QUESTION:

Almost 2 years ago our daughter was diagnosed with bipolar II and a personality disorder, NOS. Due to our managed care health system we have had 3 psychiatrists, 2 with terrible results, before being able to return to the psychiatrist who made the original diagnosis. She does seem to fit every criteria for borderline personality disorder, although the current psychiatrist still lists BP II as the diagnosis. Her psychologist agrees with the BP II diagnosis and also has added DID to her diagnosis. Getting the meds right is frustrating. Either she doesn't tolerate it physically or doesn't think she needs it. We, her parents, try to let her suffer the consequences of not being on medicine. This spring she lost her job and had to be picked up by the police because her behavior got dangerous at her workplace. (She got another job less than 1 week later). Losing the job gave her a reality check and got her back to her psychiatrist and psychologist, but that shock seems to be wearing off now. She's getting less compliant again.

I'm struggling to understand her disorders and how to interact with her. Although most BPD and DID sufferers seem to have traumatic childhood’s, this is not the case with her. However BPD symptoms are prevalent in my husbands 5 siblings, including a sibling with sexual identity disorder. Most of his siblings can function in either work or social settings but not both. I want more for our daughter, I want her to have a whole, fulfilling life.

DR. HELLER'S ANSWER:

Like everyone else she needs all her diagnoses made and effectively treated. She also needs to be educated. With rare exception individuals with these problems don't understand them and knowledge is power.

Those with DID and BPD in my experience not only need all their diagnoses made and comprehensively treated, but need Prozac and a therapeutic level of Tegretol. Those intolerant to those doses take it at night and slowly increase the daytime dose. They also need to feel safe.

Eventually she has to want treatment. Most like her don't believe effective treatment exists, or a personality takes over that doesn't believe medication is necessary.

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