Bipolar Disorder or Becoming BPD?

[Dussey]

This is very difficult for me, but here goes, and please accept my apologies for the lack of eloquence in my post.
My Ex (sorry if it's the wrong place to post this) and I have been in each other's pockets for nearly three years, and yet I can see big changes in her behaviour, even if she can't - or is denying them.
All this seems to have started a while back, and the other day when she was at mine (as we've been friends for over twenty years, we still see each other regularly), she left open her make-up bag that she keeps there. Inside were full boxes of the Aripiprazole that she is supposed to take. The earliest dated boxes were from January, 2019, and I began noticing changes in her from about last Easter.
Since 1995 she has been medicated for Bipolar Disorder, and on several occasions when she has become overwhelmed, has found herself sectioned under the UK 'Mental Health Act'.
She puts it all down to the job situation and the related stress, but there's more to it, as her behaviour is becoming more erratic, with frequent mood swings, paranoia, impulse buying, and pushing her friends out. There have been other recent incidents too (among others) which I regard as quite serious, such as sending a disturbing Email to one of her neighbours which culminated in the police and a psychiatric nurse visit her home to conduct a welfare check. They left the situation satisfied as there appeared to be no problem, but as she has worked in mental health for more than ten years, she gave out all the right answers to their questions.
I have been in touch with a friend who is a medical professional, and she has inferred that the Aripiprazole, while prescribed for her bipolar disorder, is also used in the management of borderline personality disorder, and schizophrenia in others, and if these psychoses were masked by the use of Aripiperazole, then any undiagnosed and underlying disorder would become apparent if the medication had ceased. That is my main concern. I also think the reason why she has also been avoiding the blood tests requested by her doctor since August, is that they will discover that there will be no sign of her medication if they screen for it.
She has often mentioned the 'Drama Triangle', how it works and how it can be overcome, and I can see how I am involved with that as she was bullied out of a senior healthcare position; I have become her 'rescuer', and even though I have posed this to her, she tells me that in her situation this isn't so.
She does have a problematic relationship with her Mother, and other women too, and has even intimated that she may have also been a victim of past abuse and even FGM by persons unknown.
I've tried really hard to see her through the difficulties, I really have, but at the moment there doesn't appear to be much her family or I can do for her.
She trusts me absolutely, and as I have contacted a third party about the situation as it stands, I have now betrayed that trust and I feel awful about it.
I just want her to be well, as does everyone else who cares about her.

[RELATIONSHIP PROBLEM SOLVING]

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[Naughty Nibbler]

Hi Dussey:
Sorry about the situation with your friend.  Sounds like from her background, that she has some understanding of mental illness, although she may be denying it to some degree with herself. Most meds for mental illnesses have some degree of side effects and sometimes people quit taking a med because of that. Also, a certain med might quit working for an individual.

Mental health issues can be subjective to diagnose.  Most people with BPD traits or BPD have multiple mental health issues. It can be best, to focus on dealing with the symptoms/problem behaviors.

Since she is paranoid, you have to consider that her reality can be skewed.  The "bullying" she thinks happened in a job situation, could have related to her behaviors that she is unable to acknowledge. It could be very risky to place someone with her history of behaviors in a health care mgmt. position.

She does have a problematic relationship with her Mother, and other women too, and has even intimated that she may have also been a victim of past abuse and even FGM by persons unknown.
I've tried really hard to see her through the difficulties, I really have, but at the moment there doesn't appear to be much her family or I can do for her.
She trusts me absolutely, and as I have contacted a third party about the situation as it stands, I have now betrayed that trust and I feel awful about it.
I just want her to be well, as does everyone else who cares about her.

You can't fix her.  Environmental situations can be part of the problem, but its' likely that someone in the family has a mental health issue and it has been passed on genetically to her.  Sometimes, it can skip a generation & other times a relative may have been undiagnosed, but was labeled as "odd, difficult, moody, strange, etc.

Perhaps the best thing for you to do is to establish some personal boundaries and learn/practice strategic communication skills that can make things better for you.  Are you currently communicating?

[Dussey]

Hi, N.N., thank you for your advice.
Yes, we do communicate without any problem, and we meet up quite often, and have no issues regarding personal boundaries. The hospital where she was working acknowledged that there was a problem with a culture of bullying, and her antagonists were dismissed not long after she left, however I do suspect that there was something about her behaviour while she was working there, that initiated the bullying by her colleagues. What that was, I have no idea, as she is very knowledgeable and professional in her work ethic.
The refusal to take her meds, mental health history, present behaviour, and her current lack of employment; which, it seems, was no fault of her own, have culminated in the current situation.
Dealing with the symptoms and her behaviour, as it is at the moment, seem to be the only viable option from myself in helping her. Other than that, the only course of action I can see is to have her parents intervene and make a decision about her future.
Sometimes I think she can't keep clinging to this tenuous existence much longer, and it scares me.
Thanks.
D.