Big positive change with Prozac

[GettingMarried]

Post-marriage post-prozac update:

Before the wedding we were on the brink of calling the whole thing off. Meltdowns were happening every couple of days and were completely out of control. She was angry, abusive, and did not comprehend that her behavior was pushing me to the edge. At the time I was trying to carefully document what would lead to a meltdown in order to avoid those things but the bottom line was that it was not working. In a moment when she was calm and non-combative, she brought up having formerly been on Prozac (this had come up a few times, with her saying at one point "you'd probably like me better on meds). I still don't know why she went off the meds (around the time we started dating) but she claimed to have gotten a refill and couldn't find it after we moved. She says it was prescribed for "Body Focused Repetitive Behaviors and OCD" both of which are very evident. 

I casually offered to find it, knowing full well that if I pressed the matter it could lead to a melt down and she said okay. The next day I frantically went through EVERYTHING trying to find it. Even though for her it didn't seem urgent, for me this was a hail mary pass. I the bottle, immediately went out and bought a daily pill organizer and gave it to her when she got home. Phew!

I was already documenting melt-downs and even went so far as to buy an audio recorder to try and capture her transformation from Dr. Jeckll to Mrs. Hyde. It took a couple of weeks to see a difference but the change is pronounced. She's had one minor meltdown (which she apologized for!) in the last month and even though the signs that would have led to a meltdown are still there, it doesn't escalate into conflict. Although some of the traits I'd associate with BPD are still there (narcissism, excessive concern with what others think of her, perception of slights when there were none) the violence is largely gone since the meds kicked in.

Interestingly, the story she tells herself is that she's on the lowest clinical dose (typically 10mg) but I've looked at the scrip and her dose is pretty significant (40mg daily). I was scared to death she'd quit when the headaches and nausea started from the initial dose but those lasted about a week and have passed.

Obviously, your milage may vary and I'm not a doctor. What I can say is that this likely saved our relationship.

Thanks for the support getting to this point!

[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.

[Harri]

Hi Getting married! 

I am glad you are seeing some benefits with the medication. 

Do you  think any other changes have helped too?

[Radcliff]

That's great news!  I can definitely believe that an anti-depressant might be a bit help.  Marriage is a long haul.  Even without BPD in the mix, you'd want every advantage you could get.  The big temptation after such a drastic improvement in things is to rest and enjoy life.  That's natural, but we then get caught flat-footed when things swing south.

How are you doing with the basic tools taught here, such as validation, avoiding JADE, boundaries, etc.?

[GettingMarried]

Aaaand, we have relapse... .

I noticed a whole host of behaviors coming back into play. She was on a break from work and just went back which made me think that stressed her out which resulted in the behaviors. After getting kicked hard by her in bed last night (she thrashes constantly and has just started lashing out in her sleep) I checked her meds today... .low and behold, the pill dispenser was empty despite it being the middle of the week, meaning she hasn't been taking them.

When I texted with her this morning, I forgot that I was no longer communicating with a rational person (off her meds) and texted her about the uptick in behaviors (severe body focused repetitive behaviors) and she said told me to "back off" which is not something she'd have said two weeks ago. As you said, I'd let my guard down and now I need to go back to old strategies - which honestly gets exhausting. Going to set a clear boundary about a) taking meds and b) sleeping soundly because I won't spend the rest of my life sleepless and living like this.

She really was great for about two weeks - best she'd been since moving in together. I'm hoping it isn't back to square one. Anyone have good strategies for keeping BPDs on their meds? I don't think she even remotely understands that if she goes back to her old ways, divorce is definitely one possible outcome.

[Radcliff]

The reason to work with us on learning the tools in the quiet times is so that you can exercise them when the stakes are lower, and you've got them ready when the fit hits the shan.  Boundaries is a good example.  Take a look at this page on setting boundaries.  Boundaries are what we do to protect ourselves and live our values, by defining our own behavior.  They are not about controlling others' behavior.  In fact, in doing that, we violate their boundaries.  So mastering boundaries means protecting ours and respecting others'.

You offered two great examples.  The first was her thrashing in bed so you can't sleep.  You getting up and sleeping somewhere else is a perfect example of a reasonable boundary for you.  You are protecting yourself against something, and your action (controlling your own behavior) directly addresses the problem without relying on someone else to do something different.  Boundaries that rely only on our behavior are ones we can implement on our own.  They are much more successful with much less conflict than trying to control someone else.

Which gets us to the second example -- you said you were going to set a boundary around her taking her meds.  Getting her to take her meds is not a boundary.  It's a reasonable hope, but it's under her control, not yours.  You can support and encourage her, but not force her.  Any attempt to apply pressure to her is going to be counterproductive.  Even if you don't say it, if you're thinking "no meds means divorce is likely" she may well pick up on this pressure.  Can you think of ways that you can encourage her that wouldn't feel controlling to her?

RC

[GettingMarried]

Thanks for the feedback on boundaries; that makes sense. I guess the more accurate boundary is that I don't want to have to hide in my own home or dread going home after a long day of work. Honestly, she's traveling for the weekend and I couldn't be happier that she'll be gone (and I don't think one should feel that way about a spouse).

One of the things that is so frustrating and is that she is an entirely different person and thus reacts entirely differently to everything. For example, when I initially helped her find her meds in storage (at her request), I put them into a pill organizer and she was appreciative of that. Last night, she noticed that I'd refilled the pill organizer and got mad about it. I didn't say anything at all about her taking them. It is like being married to two people, one of whom I'd be unlikely to befriend, let alone marry.

I guess one of the things that I'm realizing is that I don't care about the why anymore. Is it BPD or her traumatic brain injury or childhood trauma or anxiety? I don't care. I just know that the result is awful to live with. Would things be better if she stayed on her meds or went to therapy or wasn't stressed by external factors? I don't care anymore. I just want it to be better or to be done.

It is hard to imagine initiating a divorce a month after getting married but if things go back to where they were a couple of months ago, I don't think I have the fortitude that others on this list seem to have with regards to sticking it out. I'm stuck financially (bought a house together - foolishly - and would likely go broke selling it so soon) and can't help but feel that this relapse means I've made a terrible series of mistakes.

[Radcliff]

can't help but feel that this relapse means I've made a terrible series of mistakes.

You've got time.  It's a short marriage.  You don't have kids together.  You are learning a lot right now.  Give it some time to learn more, digest what you're learning, and apply it.

Regarding the meds, I think you would find it valuable to look at this page on how to get a borderline into therapy.  There's a video at the end by a clinical researcher who figured out how best to approach the challenge of getting someone to get past unawareness of a mental illness and into therapy.  I know that right now, you're focused on getting her to take her meds, not talking her into therapy, but I think the principles he discusses apply just the same.  The video is long -- an hour and forty minutes -- and the example he uses is about schizophrenia, but I was patient and watched the whole thing, and am glad I did.  He drops a nugget 37 minutes in, and finally gets down to business at about 1:19.  In the video, he says that one of two things needs to happen to make it likely for someone to stay in treatment:  1. Awareness that they have a mental illness (usually not going to happen), or 2. A relationship with someone who listens without judgement and thinks they'll benefit from treatment. 

You said it's uncomfortable to be around her when she is being nasty.  Do you have friends or activities that can get you out of the house for a bit, or is all of your time spent with her when she is in town?

RC