BPDFamily.com

Hello everyone.  I am currently struggling to help my wife with what seems to be overwhelming depression.   She was diagnosed with BPD 15 years ago before we were together.  She has been through DBT several times and most of the time is able to use her skills to control her emotions.  Its gotten harder since we have had children (3 and 4).  She also has some pretty bad chronic pain issues that are really bringing her down. 

The depression is really bad lately.  It's hard to get her to see doctors for her physical issues.  When I try to push for her to get more help, thats when I get unreasonable pushback.  She gets very defensive.  I have been the one calling doctors and making appointments for her, which she sometimes goes to and sometimes just ignores.  Not sure exactly where I am going with this but I just wanted to reach out and see if there was anyone else out there trying to unlock the puzzle of BPD and depression.  Any tips would be greatly appreciated.

 

What stands out to me is the "care manager" position you've been put in - calling the doctors, making the appointments she sometimes ignores. It's exhausting, and it also quietly reverses the roles: you become the parent pushing a reluctant kid toward the dentist, and nobody's spouse in that setup.

One reframe that might help with the defensive pushback: for a partner carrying chronic shame, "you need more help" often lands as "you're broken and failing again" - so the pushback you get is probably about the shame, not the suggestion. Things that tend to work better than pushing:

- Frame it around what she wants, not what's wrong with her. Chronic pain + depression feed each other; if the pain got even 30% better her mood would follow. "I hate seeing the pain win - what would it take to get that looked at properly?" is about the pain, not her character.
- Offer choices instead of directives. Two options she picks between ("Thursday morning or the doctor near your work?") gives her control, which is the thing the pushback is defending.
- Attend with her if she'll let you. "Come with me to a consult" gets a different reception than "go see someone."

And one thing nobody says to people in your spot: with kids at 3 and 4 she's in the heaviest load years of her life, and you're carrying the whole scaffolding around her. Who's in your corner? What does she say the depression feels like from the inside, when she'll talk about it at all?

She's lucky you're asking how to help rather than how to leave. A few things I picked up from partners further along than me on this board.

When chronic pain flares, every coping skill gets more expensive to run. So the depression may not be DBT failing, it may be the pain eating the energy she would normally spend on regulation. If her pain management isn't being actively worked by a specialist, that is often the highest-leverage piece to push on, sometimes more than anything on the psych side.

Also worth naming: kids at 3 and 4 are peak depletion years for any couple, and you're doing it alongside her diagnosis and the pain. Do you have anyone in your own corner, a therapist or even a steady check-in with a friend? Partners in this seat tend to burn out quietly, and her system notices when yours goes down.