Depression & borderline personality disorder in adopted children

@Sherann, depression can be inherited, absolutely. However, borderline personality disorder is a very serious, non-organic mental illness. In other words, it is situation unique. Most borderline personality patients have been severly abused in a multitude of fashions and often spend the rest of their lives in counseling and on medications. It takes a great deal of dedication on the part of the patient to live a normal life. I wish you luck with this - there are a dozen books out there one "I hate you, Don't leave me" is very profound...you might want to read up on it.

HOw old is the child? Its more typical these days to diagnose them as RAD, not BPD (borderline personality disorder) My mom has BPD. She was not abused. According to her siblings, she showed signed her entire life. She blames it on the death of her father when she was 15. BPD does not appear connected to adoption. But the closely related RAD is more common-ish. If it were my AD, i'd get a second opinion. Either way, you need to read up on it. RAD and BPD people can be super manipulative.

@wcurry66, just an FYI - I am a psychology major in the end of my graduate studies (less than one year from attaining my license)...Your mom is not BPD - almost a guarantee and maybe she needs to see a different doctor. Also, BPD is not something that you show signs of all your life. In reality Bipolar Disorder is something you show signs of and something that has no basis in abuse. It is also similar in a lot of ways to BPD (borderline personality disorder). Having worked with many patients, I can tell you this factually. Borderline presonality disorder patient, according to the DSM-IV (current diagnostic text for all psychologists), can and will sabotage all relationships, is seriously sexually permiscuous, can and does abuse others, has serious issues with coping with life requirements such as employment, education, etc., and is based in traumatic events in life. This is a boiled down version. The bipolar patient, while having a lot of the same issues, is easily treated with medications and counseling. This can and will be helpful. That is in complete opposition to the BPD patient. The BPD patient will resist treatment unless completely committed to it, can't be medicated to control mood swings or behaviors more than minimally and is out of control at least 50% of the time. This out of control manifests in behaviors that are beyond the base line of the bipolar patient. Treatment for a bipolar patient does not have to include counseling, although it is recommended. The treatment for a borderline personality patient is based in both medications and a requirement for counseling. The issues for each disorder are completely different for each patient, but similar within the type. While I respect your input, there is something that is over diagnosed in adoptees and that is RAD. RAD is not always the case and is something that, in recent studies, does not have anything to do with adoption and everything to do with interaction with caregivers - no matter who they are. There are many great studies on this matter. RAD - reactive detachment disorder - is also based in trauma or the perception of trauma, such as abandonment, failure to care for or give appropriate input to the child or infant. This is not the case in most adoptive situations. Getting a second opinion is an excellent idea.

While I respect your input as a student, I can tell you my mother's diagnosis is correct. I've been living with her borderline personality my entire life. And yes, the manipulations, the inability to hold a job/relationship, and other criterias are there. Yes, she's been in and out of treatment for 25+ years and been diagosed by more than one doctor. She gets better, then regresses. Many people with borderline personality can get better is they choose to. One piece of advice I give you - borderline clients are awesome manipulators. They know what to tell you. If they want something (like medicine, a short hospital vacation, sympathy), they can get it. Although originally thought to solely be due to abuse, there are also studies suggesting both genetic and brain abnormality causes. Kernberg may have been the first one to suggest its roots be in "psychic clarification of self and other can result in an increased risk to develop varieties of psychosis, while failure to overcome splitting results in an increased risk to develop a borderline personality". The roots of this MAY be child hood trauma, but are not limited to this. If you read some of my threads on giving my mom access to my DD, you'd see more specifics that I wrote in this thread. She's is NOT bipolar (though many in my family are). The symptons of the two are very different As for RAD - yes I know its over diagnosed. But I also have been several studies tying it to the children who face trauma from being separated from their parents and are unable to attach either through multiple placements or other side effects of the adoption process. I asked about the age of the child specifically because the aspect of sexual promiscuity are not likely seen in a child and the pure manipulations are more often diagnosed as rad. If you do some reading, you'll see more and more studies tie the two A quick google search brought up this one, for example [url=http://counsellingresource.com/ask-the-psychologist/2008/02/26/borderline-personality-disorder-and-reactive-attachment-disorder/]Reactive Attachment Disorder vs Borderline PD in an Adult[/url] I do hope, once you get out of school, you learn that listening to the patients and the families who have been living an illness is hugely important in diagnosing and treating them. Books are a great start, as are a handful of clients. But the real learning comes with experience.

Just an FYI - I already treat patients, as I said I am in my final classes (which include internships for the last two years), and all of my professors and supervisors commend me on my ability to listen to and respond to patients and diagnosis. But thank you for the advice. One thing you need to know, internet information is necessarily incomplete and usually written for the public. Which is very different from educational or professional journals. Also, speaking of listening, this is the birth mother forum and the young woman about whom you are speaking is not her AD, but her birth daughter...So, in the spirit of responsiveness, I have to say that the question is valid on its face and the statement that I made is also valid. I find that your need to tell a birth mother that she should get other opinions interesting, in the least, considering the young woman spoken of is more than likely a grown woman and has probably been in care for a while. The facts are simple...Kemberg's conclusions are not validated at this time by any further conclusive or supportive studies. If in the future there is research that upholds his theory, then I am more than willing to revisit the ideas. Up to this point, it is simply an assumption due to one or two studies. All mental health patients will manipulate for things...this is a given. It is also something a first year resident knows and is trained to deal with. I have dealt with manipulations from all kinds of people and find it interesting, and totally irrelevant, other than in the context of functioning. And, so you don't think I am talking out of my hat, I have a huge family with about half of them being bipolar and the other half or a good portion thereof are clinically depressed. My husband was schizophrenic. So, yes, I know exactly what I am talking about. With this and my training, I have a great deal of skill, compassion and understanding when it comes to patients/clients and the problems that the psychologist faces on a daily basis when assisting the mentally ill.

fyi -you may want to process why you got defensive after my first post. I posted my reality. I have lived with a woman with borderline personality for 44 of my years. Why you initially decided to discount my reality, simply because it doesn't fit into your understanding of borderline concerns me. It concerns me that you would suggest a diagnosis is wrong, based on a short description, never had met the patient, is disturbing I remember graduate school and how tempting it was to use my confidence in the knowledge I'd received up to that time to consider myself an authority. it was only after getting into the real world, that the grayness of those facts became apparent Yes, I saw in your other post you've treated patients. You can't be stating that you have the knowledge of someone whose been treating patients for decades. Nor, I hope, can you be saying that you know more that the people who have lived with a particular mental illness in their family for decades. You may want to consider how it would be if someone replied to your post about your husband with "it doesn't sound like schitzophrenia to me; you should get a second opinion". How insulting that might feel - when you know how many people you've seen, how many drugs have been tried, how many sleepless nights, and ruined holidays you've lived through Yes, I know she's a birthmother. I also know she's in reunion. So she can suggest the child get another opinion. Again, I have no idea why you find it necessary to argue my suggestions. To you think this is a competition??

I think it is time for you and Silverwitch to start sending private messages because neither one of you are trying to help me, but seem to be having your own private debate. My daughter is 31 years old and has been dealing with the depression since she was 16. The BPD was diagnosed in just the last few years. She has been under a doctor's care since the age of 16 and I can only pray she is receiving the help she needs. My other daughter is a licensed mental health counselor and has given me insight into BPD. My initial post was done to find out if this is a common occurence for adoptees. I'll probably never really know the answer to that, but I did find out that these forums may not be what I was looking for.

Sherann - You are right...the personal debate needs to be moved to pm. As for your question, I'm not sure there's an easy answer to that because so many mental illnesses have a genetic component and then the environmental/life can trigger things. (from what I've been told/read). I know there are a few adoptees on our site that have done research so if you'd like, I can ask them if they have some information for you.

It might also be useful to read on the special needs boards. However, most of the kids on those boards were either abused, neglected or spend time moving around in foster homes or orphanages. For those kids mental illness is very, very common. However, like crick said, it's hard to sort out where it came from. Some have a genetic pre-disposition. (in some cases the parents mental illness had something to do with the child's removal)Some are traumatized from moves or abuse or neglect. Then there are some that no one is sure what the reason is. Perhaps as you get to know your daughter better and learn more of her early childhood experiences, you will figure it out, but then again, you may never know. Any research you can do into your family history will be helpful to her, as well as any from her father's family if that's avaialble. Doctors always want to know the family medical history. I hate not having those answers for my adopted children. I know she is blessed to have you back in her life.

I've treated folks with depression and BPD for years. As other posters have suggested, depression is genetic. While life circumstances can definitely play into the context, there is generally a genetic link with depression. As for BPD, I've never thought about any connection between adoption and BPD, but you've gotten me interested in doing some research on the subject. It used to be that folks thought that there was no treatment for BPD, however that idea is antiquated. For at least the last 15 years or so, Dialectical Behavior Therapy (DBT) has been shown to be quite effective. Of course, having a counselor in your family, you probably know this! While studies of individuals with BPD show that many of them report a history of abuse, neglect, or separation, there is also research being done regarding neurological differences in individuals with this diagnosis and their ability to regulate their emotions--which obviously impacts their relationships. Your daughter is very lucky that you are doing what you can to learn more about her and her diagnoses. My clients who do the best are those who have supports in their lives who understand, and who don't take their reactions personally. Good luck to you and your family.

Hi Sherann, I am coming to this from a different perspective. I am an adoptive mom. My son's birth mom has struggled with depression which figured into her decision to place her son. (sorry if this seems invasive of her privacy...she has been very open about her struggles and is doing very well now) I think there are many different questions. One is if adoption itself causes depression in adotped people and the other is if depression causes pregnant women to consider adoption. Or maybe there is no link at all. I do not know the answer, but I am glad I have a good relationship with my son's other mom because if my son does experience depression, she can be a support for him. Also, I will be more likely to recognize signs and get him help if he needs it since I know her medical history. All the best to you and I hope you find support in this community.

I think there probably is more BPD in adoptees, as they have ALL lived through not having the same loving mom conceive them and raise them to adulthood- no matter the reason. They experienced a huge wound. As an adoptive parent, I hear so many people tell me all my kids need is love and they'll be fine. That's not been the case. But as I have sought help and done tons of reading and listening, I have learned how to help them heal. Parenting the adopted child is NOT the same as parenting the bio child, even when adopted as a baby there can be attachment issues. Bio kids may also have attachment issues due to extended hospitalizations or other reasons even with loving moms there. I just don't think it would be as common. In years past, there wasn't the information out there and help available to adoptive parents as there is now. So it HAD to be much harder to help the adopted child heal, and it isn't easy now.

You're right. Personal discussions should stay in PMs. I apologize Being raised by someone with borderline personality means being told never to trust your own instincts. The desire to get "whatever" means they are motivated to prove their child wrong - with little accountability for the fall out. It means regularly being told you're wrong - even when you know in your soul you're right. It means obstacles in forming identity. You may be the parents partner in parenting one day, then the next a "nothing" with some stranger for "dad". But don't worry, he'll be gone shortly and you'll be magically back to the old role, like nothing ever happened If there are multiple siblings (like in my family), it means being pitted against each other constantly. My family fractured and scattered as a result From a BP perspective, i would assume your desire for reunion is powerful. Even in normal BP situations, BKs may pull back or have needs different than what the BP may be planning to commit. When here's borderline in the mix, your love can be used against you. I would proceed with caution. Good luck to you

sherann, first let me say that I am so sorry for your birthdaughter's situation and the sadness and heartbreak it must bring to you and your family. Forging a relationship with a bpd adult will certainly bring challenges and perhaps some painful experiences. Knowing that going in I hope will be a tremendous help. Also that your birthdaughter is so open about it shows that something is going well with her treatment and management at least for now. In my little bit of experience with bpd adults, that kind of frankness about the illness itself seemed to be rare. That she has it and is not using it to manipulate you (I hope), I think that's a very positive sign. Still, you have my heart beating in sympathy with you as this news sinks in. It can't be easy. For all the reasons the other posters stated, I doubt anyone knows whether or not BPD is particularly common among people who have been adopted. I am sure people have probably tried to study it, and maybe your MH professional daughter can search her professional databases for scholarly articles. If anything definitive or replicative had been found, though, I would think it would have ended up in some thread somewhere on these forums, particularly the adoptee forums. As for a clear general link between DIA and mental illness, somehow, I doubt it. In a relatively small part of the DIA population, there may be more opportunity for triggers--the RAD child, for example, may be subject to more familial hostility and abuse--but I think those are probably the exceptions and wouldn't count for much against the many other potential triggers in every child and adult's life, adopted or not. "Primal wound," it seems, might be a trigger for depression if the predisposition is there, but I don't see how it could be a trigger for bpd. But then, I am not a MH professional. And, of course, as others have pointed out, to some extent it would be hard for researchers to create truly representative populations to study and those they do find may be self-selecting populations; if there is some association of one thing with the other, it may be less causal and more an aspect tied to that. Please understand that we are talking about a very wide range of parents with terminated rights. Especially in more recent years, many, many children who would otherwise be counted as adopted out of foster care are now being counted as entrusted/placed DIA or older child adoption thanks to "mediation" between parents and potential adopting parents. So please understand that there is no attempt here to generalize about all birthparents. I hope things go as smoothly as possible in your RU. You sound like a thoughtful and conscientous person. If your birthdaughter wants to talk about the effect of her adoption on her life, I would try to be open to that without either defensiveness or taking on any blame or guilt yourself. Regardless of the reasons for her difficulties now, you did the best you could knowing what you did for her then, yes? People who are struggling need the freedom to explore and evolve their understanding of why they find themselves in their particular situation. You can be an active and empathetic listener, affirming her feelings and journey without trading her truth in the moment for yours. - Peace, H :hippie:

While a genetic predisposition to depression may exist in some people, the condition emerges in many folks who have no known family history of the disease. While it is considered a disorder of brain chemistry, it can be triggered by all sorts of events, even in a person with no family history. As an example, a teen who is very competitive and eager to get into a good college may be excessively stressed by a tough load of AP courses, and may start to display typical depression symptoms, such as crying jags, a feeling of worthlessness and hopelessness, thoughts of suicide, outbursts of anger, and so on. Stress can trigger many illnesses, from psoriasis to asthma to depression, and illnesses, in turn, can trigger depression. While both adopted and non-adopted persons can experience depression, the adopted person may have some triggers that non-adopted people don't -- for example, reminders of loss of a birthparent, abuse or neglect, being bounced around the foster care system, coming to a new country, etc.The good news is that many people with depression can be helped with medication for the brain chemistry issues and talk therapy for the behavioral issues triggering the depression. As an example, once the medication kicks in, the person may be able to talk to a therapist about why she feels so driven to be "perfect" and is afraid to make mistakes or fail at anything, or about how to avoid negative thinking, like, "If I don't pass this test, I'll totally mess up my chances of going to a good college, which will mean that I can never get into medical school and become a great cardiologist." For some people, depression that is successfully treated with medication and talk therapy will never recur; however, some people may have multiple bouts of depression in their lives. One mistake that is often made is refusing medication. Talk therapy alone won't work for a lot of people, because the brain first has to be "reset" with medication to make the person more receptive to it. Unfortunately, there's not one medicine or combination of medicines that works for everyone. Some people respond best to SSRIs, some people to NRIs, and so on. Some drugs may have minimal side effects for one person, but may cause stomachaches, panic attacks, or whatever in someone else. And some people may find that the older drugs, such as tricyclics, work best for them, even though they may have more side effects, like weight gain. While it's tough to ask a depressed person to be patient, finding the right medication and dosage may take a while. In fact, any person, but especially a child or teen, should be watched carefully during a trial of an antidepressant, because a small number of people may get more depressed when they think that a drug isn't working, and try to kill themselves.Once the brain chemistry issue is being dealt with well, then the person can undertake talk therapy. Nowadays, many therapists use "here and now" techniques, such as cognitive/behavioral therapy, which doesn't get at the "why", but helps a person recognize and avoid negative thinking. It is considered very effective for some people, but simply doesn't work for others, especially very bright people who often "game the system" and tell the therapist what they think he/she wants to hear. For some people, working with a classically trained psychiatrist is more effective, though it takes longer, requires more visits, and costs more. Unfortunately, too many health insurors won't allow use of a psychiatrist for anything but medication prescribing and monitoring, but you may be able to find a psychiatrist who will take a case for a reduced fee or "pro bono" (no charge).Borderline personality disorder is more difficult to diagnose and treat than depression, and it can have a whole range of coexisting conditions like depression, anxiety, eating disorders, and so on. It is really important that a highly qualified professional makes the diagnosis. It is important to understand that, while genetics can play a role in the development of BPD, many people with it do not have any family history suggesting a genetic link. Likewise, while it is particularly common in people who've experienced trauma such as abuse or neglect, plenty of people with BPD have not had any such trauma, and plenty of people who've experienced trauma do not develop BPD. Some of the most common manifestations of BPD are impulsive behavior, rages, intense depression or anxiety, unstable relationships, and so on, but these are not unique to BPD, so it's important to know whether they are caused by BPD or something else.There is a lot still to be learned about BPD, and as a result, treatment isn't always easy. However, as with depression, medication and talk therapy of various sorts can be helpful.The one thing that you should understand about your birthdaughter's psychiatric conditions is that you should not blame yourself or the birthfather for them. Yes, if you were an absolutely horrible parent, and lost parental rights due to abuse and neglect, you might have triggered some of your birthdaughter's problems. However, plenty of people who were raised by fine parents wind up with these problems, and some people who were severely abused or neglected do not experience long term depression or BPD.The best thing you can do is to make sure that your birthdaughter gets the high quality mental health help she needs. And something else you can do is to give her your love and support, and remind her, when she is feeling hopeless, that she should continue treatment, including medication and talk therapy, as needed. If your birthdaughter gives any indication that she might be considering harming herself, get her some help immediately, and don't leave her alone. Also, some people with depression and BPD try to self-medicate with alcohol, prescription drugs, and illicit drugs, but these substances only make the conditions worse, so try to get your birthdaughter to avoid or stop using them. If need be, try to get her into a treatment program that addresses these issues, as well as the underlying depression and BPD.Sharon