- Can You Help a Broken Hearted Mom?
QUESTION:
Dear Dr. Heller,
I hope you can help me. Since my 17/yr daughter was two, she has been self-mutilating. I didn’t call it that then nor did the doctors. Three different MD’s had 3 different opinions; flea bites, scabies, allergies. She was literally picking herself to death. She was a extremely bright child; won many awards etc. She was always timid, shy, but a very loving wanting to please child.
By the time she reached puberty she no longer wanted to go to school, had trouble with all her relationships (still does). Had to be treated for depression for the last 4/yrs. Recently took an overdose. Says she doesn’t know what came over her.
She has been evaluated by a psychiatrist and still sees her pyschologist. The psychiatrist now says she is bipolar. But I don’t see any evidence of mania. She still picks herself but took up smoking and recently had her tongue pierced (although warned not to). She has been put on paxil and instead of depakote, flaxseed oil to stabilize her mood. I just don’t know if the diagnosis is correct or if she is BPD? When she’s depressed, I can tell, but then when she feels better she seems so “normal” or just happy. Nothing too extreme they way they describe bipolar.
Please help; Ive read so much and I am still not sure. Could it just be a terrible adolescence? I have to mention also, she has always lied about everything or at a minimum exaggerated, even when completely unnecessary, and she admits this. She says she knows there’s something wrong with her. I might add, she is badly scarred from all this picking and when I took her to a plastic surgeon, she said the pigment is gone in those areas. help! Please.
Signed a Broken Mom.
ANSWER:
If there has never been mania or hypomania the diagnosis of bipolar disorder is not established. The symptoms you described sound much more like the BPD. It is possible she has BPD, bipolar, attention deficit disorder or any combination. The self-mutilation is likely due to the BPD – although sometimes obsessive compulsive problems are to blame. There is no reason she can’t have more than one diagnosis.
The screening test I use for my patients may be helpful to you and your daughter in this regard. Simply showing her the front cover of “Life at the Border” or the back cover of “Biological Unhappiness” may give her some sense of hope to get the help she desperately needs.
