parenting a seriously mentally ill child

In the past, I have mentioned a bit about my oldest daughter having a serious mental illness but I haven’t been specific. However, today, I have decided to share the whole story, including what I and my husband are dealing with now, in the hopes that it will be of benefit, both to help others who are going through similar things know they are not alone and also to help those who haven’t experienced this understand what it is like to live with someone who has one and the impact it can have on caregivers.

Since Laura was twelve, she has been hospitalized five times for issues related to her mental illness.

As she has grown and symptoms have changed, psychiatrists have observed her and finally arrived at her adult diagnosis: Bipolar Disorder Type 1 as well as Borderline Personality Disorder.

If you aren’t familiar with these, this combination is incredibly difficult. The mental illness part of the picture – the bipolar disorder – we can help her with (as it can be treated and help is available, though hers is severe, the Type 1), but the personality disorder is almost impossible to “treat” and, honestly, at least for us, this is where we find many of the behaviors that are so difficult to manage.

Bipolar Disorder.
Borderline Personality Disorder.

Because she has engaged in seriously risky behavior and been totally disruptive at school, she wasn’t really welcomed with open arms this year so she’s been home with me. Of course, with my health issues, the stress of dealing with her behaviors has only served to make me sicker and sicker. Finally, yesterday, she saw me sick with the flu and an RA flare – not to mention the still-fractured, swollen, painful left foot – and decided that was a great time to start arguing with me about my recent decisions about her treatment options. So I have reached a breaking point with her behavior.

But, before I get into all of that, let me begin at the beginning, with her first hospitalization.

Shortly after Laura started middle school, she began self-harming. At the time, we were shocked – of course – and she admitted to thoughts of suicide and I took her to the local Children’s Hospital, where she was admitted for about a week and sent home on antidepressants (a terrible thing for someone with bipolar disorder – but no one knew at the time).

She exhibited the same behaviors again two more times – as well as symptoms of an eating disorder – and was readmitted for about a week each time within the next few months.

After that, the depression seemed to stabilize as far as we knew but her behaviors weren’t great. It seemed that anytime she had privileges – a cell phone or computer or any way to talk to other people – she would find a way to get into worsening trouble. Still, we kept working with her and survived middle school.

When she went to high school, she made friends, had a cell phone and a boyfriend, and seemed to have a regular social life.

Then one day, I was at work – ironically as a community mental health nurse – when I got a call from the school counselor and the school resource officer saying that I needed to come to the school right away.

When I arrived, I found a hysterical child, saying she was suicidal, and the resource officer with a short story she had written describing (in great detail) an assault. At the time, she insisted the short story was a work of fiction.

Again, I took her to the ER and she was admitted to Psych for about a week.

Her diagnosis was changed to Bipolar Type 2 during that stay.

A few months later, we discovered that she had been acting out terribly, lying about her whereabouts when she was supposed to be at girlfriend’s houses, and that the work of fiction wasn’t. We discovered this when she took an overdose of one of her medications.

Of course, it was traumatic for the whole family.

With the overdose, the paramedics came and rushed her to the hospital and her younger sister witnessed her losing consciousness and the whole terrifying episode.

Due to a psych bed shortage, I was locked in the psych unit of the ER with her – being a minor, she had to have a parent with her at all times – for 72 hours. This was so emotionally distressing for us both and also made me terribly physically ill. When I was finally able to get reinforcements to go home for a bit, I got the call to drive an hour and a half north at midnight because a bed had been found for her.

She was at that facility for a week and a half and her diagnosis was changed to Bipolar Type 1.

Due to the assault allegations, there were investigations and home visits and all manner of disruptions to our family. While we were just terribly upset about what happened, we were also upset because it happened when she was “out for the weekend” where she wasn’t supposed to be – and STILL at home pitching fits because she couldn’t understand why she was on restriction again.

After a LONG period of time, it seemed her behavior had stabilized (again) and she was back at school. We believed all was going well. As was her pattern though, when she had privileges, she escalated her behavior, so we later learned she was leaving all of her classes, crying and carrying on, disrupting EVERY class she was in. Also, we later learned she was engaging in more self-destructive behavior than ever before, even on school grounds.

This finally all came to light and the decision was made to take all of her privileges for good and to attempt to find a program to help her this school year, so she could hopefully find a new path. She is an incredibly gifted artist and has a sweet and caring side as well that needs a fresh start.

And I did find a wonderful program in Nashville, designed to help young women with the types of problems Laura has been experiencing. And she agreed to go – until she conferred with one of her oh-so-wise friends who came by to bring her a birthday gift.

At that point, she became convinced that she did not want to go to a faith-based program (because she is suddenly “not religious” and we are “forcing it down her throat” by sending her to the best program available to her), that the program would not allow her to have her medications (which is not at all true), and that she would be forced to do things she didn’t want to do (yes, they do have rules). So she refused to go. As the program is voluntary, there was nothing we could do.

This program, my absolute first choice, would have been wonderful for her.

Other programs either did not want to take her (with her history of hospitalization and school trouble) or didn’t have room for her – something she seems to have great difficulty grasping.

So I began attempting to home school her.

We quickly discovered that she is terribly behind, not knowing simple things like fractions, multiplication tables, basic geography, and elementary science.

As she is at home constantly, many of her behaviors – related to the personality disorder – have been an issue:

  • Her bedroom is across the hall from ours. She literally listens for my feet to hit the floor to begin calling “Mom” for the day – for no reason. She does this all day long. I have been unable to do my own schoolwork and it often feels like I have a toddler at home again because her demand for attention is constant and overwhelming.
  • She fixates on things – to the point of obsession – and asks about them repeatedly. For example, she is obsessed with her medication and what time she will get it. She is more concerned about that than ANYTHING that might be going on with other family members on a given day.
  • Like many with her diagnosis that are adolescents, her inpatient stays have familiarized her with much of the terminology as well as the pharmacology related to her illness – and it’s all she wants to talk about (though she truly doesn’t understand what much of it actually means). She will break out the jargon at the drop of a hat to attempt to explain away anything.
  • It is impossible to explain to her that she is wrong about anything. I don’t mean this in a normal teenage way. It’s a symptom of her illness. She is NEVER wrong – even when she is totally wrong – and this makes dealing with her very difficult at times.
  • She is incredibly nasty towards her siblings at times when she thinks I can’t hear her – and then blames them for “making her act that way.”
  • As is often the case with BPD, she is very manipulative at times. It’s a constant battle.

So we are in a very difficult situation.

Yesterday, everything finally came to a head.

She abruptly wandered in, saw that I was still sick as a dog with this flu-ishness and still flared with my RA, and decided that was the perfect time to start in – AGAIN – on her issues with her treatment plan.

Her first question was about a program in our county where multiple people come to our  home throughout the week to work with her. My husband and I have discussed this option, and, honestly, are not open to having our home “invaded” in that manner for months – or possibly years – on end. That is an added stress on our family that we are just not willing to endure at this point. We have all been through enough.

When I told her that, she immediately launched into the guilt mode that I have seen so many times before, saying things like, “I can’t believe you won’t get me intensive therapy three times a week when I NEED it.”  She also had the audacity to suggest that, as it’s “her house too,” she should be able to decide to do it, whether I like it or not.

I told her that I had offered her immersive therapy in a residential setting as well as life skills training and she refused.

She then, again, began complaining about the facility I tried to send her to, saying that she didn’t want that type of therapy and didn’t believe in anything. She restated all of the false beliefs she had about it, prompting me to pull up pictures of the young women she should be in class with now, taking their house dog for pupicinos and participating in group activities together.

I told her she was mistaken about the facility. And I told her I was terribly sorry for her acting this way and I truly am.

The conversation was getting heated and I told her to leave my room until my husband could get home because her behavior is so much worse when she is alone with me than if he is here.

A few minutes later, she informed me that she needed to go spend a few weeks at my sister’s house because she needed to “get a break.”

Ummm, no.

We all need a break desperately but we are going to find a solution to this problem.

So, last night, we informed of her (very limited) options and, again, encouraged her strongly to consider the program that I had chosen for her.

And I am still sick as a dog and completely exhausted.

Please understand that I don’t mean to vilify her in any way and I love her dearly.

She is just at a point where she is in need of intensive in-house therapy and a “reset” of sorts and I believe being home with Mom probably brings out more behaviors than if she were with just about anybody else (because every kid on the planet sometimes saves their worst for Mom).

I’ve kept all of this to myself for so long that I now feel that it is time to be honest about what it is – and has recently been – like to try to live with her and to try everything to help her – to no avail. As a community mental health nurse, I saw family after family go through the same thing and I don’t think anybody is served by silence. Even if my opening up only lets one other person know that they aren’t walking alone, it will be a good thing.

When we were younger, my best friend Ginny’s older sister, Julia (who actually went to high school with my dad), was both Bipolar and had BPD. As long as I knew her and until she passed away, she created drama (and often misery) in the lives of her family members with her BPD behaviors, particularly with the behaviors she directed at Ginny.

I can still remember Ginny’s mom, Marie, dealing with her and trying desperately to help her and I would give anything to be able to call Marie and talk now. I miss her terribly.

Sheila, Marie, Me, Ginny, & Baby Laura.

It’s impossible to overstate how the constant uproar of this impacts our family.

When things are quiet, often Laura will manufacture a problem, for lack of a better way to say it.

There is no way to predict what she will come up with next.

And, as her mother, I can’t explain how difficult or hurtful it is to love her and truly want to help her and be met with such ugliness so often. It’s just a heartbreaking situation.

So, if you are dealing with this in your family, know that you are not alone.

And, if you have never heard of such until now, please don’t just close this link and forget:

  • Support the families in your church and community that are dealing with SMI diagnosis, particularly combined with personality disorders.
  • Pray for them daily. It really is a constant challenge.
  • Be aware when you vote of where your candidates stand on mental health funding. There are nowhere near enough resources for the number of people who are seriously mentally ill.
  • Be informed about serious mental illness and don’t turn away because it’s unpleasant. It impacts more families than you realize and community support is key.

As for me, I am taking a rest day and trying to heal and feel better. I can’t do anymore right now.

I was blessed to spend some much-needed time with one of my besties earlier this evening – balm for my soul – and I am making today about schoolwork and wrapping presents and putting on some worship music for a while and watching Christmas movies later and letting this tired and sickly body have a break.


Be well, everybody.

Grace and blessings.



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