To add- your anger, frustration at the NHS, is real and valid. I wasn't as much angry at the medical providers but I didn't understand why my father didn't have my BPD mother hospitalized.

My feelings towards my father were mixed. On one hand, I was very attached to him, and credit him for our well being and for being our most stable parent. I also understood he was dealing with a difficult situation. In addition, I didn't understand why he seemed to allow and enable BPD mother's behaviot. I had an idea of what should have been done and why didn't he do it, similarly like you feel about the NHS not doing what should have been done.

That was until BPD mother's elder years when I did have input with the POA. I spoke with her medical team, her caregivers, the hospital staff when she was there, the assisted living and nursing home staff and when it came down to it- no matter what the plan, if she didn't agree to it or cooperate, nobody could do much for her. I think my father probably tried as well, but he couldn't do much either.

Her behavior also wasn't as apparent to health care providers when she was living on her own at home. BPD mother could present well in the office during a visit. It was when she needed assistance and had caregivers, was in assisted living, who were with her for long hours that they saw the bigger picture.

The gap in assisted living and nursing home care here is that it is based on a person's physical need for assistance in daily tasks, like dressing, bathing, eating. BPD mother did not need as much assistance in these tasks but emotionally, she needed more supervision than she qualified for.

For me, working through the anger and frustration at what I thought wasn't doing enough for her was a process, a process you also will be working through. However this goes, I think it's important to have some boundaries on what you can do, are willing to do, and also how to protect your own emotional well being.

I will share two sources that illustrate the dilemma.
https://bpdfamily.com/message_board/index.php?topic=65164.0;all

This exerpt from a book- not exactly the same situation but similar dynamics and the daughter's sadness and frustration.

https://slate.com/technology/2022/03/mentally-ill-parent-elder-care-boundaries-liz-scheier.html

I don't suggest you "let go" or not try- I think in trying, we learn what we can do and what seems out of our control.

Hey AaronP, I relate so much to your situation. It stinks man and I m ow how much it hurts and brings you down. Nowadays the anger outburst don’t bother me as much as the nearly constant demeaning, belittling, and condescending rhetoric; I feel that she wants me to feel the way she does on the inside. To be clear she is deeply traumatized but it’s hard to be empathetic to that when she’s attacking you. I’ve had numerous therapist over the years, most encouraging me to set boundaries or leave the marriage which did little to help. I felt the same that it was usually a pathetic venting with no progress and I often left without much hope. Acceptance at the best. About a year ago, however I found a new therapist and it has made a huge difference. He has me working on myself, not dealing with BPD, not the relationship but improving my self confidence, dealing with my emotions and stressors, and getting to a place where I feel safe regardless of my external circumstances. It’s not perfect but it’s better. My wife’s behavior still affects me and it’s still hard but that’s secondary to me working on my mental health. I guess my advice is this, find a therapist that understands BPD but wants to work on you first. My therapist works at a group that specializes in DBT and he specializes in therapy for men within that group. I’m commenting here today because he’s encouraged me to get my feelings out (its been a particularly tough past few days) and this is a group has a lot of folks that can relate to you, offer encouragement and be a safe place. Hang in there man.

This is similar to my BPD mother- she had mental health- they couldn't do much for her. Like you, I also tried to speak to one of her mental health doctors but he refused to speak with me, due to pricacy laws.

Before the medicines were registed on computer and regulated, my BPD mother also would get them from several doctors, none of them knowing about each other. I told her general practice doctor about it, but he wasn't able to say much to me about it due to privacy laws at the time.

Some time later, once the medicines were regulated, he was able to see what was going on and that is when he put her in rehab. She was uncooperative there and signed herself out AMA. (against medical advice).

Here, in the US, it seems our mental health system is lacking in ways and so is the care for the elderly. Like your mother, my mother did not have a lot of physical needs but her emotional needs were very high. In addition, she could "pull herself together" when being evaluated and appear completely normal to providers and so she remained legally competent.

If someone is legally competent, health care providers are limited in what they can do for them if the patient doesn't choose to cooperate with them. Also, if a patient is not compliant with the care plan- the providers can choose to not treat them, and also insurance won't cover it. Before I had the POA, I wasn't in contact with my mother's providers but in her later years, I was- and so could see this side of things. BPD mother's behavior was a challenge to her heath care providers, but with her being legally competent, their ability to help her in this situation was limited.

Even with suicide threats, they can not hold a person against their will for long if that person is legally competent and appears intact and not suicidal when they evaluate them.

I wish I had helpful advice for you in terms of a positive change for your mother, but the reality for me was that, as much as I wished there was some way to help my mother, change things for us as a family- there wasn't anything that could change her own self will. She was going to make her own choices. We didn't want her to harm herself but it wasn't possible to watch her all the time, or have her in a situation where she was watched all the time. We cared about her well being- as you care for your mother's too. But that didn't stop my mother from her own choices.

My best advice for you is to focus on your own well being in this. It's a difficult situation. I did counseling and 12 step ACA groups. These were very helpful. I think as adult children- in our family systems, we feel responsible for our BPD mothers' feelings and well being, but in actuality, we don't have that much control.

I don't suggest being detached from your mother all together. I didn't want that and it would have been impossible to not have feelings about her situation. I wish there was some resource to help her but even if there was- she'd have to choose it and cooperate with it. Even in "normal" situations, the advice to family members who have a part in care for an elderly parent- whether it's direct or indirect- is self care to avoid burn out. Taking care of yourself and having "time out" is helpful.

Mental health help is a mess in my country, they've been dealing with her for decades and even given her electrode therapy when I was a kid. She had a crisis care team after my dad died and she spiralled but because she's always difficult and won't agree to get involved in volunteering etc, they would just stop bothering with her after a handful of sessions and then she'd be left to her own devices again.
Her doctors surgery is literally across from her house and they just seem to pally with her to actually see whats really going on! They know she gets suicidal as she went in there crying that she was suicidal once, during COVID she had to leave messages on their answerphone to get her Lorazepam prescribed and my mum realised that she could get away with ordering prescriptions more often than she was supposed to! She would use different chemists so she didn't realise suspicion and she went through a phase of over using Lorazepams and washing them down with wine! I had to contact her surgery and ask them to watch what they were prescribing because they were unknowingly over prescribing to her! My mum then became puzzled when she suddenly couldn't get as many prescriptions anymore! I told them about BPD then and they've done nothing in the years since. I live 36 miles from her, she pushes my brother away who also often works away, I've said to the doctors before that we can't watch what she does or safeguard her! She could carry out her threat to take the pills she's claimed she's stockpiled at anytime after be lying dead. The NHS don't help us and have actually refused to even speak to us as her family about her mental health even when the police and ambulance had to go to her home because she put a suicide note through my brothers door one time! They were reluctant to even tell me if she was sectioned or still at her home, they didn't section her even though at that point she told them that she was going to give herself and her dog and overdose on her pills! It's crazy!

(I'll post more soon.  Thanks for reading.  Good night.)

Her overdose was worsening.  She was becoming less and less coherent, and the hallucinations were worsening. After a while I stopped negotiating with J1 and forced her to the hospital. 

I was back on duty.  My short-lived rest was over.  She snatched the pen from me.  My story was no longer mine.

I carried her down the stairs to the car.  I let go of her to open the door and she collapsed.  She was seizing and foaming at the mouth.  Sh!t.  She's going to die.

I called the PD and urged them to get me a patrol car fast.  They arrived in an instant and I threw her in the backseat.  We raced to the hospital, dragged her to a stretcher and rushed her in.  I don't remember much of what happened after that.  I know I cried, and I know I called her parents and said "I think she's going to die.  You have to get here now."

I recall her parents showing up and walking right past me.  Understandable given the circumstances.  Still, the message that my nervous system heard was immediate and familiar:

This is my fault. This happened on my watch.  They know the truth, but they need someone to blame.  That someone will have to be me.

I don't remember this, but a nurse friend later told me: "You collapsed into a hug and said, 'This will be my fault.  I know this will be my fault.'" 

I had already assumed the posture without being blamed.

She was in a coma for a few days and in the ICU for a few more.  And I watched the unhealthy family dynamics play out right in front of me.  A team of specialists came in to confront J1.  They suspected that this wasn't an accident and, given her position, they offered her a treatment program and a way to save her license.  J1 stuck to her story that it was an accident.  Her mother encouraged her and said she was right to lie.  Her father and brothers silently disagreed.  I realized:

I am standing inside a family system in which survival depends on denial and enabling.  Where lying preserves stability and the truth-tellers have learned to keep quiet.

I left this ordeal with a choice: be an enabler or a truth-teller.

I married her three months later.

Why? At some level the suicide crisis clarified my purpose.  It concentrated my entire life's work--proving that endurance buys safety, that loyalty stabilizes chaos, that devotion can outlast danger--and distilled it into one person.  This was no longer theoretical.  This was my arena. 

If she was fragile, I would be strong.  If she was drowning, I would be the dock.  If she stumbled, I would catch her.  If her family ran on denial, I would quietly hold the truth.  I told myself this wasn't self-sacrifice. It was strength correctly applied. 

I knew this wasn't my fault, but I believed it was my responsibility.  If I couldn't be happy at least I would be indispensable.

We got married and J1 insisted on getting pregnant right away.  I wanted to enjoy life as a couple, but I relented.  A few years later our son was born and we moved into a bigger house.  The early years weren't bad, but they weren't good either.  They just were.  Other than a late honeymoon we didn't go anywhere.  No trips, very few date nights, sex was rare.  We functioned, but we also worked opposing shifts.  Two ships passing in the night, as they say.  I don't recall us ever really doing anything together.
   
My shift ended at midnight and I'd stay awake until the kids' 2 am bottle.  Then I'd go to sleep on the couch so as not to wake my wife. 

I didn't know it then, but I relinquished my right to share a bed with her ever again.  I slept on the couch for the rest of the marriage.

I had quietly given up something that I didn't even realize I was allowed to want.

I don't think I noticed the lack of intimacy or play or fun.  That wasn't the point. That's not what I was there for.  I had a job to do.  The suicide attempt was a turning point.  It turned us toward each other.  Not out of love, but expectation.  Purpose. 

Love is what it feels like in the absence of chaos. 

So my job became chaos-preventer.  I became the protector.  The infrastructure.

The goal was to keep her stable. The goal was to keep her alive.

And I did keep us stable.  We functioned.  We survived.  We survived almost too well.  Because the absence of friction also revealed the absence of intimacy.  Of closeness. Of friendship.   

Hell, we rarely fought for the first two-thirds of the marriage.  And the lack of fighting meant we hadn't practiced the art of repair.

The stability meant space--space for hobbies, new music, or a movie I wanted to watch.  Small invitations toward a shared life built around fun.  Things that could bring us closer.

She refused every invitation.

"Maybe later." 
"I can't right now." 
"I've got to make these calls." 
"I have a headache."

I loved woodworking, and I had a nice shop in the garage.  Many times she'd come home and park right in front of the open door.  I was so excited to show her what I was working on.  Yes, she'd stop.  She'd acknowledge it. 

"That's nice."

But she wouldn't come in.

I don't think that I was unhappy in the marriage.  I don't think happiness even made it to my rubric.  But loneliness did.  And I felt most lonely when I was with her. 

Proximity and closeness simply aren't the same thing.
 

Hi BeagleDad1,

I'm glad that you have returned to this board. Your first message of last year didn't say much. But the fact that she has been diagnosed is very good. It even helps her to feel less worthless, because she knows it's a disorder and the disorder is treatable. What she doesn't have is the desire to face the facts in her therapy. It's ok to switch therapists a few times, but if she wanted to really heal, she would do that until she found one that she feels safe with.

One red flag that I see in your post is that you try to be "the lighthouse keeper." It sounds like you are making it easier for her to fail in many ways, are you? But if you do that, you make yourself an enabler, and things get worse. Because what will motivate her to change is the overseeing of the possible future consequences of her disorder. But with you always covering up for her failures, she will not feel like her disorder is a threat to her.

For instance, as a consequence of my wife's disorder, I have forced us to live apart, with no guarantees. That has helped in motivating her. However, since I'm still there for her all the time, she doesn't quite fear further consequences. But I'm sure that if I stop doing this, she will get herself moving faster (toward treatments). I'm afraid that this will only happen when I get tired, give up, and move on.

In regard to the pains, this may be because of low endogenous opioids (the natural pain reliever of our body). A German study of 2010 proposed that this is a key feature of BPD (https://psycnet.apa.org/buy/2010-06891-012), and from further research papers, it seems to be the case for 80% to 90% of patients with BPD. It seems to be the case for your wife and mine as well.

My wife is trying a drug used to treat opioid addiction and also alcoholism, and which has also been used off-label to treat BPD symptoms with success in almost all studies. Though since my wife is not suicidal nor dissociating, we chose to use the super low dosage, which has not been tested to treat BPD but is effective in treating chronic pain otherwise specified and autoimmune disorders.

Welcome back.  We encourage our membership to seek self care whenever needed.  And especially when the disordered person isn't responsive to our needs or is continuing to distress us.  Here are a few ideas, others will surely chime in soon and add their experiences and insights as well.

Did you know therapy is not just for your wife?  You too can avail yourself of counseling resources.  They may not be able to resolve the marital discord but they can focus on you and how you can deal with your spouse.

Many have noticed that distance apart - whether for a shorter or longer time - can give one a break from the relentless negativity.  Can you take walks in a park or other activity away from your spouse?  Or a weekend away with family or friends?  Or a vacation apart?  Of course this isn't a long term solution but it can provide you some temporary relief and that calmer time can let you gather your wits about you and determine how to best approach the future.
 

My Spouse of 39 years was diagnosed with BPD, about 3 years ago. It was mostly “dormant” until she suffered a traumatic health issue. I’ve been trying my best to hold on and provide love and support in every way possible. It’s so heartbreaking and exhausting for me… I keep wondering where it all went wrong…The beautiful memories of life and love. The joy of living everyday with each other. The minor struggles and difficulties together with disappointments, were trivial throughout life because we always had each other, and our love for each other made the struggles disappear. The difficulties and challenges, would be carried away like a feather in the wind.
I know it’s an illness, but accepting that reality doesn’t mask the pain…
I’ve been desperately trying to reach out to anyone and anybody who can understand what I’ve been going through. Someone who could relate to me because they themselves have experienced this.
What to do, and how to go about doing it. I’ve tried contacting support groups for loved ones but I can’t seem to reach anyone.
I’m the Lighthouse keeper, in what seems to be a never ending storm. I’ve been tasked with having to keep the light on no matter what. I’m just tired, really tired.
I’ve tried to set up Therapists trained in DBT. She will see them for a few sessions and then say, “I don’t like that Therapist, they’re not empathetic enough for me”. This has gone on for the past 2 years.
The worst part of trying to cope with her illness, is when she experiences “splitting” and I become the enemy and the “abuser”. In our 40+ years together, I have never raised a hand to her or uttered an abusive word, and yet, I’ve now been subjected to regular bouts of rage and terrible verbal abuse.
Where has the beautiful, loving partner who has always been my “soul mate” gone? Each time I mention therapy, I’m rebuffed with replies like “I have too many health issues at the moment and until I feel better, I can’t speak to anyone”…
Family members have all but disappeared, because they all admittedly say they don’t know what to say to her for fear of triggering her BPD.
I feel as though I’m in a minefield with a map and the map keeps changing. When she experiences some minor physical issue, it’s always catastrophic. She will insist on being taken to the Emergency Room or to the Doctor to be checked. Countless Trips to the Emergency Room with multiple MRI’s and CT Scans all come back normal or negative. Not only has it caused a great financial burden, but the toll it has taken on my own mental and physical health, has been evident. I’m not allowed to  feel sore, under the weather or even sick, because if I mention a physical problem, I am then told my pain is nothing compared to hers…
I know this post is long, but I feel so alone with no one who seems to be able to offer any words of advice, guidance or encouragement…can someone please offer me a kind word, perhaps to serve as a simple matchstick to light up the darkness I feel enveloping me…

Absolutely. I think that’s why autobiographical memory is so powerful. It’s like time travel. Like your example with the music. It connects you to a previous version of yourself. That’s why old friends are so meaningful. And, again, romance.

Because it has a certain color to it. It’s not the same as family or even friendships. It has a gravity. A pull. It draws two previously unknown people together and hands them a pen. And together you start writing a story that, one day, you hope will mark you in time. Like those songs.

And the beauty of it is the other person talks back. The songs can’t do that. They’re timeless but inert. That other person can turn to you and say “yes. I remember that too”.

I don’t think we realize how immensely powerful that is. To be held continuously in someone else’s memory