QUESTION:

My child was originally diagnosed as being Bipolar at age 7, eventually ended up on 5 meds. and then was hospitalized. She spent a number of months on a hospital residential unit. She was weaned off all meds, then given the diagnosis of childhood BPD. The doctors realize that this is not a DSM-IV diagnosis, but still say it is an accepted diagnosis. Based on the book "The Borderline Child" she does meet the criteria it describes as BPD in children. Individual therapy is not productive due to her inability to express her feelings and her continual lying. Also, she'd has no known trauma or abuse, and we've searched hard.

Her biological father has some sort of personality problem I believe and my side of the family has depression, so I can see how its possible from a biological standpoint, but not an environmental one. She also has sensory processing problems (vestibular), has been diagnosed for ADHD, which she cannot tolerate being medicated for; and she has reading and writing learning disabilities. Academically she functions at a 2-3 grade level. What alternative forms of therapy besides one on one could you suggest. I've read a bit about wilderness therapy and rage reduction therapy by Drs. Cline and Allan. Are these forms of treatment helpful ? Are there others I should look at since the traditional therapy is not productive?

Anything you could tell me would be greatly appreciated. As I'm sure you know it is difficult to get info and help regarding childhood BPD.

2nd: Are there other forms of therapy that are helpful for a child with BPD? My child is 11. She is unable to express her feelings, has had no known trauma or abuse, and traditional therapy is not productive. She also is diagnosed with ADHD and has sensory processing (vestibular) difficulties. She has reading and writing learning disabilities as well. I’ve heard of some therapies such as rage reduction therapy by Drs. Cline and Allen, and Wilderness therapy. Are these helpful and could you offer any other suggestions about therapies or where to get more info on Childhood BPD? Its seems to be nonexistent. The only book I've ever found, "The Borderline Child" is out of print and that's it.

DR. HELLER'S ANSWER:

In the 1980's a study was done which followed children diagnosed with BPD. None of them had the BPD as adults. It is not an accepted diagnoses, and it is not in the DSM IV.

Real biology is likely going on. Children like this generally are very depressed, may have a psychotic depression along with chronic anxiety. It's hard to tell. In my new book "Biological Unhappiness" I give some actual cases similar to this and how they were successfully managed.

Like everyone else, both of your children need all their diagnoses made and comprehensively treated - and it is extremely difficult making these diagnoses in children. Since most of these are genetic, I highly advise getting yourself checked as well so you can be the best parent possible since it's obvious you're trying very hard.

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