Thank you Naughty Nibbler for your detailed follow-up, and Herodias for sharing your experiences. I've answered the questions below ... .
I'm sorry about the problems you are having with your wife. You indicate that she was under additional stress and then got a prescription for Xanax. What was the nature of the stress?
My wife hadn't really had a job for 14 years and was a stay-at-home mom. She found this role overwhelming and still needed a lot of support from me as well as paid cleaners, gardeners, nannies, etc because it was all too much. I initially questioned this, and work colleagues used to comment on how many times she’d call me in a day, but in the face of angry responses I ended up normalizing it all and busting a gut to try and keep her happy. For the last 8 years she was doing some qualifications after which she intended to go back to work, and she was in the final stages of the course and trying to get her business up and running when this all kicked off. Given how overwhelming everyday life has been for her, I believe that beginning the transition probably caused her a lot of stress.
It's a familiar story to hear that a person with BPD, who had been fairly manageable, evolves into a period of time with rather extreme BPD traits. One possibility is that the behavior, without the Xanax, could be similar. One way to test that is take the Xanax away, and see if the behavior is the same.
Like so many pwBPD, I guess, she doesn't accept that there's anything wrong. Around the time this latest episode kicked off, a possible source of work she was exploring required her to undertake a detailed psychometric test and it showed that she was 99th centile for impulsivity, 2nd centile for dutiful and with tendencies to initially be very passionate about people, then quickly gets disappointed with them, followed by feelings of rejection. She dismissed the results saying she didn’t feel they were accurate, but they made me sit up because they perfectly captured her behavior. Interestingly, after the test the company concerned went quiet on her after initially saying they were very excited to work together, so I imagine their professional analysis of it might have made some connections to the illness.
I tried to figure out what might have changed in the months leading up to the test and behavior changes, and the only thing I could think of was that she had started taking Xanax. So I looked up possible connections between Xanax and impulsivity and found a number of people in discussion forums saying they had become more impulsive on Xanax. So I assumed it might be that simple. Then I discovered BPD and assumed perhaps the Xanax was a red herring until I came across the research that suggested heightened dyscontrol issues in women with BPD taking Xanax.
I told her I was concerned that she had changed around the time she started taking the Xanax and asked her to try something different for her sleep, but she says all the other options give her headaches so there's no alternative. I realize that the answer may not be as simple as the Xanax, but there’s a part of me that wonders if there was any way to get her off it, just possibly she might return to her more moderate BPD state and avoid ripping apart our family.
In what ways did her behavior change?
She told our family doctor she would lie in bed wide awake with a physical feeling like she'd been kicked in the stomach and feeling completely empty inside. He told her this was a sign that something was wrong in her life and she should look deep inside to try to figure out what it was. After a period of reflection, she realized the problem was that she felt unlovable because I have shown more love to our children and pets than to her. Not true, but there you go. She announced out of nowhere that she had wanted to leave me from 2 hours after our wedding 20+ years ago and that because she’s a Christian she has been looking for someone to give her permission to leave ever since. She said she had now found a power within herself to leave that she didn't know existed, and it was over.
Immediately, she started saying and doing weird things … things I’d seen glimpses of in the past but had long since normalized. She hit me … hard. She started swearing a lot and drinking alcohol more frequently (almost always losing her temper when she did and on one occasion causing my youngest daughter to hide under the coffee table from her rage). She started talking about the kind of sex she wanted with some hypothetical future partner and was surprised when I found this hurtful. She started to make things up and twist things into an alternative version of reality, as well as saying other very memorable and hurtful things that she would then completely deny saying. There are loads of examples of what I now know to be paranoid ideation and dissociation, but here are a few examples.
She called me in a panic one evening about whether she could take a particular size of sun cream in her hand luggage on a flight to join me and my children for the last days of what was meant to be a family vacation that she had largely pulled out of to spend time with friends instead. After a few failed attempts to find an answer on my phone browser, I told her I couldn’t easily find it and it would be easier if I had a bigger screen for the searches. She hung up on me and later told me it was because I was blowing her off. The irony was I was letting a hot dinner get cold in a restaurant while trying to find the answer for her. She then sent me a series of texts with photos of the sun cream she wanted and told me she wanted me to go and find it in a pharmacy that night so she didn’t have any delays when she arrived in the morning. Like a fool, I did, and I realize now that I have been the proverbial sponge.
On another occasion, I texted her that I was running late with my daughter because I had to stop for food and gas, and she made up a whole scenario in her head about me taking my daughter to a restaurant without her for a celebratory meal of some kind. In response to my text about stopping for gas and food I got a reply about how awful I was and how she would never do this to me. I had no idea what she was talking about, but I soon learned that she was sobbing and making accusations about me to my eldest child who was at home with her. She’d already had some food that evening because she asked me to reheat some leftovers for her before going out which I had done, but by the time I got home she was driving out of the house to go to a restaurant for another meal because she felt so hurt and angry. I held up my one small bag containing a single piece of meat to cook at home and told there had obviously been a misunderstanding.
Several times in the early stages of this recent episode she called me an “abuser”. I have always treated her well, never laid a finger on her, and certainly not emotionally abused her either. After the third time I asked her to explain why she would use such a strong and unfair word, and the best she could come up with was that she had asked me to show her more affection and make her feel more loved several times in our marriage – each time I said I was sorry she was feeling that way and I would try harder, but she still felt unloved by me so I hadn’t changed like I said I would. She said abusers say they’ll change and then don’t, so … I am an abuser! The icing on the cake was when we were then in marriage therapy a couple of weeks later and she insisted that those conversations had never happened.
You say your wife has had years of therapy. What was the reason she went to therapy, or what was the goal? Is the psychiatric professional you refer to, that mentioned BPD, someone who interviewed/evaluated your wife personally?
Good question. I always assumed she was going to therapy for personal growth, but she tells me now that the regular therapy she's been having for 20+ years was all about how unhappy she was in our marriage. We went to marriage counseling half a dozen times but it always ended prematurely because she feels that every marriage therapist we've ever seen buys into my story (her words), by which she means they actually ask her to consider that maybe she's misinterpreted some of my intentions. I literally can't do anything right for her. Recently, in light of the impending break-up, I started doing my own laundry. She got mad at me when she found I was using the dryer for certain items because apparently years ago I made a comment about the dryer shrinking something and she's been hanging much of my laundry to dry ever since. She made it clear how much time I have wasted of hers over the years because I'm now putting them in the dryer. The fact is, I'm the only bread winner and I don't have time to be hanging everything up, not to mention that after losing some weight from the stress of all this some shrinkage is now necessary!
To answer your other question, the psychiatric professional was someone I sought out to try and get an explanation for the behaviors which were getting increasingly worrying. I gave her many more examples than I can share here and she said she'd heard enough to be confident that my wife is “very sick and has BPD as a minimum.” I believe that some of her therapists have probably identified the issue in the past, but it seems that she leaves them when things get too close to the source of the pain. She has been seeing three therapists concurrently for the last four months, and from what I could pick up it seemed like one in particular was making progress and having her read stuff on identity and sense of self etc. Then last week my wife told me that partiocular therapist was no longer helpful so she's going to find a replacement. Not reduce to two therapists, mind you, but find an alternative to the third.
What dosage of Xanax is she currently taking and how often? You mention "mid-life issues". How old is your wife? After a certain age, hormones levels can fluctuate and even women without a history of mental health issues can have a problem with a significant bout of depression and/or anxiety.
She’s a petite woman (c100lbs) in her mid forties. She was taking around 1.25-1.50mg per night, which doesn’t sound like a lot compared to some, but this is a woman who used to get knocked out for the night by 2.5mg of Temazepam (she would literally break a 10mg pill into quarters). I think the family doctor did check some hormone levels not long ago, although I guess there are multiple different tests that could be done and these may have been for something irrelevant. I found out after we got married that she had some history with mental health issues - an eating disorder at university, she talked of feeling suicidal weeks after our wedding and indicated that this wasn't the first time. So if hormone changes in women without mental health issues can be profound (I guess that's the classic mid-life crisis), all the more so I suppose in someone with BPD and some of these other issues.
In reality, I suppose I'm trying to identify the root cause so I can try to eliminate it, when in fact her current condition could be the result of any combination of the Xanax, stress from trying to reenter the workplace, mid-life hormone changes, the BPD just getting worse over time, an episode of severe splitting, or perhaps something else entirely. A friend whose brother has schizophrenia told me that the way my wife talked about feeling powerful sounded a lot like her brother, and it was interesting to me that the psychiatrist said BPD "as a minimum". But I'm not a professional and it's all too easy to get carried away diagnosing when clearly a psychiatric evaluation would be best. I just don't see that happening because she thinks her deep pain and sense of unlovableness have been caused by me - I realize now that I'm just the lightning rod.
A psychiatrist is the best source to evaluate a patient for meds for mental health issues (particularly complex ones). Getting psychiatric meds from a primary care doctor can work out fine for situations that aren't complex. One problem is that the primary care doctor can't get enough truthful information from a patient, during a short visit. Commonly, patients don't share the entire scope of what's going on.
I agree. I shared some of what's been going on with the family doctor but he downplayed it as classic acting out of childhood issues that will likely blow over after divorce. I have been wondering about telling him the whole story, but I was unsettled by the fact that she recently told me that in response to her telling him I made her feel untouchable and lovable, he told her I should be chasing her around the house. Enough said. It seems that her condition is way beyond his area of expertise, unfortunately. I asked the psychiatrist whether there might be any point in trying to have some sort of an intervention with folks from the family or church, but she said it would almost certainly not be helpful to someone who has had counseling/therapy for 20+ years and is still not able to admit to the problem.
If you wife has used Xanax regularly enough to have some level of addiction, one option could be to get a prescription for a suitable antidepressant. After titrating onto an antidepressant, and gaining some benefit, perhaps you could titration to get off the Xanax.
I agree and think this would be ideal, but without her being able to acknowledge the problem, I feel powerless.
Is she working on sleep hygiene issues? getting some exercise, cutting off use of electronic devices earlier in the evening (cell phones, tablets, electronic books), relaxation techniques, trying some melatonin, etc.
Generally speaking, I believe so, although I moved into the spare room several months ago at her request to give her the space she said she needed to consider our future, so I’m not sure what her current routine is. She’s messed around with melatonin for many years, but this is the first time she’s taking anything more heavyweight.
Sorry for the long reply – it’s hard to capture the essence of it all without writing a ton. I find that writing down also helps me to process. Reading other posts, it seems that if she feels she has a safety net (I guess another man, or perhaps even just friends/family) she may actually leave. Equally, I think her current behaviors are partly driven by the fact that I’ve jumped through hoops backwards for her for 20+ years and she doesn’t believe I would ever leave her. I just read “Eggshells” and learned that I should start mirroring and stop sponging, but that it’s going to get even worse for a while when I do. No-wins everywhere you look!
