Hoping for Some Advice on BPD Treatment

[madonnafan]

Hi all,
I'm not sure where to start, hoping for some advice I suppose. We've been married for nearly ten years now, and we have a child. My husband suffers from anxiety and depression, I always knew that. After our daughter was born he began to have what I now understand to be rages against me- he would get unbelievably angry (sometimes over nothing) and I was vilified by him. I was confused, hurt, upset, and angry by these outbursts from a previously very gentle soul. He was always so upset about his behavior after he calmed down... .initially. As time passed, he would just go back to normal and act as if nothing had happened, and if I brought it up too soon it would just bring back the anger.
Two years ago he took voluntary redundancy from his job. His job seemed to cause him so much stress, it seemed like a good opportunity for a fresh start in a less demanding job. Except he hasn't really looked much. And around the same time he was reassessed by his therapist and told he had BPD traits. He took it very badly as you can imagine, and was in a deep depression for many months. He has been offered (in my uninformed opinion) little or no support by the medical team since. He had some therapy (DBT I think) and then it stopped after about 2 months. I asked what his diagnosis was and I was told they don't like to label people. I asked his therapist why he wasn't attending anymore and she said she suggested we attend marriage counseling as the next step. We are doing that, but things are very bad between us at this stage. He barely leaves the house anymore, and has told me he doesn't want to work but he will. However I really can't see how as he can't interact with the outside world very well anymore.
I'm not saying I'm blameless in our difficulties, but from the questions we had to answer in our counseling sessions I can see that I've been subjected to abuse and am at times now afraid of my husband. Our child sees very little of this, I try to avoid anything that could cause conflict while she's around, and he's only been angry in her presence a few times, although she can pick up on his moods I'm sure as she sort of ignores him when he's down. He's a great father when he's well, and as long as it doesn't involve having to go out or require effort from him when he's tired (he's on meds and he doesn't sleep well quite often).
At this stage I'm so stressed and worried about the future that my own health is beginning to suffer. Financially we can't continue like this, I do love my husband but my thoughts are turning towards what life would be like without him. I'm afraid as my daughter gets older it will begin to affect her. I rang his medical team today but didn't get far, they seem to prefer me not to get involved yet they're quite happy to leave me to look after him (I said this and got a very hostile response, but it's how I feel). I'm not sure what help or treatment he should be getting, whether it's been offered and he's refusing to engage, or what I should be doing to support him. Being an emotional punch bag (always verbal, he's never been violent) hasn't helped, and I feel more like a carer than a wife recently which is destroying our marriage.
I feel very alone, I don't think anyone has seen his BPD outbursts bar me, and I doubt I'd be believed. I went to see a therapist myself and he urged me to think very carefully about leaving, however I feel that's a last resort, I'd really like to be able to work this out. Sorry about the long post, but thank you if you read, and any advice greatly appreciated.

[RELATIONSHIP PROBLEM SOLVING]

RELATIONSHIP PROBLEM SOLVING This is a high level discussion board for solving ongoing, day-to-day relationship conflicts. Members are welcomed to express frustration but must seek constructive solutions to problems. This is not a place for relationship "stay" or "leave" discussions. Please read the specific guidelines for this group.

[Mutt]

Hi madonnafan,

 

I’m sorry that you’re going through this. It has to be difficult for you if you’re not getting support from your H or from his medical team. You mentioned that he takes meds is he treating his anxiety and depression? How old is your D?

[Radcliff]

Hi madonnafan,

DBT treatment is really the standard of care for BPD.  It is a good thing that it is available and your husband was willing to go.  Treatment typically lasts at least a year.  Do you have a clear picture on why your husband stopped?  Did he quit, or did the mental health professionals stop it?  Recommending marriage counseling and no 1:1 therapy for someone diagnosed with BPD traits is fishy.  Many mental health professionals are not adequately familiar with BPD.  One imagines the folks giving the DBT therapy would be.  Is the therapist who recommended marriage counseling part of that team or perhaps a less experienced person disconnected from that team?

It sounds like you are in the frustrating position of not having your perspective accepted by the mental health team.  A calm, solutions-oriented approach may eventually be effective with them.  The surer you are of yourself, the easier it is to be calm.  One thing that can help is journaling.  Write down what happens when there is difficult behavior.  Capture a fair bit of detail.  Hurtful or off the wall quotes can be very helpful to illustrate to an outsider what's going on.  Obviously do not let your husband know you are doing this.  Have you read "Stop Walking on Eggshells?"  The book has a description of the 9 diagnostic criteria for BPD (possessing 5 is considered full BPD, and less than 5 is "BPD traits."  It also has a list of other traits that people with BPD often have.  While you are not a mental health professional, you have much more information than they do about your husband's behaviors.  Obviously, if you go in declaring that you've diagnosed him with BPD, they may react poorly, but if you can find someone who understands BPD and use your examples from real life that you happen to know fit into the behavioral categories, and if you have a specific request -- DBT therapy please -- you may make some headway.  A huge qualifier is that since you aren't him, their ability to discuss his treatment with you is quite limited (unless you get him to sign a release). 

Did he like DBT therapy?  What did he say about it?

Finally, you said that sometimes you don't feel safe about your husband, though not physically unsafe.  Can you give a little more detail on that?

WW

[madonnafan]

Hi Mutt and Wentworth, thank you for your replies.

My husband is on antidepressants and also Epilim (sodium validate) which was described to us as a mood stabilizer but is primarily used to treat epilepsy.

He found the DBT difficult and I'm not sure if he stopped going himself or if it petered out- the therapist just suggested marriage counseling as the next step, and she was the person doing the DBT with him. She is highly qualified so I presume has reasons for what she suggested, even though all I got was that it was what she suggested next, with no explanation as to why DBT had stopped. As I wasn't sure how long treatment should go on for I didn't question her further.

Our daughter is six, and blissfully unaware of any of this, which I know will change. He's a fantastic father, she adores him, and when he's not well enough to spend time with her it's tough.

I'm afraid of his moods and his temper- he lies so convincingly that at times I've felt I'm going insane, he'll convince me I've said things I haven't or done things I haven't. He says he trusts me but can go crazy if I want to meet male friends (one in particular, he all of a sudden took an intense dislike to and at one stage asked me to never meet him again, this is now downgraded to me never mentioning his name or anything about him), and can get angry if I'm meeting female friends too if he's in that frame of mind- it has definitely affected some of my friendships, I meet people he disapproves of less often to keep the peace. Having said that if he has no issue with someone it's fine- that's the problem, the goalposts keep moving and what is fine one day can be a major issue the next.

Your advice on a journal is something I will definitely do, it will be a good way to track his moods. And I will adopt a better approach to communicate with his medical team, if I get him to explicitly state he consents to me asking for help and information that might clarify things. I've been emotional in my recent conversations with them as I'm so stressed and frustrated, but I know that is not helpful to either side. Knowing he should have more DBT is a good starting point for asking questions.

At the end of the day if they are actually offering the help and it is a case that he's refusing it, ongoing to have very difficult times ahead. I'm in the FOG but want to find a way out, help my husband, and revive what was once a very happy marriage.

[Radcliff]

madonnafan,

I can see reasons for optimism and reasons for caution in the situation you've described.  Good things are that you have access to care for him, he's a wonderful father when he's well, and you're being very thoughtful in your approach.

You mentioned that you feel alone.  When a pwBPD is high functioning, and we are almost the only target of his or her difficult behaviors, it can be terribly isolating.  That is where being a regular member of this community can help.  Get involved.  Post on other's threads.  You'll get to know other members here who will back you up and assure you that you are not going crazy!

The journal is also an important protection against gaslighting (someone making you feel like you're going crazy) and a way to track things over time to see if they are deteriorating.  When we are busy with the daily struggle to make things better, we tend to minimize and forget what's happening.

Speaking of isolation, your husband's jealousy around interactions with your friends is a red flag.  This sensitivity is not uncommon for pwBPD, but if things deteriorate, for example if his condition worsens or you are not able to maintain boundaries, the situation could become abusive, as isolation is also a hallmark of abusive relationships.

OK, enough of the cautionary stuff!  Keep those things in mind, but there is plenty of good work to do to improve things.

Learning the coping tools taught here is super important to helping things go as well as possible in a committed relationship, and also important to help protect you.  Have you had a chance to read about any of the tools linked from the "Tools" menu at the top of this page?  "Setting Boundaries" is a good one to start with.

WW

[madonnafan]

Thanks Wentworth, I'm going into things on the site now and trying to educate myself more. Behaviours that confused me are now beginning to fit in with what I'm reading on here, and it is good to be able to find out more about how to deal with difficult situations and issues. I have a lot of homework to do

[Radcliff]

Thanks Wentworth, I'm going into things on the site now and trying to educate myself more. Behaviours that confused me are now beginning to fit in with what I'm reading on here, and it is good to be able to find out more about how to deal with difficult situations and issues. I have a lot of homework to do

madonnafan,

In addition to "Stop Walking on Eggshells," "The Essential Family Guide to Borderline Personality Disorder" is also excellent.  It covers many of the tools we teach here.

What are some confusing behaviors of his that have started to fit in with what you're reading?  What has been the most useful tip for dealing with difficult situations that you've picked up so far?

WW