Mom with Severe BPD

[peacenow]

It's difficult to figure out where to begin. My mother has BPD and it's getting worse with her age. She had a psychiatrist who was also a psychologist and worked with him for a number of years, off and on, but he died tragically of brain cancer and she is still mourning that loss "he promised he would never leave me". She tried to see a couple of other therapists but they did not work out. I feel badly for her. The stigmatism of treating Borderlines is serious. My mom never had a therapist try DBT with her and from what she gathered from a session of that, she did not want to do it.

The worse issue is that she won't take anti-psychotics anymore. And whereas she used to come to again after an episode of dissociating, she now angrily states "this is who I am" and defends her Borderline symptoms as who she is as a person. We used to be able to help her to understand the truth of what was happening when she would misperceive and falsify situations, but she isn't trusting and open anymore. She is unwilling to change. She lives with my stepfather who is a classic enmeshed enabler and within the last two years multiple stressful losses and awful circumstances have fallen upon the family. My sister moved far away after a big blow up with my mother and she was the one who was left in the nest and providing my mom with emotional support as a pseudo-therapist. Then, my grandfather died. And now recently, her dog had to be put down due to biting someone. And so currently she is in a state of dissociated angry depression. She told me she never wanted to talk to me or my "ass child" again (her 10 month old grand-daughter). We have not seen her in about a month.

So, I have not lived at home since I was 17, and now I'm 39, but I moved closer to my parents when I became pregnant and they help me a lot. Well, my stepfather helps me and my mom helps when she is in a good mood, which is rarely ever anymore unfortunately.

I wrestle with the desire to move and disconnect so that I can live a happy life free of the constant emotional burden, yet I also feel like I can't leave my mother. I don't want her to get worse and want to have some closeness while she is still on this earth. But, it's very hard to have a relationship with her. I have learned to have very good boundaries and I keep a great emotional distance from her. She says that I am "cold" and it's because I don't get pulled in to her like I used to. Pulled in and pushed away, repeat. I just don't get close enough to be hurt or yo-yoed. But, I am deeply affected by her depressive moods and her psychosis even when I am not directly witnessing it. It hurts me to see her so sick and suffering. It's horrible. I feel like I am losing my mother and it's almost like dementia because so much of the good has gone and she has morphed into this other person who is not there a lot of the time and who I cannot connect with like I used to be able to.

When all the stress and recent trauma subsides, which is part of why she has been so sick for the last year, I hope that she will be able to find some peace, but I don't know. The threats of suicide are real. It is so scary, but I keep myself numb to it too because I am afraid it could happen. Numb to the possibility I guess - that's a new thing for me recently.

The dynamic is a little difficult for me at the moment. I am the only child who is connected. (i was a scapegoat before my sister moved). My brother has a lot of problems with drugs and finances and has his own family and my mother has issues with him and they also provoke each other and often end up in fights that escalate and ruin a day with the family. My sister is gone. And my oldest brother was scapegoated and cut off a long time ago. He is suffering from Bipolar Disorder with psychotic features and is finally getting stable treatment and doing better. But my mother won't accept him due to her narcissistic tendencies and her fears that he will take advantage of her.

My mother inherited a lot of money when my grandfather died and she uses it to control as much as she can.

So, this leaves me and my stepfather and I don't live there. Recently, she is not talking to me. I am feeling really hurt that she can just push me away and not care. And I'm hurt that she is doing that to my child as well. I'm not sure what the answer is here. On the one hand, I need her support, want to protect her, and want my mother and grandmother in our lives. On the other hand, she only cares about herself and makes my life miserable. I don't know what the answer is to this. It's just hard. Any suggestions for me?

[Naughty Nibbler]

Hey peacenow:   
Welcome to the Community!  Thanks for sharing your story.  I'm so sorry for your situation with your mom.  Sounds like you are the last sibling standing, in the eyes of your BPD mom.  That has to be a tough position to fill.

My mother has BPD and it's getting worse with her age. . . She had a psychiatrist who was also a psychologist and worked with him for a number of years, off and on, but he died. . .She tried to see a couple of other therapists but they did not work out. . .   My mom never had a therapist try DBT with her and from what she gathered from a session of that, she did not want to do it.  The worse issue is that she won't take anti-psychotics anymore. 

  If your mom was taking anti-psychotic meds, I'm thinking she may have more than a BPD diagnosis?  Did she stop the meds, when her psychiatrist passed, or did she continue the meds for a period of time? 

In what ways was your mom better, when she visited her psychiatrist?  Was he a bit of a relief valve for her emotions (an alternative to dumping them on the family)?

I think that many psychiatrists would take patients for general therapy sessions, but most patients would have to pay out of pocket, due to the high cost.  I think insurances will pay for periodic short visits to a psychiatrist for the purpose of evaluating and monitoring for meds, but not for the usual 40-50 minute weekly sessions.  Is your mom relying on insurance (with limitations), or can she pay for psychological services.

I'm thinking, it has to be hard to have a need for ongoing therapy and have your therapist die.  Just wondering if it might be possible to find a therapist that might fit the personality/profile of the prior one. 

The worse issue is that she won't take anti-psychotics anymore. And whereas she used to come to again after an episode of dissociating, she now angrily states "this is who I am" and defends her Borderline symptoms as who she is as a person. We used to be able to help her to understand the truth of what was happening when she would misperceive and falsify situations, but she isn't trusting and open anymore. She is unwilling to change   

Do you think it is the absence of the meds only that has caused her to give up, or the combo of losing her psychiatrist/therapist?  You can't change her, if she has given up.  She has to want to change and get back into the game of life.

My sister moved far away after a big blow up with my mother and she was the one who was left in the nest and providing my mom with emotional support as a pseudo-therapist. Then, my grandfather died. And now recently, her dog had to be put down due to biting someone. And so currently she is in a state of dissociated angry depression. She told me she never wanted to talk to me or my "ass child" again (her 10 month old grand-daughter). We have not seen her in about a month    The dynamic is a little difficult for me at the moment. I am the only child who is connected. (i was a scapegoat before my sister moved)

I'm so sorry about all the loss within the family.  I'm thinking it has be extra difficult for your mom and at least part of the reason she is saying hurtful things to you.  Sometimes, people who fear abandonment will say and do things to drive someone away.

When all the stress and recent trauma subsides, which is part of why she has been so sick for the last year, I hope that she will be able to find some peace, but I don't know. The threats of suicide are real. It is so scary, but I keep myself numb to it too because I am afraid it could happen. Numb to the possibility I guess - that's a new thing for me recently.   

Has your mom ever made a suicide attempt?  Although talk of suicide needs to be taken seriously, and emergency services called, when the situation seems possible, you aren't responsible for her behavior.  Did the meds she used to take help prevent suicide ideation for her?

Suicide hotlines offer counseling to family members of those who struggle with suicide ideation.  You can reach out to someone by text or phone to chat about your situation with your mom.  Sometimes, it can help to just pick up the phone and talk to someone who can identify with your situation.  The links below could be helpful to you.

SAFETY FIRST- CLICK HERE

THE HOTLINE
 

Recently, she is not talking to me. I am feeling really hurt that she can just push me away and not care. And I'm hurt that she is doing that to my child as well. I'm not sure what the answer is here. On the one hand, I need her support, want to protect her, and want my mother and grandmother in our lives. On the other hand, she only cares about herself and makes my life miserable. I don't know what the answer is to this. It's just hard. Any suggestions for me?   

If I understand correctly, you are a single mother?  Even if you have a partner, everyone wants to have a mom that can be there for them, to support them.  You mention that your stepfather has helped you.  Will he still help you, when your mom isn't talking to you?  Do you have anyone else in your life who can help you?

Are you able to get some therapy for yourself?  You have a very difficult situation with your mother.  Sometimes, it can help to have that type of support.  Could it be helpful for your mom to get another pet (if she isn't apt to abuse one)?   Maybe you could talk to your stepfather about that? 

Take care.   

[peacenow]

Thank you so much for your validation and sensitive responses. It has been hard and I really appreciate you expressing an understanding of that. 

If your mom was taking anti-psychotic meds, I'm thinking she may have more than a BPD diagnosis?  Did she stop the meds, when her psychiatrist passed, or did she continue the meds for a period of time? 

______

I believe that my mom is Bipolar with Psychotic features as well as Borderline, but that has never been diagnosed. My older brother is Bipolar with psychotic features and cannot function or think rationally without the anti-psychotic medication. My mother seems to have both diagnoses. She had sexual assault and trauma as a child and has almost all the Borderline symptoms. I don't know when she stopped her meds, but she would often stop them when in depressive (angry, agitated, irrational, dissociated) episodes. Certainly could have happened after the passing of her psychiatrist. She has been off of them and very sick for the last several years. She also has body dysmorphic issues and OCD features and she obsesses about aging and her body and is constantly getting surgery. Many of the anti-psys cause weight gain so she avoids taking them. She was taking an SSRI, but it does not seem to be helping. My stepfather is a physician and recently ran a genetic test to see what meds she would respond best to and SSRIs were not recommended. There was a med called Latuda (spelling?) that was recommended, but it is an anti-psychotic. It does not have weight gain as a side effect but she won't take it and has been insisting that there is nothing wrong with her and she is fine.
______


In what ways was your mom better, when she visited her psychiatrist?  Was he a bit of a relief valve for her emotions (an alternative to dumping them on the family)?

____
Well, her psychiatrist often validated her irrational thinking which helped her to feel better. He also used some interesting techniques involving tapping at accupressure points on the face and she found it to help her to process through emotionally intense situations that she had difficulty letting go of. He did help her to move past things, which is something she really struggles with again now.

____


I think that many psychiatrists would take patients for general therapy sessions, but most patients would have to pay out of pocket, due to the high cost.  I think insurances will pay for periodic short visits to a psychiatrist for the purpose of evaluating and monitoring for meds, but not for the usual 40-50 minute weekly sessions.  Is your mom relying on insurance (with limitations), or can she pay for psychological services.

I'm thinking, it has to be hard to have a need for ongoing therapy and have your therapist die.  Just wondering if it might be possible to find a therapist that might fit the personality/profile of the prior one. 

__
My mom could pay out-of-pocket but we cannot find anyone that can measure up to her previous psychiatrist and therapist. She called one woman who said she would not see someone her age, and that did not go over well due to her issues with aging. Then she saw a younger man who laid out all kinds of rules from the outset (preparing to work with a difficult Borderline) and she didn't like that.

The best guy available charged almost $300 an hour and my stepfather met with him first to discuss background. He didn't think the guy was very compassionate and the doctor did not seem very open to taking on my mother's case. So, after several failures she has given up. 

___

Do you think it is the absence of the meds only that has caused her to give up, or the combo of losing her psychiatrist/therapist?  You can't change her, if she has given up.  She has to want to change and get back into the game of life.

___
I'm sure it's multiple factors:  she is getting older, she lost her family, she lost her therapist, her children (except me) are not in her life really, she is not happy in her marriage (not sure if that's real or because of her issues), and she is not on meds so she has not been able to experience much joy. I don't think she has much that she sees to live for anymore.

__You asked about past suicide attempts:
My mom has made at least 4 suicide attempts. A year ago she pinned a "due not recussitate" note onto her chest and we (sister and I) made my stepfather call the police to have her hospitalized. He did that very unwillingly because in past attempts she has tortured him for years after he has done that. I don't feel she is at risk at this moment, but I do wonder and worry if she will do this and end her life at some point.

___
I am indeed a single mother and receive some support from my stepfather and mother. It has taken some work, but my stepfather now will continue to help me when my mom is dropping all support and love. He used to align with her to keep her healthier and avoid conflict toward him, but he is now able to separate that. I don't think she really knows what is going on but it doesn't matter. I do not have any other support. I have been in therapy for many years and just don't have the time or energy or ability right now because I'm working full-time and taking care of my 10 month old. I will at some point need it, undoubtedly.

Thanks again for your support.

[Naughty Nibbler]

Hi again peacenow:   

My stepfather is a physician and recently ran a genetic test to see what meds she would respond best to and SSRIs were not recommended. There was a med called Latuda (spelling?) that was recommended, but it is an anti-psychotic. It does not have weight gain as a side effect but she won't take it and has been insisting that there is nothing wrong with her and she is fine.   

Some members have been posting on the Parenting Board about the genetic tests.  Sounds like a good tool to try.  Hopefully at some point, your mom will give Latuda a try. 

Well, her psychiatrist often validated her irrational thinking which helped her to feel better. He also used some interesting techniques involving tapping at accupressure points on the face and she found it to help her to process through emotionally intense situations that she had difficulty letting go of. He did help her to move past things, which is something she really struggles with again now.   

  I believe that tapping is called EFT Therapy.  There are various online sources to assist with learning how to practice it.  Just something to consider in case she wants to try it, or maybe it is something your stepfather might assist her with trying.

My mom could pay out-of-pocket but we cannot find anyone that can measure up to her previous psychiatrist and therapist. She called one woman who said she would not see someone her age, and that did not go over well due to her issues with aging. Then she saw a younger man who laid out all kinds of rules from the outset (preparing to work with a difficult Borderline) and she didn't like that.

The best guy available charged almost $300 an hour and my stepfather met with him first to discuss background. He didn't think the guy was very compassionate and the doctor did not seem very open to taking on my mother's case. So, after several failures she has given up.    

The sources below can help you locate a therapist.  With the psychology Today link, you can enter a zip code and then further narrow your search by selecting specialty/issue, type of therapy and other criteria.  There is a choice for personality disorders.  Once you narrow down the selection, you can look through the individual profiles and find the best match.

The 2nd link can lead you to some DBT therapists, but your mom probably wouldn't want DBT, but it could lead to a therapist who is skilled with BPD people.

PSYCHOLOGY TODAY - FIND A THERAPIST

FIND A DBT THERAPIST

I am indeed a single mother and receive some support from my stepfather and mother. It has taken some work, but my stepfather now will continue to help me when my mom is dropping all support and love. He used to align with her to keep her healthier and avoid conflict toward him, but he is now able to separate that. I don't think she really knows what is going on but it doesn't matter. I do not have any other support. I have been in therapy for many years and just don't have the time or energy or ability right now because I'm working full-time and taking care of my 10 month old. I will at some point need it, undoubtedly.   

I'm glad your stepfather is willing to offer you help.  You have your hands full with working full time with a 10-month old.  You must be short on available time, but is it possible to connect with some community resources, mother's group/club or a church for friendship and support?

While you are on a break from interacting with your mom, check out some of the communication skills and lessons on the Website.  There is a "Lessons" thread at the top of the thread list and then there is the large green band at the top of this page with a "Tools" menu.  ":)on't invalidate" and "Boundaries" are good lessons to start with.  If you click on the "Workshops" link, you can browse through 3 pages of workshops.

There isn't a magic fix, but if you have some strategic communication skills and strategy in your toolbox, it can make things easier for you.  Some people like to read the workshop material and come back to their thread and post to check their understanding and practice applying the skills (with either current scenarios or reflecting back on past ones.)

There is a lot of information here, so take it slow, and learn a skill at a time.  It can help to bookmark workshops/articles you want to get back to.

Take care.