[daae32]

My husband and I started the process to adopt a special needs child last March. After months of red tape and reading profiles, we
recently had a 9 year old girl placed with us for foster care with
the hopes that we would adopt her. She had emotional issues in her past but the things listed were things like ADHD/PSTD/ODD - all issues we had well researched and felt prepared to deal with. She has been with us less than a month and her therapist is diagnosing her as BPD. The therapist asked us to read about the disorder this week to see if our observations were in line with hers and she fits it to a T. Of the nine criteria in the DSM-IV she meets all nine, and has consistently for years, from what we can glean from her personal history. We are now living through the rages and the accusations and the lies and the agression and the "I hate yous" followed by the "I love yous" and it has been an eye-opening experience to say the least. We have learned a huge amount about this disorder in just the past two days, a disorder we had possibly heard of in passing but really knew nothing about until this week.

Most of what I have read shows that drs and therapists are resistant to placing this diagnosis on children and was wondering what experience others have had with children and this disorder. Our therapist seems optomistic since we have caught it so early but most of what we have read is very discouraging. Another concern is that she is targeting our 7 year old son and she seems to resent that he was already part of the family, and his very existance seems to set off her abandonement fears. She has already been physically agressive towards him and actively tries to cause him pain in every way possible. While we expected some jealousy, we were not prepared for the emotional extremes this girl has brought with her. It is being discussed that perhaps they should look at a different placement, one without other children and where one of the parents could possibly be a stay at home parent. We are unsure at this point if we are willing to put our family and our son through the chaos this disorder seems to bring, but don't know how we can turn our backs on this little girl who has already been through so much already. Any insight or help would be so very appreciated as we don't know which way to turn any more.

[L-A-J-C-R-C]

Hi,

I'm sorry to hear things aren't going well for you. You ask a really tough question. First off let me say that I do not have experience with this. After reading your post part of me said, "have her moved to protect your son." The other side of me says to allow her to stay until her meds are in her system fully (as long as it would NOT be detrimental to your son) to see if it makes any difference, if they do - Great! If not, she would have to be placed elsewhere.

Good luck.

Michelle

[Tanna]

Well, I may be able to help you out by letting you see through the eyes of someone living with Personality Disorder.

I was adopted at the age of 9, after 2 years in foster care, and 5 years of abuse.

I was diagnosed with Personality Disorder, Bi-Polar, Post Traumatic Stress Syndrome, and Manic depression by the age of 13.

I remember growing up, my younger siblings in my adoptive family were 7 and 8 years younger than me. They were also adopted, but were biologically brothers, and were taken in as infants. I always felt like my parents treated them like they were their "own" children, and i was the bad apple.

Anyways, living with this for most of my life, I can tell you, it is the most horrible thing in the world. It works kind of like bolimia. I'd be in a bad mood, and you couldn't say anything to make me smile, and I hated people for trying to make me happy, and I'd do anything in my power to piss them off, so they'd leave me alone. The last thing I wanted when I was in "one of my moods" was for people to be all around me. Then, when I'd start to slip put of it, I'd see the results, and everyone around me would be mad at me, and crabby, and then I'd slip into a depression because I saw what my "mood" had caused in the house. So then I'd go for days without looking anyone in the eye because I felt guilty. At the same time, they didn't know if it was "ok" to talk to me yet, and nobody spoke to me. Then I'd get mad again, thinking, "fine, screw you too!"

It was just a vicious cycle of that for about 7 years. I even broke my little brother's shoulder one time. Then I ran away because people wouldn't leave me alone about it, and I felt so bad that I couldn't face him.

I don't mean to scare you, but I thought it would be helpful to see what is going on in the head of a person with these conditions. I know it is hard to see past the behaviors, but the worst thing you can do is not let go. I ran away for good at the age of 16, because even after attending 10 months of in-patient therapy, my parents would not let go of what I had done in the past. I was so sick of them never letting me start over, and never letting me live things down. My bad behaviors were always brought up, and I hated them for constantly reminding me of what a horrible person I could be.

Moral of the story...A person with these disorders looses a lot of control of themselves in sertain "moods" and DO fell very bad for it later. If you get involved with this, just make sure to allow them to have a "fresh start" after any episodes. Because knowing that you are not going to be restricted, and blamed for everything, forever, makes it a lot easier to get over it, and learn from it.

I hope I helped you, and didn't just confuse you more. Feel free to send me an e-mail with any more specific questions. For 22 years old, I've sure lived a lot!

[lucyjoy]

You might want to check our reactive attachment disorder (RAD).
That's more likely the diagnosis at this young an age. Unhealed, it becomes a personality disorder. I wouldn't give up hope just yet. RAD can be treated in children. You need a therapist trained in the treatment of RAD. You really have nothing to lose by trying it.

For more information see www.radzebra.org www.attachment.org and www.attach.org

This child does need a stay at home parent that is committed to her treatment.

She also needs an alarm on her bedroom door for her protection and everyone else.

[aMarylandfamily]

Many children with personality disorders go through several diagnoses before they begin talking about this ... we had a little girl placed with us years back who would be 9 or 10 now ... who too was into major rages and agressive/violent behaviors towards the siblings in the home ...

One major question to answer before finalization of this adoption is what services will the placing agency provide you with (i.e. residential treatment funding if necessary) as needs expand and whether or not this child will become violent against herself ... after numerous cps false allegation investigations we were warned that if the child hurt herself we would be accused of neglect for not protecting her from herself ... and she was suicidal! ... and could do 25 years depending on the severity of the injury (many were self-inflicted to get cps interacton) ... at which time we had to look at the "big picture" and determine the effects on keeping her relative to the other children in our home ... several foster care placements later and now in residential with little hope in her prognosis we don't regret our decision ... only what couldn't be ...

Hope this helps ... again not being morbid - just honest as another poster stated so you have the whole 10 yards to consider in your decisions.

Best wishes and keep us posted ... support is what you need most and this board has lots to offer ... even when the news isn't what you would like to see (sorry - she won't get better with just love and the road ahead is not an easy one).

[Shoshana]

I apologize if my post isn't a direct response to yours, but I wanted to say something about the "diagnosis" of Borderline Personality Disorder in a child.

According to the Diagnostic & Statistical Manual IV-R of the American Psychiatric Association which contains the diagnostic criteria of all mental disorders, a diagnosis of a personality disorder CANNOT be given until the age of 18. In addition to the definitive traits listed for a particular diagnosis, the key ingredient is a LONG standing pattern of enduring patterns of perceiving, relating to, and thinking about the environment & oneself and exhibited in wide range of important social and personal contexts. Only when the traits become inflexible and maladaptive AND cause either subjective distress of significant functional impairment are they called personality disorders.

Children cannot be diagnosed with personality disorders because their personalities are still forming and because, even if they exhibit the predominant traits of a particular disorder, they cannot meet the rest of the criteria.

I think that this particular diagnosis is fairly perjorative, very serious, and difficult to treat. If a therapist/counselor IS giving the diagnosis to a child, then they are NOT following standard procedures for diagnosis and they are violating the criteria in the DSM-IV-R.

Best,

[lisamz]

I am new to this forum, but would like to post a reply. Our son was adopted several years ago, and like your 9 year old has had almost every "label" that accompanies children like ours... RAD, PTSD,ODD, ADHD, etc. He is 8 years old, and was in intensive child psychotherapy for about 3 and 1/2 years (4 days per week), as well as different meds, special education,etc. My husband and I are both in the special education field also... we have been doing OK for awhile after a rough start. Lately though, things are getting "wild" again... extreme moodiness, violence,, and what I termed 'psychotic breaks". Poor little boy! What it must be like to live inside that body/mind with so much confusion/chaos. We are all back to the psychiatrist ( he is EXCELLENT!!!!), trying new meds, and learning to cope with new/revisited issues.
The reason for this long post is that many of the symptoms my son exhibits are very much BPD... I know that technically he is too young to have this formal diagnosissss, but feel that this is where we are heading. In addition to the adoption issues, we have issues of the extreme sexual and physical abuse/neglect/birth/prenatal issues (pretty extreme stuff from before we met him), and there are some transracial adoption 'issues' too.
I am writing to share and to let others know that they are not alone, and that there is some help out there. We love our son sooooo very much, and will continue to search for help/answers/support.
Keep the faith, and remember to share... it helps!

[Dr. Art]

He is not too young for a diagnosis to Bipolar Disorder and not too young for effective treatment. I'd strongly urge you to get a thorough and competant evaluation. You can find the right person to do that at www.attach.org on the list of registered clinicians.

[karenw]

To daae32-I have no special insight but I am offering another voice of support for your trials and decisions (whether to adopt, etc). Mental health diagnoses are tough in kids with a stable background, but are even harder in kids who have endured trauma. We never know all our kids adopted from substitute care have been through. Bipolar disorder can be managed/treated, but borderline personality dis. is a lot tougher (from my limited experience). Good luck with your journey and keep us informed.

Tanna-Thank you so much for your insight. You are brave and I admire you for being able to discuss these issues with the forum. I hope you are experienceing some peace in your life.
Karen

[Just Julie]

I also empathize with you daae32. I agree that she would benefit most from a stay-at-home parent and RAD treatment. She may also be physically bigger than your son, especially when she hits puberty. That could be a very insecure situation for your son.

Tanna, thanks for your openness. Your story is revealing and touching. I am glad to see you enjoy spending time with your siblings. There seems to have been some healing there. God bless.

[roxanna425]

Didn't she say that the child may have Borderline Personalilty Disorder, not BIPOLAR? BPD, can't be diagnosed in childhood, bipolar can. Borderline, may present with many of the same behaviors as and may oppositional children that have lived through trauma may grow up to be adult with BPD.

I am not sure why, after reading ADHD/PSTD/ODD in the file, a it is a suprise if the child has rages and accusations and lies. "I hate yous" followed by the "I love yous" should be pro-forma with those diagnosis in the file. You said that you'd done your reading and felt able to parent this child. Is she bigger than your biochild or is she older? I feel that if the diagnosis was listed and if you accepted the challenge then a diagnosis of a personality disorder should not be a dealbreaker. It's not like the child was presented as unencumbered by psychological problems and the potential family was unaware. I think a stay at home mom would be a good idea but any child with ODD, PTSD and ADHD should have a full-time parent and opposional behavior can escalate to violent behavior so sibs are chancy. I hope you don't think I am not sympathitic but the child has abandonment issues, the parents were warned..perhaps the sw didn't ***** well but now the child may pay the price. You have to do what's best and safest for your family. It's just too bad.

[Dr. Art]

Borderline Personality Disorder is only diagnosed in adults (18+) while BPD can be diagnosed in children. Children with RAD who are untreated develop into adults with Personality Disorders, most often Borderline Personality Disorder, Anti-social Personality Disorder, Narcissistic Personality Disorder, etc. Since about 50% of maltreated children have RAD and about 50% of those children also have BPD, a high proportion of children with RAD, if untrated, will grow up to have both BDP and Borderline Personality.

[lisajm54]

All of this sounds similar to my daughter. She just turned seven but has had the diagnosis of ADHD, PTSD, Mood Disorder and Bipolar for about two years. Her doctor added RAD when she was adopted last year. Now he says we are also looking at Disassociative Identity Disorder. Is this possible at seven?