re: 12 Year Old Girl with BPD

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The diagnosis really isn’t the important thing here, and labelling a pre teen as “Borderline” is malpractice.

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Gotta agree to disagree here. DSM allows diagnosis as young as 12 with symptoms persistent for at least a year. It’s rare but it happens.

Unless she has disclosed trauma that indicates a diagnosis of something like PTSD (or witnesses can verify that she experienced that trauma), then that’s what you have to roll with when behavior is that extreme and longer term treatment is needed.

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Personally Disorders are based in rigid patterns of thought, emotion, and behavior that persist into adulthood. The idea that a 12 year-old has a personality disorder flies in the face of all current understanding of human development. It is asinine and irresponsible.

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Again, you have to go with what the client is presenting. What would you diagnose her with when there’s been no disclosure of abuse/neglect present?

It’d be even more irresponsible to pretend that this isn’t possible in a 12 year old.

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i think the issue isnt whether or not its an accurate diagnosis, but rather the repercussions that come with a BPD diagnosis later in life. a pre-teen exhibiting BPD behaviors could and should absolutely be treated as if they have the diagnosis, but the minute it gets put pen to paper as a borderline personality diagnosis, there are potential life-long impacts even if it turns out maybe they DONT have BPD. lots of pre-teens and teens have some pretty significant emotional problems that they work through to become very normal adults.

but to your point, yes i think it is appropriate that a doctor at least TREATS them as if they are in fact borderline

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And that’s understandable but that diagnosis can be changed as symptoms/presentation change. IMO it’s a similar circumstance as kids being diagnosed with ODD at a younger age when it’s actually a personality disorder later.

I think it’s also worth noting that without the BPD diagnosis, longer care treatment could be more difficult to obtain which can definitely run counter to the concern about the label itself.

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i am basing this totally on my own anecdotal experience, but i know that in order to receive a security clearance for the government, you have to answer "have you ever had a diagnosis of borderline personality disorder". there isnt really any wiggle room for whether or not that diagnosis was changed. again, i understand what you're saying, i just think doctors should be very, very careful with such a diagnosis on a child.

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Well, sure.

But OP openly admits his daughter threatened to kill her 1 year old sibling. At some point, her (and really the client’s too) safety now has to come before the concern of her potentially applying for a government job down the road.

That said, we’re all having this discussion out of our scope since none of us personally treat the kid, obviously. Given that insurance will also push back on a BPD diagnosis before the age of 16, my guess is they have very good reason to diagnosis her with it.

Checking in on you Leo.

How are you? How's your daughter?

To quote Shakespeare, "Get thee to a nunnery (or girls boarding school run by nuns)

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DSM allows diagnosis as young as 12 with symptoms persistent for at least a year. It’s rare but it happens.

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No it doesn’t. Age <18 is an exclusion criteria . Look it up in the actual DSM V and not google. DSM is dog shite anyway and lost all credibility in my book when they started to call pedophilia a mental disability.
Get your kid a counselor who focuses on DBT and be wary of the shite on the internet or from people without any real clinical knowledge/experience/credentials. Have her take the MMPI-A…a psychologist should be able to administer it..it’s honestly what I’ll order for patients if I suspect underlying character pathology .. it’s long but it’s validated and hard to fake/cheat.
Don’t let some dumb frick mid level NP or PA put your kid on an antipsychotic that’s gonna do nothing but give her metabolic disease by the time she’s 18. My best advice is love. Love em through it.. any thing else confirms the warped narrative they’re building upon inside that they’re unloveable destined to be abandoned

Find a psychologist that specializes in DBT. You could take her to a mental institution to get evaluated first. Then when the results come in you can either do an intense therapy program involving several doctors in one place, or you can leave to find someone with a private practice. The PP won't do intense therapy though, at least from my experience. The problem with the mental institution is that it is depressing and probably a run down facility. You have to get buzzed in at every door and the bathrooms are locked. Extreme patients are there.

The psychologist will recommend a psychiatrist should she need meds or a psych eval.

She needs therapy. I'm sorry for what you are going through.

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I have prayed over her, medicated her, but it only gets worse and worse.



Tough situation, but I can tell you what won't work. Prayer.

Medication and serious therapy with mental health professionals is what she needs. I have a niece with bipolar disorder and it took a while to find the right mix of meds, but once they did she got much better.

Do some serious research on the best doctors and therapists in your area and spare no expense. She won't get better on her own and there is not much you can personally do.

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This is all true and the best advice in the thread. Praying has psych benefits for many people, but praying will not help lessen the ravages of mental illness for this young girl or anyone with diagnosed mental illness. Sadly, obtuse/unenlightened folks will be defensive, taking the prayer comment as an attack on religion and their church...it is not, but it is reality.

My brother sufferd from schizo-effective disorder (elements of schizophrenia + mood irregularity/disorder such as BPD) for his entire adulthood. There is no cure for mental illness, but it can be helped through intense treatment and medication by the right professionals. I suggest a two-week mental health in-patient stay now, where she can be observed at all times and diagnoses can really be flushed-out. My brother didn't have the benefit of this stay until after, and in response to, a suicide attempt, but it finally provided a thorough diagnosis. It may be learned that the girl has multiple, currently unknown issues which can be diagnosed, such as autism, paranoia, and depression.

Health insurers can often assist in lining-up the right medical providers. Also, explore social security benefits for this girl, as she may qualify at some point to draw through your and/or her mother's SS and Medicare will follow.

And, it's bothersome that some have suggested essentially discarding this girl. Parents need to be fearless advocates for their kids. Her condition is the fault of no human...could be genetic, environmental, pre-birth related, etc...it doesn't matter.

And suicide threats, and all threats, are not to be taken lightly. I speak from familial experience. Report threats to medical professionals and the authorities asap. Remove sharp objects in the home from the girl's access.