Things I learned in the hospital.

[Before you can make things better, you have to stop making them worse...]

My dBPDgf was in the hospital for 10 days because she was suicidal.  They put her on numerous mood stabilizing medicines and also diagnosed her as bipolar type II.  And I learned that she had been diagnosed Bipolar in the past, and has had around 10 stays in mental hospitals - sometimes lasting months.  She has gone through DBT, been on almost all sorts of meds

While in the hospital, she remained depressed.  She complained about some of the nurses and techs, complained about some of the other patients, complained about the food, and suggested to me that she should lie so she can come home sooner.  I viewed it differently, and saw the staff as very good and supportive and very helpful.  They are the experts, and I trust that they observed her carefully and tailored her treatment to what they observed.

On the weekends, they had group therapy sessions that families could attend and ask questions.  I found the therapist who led the discussions to be very smart and informative.  She said that most people in that hospital are because they attempted suicide or thought about suicide.  She also said that most people have multiple diagnoses, and I asked her to explain how they deal with that.  She said there is an 85% overlap between Bipolar and BPD in women, and that men are more likely diagnosed as APD because of the way our culture views things.  She also said that Bipolar is chemical and has a strong genetic component and is very treatable with medication.  And she said that if a person is Bipolar and has a personality disorder, they first have to be stabilized for the Bipolar before they can approach the personality issues.  That makes sense to me, especially since the way I have felt at home is to avoid anything stressful because I knew she was too unstable to handle anything.  The therapist strongly discouraged couples therapy until she became stable, and said that she felt it almost always makes the problem worse.  She suggested that my GF avoid the elephant in the room until she gets herself stable.  I agree, but don't know if she can control her worries.

She may very well have bipolar disease, but I feel her bigger issues are still BPD.  I say this because she hasn't changed much with the medication, yet the other people with bipolar at the hospital seemed much happier as soon as they were on meds.  And the black and white thinking and fears of abandonment are still there - front and center.  She still wants to blame external forces for her troubles.  Mood swings in people with Bipolar are chemical, whereas with BPD the mood swings are triggered by external things.  She needs a ton of therapy to change the way she thinks about things and to change her reactions.

But still - she is very depressed.  Do pwBPD have issues with these deep depressive episodes?  I think the deep depression and her description that Lithium is the medication that made her most stable in the past are the reasons they diagnosed her as Bipolar.

A psychologist friend of mine says that in her opinion, many people with BPD are misdiagnosed as Bipolar because bipolar is treatable with medication, and looks better to insurance companies.  So they treat them as bipolar and hope it works, because BPD treatments are more difficult and exhausting.

regardless of her diagnosis, I just want to see her happy and stable, and am not really worrying about the future of the relationship right now.  But the more and more I get into it, the more I realize that long term stability for her will be a very long road and is probably never going to happen.  In the meantime I just need to take care of my own health.

[maxsterling]

My dBPDgf was in the hospital for 10 days because she was suicidal.  They put her on numerous mood stabilizing medicines and also diagnosed her as bipolar type II.  And I learned that she had been diagnosed Bipolar in the past, and has had around 10 stays in mental hospitals - sometimes lasting months.  She has gone through DBT, been on almost all sorts of meds

While in the hospital, she remained depressed.  She complained about some of the nurses and techs, complained about some of the other patients, complained about the food, and suggested to me that she should lie so she can come home sooner.  I viewed it differently, and saw the staff as very good and supportive and very helpful.  They are the experts, and I trust that they observed her carefully and tailored her treatment to what they observed.

On the weekends, they had group therapy sessions that families could attend and ask questions.  I found the therapist who led the discussions to be very smart and informative.  She said that most people in that hospital are because they attempted suicide or thought about suicide.  She also said that most people have multiple diagnoses, and I asked her to explain how they deal with that.  She said there is an 85% overlap between Bipolar and BPD in women, and that men are more likely diagnosed as APD because of the way our culture views things.  She also said that Bipolar is chemical and has a strong genetic component and is very treatable with medication.  And she said that if a person is Bipolar and has a personality disorder, they first have to be stabilized for the Bipolar before they can approach the personality issues.  That makes sense to me, especially since the way I have felt at home is to avoid anything stressful because I knew she was too unstable to handle anything.  The therapist strongly discouraged couples therapy until she became stable, and said that she felt it almost always makes the problem worse.  She suggested that my GF avoid the elephant in the room until she gets herself stable.  I agree, but don't know if she can control her worries.

She may very well have bipolar disease, but I feel her bigger issues are still BPD.  I say this because she hasn't changed much with the medication, yet the other people with bipolar at the hospital seemed much happier as soon as they were on meds.  And the black and white thinking and fears of abandonment are still there - front and center.  She still wants to blame external forces for her troubles.  Mood swings in people with Bipolar are chemical, whereas with BPD the mood swings are triggered by external things.  She needs a ton of therapy to change the way she thinks about things and to change her reactions.

But still - she is very depressed.  Do pwBPD have issues with these deep depressive episodes?  I think the deep depression and her description that Lithium is the medication that made her most stable in the past are the reasons they diagnosed her as Bipolar.

A psychologist friend of mine says that in her opinion, many people with BPD are misdiagnosed as Bipolar because bipolar is treatable with medication, and looks better to insurance companies.  So they treat them as bipolar and hope it works, because BPD treatments are more difficult and exhausting.

regardless of her diagnosis, I just want to see her happy and stable, and am not really worrying about the future of the relationship right now.  But the more and more I get into it, the more I realize that long term stability for her will be a very long road and is probably never going to happen.  In the meantime I just need to take care of my own health.

[Learning_curve74]

Hi maxsterling, sorry to hear about your dBPDgf being in the hospital. 

You may want to read this about bipolar and BPD: What is the relationship between BPD and bipolar disorder?

I believe your friend is right in that many people are diagnosed bipolar because it's easier for insurance reasons as well as with the drug therapy. It is possible your gf has bipolar comorbid with BPD. So even with rx treatment of bipolar, she will still have the BPD symptoms which you are seeing. My xBPDgf has been diagnosed with both, and she has also suffered severe depression. I think somewhere in that topic thread above there may be a discussion about how they try treating with drugs to see if the issue is bipolar, and then they may move to BPD diagnosis if there is not much effect.

You are right that it will probably be a long and difficult road for your dBPDgf. You can support her but make sure you take care of yourself too. 

[Surnia]

Hi maxsterling

Good to hear you again and thank you for sharing what the T in the hospital said. I think its quite interesting.

I like the possibility for family members to ask questions! I never had the chance to have it. I think it is very important.

regardless of her diagnosis, I just want to see her happy and stable, and am not really worrying about the future of the relationship right now.  But the more and more I get into it, the more I realize that long term stability for her will be a very long road and is probably never going to happen.  In the meantime I just need to take care of my own health.

 and