BPDFamily.com

Are most people with BPD depressed?  What about anxiety or PTSD?

If so, are the typical treatments effective?

Here is the reason I ask.  W's P has suggested she undergo a couple of experimental treatments for depression and PTSD.  One is called "Transcranial Magnetic Stimulation" and the other is Ketamine Infusions.  Her P says they do this for patients who are unresponsive to other antidepressants and anti-anxiety medications.

W has been off and on nearly every type of antidepressant most of her adult life.  From my observation and from her own testimony, none have had a significant effect.  The only thing that has helped are Benzos, but those she develops a habit for.  I think those "work" for her because they make her feel different in the short term.  In other words, they work like other drugs that give her a "high" feeling. 

While expensive, I am open to the idea of the Ketamine or TMS provided they work.  Does anyone have experience with either in relation to BPD?  My worry is that BPD depression is not typical depression, and that after considerable expense nothing will change.  I am grateful that she is seeking treatment, and accepting that the treatment she currently is tying is not working. 

An aside here regarding MC and other issues I have brought up, I have little hope that MC will be any different this time unless something changes with W.  Admittedly, there are things that can change on my end, but those things will help me, not the R/S.  I am concluding that there are certain aspects of the r/s dynamic that are unacceptable (verbal and physical abuse), and unless Ws behavior changes, not much can be done.  That is probably why I am open to this.  She does do a lot of work on her end, much more than I typically read about on here.  T 2-3 times per week, intensive therapy, medications, DBT...  If she truly wants to improve her behaviors/moods I don't know what else there is left to try.

The only thing I can speak to is the TMS. There is absolutely no downside and a lot of upside. No harm in doing it. I've also read a lot about the benefits of special K, but I don't know as much about it. There's a podcast done by a pBPD person, the name escapes me. But they talk about how helpful the TMS was for their depression. I've also read how the depression has to be treated and handled before addressing any other issues. Gotta get the patient on even keel before working through complex intra-personal problems.

Admittedly, there are things that can change on my end, but those things will help me, not the R/S.


Max, I think there's some faulty thinking in this idea. The relationship is a result of the dynamics between the two of you. While your W may be the one with the most obvious diagnosis, your interactions with her are a contributor to the relationship as well.

Its is established that we can't change someone else, we can only change ourselves. However, when we make a change that also impacts the dynamics between us and the people we relate to.

It's good that your wife is motivated, yet treatment has not been very effective. I don't know if it is or isn't going to be. However, you are also overfunctioning as an emotional caretaker. How can someone learn to manage their own emotions when someone is doing that for them?

It's hard to know what your wife is capable of. It might not be much, or it may be a bit more than what she is capable of now. When you do take a moments time for yourself, she rages. So you do less for yourself to manage her rages and this reinforces them. She may not be able to help the raging, but the raging also works for her. So why should she stop?

However, she may not be capable of managing herself. Medication, substance abuse- all are ways of escaping uncomfortable feelings. In addition, your constant focus on helping her, staying up at night with her to keep her calm- you still need to take care of yourself in order to be able to help someone else.

But doing that is scary, in a way, it's easier to try to manage her and keep the peace rather than upset the balance of things. But doing this will likely perpetuate the patterns. Still, it's a predictable thing to do and easy to default to this when you don't have the emotional reserve to resist her reactions.