Buspirone

[maxsterling]

Anyone's pwBPD been on this stuff?  Wife was prescribed this yesterday, and I read about it and feel hopeful.  I think she needs some kind of medication to calm her emotions, but I feel the typical Xanax makes things worse in the long run because it amplifies her up/down and black/white.  But the real positive here is that she made the determination to go back to P and ask for meds without me prodding, asking, or suggesting in any way.

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[sweetheart]

Hi max,

h px buspirone 5 weeks ago for severe anxiety and panic attacks. Has had ongoing issues with anxiety since school. Told to take Buspirone either as required or regularly twice a day, as yet it's done absolutely nothing to alleviate his symptoms of anxiety.

[Notwendy]

It's a positive that your wife asked for help.

I think it's sometimes trial and error with these types of medication, that they can start with a lower dose and increase it and also change medications if it doesn't have an effect.

I hope it helps her.

[maxsterling]

Thanks Wendy & Sweetheart.  I guess I will keep my fingers crossed.  Not sure if W has been on it before.  But with her and meds - she has always maintained that SSRIs do nothing for her, and Benzos are the only things that work.  Buspirone is neither.  I disagree with her that SSRIs do nothing for her.  She just does not get the "complete relief" that she wants, so she stops taking them.  She likes the benzos because they give her instant and complete relief - a "high".  But from an outside perspective, she's more even on the SSRI, and completely back and forth on the benzos.  I still think it positive that she is trying something - the action alone speaks volumes. 

On the other hand, she was supposed to meet with a social worker after work today.  But once again, she cancelled.  Not that the social worker could really help her with anything right now, but I wonder if this is a required visit because of her SSDI benefits.  This behavior really frustrates me.  She probably makes about 4 times as many plans as she actually attends.  This is a pattern for her - planning on doing this or that to help herself, and more often than not cancelling.  I see myself playing a role in that, too, because if I am home she will cancel nearly anything to spend time with me. 

But - she did cancel for a reason - to spend time with co-workers on a social level.  I see that as a BIG step forward.  I am working a second job tonight.  Part of the reason I have the second job is for my own relief, but also as a means of forcing her to do things on her own.  She seems to be upset (as always) that I am working tonight, but I think in the long run it is a good thing for both of us.  I didn't work the past two weekends, and it turned out to be hell for me dealing with her anxiety attacks as she could not do anything on her own.  So if I wasn't working, I know she would convince me to go someplace and spend the whole day together, and I would be stuck listening to negativity and complaining. 

[HappyNihilist]

I agree, max - it is a good sign that she talked to her doctor and sought help on her own. 

It really is trial-and-error, like Notwendy says. Buspirone can be great for anxiety, without the icky side effects and withdrawal of SSRIs and benzos. Hopefully it will help her with her anxiety.

However, neither SSRIs nor buspirone will help much with emotional regulation. Has she ever tried an anti-anxiety medication (SSRI, benzo, etc.) along with a mood stabilizer? A lot of the same medications that are effective for bipolar disorder also have good results for BPD.

[Notwendy]

Good for you Max- that second job is something that is good for you- income, advancement, a bit of sanity. And it is good for her- even if she makes a fuss over it. It isn't good for her for you to be available all the time for her to ask you for help, or to turn to you to manage her emotions. With you not being available all the time- it creates the opportunity for her to rely on herself.

And she is- going out socially, taking a step to get medication.

When someone is stressed over a task, the tendency is to take the least difficult path. If you are available all the time for her to ask for something like using the computer for grades, or solving some problem for her, then her inclination is to ask you. If she turns to you to help manage her stress or to vent, she doesn't learn to manage her own feelings. Accomplishing something on one's own raises self confidence and the opposite- feeling always dependent diminishes self esteem.

Take care of yourself Max- and let her grow.

One difference between Buspirone and the SSRI's and benzos is that they are long lasting. They take time to build up to an effective level, but that level stays steady. Benzos are quick acting, but short acting- they work fast, but don't last. They are also more addictive in that sense. I could see where someone would like the quick relief- high effect of them.

HappyNihlist has a point, but I think when starting a new medication, they start with one. If they added more at the same time, you wouldn't know which one was working or if there were side effects, which one did them. It is good that your wife took charge of this and hopefully working with her doctor - they will find something that helps her.

[maryy16]

BPDH has been on it for years. He takes it along with Prosac. I have found that it doesn't decrease the intensity of the rages, BUT it has decreased the frequency of his "episodes." So, in my experience, yes it has helped greatly.

[Grey Kitty]

My wife was on buspirone and prozac (plus a trying a couple things to help her sleep).

Both were for anxiety and depression, not BPD. (My wife's BPD was very mild at the time, down to minor traits, I guess)

She was warned by a psychiatrist friend that when she started taking (one or both medications; I don't recall), while it would help anxiety, for the first week or two, the anxiety would get worse before it got better. She was very grateful to have that warning.

As far as I know, she is still on them... .but we're separated, and I'm not involved in her meds anymore, so I probably wouldn't know if they had changed.

[maxsterling]

So far, so good with this.  To early to tell whether it is the medication or not.  Here are the changes I have noticed so far:

1)  She was able to go to work this morning without a kicking and screaming episode (literally - this is her MO the past few weeks - literally kicking and screaming). 

2)  My brother stopped by yesterday on his way through town, and she handled that without too much incident.  I think part of the change here is that I just let go of the whole situation while I was working a second job, and just stated the facts and let the rest happen. 

We did go out so see a movie Saturday night, which turned out to be typical date-night frustrations for me because of her complaining and negativity.  On the other hand, it was better than many recent outings because there was no (literal) kicking ans creaming involved.

[formflier]

 

Max,

Is "letting go of the situation" a new thing for you?


FF

[Notwendy]

That could be a positive sign. I think it takes a while for these kinds of medications to take full effect,  but some positive change is hopeful.

She's still going to be who she is. If there was a medication that completely "cured" BPD, I think we'd all be putting it in the water supply.

However, if this can help modify her anxiety/emotional dysregulation enough for her to process better and behave more appropriately, it could be a great help.

I think that second job is a good thing for you Max, and also good for her.

[maxsterling]

Max,

Is "letting go of the situation" a new thing for you?


FF

Cognitively, no.  Emotionally, yes.  She sent me some nasty text messages yesterday after I informed her my brother would stop by.  Accused me of being manipulative and causing her stress.  I declined to engage, and told myself that it will likely blow over, and if it doesn't, there's nothing I can do about her feelings.  But all day it was on my mind emotionally.  Although I could have requested to go home early from work, I didn't, an instead let whatever happened happen.  In the past, I may have gone home early to try and calm her down.

[Grey Kitty]

Although I could have requested to go home early from work, I didn't, an instead let whatever happened happen.  In the past, I may have gone home early to try and calm her down.

And I'm guessing that the normal result of going home to "calm her down" is that she dysregulates at you in your presence, instead of doing it alone... .resulting in you feeling a lot more stress... .and her not being measurably calmer than before.

[Notwendy]

Max- good for you for staying at work. Consider that you are also acting in your wife's best interest. If you are always available to calm her down then this can make her dependent on you for that. It will keep her from the opportunity to learn to calm herself.

Naturally you would want to be available for some times but it is better to be a support and not a crutch. Even parents have to learn to let their kids learn to soothe themselves, iron out their own squabbles between friends and do their own homework. If they don't do that their kids won't learn how to be independent adults.

You are taking care of yourself and letting her grow.

[maxsterling]

Although I could have requested to go home early from work, I didn't, an instead let whatever happened happen.  In the past, I may have gone home early to try and calm her down.

And I'm guessing that the normal result of going home to "calm her down" is that she dysregulates at you in your presence, instead of doing it alone... .resulting in you feeling a lot more stress... .and her not being measurably calmer than before.

Bingo.  That's the lesson that takes a while to learn, and a million times more valuable than all the validation and SET skills combined.  I ask myself "1) is this my problem? 2) is there any way I can make it better? 3) is there any way I can make it worse?" Often, my consensus is that she's going to dysregulate no matter what, and the severity of the dysregulation will be the same regardless.  So if I am already out of the house, just let it burn itself out.  But, I still screw up all the time and forget this, and try to fix things when there is nothing that can be done.

[Notwendy]

So if I am already out of the house, just let it burn itself out.  But, I still screw up all the time and forget this, and try to fix things when there is nothing that can be done

It's progress, not perfection, but still progress is progress. Take the credit! and carry on .   

[maxsterling]

So if I am already out of the house, just let it burn itself out.  But, I still screw up all the time and forget this, and try to fix things when there is nothing that can be done

It's progress, not perfection, but still progress is progress. Take the credit! and carry on .   

Such as last night.  I skipped group therapy so that I could spend the evening with my wife.  My thought is this was the right thing to do considering I am working two jobs and out of the house the next two nights. 

I cam home to her immediately telling me she was in a grouchy mood, me trying the various validation

tools, and eventually her kicking and screaming and telling me she hates me when at bedtime I could not say anything to solve her depression.  So, I slept in the other room, and was triggered into having many violent and disturbing dreams.  In hindsight - going to group therapy would have been the better choice.

[formflier]

  In hindsight - going to group therapy would have been the better choice.

Max,

Very impressed with your ability to "observe" yourself and think about making better choices.

Not saying I'm perfect now... but this was part of the detachment process for me.  Being able to step outside the r/s and look at it... .and look at my choices.



Let's assume you skip group and go home.  What could you have done differently to limit your exposure to the bad stuff... and maybe end up with less bad dreams... .possibly.

FF

[Notwendy]

My thought is this was the right thing to do considering I am working two jobs and out of the house the next two nights. 

Did you want to do this or feel obligated?

It's important to pay attention to our own feelings- and any FOG

Also, it happens. Even though you have made some changes, it may take a while for your wife to realize them. If when you are home, this happens- you become what she uses to moderate her emotions with- by venting, projecting, then it makes sense that she would think this is the same as usual.

What were your emotions and how did you react? Did this feed into it?

Don't consider these episodes to be failures. They are learning experiences.

I fell into one recently, but it thankfully didn't escalate. Things have been calmer, to the point that I could almost forget that they were not. I was stressed and upset about something- more than usual- something that had little to do with him, but I was stressed, tired and had it. I needed to be alone to de-stress- my own time out.

I explained the situation to my H. He could hear the frustration and upset in my voice. I also think the fact that I needed to be alone was triggering to him. He responded in an angry voice, and throughout the evening would react to things as if they were personal that I didn't say were personal in the first place. I recognized, still, that the boundary between us was blurry- at least on his side- and that my emotions can trigger him even if they have nothing to do with him.

Before I could see a bigger picture- I would have had my feelings hurt when he reacted to me. After all, it had been my rough day, not his and still, he was angry at me. But thankfully, I could see that his reaction was not about me either and that his feelings were not my feelings. I did not react to him. I repeated that I needed to destress and took some time to myself so I could get a grip. Then, I was able to not react to him.

It took a long time for me to be able to remain calm in the emotional storm. I also recognized when I could not, and had to destress alone. It's a work in progress, and it is how we learn. You can do this Max.

[maxsterling]

Wow.  I'm glad I locked the door.  Things have really deteriorated.

[formflier]

 

   

FF

[maxsterling]

Came home from my second job last night.  Tried the "test the waters" technique of asking her how her day went to gauge her mood - obviously still depressed.  A while later I tried making conversation with her, to which she immediately went to blame/rage.  I tried to validate, she wouldn't even give me a chance to talk.  I quickly excused myself to go to bed (enforce boundaries), that's when the name-calling and "I want a divorce began".  I went to spare room and locked the door, she banged on the door for a bit (good thing I locked it).

[formflier]

Came home from my second job last night.  Tried the "test the waters" technique of asking her how her day went to gauge her mood - obviously still depressed.  A while later I tried making conversation with her, to which she immediately went to blame/rage.  I tried to validate, she wouldn't even give me a chance to talk.  I quickly excused myself to go to bed (enforce boundaries), that's when the name-calling and "I want a divorce began".  I went to spare room and locked the door, she banged on the door for a bit (good thing I locked it).

How was she this morning? Does "How has your day been?"  Usually work or do you suspect it helps her head down a negative path? Would "tell me about your day" be better? "What was the kindest (or best) or some other good thing that happened to you today?"

Note... .part of me says leading them to a road of good thoughts is good... .another part of me says that if they can think of nothing good... .it would invalidate and add fuel to fire.

Hang in there max... .how do you feel about the boundary you enforced last night?

[maxsterling]

How was she this morning?

Don't know.  Didn't see her, or hear from her.  She was in bed.  I did hear her tell the cats to "go away" but that is about it.

Does "How has your day been?"  usually work... .or do you suspect it helps her head down a negative path?

Would "tell me about your day?" be better?

In an extreme dysregulated state like she was last night, makes no difference.  She's going to hear what she wants to hear in my words.  She's been stewing in her head all day and she is just waiting for me to open my mouth with anything so she can respond.  Changing things up could be better during a non-dysregulated time, but I doubt it .

Hang in there max... .how do you feel about the boundary you enforced last night?

Excellent.  I enforced my boundary without trying to fix or sooth anything first, or without JADE.  I protected myself in a way that allowed for my physical an emotional safety.

[formflier]

Excellent.  I enforced my boundary without trying to fix or sooth anything first, or without JADE.  I protected myself in a way that allowed for my physical an emotional safety.

How do you feel about boundaries now? How does that relate to how you feel about your r/s?  Boundaries was a big turning point for me.

[maxsterling]

She's on the lowest dose of this medicine.  I think she is supposed to increase the dose starting tomorrow.  So far, I have seen no change in her anxiety levels.  After reading more about this medicine, I have heard many positive results, but usually it takes a few weeks and a much higher dose that what W currently takes, and usually when taken with an SSRI. 

It's gotten to the point where she has painted her job 100% black.  She took the day off yesterday, and at least did a few things that I would consider self-care.  Last night I went from being painted black to begging me not to go away, not even to get up to use the restroom. 

Interesting this morning - we have been reading from Al-Anon meditation books and "the language of letting go."  After today's readings, she told me she felt like I was choosing what to read to her as a means of trying to control her.  All I did was read the entry for today's date. 

Some thoughts on BPD in general.  Listening to my wife's language makes me wonder if mentally she wants to return to a time in her life pre-trauma.  So, when she says she "hates it here" and "wants to leave", what she really wants is to go back in time to a place that feels comfortable and safe and innocent.  I say this because she often talks about leaving or wanting to leave, but can never tell me what place would be better.  Usually, in the same conversation she is talking about hating "this life" and wanting to "start over".  Once again it reminds me of my Alzheimer's grandmother who constantly felt she was out of place and needed to "go home".

[Notwendy]

I'm curious as to why you are reading the literature from Al Anon to your wife?

You have mentioned sharing other aspects of that group with her, but it isn't for her, it is for you.  In general, I don't think what goes on in these groups is meant for the spouses- eventually after recovery some spouses attend, but initially it is to help the members who need it.

Melody Beaties book is for you Max. Sharing it with your wife to help the two of you is like her sharing her Buspirone with you to help the two of you. What can help you isn't necessarily good for her.

To benefit from the concepts of co-dependency in that book, one has to dig deep inside oneself. For someone like your wife, that could be disregulating. If you are reading it with her with any intent to help her, then she would feel controlled or manipulated.

It will take time for her medication to work, and her doctor will probably increase it over time.

You are doing really well at taking steps to take care of yourself. It is OK to study the materials in your Al Anon group on your own. It may feel backwards, but the stronger you are emotionally, and the better your boundaries, the better you will be at handling things in your relationship.

She took the steps to take this medication, and that's a big step for her too. Yes, she may have emotionally rough times, but your emotional growth helps you deal with this too.