From high to low-functioning BPD?

[Jessica84]

My uBPDxbf used to be well-respected and influential in the community. People sought his opinions and loved his ideas. He was considered radical, but innovative. I know because we work in the same field. Over the last few years, I've noticed they treat him differently now. I've watched his mental health decline. Now he is mocked, ridiculed, criticized, even attacked, seen as a general nuisance by most of his peers, the sames ones who used to respect him and welcome his input.

Some of them had to block him to stop receiving his ugly late night texts and emails. I've witnessed him obsess on getting back in their good graces, but the more he tried the worse he looked. He would apologize, then get mad at himself (and them) for apologizing, take back the apology, defend himself some more, than apologize again! As a result, his business has suffered along with his reputation. He racked up huge debt overspending, often picking up large tabs to impress his colleagues who no longer refer him any business, so it's been a downward spiral for him financially and image-wise. He has gone from respected to angry/rude guy to now hopelessly depressed.

Can BPDs go from high-functioning to low-functioning? or is this due to his behavior and people have tired of his antics? Either way, he needs help. His "therapists" are no more than drug pushers. His appointments last 15-30 mins and generally they just reach for their rx pads and shoo him out the door bc he's often too obnoxious to handle. But the reality is he is suffering. He is suicidal and not getting real help or support from anyone. Is there nothing I can do ?

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[Mr. Solo]

My dBPDw was a fantastic mother and wife overall for fourteen years (high functioning?). I can look back and see the BPD messing with her at times but she dealt with it much better then. Four years ago she flipped and she hasn't been the same since (low functioning?). She was very popular and well-liked before she flipped. Now the majority of people think she's crazy and stay away. She went from being everyone's friend to having 2-3 friends that treat her like crap. A very successful photographer to losing all of her clients.

[MammaMia]

Jessica

I suspect you are correct that your uBPDbf's fall from grace may be a combination of both factors that you mentioned.  As he has become more ill, people have noticed a change in his behavior, and now question his ability.  He has crossed the line in several ways, which confirms to them that "something is very wrong".

If therapy is not helping, he may need to seek care elsewhere.  Bpd is a personality disorder... .it is part of who he is.  He may be able to learn to control his behavior better, although there are no guarantees.

Find a therapist who specializes in BPD, and your bf needs to address the depression in a major way.  He may even require hospitalization to get a definitive diagnosis.

It is wonderful that your bf is amenable to treatment.  That in itself is a huge step forward. Try to guide him to someone who understands his type of disorder well and can work with him one-on-one, not just medicate him.

[Jessica84]

Mr. Solo, that is almost exactly the same story with him. I don't know what set all this into motion, maybe it got too exhausting to have to control it all the time? Is she in therapy? on meds?

People think he's crazy too and try to avoid him. They don't see what I see, or they don't care to see it. He's lost nearly all of his friends and clients. He calls me his "best friend" but he broke up with me so even our friendship is strained now. NC from him since Friday. I haven't attempted contact. Maybe I'm a bad friend, but I don't want to push him, and I don't know what to say.

People here give a lot of "take care of you" advice. That's good advice, but what if we're already doing that? I have good r/s's with friends, family, co-workers, enjoy social activities, hobbies, go to the gym, etc. This got a whole lot easier for me once I learned to depersonalize much of his drama.

But while my own life is pretty well intact, it is hard to watch his falling apart and getting worse. I feel like I'm chained to a tree while looking at him tied down to a railroad track with a train blowing its horn up ahead, and being powerless to stop it. He's no damsel, and I'm no rescuer, but I do feel so helpless, and useless.

[Jessica84]

Jessica

I suspect you are correct that your uBPDbf's fall from grace may be a combination of both factors that you mentioned.  As he has become more ill, people have noticed a change in his behavior, and now question his ability.  He has crossed the line in several ways, which confirms to them that "something is very wrong".

If therapy is not helping, he may need to seek care elsewhere.  Bpd is a personality disorder... .it is part of who he is.  He may be able to learn to control his behavior better, although there are no guarantees.

Find a therapist who specializes in BPD, and your bf needs to address the depression in a major way.  He may even require hospitalization to get a definitive diagnosis.

It is wonderful that your bf is amenable to treatment.  That in itself is a huge step forward. Try to guide him to someone who understands his type of disorder well and can work with him one-on-one, not just medicate him.

Thank you for this. He is either misdiagnosed or they're diagnosing (and medicating) the individual symptoms-- OCD, ADD, anxiety, depression. He may even be bipolar but his mood swings are far more rapid, I mean within seconds and without warning. He has all 9 traits of BPD, including self-harm, punching walls until his hands bleed, burning himself. But I don't DARE tell him he has a borderline disorder! I could help him find a therapist who specializes in this as long as they handle other types of problems so he wouldn't know it's a "BPD Specialist". But then again I can't make him go. He hates his therapists, but won't find a new one even though they're not helping him. At all.

[MammaMia]

Jessica

Does your friend have any family who may be able to help influence him to find a different therapist?  Just like taking a new medication which requires trial and error, patients and therapists do not always "click".

If he is suicidal, there is always the option to involve law enforcement who can escort him to an Emergency Room for evaluation and possibly a 72 hr hold to determine what is really going on.  This might seem radical, but it has opened the door to saving many lives.  Threats of suicide accompanied by destructive behavior should not be ignored.

You are in a difficult place to be sure.  As an adult it is your friend's responsibility to seek help.  HOWEVER, if he is unwilling or unable to do so, it may be necessary to use other means to force him to do what needs to be done.

[Jessica84]

One of his colleagues was running around talking to people about having him committed, involuntarily. Someone told him about it and he basically shot the messenger. Impulsive as he is, or defiant maybe, he went off all his meds right then and there. After a period of withdrawal he was amazingly better. He was controlling himself well w/o the meds. I also learned to be calmer and more validating, and we were closer than ever. Then he got into a high-stress situation at work, and he was right back to the same as before. Unpredictable, moody, angry, impulsive, reckless. I stayed calm, but once the depression hit, he ended our r/s. Now he has no friends, no support at all. His family lives out of state except his mother who is very elderly and has many health problems herself. Very sad.

[Mr. Solo]

My wife began DBT a few years ago after a short stay in a behavioral health residential program. She stopped going after a few weeks. She began DBT again about a year later but wouldn't comply (wouldn't go to group). She currently doesn't do any therapy. She has tried reading a few books about BPD but she cannot finish. She is frightened by what the book say. She was prescribed Prozac and Adderall for BPD, Depression, PTSD, and PMMD. She doesn't take the Prozac at all but she enjoys taking the Adderall. She also smokes marijuana, which from what I have read, is not exactly good for BPD as marijuana heightens emotions. Actually, when she began smoking marijuana, that's when she flipped out for the first time.

My wife had people bamboozled about me for a while but since she left she has had no choice but to expose herself. The people she bamboozled have started to see what I dealt with as she doesn't do anything she says she is going to do and she rages on them all the time. She recycles them on a very tight schedule.

My wife has always called me her best friend; even after she left and took the kids. Even when we were still together she would ask me to just be her best friend (with benefits). I think it was her way of saying she wanted to be married but didn't want to have to be tied down. She wanted to treat me like a friend and keep me at a distance but get all the benefits of being married.

I am trying to take care of myself but I am in a bad situation. My family and I actually moved in with my dying mother to take care of her a few months before my wife left. I am now stuck here. I say stuck because my mother was an uninvolved parent and here I am trying to care for someone who didn't care for me when I was a child. Just trying to do the right thing but it has been terrible. My dad's dying wish was I take care of her so here I am. No help from my siblings either. My mother also has mental health issues which makes it worse. She is very paranoid. So, I don't get a lot of time to do things for me. If I do something, I get guilt trips from my mother and family. I don't have a lot of friends right now because my wife ran them off with her behavior or I ran them off putting up with so much crap from my wife. I am an introvert and have Aspergers so friends do not come easily. My family has never been a real family. I have been going to CBT for about a year and a half. That is really the only time I get to talk (which is why this message board has been great!). As far as hobbies, my wife robbed me of those as well. Anything I did for myself throughout our marriage became a basis to leave me. Before she left, it was a basis for saying I was not committed. I essentially had to like what she liked. I listen to music every once in a while and that's about it. I cant find the time nor the energy to do much else.

In the meantime, my wife's life is falling apart and getting worse as well. She will not work. She will not go to therapy. She can't pay bills. She can't take care of our children properly. Like you, I am a rescuer so it is very hard for me not to get wrapped up in her stuff. I love her and want to help but she drains me physically, emotionally, and mentally. She has for over four years.

Reading articles, lessons, and stories here has helped tremendously. My wife almost had me convinced I was crazy. It is comforting to know I wasn't imagining things and I was the one remembering things correctly. I am still healing from what she did to me and our family. I think I am healing anyways. Sometimes I wonder. It seems to all come back when she rages or she starts saying things that are not based on reality. The hurt and frustration comes back. It is hard. I sometimes wish I didn't "love" her so much.

[maxsterling]

I don't think my SO was ever high functioning, but she obviously was higher functioning in the past than she is now.  After all, she was able to get a master's degree, travel by herself, and somehow live by herself for a number of years, although I suspect she was just barely hanging on.  Right now, she barely survives the day when I go to work.  I can't imagine her ever doing anything by herself.

But what I wonder is if it is possible for a pwBPD to go from low functioning to high functioning.  The slow deterioration makes sense to me - years of damage compound in itself and the internal shame and self-hate builds and builds.  But are there many cases where a pwBPD has gone years without a stable job to finding something that finally works for them?  Or years of self loathing and depression to finally being able to take care of their own needs?

[Jessica84]

Well he just called me, while on his way to work. He told me all kinds of bad things seem to happen to him when we're apart. I'm not falling for this. I'll be supportive but I'm not recycling unless he gets real therapy. He's almost 60 and still undiagnosed. He missed his T appt today bc he got drunk last night and was too hungover. Lovely.

He says he has a "plan" to get his life on track. Staying off the meds, changing his diet and dating new people - even lovier. Anything but get to the ROOT of the problem. Said he went on a date with a woman the other night, but that she had too many issues. There's irony for you.

As long as he isn't suicidal, I'll let him be for now. I can be supportive, but I know me well enough that hearing about him dating this soon will not be good for my mental health. 5 years dating, less than 2 weeks broken up and he thinks sharing his dates with me already is appropriate? BPDs are not only sensitive, but they can also be incredibly insensitive. But I must've handled it well. He said he enjoyed talking and would call me later. Oh lord help me.

[Jessica84]

Mr. Solo - I am so sorry for what you're going thru. I know it's draining. I think we all know it is sometimes more than we can take. You always have friends here! Taking care of a parent isn't easy, taking care of one who didn't do the same for you, is a testament to your character and strength. Give yourself a break. Love, unconditional love, is hard work. I sometimes think I'd rather stick a fork in my eye!

Max - I wonder this too. Can they rebound and go from low to high again, once its lost? To some extent, I think the BPD wears them down over time. They get tired of trying and finally give in to the disorder. Rage, depression, blaming soothes them in some strange way, and they cling to it like a blankie.

[MammaMia]

Jessica

PwBPD are so self-focused that they have no concept of how their inappropriate words or actions hurt others.  Everything is all about them, and if it is not, they are not interested.

Do not take his running off at the mouth personally.  I doubt he was intentionally trying to hurt you because he still considers you his best friend.  Sadly, pwBPD l lack empathy for anyone or anything but themselves.  This, too is part of the disorder.

[Jessica84]

Jessica

PwBPD are so self-focused that they have no concept of how their inappropriate words or actions hurt others.  Everything is all about them, and if it is not, they are not interested.

Do not take his running off at the mouth personally.  I doubt he was intentionally trying to hurt you because he still considers you his best friend.  Sadly, pwBPD l lack empathy for anyone or anything but themselves.  This, too is part of the disorder.

Interesting and I know you're right. I didn't react to that, mostly because I know it's not his fault or on purpose. I never knew that about him before, until about a month ago. My ears would only hear rudeness and disrespect! But his behavior spinning more wildly out of control got me more focused. And working on myself too. We all wait to become Buddha once a crisis hits, don't we? 

Don't get me wrong. It still sucks to hear about it and I'm trying to figure some kind of boundary for that. I felt like saying hey, the grass isn't greener, is it? But I didn't. Proud of myself for not going there. I've been practicing controlling my emotions in general. Practice helps. I don't feel out of control or anything, felt more like a mosquite bite.

He texted me with "what good thing did I do in my life to deserve someone like you to be so nice to me?" The irony there is, it's what bad things he's done! Without the hell he's put me thru, I'd have never tried so hard to understand him, myself, this relationship, or this disorder.

[bpbreakout]

My BPDw has gone from low to high functioning. She has some major issues with depression and bipolar a few years ago and was at home with two kids under 10.

Since then she has managed to get back to work full time and seems to have a lot of good friends in our local area and I think is able to reserve all her disfunctional behavior for us at home. I think she has a narcististic streak which has helped her recovery in the outside world but a lot of people have no idea what she is like at home. I wonder what would happen if I left her.

[waverider]

pwBPD often live "try hard" facades to cover up their inner chaos. These facades can be very appealing and high functioning, but they are fragile. Hopping from one RS/friendship/workplace to another often keeps them one step ahead of being "exposed".

Prolonged exposure to these facades often leads others to question their authenticity. This is a pwBPDs worst fear, so they up the anti, and oversell themselves. This has the reverse effect of exposing the facade even more. The pwBPD then goes into fight or flight mode, alternating between playing victim and lashing out. Triggering dysregulated behavior, their environment deteriorates.

This is the process of going from high functioning to low, desperation, anxiety, panic, hostility even depression set in. They are heading into crisis, they are raw with nothing to hide behind.

A similar thing occurs if the person has been using alcohol, drugs or med abuse to block their issues and comes off them. Again they have nothing to hide behind and have no real core coping skills or confidence

[Jessica84]

Maybe they have to hit a sort of "rock bottom" to finally seek help? As in no recycles, no replacements, no attention, no substances, no facades, no one left to blame or paint black, and facing the painful truth about themselves?

That's a lot of insufferable no's, but maybe that's what it takes to get to the point of total exposure and lead them into treatment. Then it may be possible to return to high-functioning again, however long that takes. I would imagine it takes a pwBPD a long time to get there, and even longer for the therapy to take effect.

[waverider]

That's a lot of insufferable no's, but maybe that's what it takes to get to the point of total exposure and lead them into treatment.

Or suicide... .unfortunately one of the harsh realities of BPD. Some simply cannot ever see the light at the end of the tunnel, or own their part in getting there. It just gets darker and further away.

Crisis is often necessary but you have to very careful with the the old school approach of playing hard ball with them, it is often that approach in their early years that fueled the disorder in the first place.

[Jessica84]

Thanks waverider. I worry about suicide with him a lot. But as long as he's trying to make improvements (like changing his diet), or making plans (anything in the future) I know he's feeling some sense of hope. That could change on a dime though.

What do you mean by hardball approach? like tough love?

I don't want to push him or make any demands. Especially when he's teetering on the brink (lots of suicide ideation). But I would like to nudge him gently toward therapy. He wants to have lunch with me soon. I'm trying to figure out the best way to suggest it, without making him feel worse than he already does. He knows he's got serious issues but he's also stubborn. Any suggestions?

[maxsterling]

A sobering reminder - therapy is no guaranteed fix - the therapist can't fix BPD.   Therapy is probably more often just another management strategy.  Only he can solve his issues.  The pwBPD has to use the tools the therapist provides.  So even if he goes to a T, there is no guarantee for success.  Sad, but true.  My fiancé has had no shortage of therapy and diagnoses, and while her behavior has improved over the years, she is still VERY low functioning, VERY depressed, and VERY angry.  At this point its up to her to actually follow through with the treatments.  Over the past two years, she has been offered so much, and she just can't get off the couch to go.

[waverider]

What do you mean by hardball approach? like tough love?

Yes, you need to be firm and consistent especially with boundaries, but you also have to carefully monitor what effect it is having and just take one small step at a time. Too much of a sense of being a failure in their face at one time can completely overwhelm them, and they simply may not have the tools to pick themselves up, or think that life is worth living. Seeing realistically past tomorrow is a hard enough task as it is.

[waverider]

A sobering reminder - therapy is no guaranteed fix - the therapist can't fix BPD.   Therapy is probably more often just another management strategy.  Only he can solve his issues.  The pwBPD has to use the tools the therapist provides.  So even if he goes to a T, there is no guarantee for success.  Sad, but true.  My fiancé has had no shortage of therapy and diagnoses, and while her behavior has improved over the years, she is still VERY low functioning, VERY depressed, and VERY angry.  At this point its up to her to actually follow through with the treatments.  Over the past two years, she has been offered so much, and she just can't get off the couch to go.

It can cement the attitude of being victim permanently in place. I worry about this too. Almost feel like my partner is being over counselled at the moment. By being the victim and being soothed is almost a role she has now taken on. Hand balling all responsibility over and retaining none.

[Jessica84]

Thanks for the responses. I don't expect a miracle or even a recovery. But he's had no real therapy, only medication. I think he finally wants help. I think he'd like tools. He wants to know how to cope better. He's said this to me several times. He also started reading books on happiness, anger management, coping with depression, how to be successful. He's a big fan of how-to's. Like once he told me he googled "How to talk to your girlfriend after an argument". LOL

This is really new for him. He used to justify his crazy behavior and try to convince me it was normal, and that I was the crazy one. I think he may be more open now, and I'd hate to see this window of opportunity close before he changes his mind, or shuts down completely and loses all hope.

[waverider]

Thanks for the responses. I don't expect a miracle or even a recovery. But he's had no real therapy, only medication. I think he finally wants help. I think he'd like tools. He wants to know how to cope better. He's said this to me several times. He also started reading books on happiness, anger management, coping with depression, how to be successful. He's a big fan of how-to's. Like once he told me he googled "How to talk to your girlfriend after an argument". LOL

This is really new for him. He used to justify his crazy behavior and try to convince me it was normal, and that I was the crazy one. I think he may be more open now, and I'd hate to see this window of opportunity close before he changes his mind, or shuts down completely and loses all hope.

It is a good start, but be prepared for that window to open and shut many times before the room becomes full of fresh air. One small step at a time