BPDFamily.com

Hi all, I just want to share my good news.

For some time I have been expressing my hopes of writing a success story on this board, and it seems like it won't take too long because I'm already beginning to see improvements.

By mid-January, I successfully arranged our separation, against her will. This first step was essential to stop the conflict. Then I could delve deeper into my research. I already had hopes because of the DBT treatment studies, but my hopes increased after I did extensive research on pharmacological treatments as well, particularly the studies on opioid blocker medication and the endogenous opiate dysregulation theory on BPD, as well as the successful reports on off-label usage of opiate blocker medication to treat specific BPD symptoms.

At the beginning of February, I got her on opiate blocker medication. Initially, we went for the very low dosage (about 100 times less than the regular dosage), which is very innocuous. I do think the low dosage helped with her well-being, but it was not preventing her from having outbursts, which could still go on for hours and extend to the next day. At times I brought her to my place for a weekend. In the first weekend she had the worst outburst, and the next ones were less awful, but still bad enough for me to try to rush her out.

So now in March, a couple of days ago, while she was here again, we upped the dosage to the low end of the regular dosage used in BPD studies. I was not expecting her conflict-seeking patterns to subside, but I was expecting that the complete blockage of opioid reward would prevent her from continuing the outburst. The results were exactly how I expected. On the morning of each day, the effects subsided, and she gradually began to go into havoc again until I got her the medication. Usually when she is angry, she refuses to comply with any kind of treatment, but this time it was different, as she hardly resisted. Because she is also noticing the improvement. Her only complaint was the side effect of sleepiness, but we cut the dosage by half. Yet, she felt completely restored for having slept so well over here. It was our longest weekend together, which extended into 4 nights.

As she noticed the improvement of our interactions, this perception increased her hopes for our relationship, which then made her become more proactive. So she finally scheduled herself for her first DBT session for next week. She also scheduled her consultation to insert an intrauterine birth prevention device (we are not having sex, and she says it's because of her fears of getting pregnant again).

Later on, while she was upset about being in her mom's house and not feeling welcome there, I said perhaps I could rent a place for her if I got a good job. That made her angry at me. She stated that I made her feel disgusted. At first, I couldn't understand why, but then she wrote this to me:

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Now I'm the one who's going to set the conditions, the deadlines... okay?
If I don't move back in there in 1 month, with you taking me back, AND I'M IN THERAPY, I'm only going to treat you as the father of my children, because I know myself. I want to be married, with someone every day, and if you don't give me that, I assure you I'm going to pursue it for my life.

But whether you want to believe it or not is up to you.

I'm young; I'm 31 years old, and I have my whole life ahead of me. If you think it's going to be difficult to build a life and a family with someone, you're wrong, and my uterus is in perfect shape.

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I became very proud of her for the fact that she has finally used logic. I actually find it a cute and naive threat. I read it as "I need to be with you."

Another promising type of treatment that I researched is the non-stimulant ADHD treatment medication, which has repeatedly been shown to improve BPD symptoms as well. She is using one that decreases norepinephrine in the entire brain while stimulating a specific region of the PFC, which helps in controlling emotions and with being more logical. She has been taking this medication intermittently and in fractional dosages, but it might also be helping.

Please feel free to ask questions, express concerns, and give advice.

It’s good to hear some hope in your post. Just a quick note that the board usually stays away from getting into medication or treatment specifics since none of us are clinicians. Where people here tend to be most helpful is around the relationship side of things. I’d be interested in hearing more about how the separation and the start of DBT are changing the dynamic between you two.

Yes, Mutt,

I'm not expecting any advice on the pharmacological treatment itself.

However, I am still concerned about her adherence. When she is here, adherence is easy, since I can just put it in her mouth. But when she is in her mom's house, she forgets, and I try to remind her, but my reminders are not always effective since being there tends to make her frustrated and oppositional. Very childish.

Frequently, communication becomes so hard and unpleasant. If I keep the conversation going, she might remain in the self-feeding drama loop. For instance, now she is creating paranoid thoughts about it. However, when I don't maintain a conversation, she tends to gradually drift away from the medication. I think it's because she links the treatment to me. I'm her motivation source. She won't do it for herself.

It's a difficult situation. I feel like I need to replace instant messaging with some other, more effective way of communication. She leaves behind too many of my messages, skimps on reads, and even gets the audio messages she gets wrong because she hears them in 2x while interacting with the baby at the same time. I have searched for some walkie-talkie apps, but they won't work since she is completely averse to the possibility of her mom or sister listening to our conversation, so she only listens to my audio messages using headphones.