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Daughter with borderline personality disorder and bipolar disorder. How do I handle?

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Dr. Preeti Parakh

Addiction Medicine Specialist

Practicing since :2002

Answered : 1486 Questions

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Posted on Tue, 19 Nov 2013 in Mental Health
Question: I have a 33-year-old daughter with Borderline Personality Disorder and Bipolar Disorder and a 37-year-old son with Asperger's. My daughter is medicated and is under the care of a psychiatrist. My question is: when they do or say something that hurts me (which is often), do I ignore it (as I have usually do) or say something to them. If so, what do I say and how do I say it? I realize that with their disorders, their ability to realize that they've hurt someone by their words or actions is limited. Do I point it out to them so they'll recognize their behaviour or ignore it since they can't really help it.
doctor
Answered by Dr. Preeti Parakh 2 hours later
Brief Answer:
Yes, you should object.

Detailed Answer:
Hi,

Welcome to Healthcare Magic!

It is a very difficult situation when someone in the family has mental illness because one doesn't know how to correctly handle them. Parents are often either over-critical or over-protective of children with mental illness. Both situations are not good and one has to find a delicate balance between the two.

In your case, I feel that you should view your son's and daughter's case differently. While your son indeed has a disease which limits his ability to understand how you are feeling, your daughter has borderline personality disorder and bipolar disorder. Except for when she is in hypomania or mania, rest of the times, I feel she should be able to realize that what she did was wrong and that she has hurt you and ought to apologize. Even in mania, she is not expected to lose that understanding, but often people become irritable in mania and are unable to control themselves and end up being hurtful. You can also observe your children's behavior with other people and see if they are equally rude with others or not. If not, then they certainly can behave better with you too.

In my opinion, both your children have over the years learnt to take you for granted and know that you will not hit back for their rudeness. I feel that you should very politely but firmly convey it to both of them that some kinds of behavior are not acceptable to you and you wish to be treated the way you deserve, that is with love and dignity. Do not object to more than one thing per day, so that they get the time to think and evaluate and are not overwhelmed with criticism. Choose only the worst of offences to intervene and ignore others for the time being. Leave these minor issues for later.

When doing this with your daughter, make sure that the situation is not allowed to go out of control and turn into a scene. Because if this happens, it will be a victory for your daughter and you will end up feeling guilty for having hurt her. To avoid this, adopt a polite but firm and assertive manner. Do not lose your calm at any cost.

When doing this with your son, talk to him when he is alone with you. Be very loving towards him and tell him that you know he did not do this on purpose but because he did not know that it might hurt you. Tell him that you are sure that now he knows that it hurts you, he is not going to do this in future. Also remember to frequently praise him in front of others for all the good things he does or if he is nice to you.

I feel that if you can do this, you will notice a change in both their attitudes, though it will take time. At least, you will not feel that you are letting yourself be taken for granted. You will definitely feel better for making an effort to get yourself what you deserve.

I hope this helps you. Please feel free to ask if you need any clarifications.

Best wishes.

Dr Preeti Parakh
MD Psychiatry
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Preeti Parakh 14 hours later
Thank you for your thoughtful reply. My daughter DOES treat other people the way she treats me. She has been fired from countless jobs and has lost numerous roommates. She has had a boyfriend for over a year now, which her psychiatrist says is practically unheard of with Borderlines, but she still has Borderline Rages with him and he recently backed out of his agreement to move in with her. They are both in counseling, trying to make their relationship work. I think she is really trying to be nice at her new job since OTHER people told her that she needs to suck up to people to keep her jobs. (I asked her nicely if she thought her BPD had anything to do with her losing her last job and she said, "I do have a tendency to not tolerate dumb people".) So, I think she's trying. When she was growing up, she would chase me around the house screaming until I locked myself in the bedroom, then she would pound on the door. I don't know if you know anything about Borderline Rages, but they are pretty horrible. My son also treats other people the way he treats me. However, he is extremely patient and loving with his children, which I have complimented him on countless times. His 8-year-old daughter is exhibiting signs of BPD (her mother is an undiagnosed BPD) so he is looking into counseling for her. I will try to respond to his affronts to me in the manner in which you described. I sometimes feel like I'm nagging him, though, when I constantly ask if he's gotten a counselor for Gabi, etc. He also has ADD and has a tendency to put things off indefinitely. They live 2,000 miles from me, so our communication is limited to chatting, emails, and twice yearly visits. Any advice you can give me on how to communicate more effectively with my son and daughter would be appreciated.
doctor
Answered by Dr. Preeti Parakh 34 minutes later
Brief Answer:
As below.

Detailed Answer:
Hi,

Welcome back!

For communicating better with your children, you need to ensure that the message is conveyed clearly, but preferably without any emotional overtones. It is always more effective to tackle one issue at a time. This helps in ensuring that the message is conveyed without distraction and also prevents you from feeling that you are nagging. While dealing with something important, ensure that other issues do not crop in and take care to guide the discussion back to what you were focusing on.

This, in addition to what was described above, will help you communicate better with your children.

Best wishes.

Dr Preeti Parakh
MD Psychiatry
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Preeti Parakh 27 minutes later
Thank you for your prompt reply. I mentioned that my son's children's mother is undiagnosed Borderline. I also mentioned that they live 2,000 miles from me. My son was forced to move there when his ex took their children and moved back there to be near her family. He has no family or support group there but her extended family always includes him in family holiday celebrations. I think that, because of this and her Borderline Personality, his ex thinks she should be included in any activities that our family has. I think she wants to be invited to come here for Christmas when my son and the children come and when I go there to visit, she wants to be included in everything that we do. She has extended Borderline Rages when she feels excluded and threatens to call the police, refuses to let me see the kids, etc. My son is afraid of her because of her rages (she has been physically abusive to him in the past, destroyed his home, etc.) and doesn't want to be around her. He goes to their extended family activities, reluctantly, because of the children. He's tried joint counseling and mediation to work out these issues, but she doesn't go. She has custody and he pays child support and sees the children twice a week. All this is an informal agreement since she has refused to attend any attempted formal hearings. I realize that he is pretty much letting her push him around, but I think he feels that as long as he doesn't have to live with her, he's satisfied. How do you think I should deal with her now that Christmas is coming? and when I go there to visit in the summer?
doctor
Answered by Dr. Preeti Parakh 37 minutes later
Brief Answer:
I think you should ignore her.

Detailed Answer:
Hi,

I feel that the best strategy would be to ignore her. It perhaps will not be possible to exclude her from the family gatherings because of the children, but when she is there, try to ignore her. By ignoring her, I do not mean doing so literally. Be polite to her and answer her when she speaks to you, but otherwise ignore her. If she does things you do not like or provokes you in other ways, avoid reacting and let others handle the issue. Just act as if you don't care what she does.

Do not ask your son to be more assertive with her. Let him deal with this as he wants to. Otherwise he may find it difficult to handle her and you won't be there all the time with him to support him.

Best wishes.

Dr Preeti Parakh
MD Psychiatry
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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