Dealing with wife having body dysmorphia

[Pvd-idoc]

My wife and I met 3 years and got married july of last year. My wife was upfront about her mental health issues from the beginning. She tried to warn me but of course I thought I could be the one to "save" her. I grew up with many family members who had severe mental illnesses so I had this false sense that I could deal with all challenges.  Our relationship has been a whirlwind but I have been able to manage it most of the time.

Unfortunately, something happened a few months prior to our wedding that has just wrecked our lives. My wife went for a routine dental visit with a new dentist who decided to rebond part of one of her front teeth that had chipped when she was young. The dentist overdid it a little and made the tooth larger than it was. That small mistake started a cascade of events that has brought our marriage to the brink. My wife has spent essentially every single day since that day obsessing over the appearance of her teeth. We have been to 8 different dentists, she has called probabay every dental office in the country that specializes in cosmetic dentistry. We finally found someone who was willing to take her case and we spent nearly 10 grand to redo her front 4 teeth. Unsurprisingly she is still unhappy with her teeth.

She has described the change in her appearance, which really was minor and essentially imperceptible  to anyone, feeling the same as losing a limb or loved one.  While I can understand how hard it must be to constantly feel like you are not yourself or to see your normal looking tooth as monstrous or grotesque. I can't not stay stuck with her any longer. Dealing with her completely emotional dependence on me has been challenging from the beginning but it has become impossible because she is just in a constant state of anxiety, depression or anger about the situation. She basically expects me to listen to her and comfort her at all times. It has almost eroded my sense of self and seriously impaired my ability to manage my own mental health. While she does recognizes this and is horrified and distraught over  how she has behaved. She seems unable to stop herself from spinning out. She has used alcohol and weed to regulate her behavior but it only temporally dulls her brain. Her family has also recognized how troubling her behavior has been. Her mom basically wants me to give her an ultimatum that she need to try SSRIs along with intensive DBT and other therapies or I will divorce her. My wife has gone through quite a bit of trauma in her childhood and was sent away to a boarding school with other "troubled teens". She has horrible memories of being put one different psychiatric med and has been really resistant to trying them again.

 I just don't know what to do anymore but I also know I can't keep living life like this. I am sorry this is such a long and rambling post

[judee]

Hi there,

It must be so hard for you to deal with your wife's mental issues...It is totally understandable that you can't keep this up.
It sounds like she is projecting all her fears and stress on what happened with her teeth, to the point of psychosis. I guess that is what BDD is about.
she has a lack of trust in 'the world' and an intense fear that that world will only harm her.
So I am not a therapist...but not sure if taking Ssri's will be of any use, since she will probably also severely distrust those and feed the fear. But a therapist can surely benefit to guide her through this.
I believe she can 'snap out of it' even if it takes awhile. Maybe instead of saying its hardly visible ( which invalidates her perception prob leaving her more scared) you might be able to help her accepting the perceived loss and (in her mind) disfiguration?
Have you tried approaching it in a way of saying : 'If this is the worst thing ever, your teeth are ruined, then can you live with this?' Along with confirming she looks amazing and she is ok.
Sounds weird, but I have tried it with a friend once and eventually worked.
All the best to you..

[Mommeredith81]

Wow, that's pretty hard. It seems like if it hadn't been the dental work, I wonder if it would have been something else? You've spent a lot of money and a lot of time trying to help her on this. Sounds like her parents are on your side and need to set a boundary of getting her the right help. What kind of treatment is she getting for the mental health disorders? Has she been diagnosed appropriately? I'm not a therapist at all but maybe there's an OCD component to focusing on that one issue. Anyway yes this seems very hard on you (and her). Be good to yourself.

[Pvd-idoc]

Hi Judee- As you said I think she is projecting a lot of her fears and anxiety on to her teeth. My wife is a few years older than me and turning 34 this summer. I think the idea of aging is hitting her hard as well especially since her appearance /good looks are a big part of her identify. I think she is finally starting to realize that she will have to live with her new smile but she is still in a phase of mourning. She has been in therapy throughout this time but it has been sporadic at times. I think here therapist has finally recognized that she probably wasn't getting enough help since she started self harming and was frequently having suicidal ideation. Ultimately, I do think validating her feelings and telling her she looks beautiful probably helps quiet a bit. I guess I am just hoping there is some light at the end of the tunnel. Thank you for your advice and support!

[Pvd-idoc]

Mommeredith81-

My wife has been diagnosed with BPD by some providers but her anxiety has generally been the dominant issue. I think some doctors have that that there maybe some OCD competent too but I am not sure if that's every been specifically addressed. She currently takes Xanax to sleep and to manage the more severe panic and anxiety attacks.  She sees a therapist most weeks but I feel that has been inadequate. Just since I made this post, my wife mentioned that she has discussed starting treatment with ssri's along with maybe entering a grief counseling program with her therapist. I am hopeful that these will bring about a positive change.

[Mommeredith81]

That is hopeful. Most of us hate aging (myself included) but she can't seem to see the good in herself, and seems to focus unnecessarily on this one issue. I think you may want to make sure she makes good on these new therapies, and if they don't work, try something else. It often does take a while, and good doctors and medications, to find the appropriate treatment. But of course, that doesn't mean you have to stay, if ultimately it doesn't work to your comfort level. BPD seems to me hard to treat, but the meds could still help the symptoms and related issues, if there is a good foundation.

[ThanksForPlaying]

I think MomM is on the right track here that it would have been something else if not the tooth issue. Have there been any other anxiety-inducing issues in the past 3 years? You may start remembering things when you think about events from this new perspective (after you've seen what happened with the tooth).

What about her relationships before you? Any stories you've heard that seem similar? It's unlikely this is the first of these disregulating events. Of course, identifying past events doesn't help you with moving forward, but it may help you build a clearer picture of the extent of what you're dealing with. Hang in there.

[Turkish]

Her mom basically wants me to give her an ultimatum that she need to try SSRIs along with intensive DBT and other therapies or I will divorce her.

What business is it of theirs? If she had a traumatic childhood, I'd cut her parents out of the triangulation. Your marriage is your business.

[Pvd-idoc]

This is the longest relationship my wife has been in. Her previous husband basically checked out and didn't want to deal with the emotional rollercoaster.


Turkish- it's funny my wife's ex husband is Turkish and I am on pretty good terms with him. Anyways my wife has a dysfunctional but very close relationship with her mother. I would rather not involve her in our life but that's who my wife reaches out to in an any hardship. She also has been very generous financially with supporting our relationship

[PearlsBefore]

I always tell myself I'm going to quit over-sharing here and quit my BPDFamily.com addiction...yet threads like this suck me back in; partially to give advice, partially to unload my own burden. The usual combination we all face.

I definitely understand the "I grew up with mental illness in my family of origin, so of course I thought I could be the one to save her" mentality. Nothing annoys me more than the tired trope of "narcissists seek out pwBPDs to prey upon"...I'm sure it happens, but the vast majority of people I've met (granted they are the ones in support groups and such) are actually decent human beings who bit off more than they could chew.

I don't think body dysmorphia is a particularly common/strong indicator of BPD, but of course the comorbidity rate is higher than usual...in all, my primary pwBPD has a few "minor" issues revolving first around the fact her upper lip is very slightly disformed from childhood oral surgery, and then later panicking about breastfeeding ruining her breasts' shape. The former is just an annoyance to me because it's insecure vanity, but the latter came a little bit closer to what you're describing of fixation. As you said, part of it likely just the insecurity of aging - and it hits a BPD much harder because remember...they constantly think/know that YOU are planning to leave them...so to their mind if they're 30+ years old and have a mole, or crooked teeth, or saggy breasts, nobody will ever ever love them and life will be a disaster. I can't imagine how horrifying it would be constantly having that mindset - I have sympathy, but not much.

As Turkish said, I'd ignore her mother's (and your mother's) concerns; granted you're not quite at the number of years where I can say you almost certainly know your adult wife's needs better than her mother does - but keep in mind that there is a very strong correlation between BPD and unhealthy childhoods...parents often have a conflict of interest in regards to their child's BPD...because they subconsciously crave reassurance they didn't do any lasting damage or this is really still all the child's fault.

One of my usual go-to phrases on this forum is to extol the virtues of alprazolam/xanax, comparing it favourably against the lesser buspirones and non-benzos. My experience has been that it's relatively "easy" to get them in when a breakdown is imminent, but very difficult to keep up a daily regimen. In our instance, the addition of an SSRI was not helpful - in fact seemingly counter-productive though it's always difficult to tell what's the drug interaction's fault and what's the wildly fluctuating doses/on/off fault. But I wouldn't pin too many hopes on it myself.

As for relationship lengths, , it was always a point of dry droll observational wit that I shrugged off dry spells lasting a year or more, while she was unable to go six weeks without sex but unable to keep a guy...leading to that meme I posted in the off-topic forum ("I wish Facebook had a 'BPD' setting for relationship status, I'm tired of logging in to switch it every thirty minutes").

I strongly recommend AGAINST responding with "Honestly? Your life is a shambles, your mental health crumbled years ago and will never be restored, you're a total mess and you think your TEETH are the big problem right now?". That doesn't go well ;)

[Turkish]

This is the longest relationship my wife has been in. Her previous husband basically checked out and didn't want to deal with the emotional rollercoaster.


Turkish- it's funny my wife's ex husband is Turkish and I am on pretty good terms with him. Anyways my wife has a dysfunctional but very close relationship with her mother. I would rather not involve her in our life but that's who my wife reaches out to in an any hardship. She also has been very generous financially with supporting our relationship

Yeah, that sounds like a tough thing from which to detach... I experienced similarly with my ex and her mom. Enmeshment. Her mom was sympathetic to me, too.

I'm not Turkish... that was the name of one of my pet rats my ex made asked me to abandon in order to move in with her. Tommy was his brother, named after characters in the movie Snatch. Fixed male lap/shoulder rats, docile and friendly. My buddy took them until they died natural deaths.

[Pvd-idoc]

I appreciate all advise that everyone has given so far. I certainly recognize my obvious narcissism but in my (poor) defense this was only the second relationship I have ever been in. I come from a religous Muslim family so my mom made it necessary for us to have Islamic ceremony to live together. I guess in some way that momentum was something I couldn't or didn't want to stop.
I feel guilty in even saying this I feel terrified that I am permanently disabled being in this relationship. My wife made me feel so vunerable and at ease at the sexual abuse I suffered as a kid that I can't imagine anyone making me feel so at ease.