How do I deal with wife's passive suicidal ideation?

[Depression = 72% of members]

We took a trip over spring break last week, and it was as much a roller coaster as I expected and feared.  I totally lost all my boundaries and feel totally set back.  She only calmed down when I seemed broken, which really opened my eyes to the emotional abuse that has developed.

It was also great at times and I got glimpses of an older version of her that I loved.  And not just the initial honeymoon phase - I'm talking about when her mental health was an issue but not a devastating one for either of us.

Anyway, I could write a book about the week.  But the thing that was new and so troubling was the talk about suicide.  She has attempted suicide before more than 20 years ago.  And she can fall into hopeless "what's the point" moods.

But this was explicit.  It was also always just on the side of "passive" ideation and never "active."  Though very much on the line.  I tried to set boundaries and that just deepened things. I talked about calling 911 and that was a disaster.  I did not call because we were in a big city far from home, and I couldn't really see how that would play out.  She finally regulated and we were fine getting home.

I'm trying to lean in right now on my end, even as I get healthier boundaries.  And I have done research that when someone is in that kind of crisis, you don't shut them off and call 911 necessarily.  But it's also obviously a horrible black hole of a trap.  How do you deal with uBPD when they are suicidal?  She's clearly also depressed and she does legit have CPTSD too.

I know the answer is just that she needs help, which she won't really get.  There's been so much over the years, I can't tell if this is a final red flag or a kind of extinction burst as we make progress.  Because when she is regulated right now, she is more together and present than ever, which is such a contradiction.

[FirstSteps]

We took a trip over spring break last week, and it was as much a roller coaster as I expected and feared.  I totally lost all my boundaries and feel totally set back.  She only calmed down when I seemed broken, which really opened my eyes to the emotional abuse that has developed.

It was also great at times and I got glimpses of an older version of her that I loved.  And not just the initial honeymoon phase - I'm talking about when her mental health was an issue but not a devastating one for either of us.

Anyway, I could write a book about the week.  But the thing that was new and so troubling was the talk about suicide.  She has attempted suicide before more than 20 years ago.  And she can fall into hopeless "what's the point" moods.

But this was explicit.  It was also always just on the side of "passive" ideation and never "active."  Though very much on the line.  I tried to set boundaries and that just deepened things. I talked about calling 911 and that was a disaster.  I did not call because we were in a big city far from home, and I couldn't really see how that would play out.  She finally regulated and we were fine getting home.

I'm trying to lean in right now on my end, even as I get healthier boundaries.  And I have done research that when someone is in that kind of crisis, you don't shut them off and call 911 necessarily.  But it's also obviously a horrible black hole of a trap.  How do you deal with uBPD when they are suicidal?  She's clearly also depressed and she does legit have CPTSD too.

I know the answer is just that she needs help, which she won't really get.  There's been so much over the years, I can't tell if this is a final red flag or a kind of extinction burst as we make progress.  Because when she is regulated right now, she is more together and present than ever, which is such a contradiction.

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[Cat Familiar]

How awful that you had to deal with this during what should have been a fun, relaxing time.

What do you mean that you “lost” all your boundaries and “feel totally set back”?

It’s very difficult to be a partner of someone who is talking about suicidal ideation. (I experienced that in my first marriage.) Discerning between active and passive is a burden that no partner should ever have to be entrusted with, but here you are.

Definitely call 911 when means are mentioned and there is a possibility that she could actually follow through. What helped me when my ex was threatening suicide was to call a suicide hot line and ask what I could do to be supportive.

I’ll see if I can find more information to help you.

[Cat Familiar]

Not a great help, but here are some articles:
https://www.verywellmind.com/suicidality-in-borderline-personality-disorder-425485

https://www.psychiatrictimes.com/view/managing-suicidality-patients-borderline-personality-disorder

https://www.mibluesperspectives.com/2020/09/17/understanding-the-link-between-borderline-personality-disorder-and-suicide/

https://www.helpguide.org/articles/mental-disorders/helping-someone-with-borderline-personality-disorder.htm

[stolencrumbs]

Sorry you're dealing with this. It is really hard. My ex was/is chronically suicidal, and that was the hardest thing for me to deal with. The second link that Cat provided is, imo, really good and important. https://www.psychiatrictimes.com/view/managing-suicidality-patients-borderline-personality-disorder

I'm not sure if you're wife is in the same camp as mine, but if so, I think it's important to understand the difference between chronic and acute suicidality. A lot of resources out there on suicide are aimed at acute suicidality, which might not be as relevant if you're dealing with someone who is chronically suicidal.

I don't think I always handled it well, but I will say that something that seemed to help was not freaking out about it. As that article says, the suicidality is partly about control, partly about escaping pain, and partly about being heard. To the extent it is about being heard, focusing on the fact that she is suicidal is likely to feel like the opposite of being heard. Over the years, I was able to have a number of good conversations about it and better understand it by just being curious about it and listening to what she was saying--basically ignoring the topline suicidality and focusing on what she was actually saying about how she felt. Again, as the article says, if she is BPD and chronically suicidal, that kind of just "comes with the territory." It sucks, but at least I just had to sort of learn to live with that fact. That was not easy to do because it is completely natural to freak out when a person you care about talks about killing herself. But ultimately, that was the place I think I needed to come to. 

Having said that, I did call 911 a couple of times when she was actively threatening to kill herself and had prepared the means to do it, so I think there are times when that might be appropriate. 

[FirstSteps]

What do you mean that you “lost” all your boundaries and “feel totally set back”?

On this, I kind of made a conscious choice to start apologizing more, not to leave the room when it got to be too much, to cater into her immediate needs more.  It was partially because I was trying to "lean in" on my end, recognizing my own role in some of our marriage dynamics.

And it was partially because we were going on a big trip and I couldn't imagine catastrophic consequences in trip prep or on the trip.  Of course, it all happened anyway ...

Now it's hard to get back to where I was.  I'm realizing that I just need to do it, but I feel like I lost a lot of momentum on my self care and healthy behaviors with her.

[FirstSteps]

Thank you so much both Cat and stolencrumbs.  The articles are a huge help, especially that second one.  I was not familiar with the "chronic" versus "acute" definitions before.  It also helps to go in and read that hospitalization is not an answer, unless truly needed as you say.

It's also good perspective that this is part of the deal.  A really horrible part of the deal.  I definitely have it in me to address the underlying feelings, if I can calm myself that it's not acute (and if the kids are nowhere near).

This gets back to my big picture struggle now.  What can I really live with, now that I'm fully aware of what I'm dealing with?  Do I want to have years or decades of being more or less blamed for her suicidality and then have to coach her through it?

I found out this week that she was diagnosed by psychiatrists with BPD and also bipolar before I met her.  But she dismissed the diagnoses out of hand because she didn't want a lifelong "crazy" diagnosis, rather than the more curable depression and CPTSD that she's focused on.   It makes me really angry, though I'm not surprised.