Age: Do the symptoms of BPD improve/worsen with age?

[Triple H]

I have often heard a theory that many BPD's began to realize how childish they have been behaving between the ages of 30-35. I do not agreee with this. I think BPD stay the same or get worse.

[Mousse]

This is probably most relevant to the long-term partners on the board:   I felt some relief when I read that BP's  often get better with age, but I've read some of your posts stating that your partners have gotten worse.  What was your experience?  Mine is 39, we've been together almost 7 years.  He's gotten more willing to listen to my concerns after an argument, and really does seem to be trying to control himself and change.  I've noticed subtle changes for the better in terms of attitudes toward my feelings, but my overall impression is of 2  steps up, 1 and a half back over the last four years when I finally started to stand up for myself.  I'm at a tranisiton point with this marriage where I am starting to build a foundation to leave on, but I could use some input from you.

[comanche]

I think I heard once, and it makes sense, that as we age, and get physically weaker and lose our confidence, our fears bother us more. If a person has a problem in their youth, age will make it worse and any quirk a person has when young gets magnified as they get older.
The idea that people mellow out in their old age is baloney. They get more fearful, more irrititable, especially when they get sick. IN fact everybody tends to get like that BP or not.
Growing old gracefully is not the norm, I am afraid.

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[Alana]

I believe that a high functioning BPD could improve over time in the right environment. The keys being that the BPD is surrounded by others who are very psychologically healthy and behave in emotionally mature ways AND the BPD is open to at least some self-examination. That's a lot of 'if's. I don't mean to imply that worsening behavior by a BPD is a Non's fault, but I definitely believe that a BPD can get worse if surrounded by the unhealthy behavior of other people.

Hope this helps someone.
Alana

[tired]

My limited observations of 2 emotionally healthy older people who recently passed away is that growing older gracefully is possible.

My observation of elderly people (and I have had quite a bit of experience with them) is that they become more of whatever they are.  If they are emotionally unstable, unhappy, mean, whatever, you will see more of that as they age.  Those that are happy, grounded, willing to accept help when they need it and emotionally healthy will be happy.  I have seen both sides, and really, just as in the rest of life, we all determine what we are like.  One of my motivations to figure out my own issues and fix them has been to see people age.  We need to fix stuff before we hit those years!

[StressedinCleveland]

I think the "getting better with age" observation comes from psychiatrists who mainly see BPD as self-harm (cutting) and suicide attempts. These specific symptoms do "mellow" with age. Also the promiscuity often gets better, simply because there are fewer partners that a 60-year-old hussy or lothario can attract. Also, the classic picture of a young BPD having their flaws overlooked because of their great looks and sexual prowess will definitely fade over time.

[sonomanona]

I am approaching this issue from the perspective of a spouse rather than as a child of a person with BPD.  And we are perhaps older (53) than some of the other spouses who have responded to this question. 

In my case, I think that some things are better with age, possibly because the young male testosterone issues have decreased.  In the earlier years, my husband tended to react to every perceived threat, insult, challenge, etc., in a physically aggressive way.  He's still not really caught up to his actual status physically (meaning that he still has a rather inflated idea of his ability to kick butt) but he is less inclined to let his rages spill over into risky physical conflicts.  So that part's easier for me.

He's still awesomely self-centered and clueless about how he impacts on his family.  And as I get older and want support through the inevitable trials of life, I find myself feeling sadder about how incapable he is of letting someone other than himself be the focus of attention, and how much I long for a partner who is actually capable of empathy. 

But at least I find myself less anxious about him letting his rages turn into public conflicts.  I guess that's better(?)...

[Abigail]

  I don't believe the aging affects the disorder so much as the situations they are in.  Our doctor told us that borderlines are highly allergic to stress.  Perhaps that is why so many don't show the symptoms in the early stages of a romantic relationship, provided there is no stress in their lives.  In the first 23 yrs. of our marriage (before we knew about BPD) there were some okay times but stress did make it worse.  So did holidays!  He could be doing fine but on Thanksgiving or Christmas Day, you could count on the day being ruined in one way or another.
  Fortunately, he has received treatment in the past two and a half years and has made a dramatic turnaround.  He is on maintenance medications and also has a medication to take in times of high stress.  Works great!
  Abigail

[tired]

Our doctor told us that borderlines are highly allergic to stress. 

Wish they had a vaccine for that 

How we behave when we are under stress tells a lot about all of us.  Sure, things go well during the dating phase of any relationship.  What happens when finances are tight?  When a family member dies?  When teenagers have problems?  We all see what we are made of during those times, us as well as our BPD's.

[nevergiveup]

I think it depends what the question means - does it mean "Does the person get worse in general?" or "Does the person get worse inside a specific relationship?" I don't have a clue about the first question, but I think for the second question the answer is yes, because they treat people with kid gloves at first, seeing how much abuse they will take, how far they can push it, and then if the other person looks like they will take it and they stick around then the bpd will see that as a green light to treat them as badly as they like. My ex certainly got worse over the years - at first she worried I would leave her, then later she didn't care, and finally I think she kind of despised me because I DID put up with her crap.

[longtime]

I had the same question so I asked my T.
He said that many eventually burn out. It takes a lot of energy to sustain the levels of emotionally intensity that they experience and as they age they find that this level of intensity it is not possible to maintain.
Hence, with age they "Mellow" (My word not his)
Longtime

[Almost_Nobody]

Perosnality disorders tends to increase at age 50+ and tends to decrease at 60+

[another_guyD]

As a person ages 50+ it seems they mellow (though my observations are purely anecdotal evidence).
My mother is a nurse who deals with a lot of geriatric patients for a week to a month at a time.
She says that attitudes of these type of patients are usually angry or very nice, rarely any middle grounders.
I am not sure this matters but interesting info none the less.

I am curious about the study. What symptoms were they gaging this by? Medical studies are some the most
ambiguous studies and are often as flawed as their subject; humanity is hard to quantify, much less the human with BPD.     

[yoo]

As concerns (most probably) low functionning BP, there is a recent paper by Zanarini et al. A 10-year follow up of 362 BP initially contacted while they were in-patients. While impulsivity and severe difficulties in interpersonal management showed a reduction in some individuals, chronic disyphoria, abandonment and dependency issues tended to remain over time. Here the ref.

Zanarini, M. C., Frankenburg, F. R., Reich, D. B., Silk, K. R., Hudson, J. I., & McSweeney, L. B. (2007). The subsyndromal phenomenology of borderline personality disorder: a 10-year follow-up study. American Journal of Psychiatry, 164(6), 929-935.

To my knowledge, there is no follow-up study on high functionning BP.
But no need to say that this type of investigation would be deeply needed :-)

- yoo

[smerdonsh]

Thanks Yoo, that information is very interesting.  And I do wish there were more studies conducted with high functioning, but it also may be dangerous to do that since they can be so manipulative and the data could be scewed as well.

[beachgirl]

I think it is different for everyone. However...from my research and my experiance. BPD is at it's very worst from age 17 to about 30. 

[Raven Valley]

I first found out about what exactly the disorder is on wikipedia, but on there it says it lasts for about a decade, that it lessens in severity over time. But a lot of the threads I've been reading here seem to be by people who have known sufferers for a lot longer than 10 years without any dissipation of the disorder.

Is wikipedia wrong?

[Skip]

This may be a definitional thing... often the technical literature refers to low functioning BP.  These individuals have difficulties holding jobs, self harm, and often spend time as inpatients in hospitals.  These severe symptoms often reduce in time.  They learn to adapt.

The majority of the BP discussed on this sit are either high functioning, sub-clinical (traits as opposed to clinically disordered), or past this "severe" symptom period. What we discuss here is the difficulty of maintaining a relationship with a BP or person with BPD traits... and that level of difficulty can persist for many years - even a lifetime - if a significant effort is not made to address it.

Hope that helps.

Skippy

[RainbowGirl]

I dont think that slipping will necesarily put you back to the start, its a two steps forward, one step back process from what i've seen. I think the major difficulty with BPD is that every patient is different, there are different vices, different coping mechanisms, different drugs and therapies that may help one, but not another, and thats why its such a difficult disorder to diagnose, treat and live with; because there are no 'right' answers, because each patient is individual. I have a friend of a friend, who went through two years of therapy, and now leads a full and healthy life, although she does sometimes feel like she has bad days when she thinks about the past and feels like it may be creeping back. So she is not 'cured' as such, but has been given a chance to deal with the issues, and has learnt to live with, and cope with her feelings. In 2 years, she has had 2 days off sick, and they were genuine... Now of course the same therapy wont work for everyone, but it shows that things can be done, but perhaps not to get rid of BPD, but to learn to cope. Hope that makes some kind of sense...!
Rainbow x

[Abigail]

It is a disorder, similar to something like diabetes, in that it can be managed with the proper treatment of medication, therapy and changing one's way of thinking with some form of cognitive behavioral therapy which can include DBT (has been shown to reduce self-harming behavior).
Symptoms may wax and wane depending on the amount of stress they are under, when they first fall in love and certain traits may lessen in severity with some individuals.  There is no cure at this point but it can be properly managed, if the individual is willing and is able to receive the right treatment.

As Skip mentioned, there is a difference between low functioning and high functioning borderlines and most of the research has been based on low functioning types which are more often seen in clinical settings.