ride.

As we try to grasp the best way to help our daughter, we feel like the factious component still plays a big role. We just had blood work taken with our new Psychiatrist, so we are hopeful that maybe there is a better match with her medication.

Presently she is addicted to a boy, who is also in her behavior unit. There are times where she seems to get that this kid isn't good for her, yet most of the time, he is the driving force of everything in her mind, despite their breakup last week.

A few questions:

1. Many doctors have said she is young and even with bipolar, they would put it in quotes. Our daughter holds bipolar as a badge of honor. She becomes very argumentative and inappropriate with her language frequently. Food seems to be a key to calming her down. Are these moments where she can truly be "verbally aggressive" an example of a manic moment?

2. It's hard knowing what is "bipolar" especially with a 13 year old who is highly manipulative and attention seeking. Does it take a long time to find an effective medicine regiment? Or could we possibly be going the wrong direction with medication in general?

3. Above all, no matter what our daughter has in actuality, does anyone have advice on motivating a young teenager, who doesn't want to fix her problems? In all honestly, the hardest pieces of life that our 13 year old has experienced have been from her own pushing to places like behavior units.

There is a narcissistic aspect of our child, which is baffling. She has to be the center of everything. Her fixations, especially on self harm talk or being paranoid, have guided her towards those experiences.

Our daughter, whether conscious of it or not, knows exactly how to get herself to a behavior unit and how to get herself out. As her school now expresses it, she uses her "magical words". The power that our daughter has managed to achieve is scary, especially in a school environment.

Her honeymoon time at her current school seems to be over. If she doesn't pull it together soon, she will open a door to the most, restrictive school in our district.

She is in DBT therapy presently. The benefits aren't being felt yet, due to our daughter's resistance.

This year has also been met with a rise on impulsive behavior. She stole some jewelry from a neighbor. Thankfully my husband got her to confess. Although the friendship has been cut off, the neighbor dropped it.

We are truly concerned about our daughter's erratic behavior. She is so capable in many ways, but we find she is getting more and more withdrawn from the real world. She seems to like being institutionalized.

Any advice? Sorry if I exceeded the typical welcome thread. Appreciate your time.

Sincerely,

Mom4hope

If she has bipolar disorder medication should REALLY help. If she also has bipolar, the fact that shes been diagnosed so young shoulf also be a great benefit to her. Medication is fairly essential if your daughter has bipolar. The time before medications came out was the time of just grabbing the mentally ill and confining them into long term institutions. The invention of psychiatric medications has allowed so many with these illnesses to live independent and high quality lives. They are very important

Bipolar people can be very successful if their condition is well managed. This means therapy and medication and potentially school supports like an IEP. Bipolar is a tough illness though so you may have some ups and downs and a few relapses. Which is why its SO important for her to get treatment at a young age so she has a good amount of time to deal with it.

This is all if she has bipolar OR the start of a personality disorder like borderline- which has similar symptoms and often co-occurs and or is mistaken for bipolar. Id suggest reading about that to because- though Im not a doctor- it might be a good idea to bring that up with one seeing as some of the things you describe sound... like maybe thats something that should be asked about too.

Its really great that you are trying to help your daughter. Basically all I can say is... be there for her- listen. Dont allow her to do whatevrr she wants because she has an illness- but if she does something that isnt great- ask why. Maybe if you keep asking and you guys find an ability to connect action with how shes feeling- youll be able to look at those feelingd and understand and rewire new helathier coping strategies and behaviors to help your daughter.

Basically my advice is to keep an open dialogue with your daughters therapists and the rest of her team. And to work with them to hopefully- get your daughter much able to function highly. You guys definitely have time on your side which is great- so use it as much as you can while your daughter is still young and hopefully you can save a good deal of pain that would have come with no knowing why.

hey,

welcome to the forum.

hope being here helps

I'm sorry that your daughter has been struck with serious mental illness at such a young age. I feel for you and your family, too, since I know it must hurt to see her hurting and to struggle to find help that will make a positive difference.

If your daughter has bipolar disorder, it may take some time to find an effective medication or medications. Just because what she's on now may seem minimally helpful, that doesn't mean other medications (or adjustments to what she's on) can't/won't.

Therapy is crucial, in my view. For bipolar disorder, learning acceptance and coping skills, dealing with stress in a healthier way, developing insight, and managing dysfunctional thinking are all beneficial. Though DBT is helpful, so is CBT, and therapy that focuses on living well with bipolar disorder. For Borderline Personality disorder, DBT is particularly helpful. DBT really focuses on calming emotional regulation.

Therapy was not immediately helpful for me. I had to break down a barrier in my mind before I could really benefit from it. An outstanding therapist can help with that. By all means, if your daughter's therapist makes no headway to help her, that doesn't mean another won't.

Welcome! I really hope being here is helpful for you. We all try to support each other.

I don't have a child, and I developed Bipolar most likely by my mid-teens but it is hard to know as I had a and case of PTSD. What I do recall is that I was DESPERATE to be helped and really felt I wouldn't survive. I consider myself pretty intelligent so I did manipulate situations to try to get the help I was desperate for. Unfortunately, it was the 90's and no-one (even the professionals - that I wasn't even referred to anyway) had a clue about mental illness even though it was obvious to all at school I was in serious trouble.

I don't know your daughter or situation so this is just an idea shown out there. Maybe she is desperate for help but doesn't know how to ask. This doesn't explain why she would want to be admitted to facilities and not really participate in help. But there must be a good reason she is doing that. I really hope you find some answers and that your daughter's health improves soon.

It's really not clear to me why they are saying bipolar at all, which probably explains why they suggest "quotes" around it. (Well, that and her age. It's dicey business trying to diagnose something like bipolar at that age, and consequently, many practitioners will be tentative about it.)

You asked, "Are these moments where she can truly be "verbally aggressive" an example of a manic moment?"
I'm going to say no, mainly because mania isn't about moments, it's a sustained state of being. Moments suggest acting out, perhaps her idea of what bipolar is(?) Or the frustrations associated with that age?

I will say that I can see in what you describe, the other dxs they've thrown out there (borderline, factitious disorders and your mention of her narcissism). Unfortunately, I have no ideas for you how to motivate her to want to get better. She knows what she's doing, and for her, the results are a payoff. How to eliminate *wanting* that payoff? Who knows. Have any of the professionals had ideas? My only experience has been in dealing with an adult with these proclivities. I feel your frustration in trying to understand what seems to make so little sense.

Sorry this isn't more helpful. My heart goes out to you.

Welcome happy to have you here, this is a great place to come for support and we are happy to help when we can.

We are only getting a small part of the picture and not health professionals(mostly). The things that stand out to me are the manipulation, self harm and attention seeking as well as the comment about agressive "manic moments"

There is a difference between these things being constant without any real breaks or depressive episodes and having full mood change episodes though.

Those moments of agression I probably woulnt label as manic unless it is combined with the other symptoms for a period of time. There are some people who have ultrarapid cycling however so it is possible. I also have general anger issues not related to bipolar in my opinion though.

Medication can definitely be a long process to figure out. Im at just past 2 years of medication and still not there yet.

If I am competely honest I find being in a psych ward comforting. I dont try to get myself hospitalized but once I have come out of the mania a little I can appreciate it. It is a place where I am accepted by others and I dont have to fight my battle on my own. There are people to help me and friends to understand me.

As far as motivating a teenager to work on herself that is very very hard. I know I could have had a much easier time if my mother had cared at all never mind how much you sound like you care. Shes got a lot going for her even if she doesnt know it or necessarily want it right now.

Im not sure if my behavior as a teen was bipolar or borderline or not, it was attention seeking and trying to destroy my pain because I had a lot of it and so little help though. I am fairly certain I have bipolar now though and pdocs all agree on that.

If it is bipolar medication should help even if it takes a while. Therapy can help with both bipolar and borderline so its definitely a good idea. It didn't help me as a teenager but again I didn't have any family support. I'm not sure it's helping me now either I'm fairly resistant to most help but I am trying to do better and I have a husband who has my back now, it makes a big difference. I also just got a much better pdoc(psychiatrist) and love my GP, having people I feel comfortable with and trust is helping a little too. My T(therapist) im still not sure about, I havent really come across one yet that clicks. Really listen to how she is feeling about the help she is getting and see if there is some way you can change things a little to something or someone she responds better to. Thats definitely easier said than done though.

I wish you and your daughter the best and you are on the right track, you are trying. Thats the best thing a mom can do

I was your daughter but I wasn’t getting help. What medication is your daughter on? Is there a teen intensive outpatient therapy center where you are? She very much likes institution as their more able to handle her outbursts that may scare her. I started my eating disorder at 8. I was cutting at 11. I thrived on in-school-suspension. I felt very much felt that my homelife was the issue not me. Of course I was wrong.

My son started young just like me. We decided to keep him out of school and homeschool him. When he went to cyber school was the worst time of our lives. We eventually went back to traditional homeschooling.

1. Bipolar is cyclical so look for other things that may indicate a manic episode.

2. I’ve been through countless meds and so hasn’t my son and husband. The best thing I have had for verbal outbusts and self control is an antipsychotic. Zyprexa works best for me. The key is ALWAYS take the medication preferably same time every day.

3.I don’t know how to motivate a kid to get better. We’ve been on and off medication for years with our son. We finally got my son’s grades under control by paying him for good grades. I’m sure if you asked her it’s you that’s the problem not her. How to get her to change her opinion. Have you guys also tried family therapists? It has take years even as an adult to be med compliant. A good therapist can make a world of difference. She may just not trust adults.

I would sit down and find a trade that she’ll be willing to train for. In most states she only has 3 yrs before she can drop out and she needs some skills to fall back on when she’s well. I’ve had obsessive about self harm and get paranoid. Do you know what her paranoid thoughts are? I know you’re in crisis mode right now. A goal to focus on takes the pressure off her behavior and look towards a future. She may do well in CAPS Cadet FAQs | Civil Air Patrol National Headquarters . My son did really well in karate 3x a week. He would train when aggravated and learned more self control.

The best person to ask would be her doctor. Then try to figure out and outline some sort of treatment plan. DBT is usually the most effective thing for BPD issues such as being manipulative, acting out, anger/rage, cutting impulsive behavior,, and paranoia. Unfortunately one of the problems with disorders such as BPD is there's huge amounts of resistance to getting help and going through the actual therapy which can be extremely beneficial if stuck with.

Medication can sometimes help ease anxiety and things but not most of the behaviour, but I would definitely have a serious talk with her new doctor, explain everything that's going on, get clarification on your daughters diagnos(es) and go from there.

I hope you're able to find some help for her

Hi and welcome to the boards! I hope you are able to find lots of information to help you through this journey.

I wanted to share a small piece of history as I feel I can relate to her. I was 14 when my despair, delusions, and explosive behavior began. I was soooo good at hiding what ever it was I wanted to hide. I was a liar, a manipulator, and I too (then, not now) wore my bipolar as a badge of honor. I was diagnosed with major depression at 14 and the with bipolar 1 a year later at 15. I was different however in that I hated the psych ward. Instead, I retreated to my own little nook in the trees in my back yard. . I could go on but not only is it a little shocking, it is also a bit embarrassing. I had to leave school early pretty much every day my sophomore year because I would start thinking and believing things sometimes and often times I would experience derealization. I ended up having to drop out my sophomore year and do a home hospital program from home. I went to a special school for my junior and senior year where I was never in class because I was terrified to be there. The few times I would go to class, I’d pass out from all of my sedating meds. It’s pretty amazing I survived, let alone graduated. I did start to get better toward the end of my senior year and by the time I was 20, I had stopped meds and it was like it never even existed. I went to college and everything. Of course I had a psychotic break when I was 28 and a mom with kids of my own. I’m 35 now and I’ve had ups and downs since. But I have a pretty amazing doctor and I know better than to ever stop meds again.

I have 3 pieces of advice. Firstly, if you are spiritual, immerse your child in that. Personally, my parents were Christian so I was required to go to worship 1 x a week and Bible study 1x a week. I hated it but in hindsight, I had so much darkness in my head, it was the best thing for me. I’m not saying you have to do this at all but I’m suggesting that if you are spiritual in any way to strongly encourage her in that direction. Secondly, find her a really good doctor!!! Look until you find one who is truly willing to fight for your baby’s wellbeing. Thirdly, find her a really good therapist. One that she connects with. It will help her a great deal to be able to process her experiences and learn coping skills. If you have any questions or just need support, please feel free to pm me! Good luck and best wishes in your journey with your daughter.

Wow. Lots to be going through.

She is too young for a formal diagnosis of an Axis II Personality Disorder, but what you are describing makes one think of Histrionic personality disorder (no, not narcissistic at all). If that is the case indeed - meaning, if that is where she is leaning to in her development, then no wonder that DBT that has been built out for Borderline personality disorder and especially those truly suffering and hoping to improve, does not help her. Also, not everybody would like to fill out checklists and this does not seem to be her thing at all.

No, what you are describing as her being verbally aggressive in a manipulative sort of way is not a "manic moment", but more importantly, there is no such thing as a "manic moment" - to meet the criteria for mania a period for mania has to last a certain duration. Look up "mania" in the DSM - the DSM's list of criteria is on Wikipedia. Extreme mood variability would be more along the lines of Borderline personality disorder than bipolar disorder (borderline personality disorder is an Axis II disorder primarily treated by therapy and not formally diagnosed until the age of majority whereas bipolar disorder is an Axis I disorder primarily treated via a combination of pharmaceuticals and talk therapy and diagnosable in children and teens). I think you are extremely aware of your daughter's issues and attuned to her and should listen to your instinct; if she appears manipulative, powerful and almost omnipotent to you in how she engages the mental health and educational systems, then this is probably because she is and this behavior would not be consistent with bipolar disorder all that much.

To take a pretty big dose of 15 mg of Abilify being a growing teen without a clear (sans quotes) dx (dx = diagnosis) of bipolar disorder is a lot; most of these medications have side effects that have to be outweighed by clear benefits and it is not clear in her case what Abilify is used for - you are not reporting clear psychosis, clear mania, clear depression, which would be main symptoms the medication is used to treat.

I do not know how early a neuropsychological evaluation can be sought for a teen, but I would ask for it as soon as it is available. A neuropsychologist is a PhD psychologist who special training, who, on top of a clinical interview, will administer batteries of tests to your daughter that are specially designed to work around lies and manipulations - she won't be able to outsmart those tests.

Also, does she have an outpatient psychiatrist who specializes in adolescent psychiatry?

I would just like to point out that on top of the mental health issues your daughter is having, she is dealing with puberty. The surge of hormones, rage, outbursts, uncontrollable emotions are a hundred times worse for her. Make sure to comfort her and give her chocolate. I know that makes no sense but on my girls worst day to know I would pick them up with a mini candy bar would get them talking a smile.

I'm so sorry you and your daughter are struggling, Mom4hope I don't have a lot ot add to what the others have already wisely said. You've been given some great advice in my opinion. I agree with all the others. Just try to be there for her. Support her if she needs it. Of course you don't have to give her everything she wants. But just listen to what she has to say. Reminder her that you love her and that you'll always be there to help her. That, above all else, is the most important thing that you can do as a mother. Of course everything else is important as well. Therapy, meds... all the stuff that should help with Bipolar. It won't be easy and it will take time, but trust me when I say that things can get better. Take it one step at the time. Take baby steps. You're a wonderful mother and I think it's great that you're doing all of this to support your daughter. That proves you're a loving, caring mother. Keep doing what you're doing. Remember that you're stronger than you think. You've got this. Stay strong, Mom4hope. Please don't give up. You can do this! You're strong, I know that. I believe in you. Is there anything we can do to help you? Please let us know. Remember that we're here for you. Feel free to vent here as much as you want. We'll listen to what you have to say. We care about you. Keep writing here if it helps. I'm here for you as well if you need it. Feel free to PM me anytime. Let me know if I can do something to help you. Wish you good luck! Let us know how it goes. I'm so sorry you have to deal with this

It is true she is too young to have a formal diagnosis of a personality disorder (though I still stand by the borderline and narcissistic traits being present, and because no mention was made of any provocative dressing or being inappropriately sexually provocative --which are common to histrionic pd (Histrionic Personality Disorder: Symptoms & Treatments), I don't see it, as most of the other traits fit into narcissistic. I think if someone had histrionic, they would, at that age, in this day and age, show the provocative aspects. (Something that would be very distressing to a mother, so would likely have been mentioned.))

But mostly I'm popping back to point out that the girl does not have interest in getting better (OP, numbered item 3) That is a FAR more likely reason DBT is not working (than that borderline isn't her issue). DBT takes work. Real work. Those who do not commit to it, do not see results.

But MOST of all, how are you doing, Mom4hope? Thinking of you.

She does not want to get better because she is not suffering. The first eval mentioned factitious disorder - maybe pursue that line of hypothesizing further?

Um.... where did the OP go?

I have no advice to offer but I just want you to know you have support here. Keep posting as needed.

Thank you very much for all that you shared!

Although completely boy driven at this stage, our daughter has shown willingness to enter the spiritual world once again. My family was raised Jewish and my husband has a Christian upbringing. We have always been respectful of each other's backgrounds, yet the last couple of years at the height of our daughter's situation and her resistance to attend anything at our local Synagogue, we stopped the fight.

Her school environment is a behavior unit, so the Synagogue connection is a true slice of life, where she has a chance to be seen as the beautiful person she is indeed. The Rabbi seems to have positively stepped in this week to slow down our 13 year old's fixation on a 16 year-old boy. It's a relief that the 16 year old has slowed things down and been receptive to just being friends.

Right now, we're trying to get a better handle on meds. DBT seems to be the best therapy option, but our resources are limited, and our daughter is resistant to the therapy that is $150/hour.

Our last ER/hospital/behavior unit run, setup a home contract, which our daughter definitely is having difficulty following. Especially in terms of her help with chores at home, and her responsibility to do some work, when she gets to my classroom after school.

She has a constant need to be in charge. She is incredibly cold to me. There is no right that I can do in her eyes. Her respect level has improved a little bit, yet overall she only does as she pleases.

Of recent Dr. appointments, it seems like our daughter is less "bipolar" and more an issue of a personality disorder and depression.

It's a very confusing/heart wrenching process.

I want the best for my 13 year old. I hate that she is in a behavior unit at school, but she won't conform to the basics of life right now. Then we have her 14 year old high school sister, who is doing her best to lead a normal high school life. Yet, things are far from normal in our house. Our 13 year old monopolizes all of our energy at home, for years now.

Keep praying that my youngest will start fighting what ails herself, rather than me. It feels unjustified, I have become the enemy in her eyes. I want to do right by her, I wish I could shake her back into reality at times.

It's a drama that only intensifies, as time keeps passing by.

I apologize for my reply becoming a vent session.

I am a happily married, positive person. I love being a Mom to my two, beautiful daughters. I am a 4th grade teacher, and love my job.

Sometimes it feels like the greatest challenge is getting our 13 year old to care about life as much as her problems. She is so capable and beautiful. I wish she could see the promise that I see inside of her. Yet, it's hard guiding her towards that, when she views me as the enemy.

Thanks for your time, if you are still reading.

With sincere thanks!!!!!

Take care.

Mom4hope

So glad to hear back from you! I don't pray, but you all will definitely be in my thoughts. Such a challenging situation. I'm so glad for all involved that the fixation has eased. That's a big difference at that age. No worries on venting -- sometimes one must!

My son also hated me more extended periods of time as an adolescent and would also act out on it. Over time our relationship has slowly, if painfully, improved.

I made a lot of mistakes in raising him but also did a better job on other things. I would be skeptical of any mental health diagnosis of someone so young and focus just on behaviors rather than diagnoses.

Mom4Hope, I hope the treatment plans work out for your daughter. My sibling had a lot of behavioral issues growing up, too. They had emotional outbursts, were aggressive at times, depressed and even suicidal. They was told they might have bipolar disorder. Turns out they had OCD, plus depression, and not sure if anything else. With treatment plus maturing as an adult they are pretty stable now and we have a good relationship. I cannot offer advice as to what is going on with your daughter, but I think it's great you are getting her help. She has a lot of neurodeveloping left to do, too, so I don't think anything is fixed yet such as her personality. I will also say my sibling's mental health affected me a fair amount growing up, and it might be something to consider with your other daughter, if she could use support as well. Like a therapist to process things perhaps.

I don”t have any advice but wanted to say hello and offer you a warm welcome to PC where you’ll find many wonderful, caring people and lots of support. You have your hands full. Please take good care of yourself in the process.

I just wanted to mention that during my worst years I absolutely abhorred my mother and I was nothing but cold and callous to her. She is and was absolutely amazing! She is the most warm, kind and loving person I know. As I grew, I realized this. I hated myself for a while for treating her the way that I did. We now have a wonderful relationship. I just want you to know hope is not lost.