Dealing with SO's suicidal thoughts (not threats)

[Haye]

I read through tools workshop on suicidal threats. My concern is about how to deal with dBPDso who isn't openly suicidal, or not attempting a suicide but keeps having suicidal thoughts deep inside. This has been going on as long as he can remember, so it is not a new thing. He is being treated in what is called a dayward ie he goes to the ward and meets his designated psychiatric nurse, three times a week private sessions.

Yesterday eve he seemed a bit off somehow, like contemplating on something. I asked him what is it, he wouldn't answer me. I asked him to tell me honestly what is going on in his head and he said "well, i just don't want to live". Looked at me straight in the eyes, with a very weary and sad look on his face and continued: "You know I didn't want to reply."

I felt so small and, i don't know, unable to help him in any way. To comfort him, etc. He wasn't cold or distant, just someone who is in a very deep depression episode. He said that he isn't going to do anything permant to himself and i did make him swear that he doesn't. We both know these episodes come and go, but it's still... . Hard. We have talked about these episodes and he has pointed to me that the way he feels at that moment isn't true in the big picture and what he says and feels (things like "i just can't make it any more" do not mean he feels like that all the time.

I'm pretty certain these are not used to get a reaction out of me, i have not seen anything manipulative in the way these thoughts come out. He just seems very very tired of living. In a way i do understand his feelings. The whole BPD diagnose is relatively new and all his very being is in turmoil now. He has been going through his past with his decicated nurse, I think for the first time in his life totally open with all the s*t he's been through himself and also what he has caused to others. He's very sensitive and emphatic so knowing and owning the grief he has caused wears him down.

Do you have any advice as to is there anything i could do at those situations? Anything i should not do or say? There are some plans to have phone numbers to some workers he could call when he drops to that hole, but those are yet still plans. 

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[Lilibeth]

Haye, reading what you are going through brought tears to my eyes. Dear friend, don't despair. You are already doing so much, and you will learn more from here. We all help and support each other here, so you will find help here - but you will need to fit it to your situation. Haye, i've found there is a lot of peace in just going on doing the daily things you do... . keep your home running the way you do. Do all the things that you do every day - that you plan every day. That will create it's own peace and it's own energies. You say - 'I'm pretty certain these are not used to get a reaction out of me, i have not seen anything manipulative in the way these thoughts come out. He just seems very very tired of living. In a way i do understand his feelings. The whole BPD diagnose is relatively new and all his very being is in turmoil now.' The fact that he is willing to try to help himself is itself a huge, huge thing, but it is not easy for him and certainly not easy for you, and most of all, it is not easy on either of you. You need to be strong, even if you are hurting inside, dear friend. Yes, you need to know who you can call in case things go out of control, but otherwise just be there, and work out strategies that help you to be able to cope. Listen to him, and let him talk his thoughts through. I feel if you suggest alternatives he may see that as a rejection of his feelings... . that you are not taking his feelings of not wanting to live seriously (for whatever reasons). It's hard to understand how their minds work, Haye, but there it is... . just let him talk, but try and not let it get to you. You need to remain strong and focused (which is not easy - so don't feel bad if you feel, sometimes, that what you say/do is not helping). These things take time. Gradually he will let go of the past... . Seeing you go about things as normally as you can, without showing him that you are working around feelings that may trigger off his suicidal thoughts, are sure to help. It is a long journey, but you are not alone... . we all feel for you and are with you... .

[waverider]

Is he been treated at all specially for depression. Coming to terms with BPD often means stripping away the old ways of denial and delusion which has been their suit of armour. Constant depression is often the consequence brought on by the resultant feeling of hopelessness.

I have been through this many times, whereby my partner hasn't actually attempted, or threatened, but there has been much self harm where she simply didn't care about the consequences.

Until progress is made they simply cannot see the point of anything, and can get stuck in this mode.

I would certainly discuss with doc as to whether antidepressants are worth considering. Also keep some phone numbers handy for depression hotlines, otherwise it can get you down to if you are the only one they can talk to.

When someone is depressed it is best to listen and acknowledge that you can see they feel that way, dont try to "problem solve" their issues. It is taken as an attempt to dismiss them and can be very invalidating. The depression is deeper than the issue at hand and you miss the mark.

[Haye]

Lillbeth, thank you for your kind words! Heartwarming. 

Is he been treated at all specially for depression. Coming to terms with BPD often means stripping away the old ways of denial and delusion which has been their suit of armour. Constant depression is often the consequence brought on by the resultant feeling of hopelessness.

Yes. Originally first doc declared him as depressed (not severely even), gave antidepressants and that was it. Talked to the same lady again, tried argue together that it isn't just that, but something much bigger and deeper etc and doc #2 took him more seriously - misc anxiety diagnoses, being suidical + misc SI. Unfortunately this one treated him only for a very short time. The psychiatric doc in charge of his case now is still quite unsure of his dignoses though has started to agree with both me and my SO about the BPD+PTSD etc probably being correct.

And so true what you say about coming to terms with BPD! I'm pretty certain that's also one major thing keeping him down. But i can't helpt to think that though he now understands his own behaviour and i see it as huge progress, though the cost right now is a bit too high.

Problem is that the doctor sees his condition too bad to be able to handle therapy -> i supposed they plan to keep him in this "no armour" -mode forever . We have a meeting coming, planning his treatment, and do hope i could somehow get the doctor to see that he can't be left to live like this, but needs help to build normal defences.   I do agree that it's likely digging out more traumas is likely to make his condition even worse and thus that "dirty laundry" is probably best to be saved until his more balaced.

... . But certainly there are all kinds of sort therapies concentrating on positive things and not digging? Any ideas or suggestions?

[Stalwart]

I can only speak from my own experience but when my wife started treatment she'd been diagnosed. The group she went to specialises in BPD, problem is we live in an area where I'm not certain that is as advanced as some other metropolitan areas may be, but none the less her therapist is working on DBT to the best of her ability.

It has very little to do with her past or digging at all. I think that's why my wife responds so well and enjoys her meetings with this therapist. It isn't about going back, it's about moving forward in a better direction.

I know my wife speaks sometimes about her experiences gone by but mostly it's discussions and lessons on mindfullness, better self-esteem and not about the things she feels she done wrong in her life.

Best thing to do is ask them what the therapy is about and how it's done. If it sounds possitive and not negative try and give it a chance. It's really helped my wife and like I said 'she likes it'. This is the first time in the ten years I've been with her that she stuck to a therapy and didn't turn against her therapist. It's also the first time though she gone into a therapist with a proper diagnosis and not just depression or ADD.

Hope it all works out for you.

[waverider]

Not being "ready' for therapy is a real issue, as that needs commitment and responsibility, the very traits a pwBPD often lacks. We are still stuck in this mode. Endless false starts and drop outs. In my case my partner is still stuck in the mode of there must a pill or something "someone else" can do to cure me. Simply wont knuckle down and do her part. Inability of self rescue is the issue.

The analogy of this is the person who finds validation in people rescuing them jumps in the water drowning, is rescued, then promptly jumps back in the water again wanting to be rescued. The whole process and talking about it gives them self worth.

In therapy this often results in them constantly trying to focus on past events and reasons, whereas therapists will often not want to dwell too much on yesterday and focus more on what needs to be done tomorrow. This is the hard part for a pwBPD as tomorrow depends on them, yesterday can be blamed on someone else.

Soaking up the S & E then running away when the T comes out. Allowing this to happen is the common mistake of the well meaning partner who pours on the S & E in an attempt to sooth and leaves off the T. All this does is validate the self pity, an reinforcing the behavior.

It's really helped my wife and like I said 'she likes it'. This is the first time in the ten years I've been with her that she stuck to a therapy and didn't turn against her therapist.

This is important, for if nothing else its sets a precedent for opening up to some one else. Learning to accept therapy if you like.

[Haye]

Not being "ready' for therapy is a real issue, as that needs commitment and responsibility, the very traits a pwBPD often lacks.

Oh, oh no, it's my SO's doctor who thinks he is not in good enough shape for therapy sessions. I live in europe and in my country you need to get a doctor's approval and recommendation to get appr 60% percent of the therapy bills compensated by health insurance (i learnt english at school as a 2nd language so i might not always write enough). He himself is determined, willing and ready to go through whatever it takes to get better. I don't think the jumping to river and be rescued applies to him. He's not blaming anyone else and he never uses his past as an excuse for things he has done (before getting in terms with BPD he used to blame his dark side, but that's gone and he's assumed responsibility for also the darkside's doings).  It's actually me who occasionally tells him that yes, he has done wrong in many cases, but it is understandable when thinking his past and his condition and that he should not be so utterly hard on himself.

Stalwart, I think DBT is exactly what my SO needs, but it is not easily available in my country  :'(. Plus it isn't likely to be approved by the doctor even if we find a therapist who knows DBT. Then again, at this point we probably should consider DBT (or some other therapy) paid completely from our own pockets. It'll be tough financially but then again health is vitally important. My SO doesn't have a burning need to dig his past, is not a very pretty sight and he is too hard on himself on what he has done. I know he  willing to dig as deep as is needed or wanted if a therapist sees it needed. But yes, we both feel that moving forward is what is needed, indeed mindfullness, better self-esteem etc.