What is borderline BPD?

What is borderline? Can teenagers have it / develop it? My son has six to eight traits and am hoping with personality changes will grow out of it aka become subclinical or better manage his traits / aka accept.

He’s definitely not bipolar as he has not had any maniac episodes but he has had mood issues that can be intense for hours only to abate very quickly

Hormones

Has your child been diagnosed with a borderline personality disorder or is this armchair therapy?

We use the DSM to diagnose a patient. It defines what is a disorder. We don’t just say, that person is batshit crazy anymore.

Borderline Personality Disorder DSM-5 Criteria And How It’s Treated (mind-diagnostics.org)

or do you mean bipolar disorder?

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“Teenager” is the diagnosis. they eventually grow out of it.

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ADHD, complex PTSD, and DMDD. Bipolar definitely does not seem to exist

Traits 1-3, 6-8 is most prominent. Teenage hormones are definitely at play as is trauma.

No this is something more. Sometimes people are mentally ill.

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Diagnosing mental illness is tricker than a lot of physical disorders. If you are bleeding, that’s easy to figure out.

Are you sure there is no mania? Last time we talked, I suggested getting a second opinion. Did you seek one out? Sometimes fresh eyes are good and seeing new things.

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Yeah, the experts can’t charge big bugs by just calling it “teenager”, but I agree that sometimes people are mentally ill and you’re proof positive that one doesn’t always just grow out of it.

So the boys see a psychiatrist and we have a trauma therapist who does TF-CBT. We have a marriage therapist. The DMDD and ADHD were well known. The Adjustment Disorder with anxiety was changed to PTSD with the neuropsych evaluation in April. We didn’t put it together at first but the mom did relapse binge drink in the 5th month of pregnancy

Do they have physical signs of fetal alcohol syndrome?

Drinking and pregnancy do not mix. Obviously there is a difference between a drink and binge drinking. Our ancestors drank all through pregnancy but it was also had less alcohol in it.

No but his processing difficulties suggest possible FASD not the more severe FAS which is heavy drinking in the first three or four weeks

From the reports, it appears that she had a DWI in her fifth month of pregnancy with the younger child

Is it possible she did other drugs? In my limited experience with FAS, I have never seen one that wasn’t obvious but we only do rotations in pediatrics. I would have a pediatrician do an evaluation.
Now I Have seen behavioral issues with drugs. Meth is the worst offender in my experience.

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Not sure if there was anything other than alcohol. His trauma therapist is looking up how to help if it is FASD. We are also trying to find a better pediatrician and this can be difficult as it’s hard to know which would be best suited for the boys as it’s hard to tell them apart trauma wise - developmental yes - foster care not so easy as it’s hard to know experience

Like you, we don’t know the facial features. It appears that most kids who might have FASD might not display the features but also don’t have the severity of FAS. Of course this is armchair not official

Not all will show the facial features but all the ones I’ve seen have. I’m sure I’ve met some that didn’t show the typical features but it’s not my pond to play in.
I know you listed all the meds once. That seems excessive. As the number of meds increases, you run into more issues with contradictions or side effects. I would strongly consult with your doctor to see if there are any you can remove.
I think you listed six psychiatric meds. That’s a lot.

Yes after having the neuropsych report, our psychiatrist reduced his meds to Zoloft and Focalin. The psychiatrist waited on the report for three months and then as soon as she had it made changes to both boys - the older kid is on Focalin.

The boys were on five meds from 2018 to 2022; they were on Medicaid so they were seen very briefly - one was on Risperdone the other on Abilify. One was on Clonidine - the other was on Impramine. Both were on Focalin and Guanfacine. Both were on Mirtazapine. The younger kid lost a lot of weight after being removed from the meds and is only beginning to gain weight now in a new growth spurt

There is a lot of difficulty with hygiene, aggression, and defiance. He also has issues with hoarding - my wife calls it stealing. He is a very picky eater.

How bad is the hygiene? That could be normal. I was odd for being very clean as a child.

Aggression, defiance? What are the ages again? With two children that can be common. How bad is the aggression?

Picky eaters are common. Drives me nuts. That’s one thing me and my gf clashed about. The child doesn’t like to eat vegetables.

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Aren’t there enough other threads to take a shot at Wintermute in than this serious one?

I was also very clean. The older kid showers :shower: every two or three days and uses deodorant. Sometimes he needs prompting to bring clothes down, use deodorant, or shower

The younger kid soils himself and then argues about showering sometimes unfortunately going to bed with soiled clothes. He will tie a coat around himself to conceal that he had a bathroom accident so we have to be mindful. He has encopresis so he will hide his soiled clothes when he has the opportunity.

He is able to wash his underwear and clothes but will attempt to find hiding places whether under furniture or under other clothing. This also leads him to need to Swifter the bathroom floor or even hand wash it

13 & 12 The play fighting is normal. Our dog gets in the act and will intervene if they get too crazy. Sometimes the older will get carried away and the young one won’t want to give up and really has a hard time with personal space. Both have a revenge mindset and will wind each other up - they both escalate each other. Generally this is fine unless the young one turns aggressive

The aggression from the older is limited to slamming doors and complaining aka a meltdown. The younger one kicks, hits, bites, and says f and b swears especially at his mom. We both got bitten trying to test him for COVID but he will let perfect strangers test him. This has lessened significantly but he still says no and is defiant. The aggression has subsided except for holidays but his hoarding has gotten much worse

Sorry, I feel there’s never an inappropriate time to take a shot at WM. He attempts to ambush me at every opportunity, in most cases using the “comrade” charge at every opportunity, even though there’s never any justification for hurling that slur.