No one seems to know what to do with my 13 yr old anymore, can you help?

My 13 year old daughter has been in a battle with her mental illness for the past 16 months.9 inpatient stays,3 day treatments,in home therapy and out patient therapy weekly. Unfortunately she also has borderline personality traits as well. She seems to like the attention she gets from being ill and does not put in an effort in therapy to get better. She seriously likes going to the hospital. No one seems to know what to do with her anymore,my insurance will not pay for long term and the state we live in (MI)has terrible mental illness care and will not help. Do you have any suggestions??

Thank you.

This question has sat with me for a long time. Reading it makes me feel powerless, and I wish I could fix this broken system with three snaps of my finger. To be honest, I know nothing about the language of seeking treatment, drowning under heavy costs, and advocating for long-term residential. For that, I can only refer you on to places like the Child and Adolescent Bipolar Foundation (bpkids.org), National Alliance On Mental Illness (http://www.nami.org/) or Mental Health America (http://www.nmha.org/). Places which you most like have already called or pleaded with it. Yet, they know  some answers and have have learned more legalities of these situations than I can hope to right now. I am sorry I cannot help you figure out the steps to take to get her treatment and get her engaged in it. What I can do, however, is give you insight into my own thoughts and struggles, and what has worked for me. Hopefully, these meager words will be enough to at least make a small impact in the Hell you live. I see your pain, and I understand the struggle.

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Whenever I think of the hospital, I feel a yearning to be back within those locked doors. Nowhere else have I felt more safe, and if I could, I would stay there until my symptoms went away and I was “normal”. When I tell people this, most look at me as if I had grown an extra head. Why, they ask, would you want to be in there? Imagining it now, it must be ridiculously confusing to other people and heartbreaking to my mom. The thing is, though, the environment is the only one I have encountered that is stable and safe. I can rage, break down, panic, and feel every need to kill myself or go after another, and I will be stopped. Nobody can get away with majorly hurting me, either. There is staff around nearly every corner; the curtains are velcro; the windows do not open; sharps are locked away; and everything is monitored. If you do lose control, they will control you and stop any harm being done The people there handle your swinging moods, love and hate relationships, and irrational anxiety.

More than that, though, it is a removal of most major stress and anxiety. School is shortened to two periods, and there are no deadlines, projects, homework, pressure to keep up the pace or get good grades.  You are away from your family most of the time, so any tension that is brewing between parents, siblings, and relatives are miles away. Ignorant teachers can no longer lecture and humiliate you. Those kids at school who mercilessly harassed can not get to you. Everything in your day is planned to the minute, with a schedule up for all to see, so there are no surprises, uneven transitions, and it is the same everyday. Medication is at the same time through your entire stay; visiting hours are from X – Z; meals are always scheduled for the same hour; activity is at the same time; and what time you are to attempt to sleep is the same. There are no surprises to thrust you into anxiety. It is all extremely structured and  predictable.

Once we are discharged, all of that goes away. Changes in routine can pop up at any time, sending you into rage, and anxiety. There are barely any constants, leaving you with little structure and certainly on what is going to happen that day. I know that, when I am unstable, I cannot handle that. At all. It sends me into a panic, and I snap and meltdown at the slightest change. Inside my own head I don’t know what is going to happen from second to second, and handling that  on top of all the uncertainty of the external world is just too much. It overloads my entire system, and I shut down. Retreat into my world, doing my best block out and regulate all the chaos around me. No, to you not being able to go to a certain restaurant  as originally planned is not a huge deal; however, to my unstable mind, it flips my world upside down. It snaps me in two, and all systems fail.

All the other triggers that were stripped from life are thrown back at me, as well. I now have struggle through nine periods of school, with staff and teachers who ignorantly set me off. Kids harass, exclude and look at me as if I am growing a third arm.  Those are nice to me ask me where I have been, and back in my more unstable days, that question was enough to send my mind spinning. Anxiously, I would make some lie that would hopefully satisfy them and turn the conversation. If it didn’t or I chose to tell the truth in the first place, I would stutter out the truth. The reactions ranged from pathetic to horrified, the latter of which stung through my heart like a dagger. Even if response was one of not caring or supportive, it still it exhausted me. By the time I got home, I would just fall apart. My mom, to no fault of her own inn most causes, would trigger me into a spiral by the way she handled things. Often, I would isolate in my room, feeling that nobody around me really understood.

Dealing with that, on top of the hurricane my head put me through each day, was exhausting. It seemed that a whole week’s strength would be used up in a single hour, and I was left counting minute to minute. I didn’t know how to cope. My mind yearned to be back in the walls of the hospital, where everything was structured, secure, and taken care of. Soon enough, I was, and the clearest emotion rushing through my body was one of relief. I was safe. I didn’t have to fight so much anymore.

Of course, the goal is not to be in the hospital; however, there is no easy way to fix this hospital-love as home can never offer all of things that those units do. Only so much in life can be controlled, so that complete structure is impossible. Until she is more stable, though, you can make a few changes to the way things are around the house if you feel that you can. To start, maybe try making a schedule for each day, and post it for her to see. Meals are at the same time as much as possible; medications are given at the same time; and so on with as many things as you possibly can. Even little things can make a difference.

2 thoughts on “No one seems to know what to do with my 13 yr old anymore, can you help?

  1. Have you tried looking at D.B.T for her Borderline traits? or STEPPS – a new program focussing on the inner child also good for Borderline treatment.
    Another therapy is SCHEMA Therapy for Borderlines. Also looks at inner child stuff.

    I agree with the hospital comments of the author. It felt to me it was a safe haven, a place to be where people cared (not all are like that though I’ve been told!).

    Good luck 🙂

  2. what a wonderful resource your blog is. my husband has Bip. 2 and I write about it
    occasionally on my blog- i’m doing a series about his dx and what ‘happened after’.
    thank you !

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