The BPD diagnosis is more likely C-PTSD...what now?

[Meridius]

Hi everyone,

After posting on the "Bettering and Rebuilding" threads, this is my first post after the wife and and I split and moved three months ago. 

Two weeks ago, an independent psychiatrist questioned her BPD diagnosis first made in 2011.  He thinks it's more C-PTSD.  We met in 2016 when she was in "remission".  Now we've split up after alot of chaos.  But this whole opinion, I must admit, C-PTSD makes more sense to me after reading so much about BPD and C-PTSD. 

Has anyone had a changed diagnosis and did it make a difference in the relationship?

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A bit of history
It's been three months since we've split.  Briefly, she was diagnosed BPD in 2011, did DBT and then met me when her BPD was "in remission".  She didn't exhibit any of the extreme BPD traits so we married in 2017.  It was both our second marriages.  Then a bullying and harassment by her boss triggered off all kinds of craziness and that's when I started posting here.  After two years of her being high on the spectrum with suicide attempts, verbally abusing my kids from my first marriage, drinking, overdoses, dissociation, major panic attacks, false accusations, and really inappropriate trust-destroying behaviour for a partner, I moved out last Feb.  I had been suffering from physical stress anxiety responses (gut punches in my upper abdomen).  Then had to go back due to Covid and tried to keep the peace.  Our attempt to rebuild trust was an absolute disaster.  Then she got really angry about something I said, decided to move out and managed to find herself a place to live in May. I thought it was over.

Detailed history thread is here --> https://bpdfamily.com/message_board/index.php?topic=343460.msg13117022#msg13117022

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What's happening now
So the day she told me she was moving out, I was so relieved.  Then as part of her continuing Worker Compensation insurance, I was support person for an independent psychiatric assessment.  This happened two weeks ago.  It went 3 hours.  The psychiatrist was very professional, but had to ask her to tell what happened.  She disassociated once while recounting the workplace bullying.  The pysch gave his strong opinion that the time context in which she was diagnosed having BPD was not long enough.  And that all the stressful events of 2011 (mother's death, separation from first husband, her cancer) were more traumas in the short term.  The diagnosing professional did not monitor my wife over a long enough time.

So I already have my boundaries up.  I trying to keep my serenity and my peace.  I'll do little things to help her, consciously go grey rock before meeting just in case she gets angry and brings up old things.  I've found a really nice place for myself and my daughters.  And I chose it specifically a not-dog-friendly place so she would not be able to move in with her two dogs. 

I'm happy where I am living now.  I'm trying to help her spiritual community support her better by talking to the community leaders who then talk to the other ladies to provide support.  It FEELS awkward, but I did tell her I could be friends, and am working on boundaries to make that possible.  I am sleeping really, really well now.

Oh...in the background, she moved out with a pre-existing physical health issue that has flared up in a very big way.  She's having major surgery(body part replacement) later next month and as I said I would be a friend, I'm helping a little bit to plan before and after hospital/rehab.  So I talk to her regularly.  Since I don't have to talk every day, it's been okay.   For me, it's easier to help on a purely physical thing, and I get why.

But I still can't shake the psych's comments.  Has anyone had a changed mental health diagnosis and did it make a difference? In the relationship?  How?

What should I be asking or thinking about for my own mental serenity?  For her?  For how the split is going?  I can't file for divorce until October here in this country(min 12 month separation), so part of me is wondering what kind of intelligent questions should I think about?

[Learning_curve74]

Hi Meridius, I'm sorry you're going thru this tough time questioning things. I know it's difficult because a lot of us here, myself included, have gone thru similar experiences.

My ex-gf from a few years ago has had many changing diagnoses: bipolar, bpd, ocd, possible c-ptsd, in addition to her alcoholism. There is a lot of overlap in symptoms, and I wouldn't be surprised that comorbidity of two or more of these conditions are common. I'm not 100% current on what the general consensus is on whether bpd and c-ptsd require different treatment, but treatment is difficult and probably needs to be individually tailored in all cases.

My latest ex-gf probably has c-ptsd and has been in therapy on and off. I'm fairly sure that nothing would've turned out differently whether or not somebody with credentials put an alphabet soup name tag on it though.

What is your goal in understanding this? Is your intent to change how you interact with your wife with respect to having a different diagnosis? It sounds like you're being very kind to her while trying to maintain some detachment, which is very admirable.

[once removed]

cptsd, ptsd, bpd, for that matter, codependency, can look a lot alike in some ways.

i have found that in general, "highly sensitive, easily triggered, person who does not do well with stress" is a simpler description.

the difference with BPD traits is that, specifically, you have a person with a heightened fear of abandonment, possible/likely self image issues, etc, on a pathological spectrum.

to complicate things, you can always have comorbidities.

What should I be asking or thinking about for my own mental serenity?  For her?  For how the split is going?  I can't file for divorce until October here in this country(min 12 month separation), so part of me is wondering what kind of intelligent questions should I think about?

the good news is that the tools work with everyone, and especially the highly sensitive. in general, you want as peaceful a path as possible. the divorce process can trigger the best of anybody.

[Meridius]

Hi Meridius, I'm sorry you're going thru this tough time questioning things. I know it's difficult because a lot of us here, myself included, have gone thru similar experiences.

My ex-gf from a few years ago has had many changing diagnoses: bipolar, bpd, ocd, possible c-ptsd, in addition to her alcoholism. There is a lot of overlap in symptoms, and I wouldn't be surprised that comorbidity of two or more of these conditions are common. I'm not 100% current on what the general consensus is on whether bpd and c-ptsd require different treatment, but treatment is difficult and probably needs to be individually tailored in all cases.

Thanks learning curve.  The diagnosis is a whole bunch of co-morbidities.  The part that makes me angry is that she told me it was BPD that was in remission, and then stopped.  So I figured a relapse.  I spent time in BPD family groups, learned about how to deal with it, but all the time the nagging question for me was "Why?".  Her behaviour didn't see as consistent as other BPDers in the forum.  But after a while, I realised comparing is NOT the answer.  I just got to deal with what's in front of me.  The diagnosis isn't the important thing anymore.  There are traumas that will be teased out slowly and painfully.  And even that is just facts.  Perhaps that's just my way of trying to use intellectual understanding and logic as a cold comfort for the "WTF?" raging inside. 

It's a bit late to be learning this, but at 52, I'm learning how to break up with someone who is treating me badly.  For other relationships, I'd just take it, or break up because the timing of the relationship wasn't good.  But this is the first where I ask "How is she treating me?".  The hospitalisations, suicide attempts, cries for help and general physical problems kept me sucked in for a while.  I couldn't see the hyper-sensitive lashing out at me and my kids for what it was.  I couldn't see the emotional manipulative stories for what it was.  I couldn't see the overdoses, drama about the drama, splitting black, reading of my personal journals, playing one doctor off another, and 3/4 bottles of red wine a day for what it was.  A "feverish selfish little clod of ailments and grievances complaining that the world will not devote itself to making her happy".  (apologies to George Bernard Shaw)

I've read Peter Walker and I sensed there was some childhood trauma and very bad stuff in the background.  She had claimed she'd reconciled with her dad, but after over a year of watching her reactions, it was obvious there was well...stuff missing in the reconciliation.  And trauma was harshly colouring how she reacted to things. 

I've let your answer and my thoughts settle a bit.  And read the next response, and I don't think the diagnosis makes too much of a difference to how I respond. 

My latest ex-gf probably has c-ptsd and has been in therapy on and off. I'm fairly sure that nothing would've turned out differently whether or not somebody with credentials put an alphabet soup name tag on it though.

What is your goal in understanding this? Is your intent to change how you interact with your wife with respect to having a different diagnosis? It sounds like you're being very kind to her while trying to maintain some detachment, which is very admirable.

I need to change how I interact with my wife, but not because of a change in the diagnosis.  I was at an AlAnon meeting tonight and shared my epiphany that if she's complaining about me to me, I don't have to react as if it's about me.  She's just talking.  Oh...gosh...serenity and peace is within grasp if I remember this.

I do have to maintain some skills to keep things calm because she's currently in hospital recovering from a hip replacement surgery (YES...major surgery), and the common church friend who's organising the visits roster asked me if I wanted to be kept in the loop.  The hospitals need to limit visitors with Covid, so she's got a social media group going to avoid double-ups.  She's told me that she's had to deal with my ex'es emotionally manipulative requests and is strong enough to say no.

I'm not sure what's more surreal.  Life with a BPD/CPTSD person.  Or talking with her friends about what it's like to deal with her and giving them tips on how to best help my ex.  And them not surprised we separated.  I've managed to only go to visit her once in hospital.   A welcome change to every day for the other hospital/rehab stays.

[Meridius]

cptsd, ptsd, bpd, for that matter, codependency, can look a lot alike in some ways.

i have found that in general, "highly sensitive, easily triggered, person who does not do well with stress" is a simpler description.

the difference with BPD traits is that, specifically, you have a person with a heightened fear of abandonment, possible/likely self image issues, etc, on a pathological spectrum.

to complicate things, you can always have comorbidities.

Yep...there's levels to this.

the good news is that the tools work with everyone, and especially the highly sensitive. in general, you want as peaceful a path as possible. the divorce process can trigger the best of anybody.

OR, about the tools...what tools are you referring to?  The tools in the web site banner above?    A divorce is triggering for sure.  The best tools to keep as much peace as possible is good idea.

[once removed]

OR, about the tools...what tools are you referring to?  The tools in the web site banner above?    A divorce is triggering for sure.  The best tools to keep as much peace as possible is good idea.

the more you absorb, the better off youll be. there are psychology tools (web site banner above) and then there are "resources", and while i was referring specifically to the communication tools (SET, BIFF, and the like), i should have been clearer to say "resources" because as you say, you are looking to detach, but to keep the peace, so the lessons (many on Detaching, Bettering, and everything on Co-Parenting: https://bpdfamily.com/message_board/index.php?topic=239547.msg1331847#msg1331847) will be invaluable.

this is scratching the surface, but one of my favorites: https://bpdfamily.com/message_board/index.php?topic=164901.0