Considering separation after 3 yrs of marriage bcoz of wife's BPD

[Downtown]

Stormie, thanks so much for returning to give us an update. I was wondering how you two are doing. I'm glad to hear you spoke with a psychiatrist for a second (or third) opinion.

 

The psychiatrist has described my W's condition as Psychosis, rather than Bipolar or BPD. She noted that with the right medicine taken in the right quantities at the right time, this disorder would not be a big issue in our lives.

Stormie, I hope the psychiatrist is right. Perhaps so. Psychosis, however, is not what you've been describing here. For the most part, you've been describing a distorted perception of other peoples' intentions and motivations. We all experience these distortions every time we have very intense feelings, which causes our judgment to fly out the window. Because bipolar and BPD sufferers lack control over their emotions, they experience these distortions (of other people) more frequently and more intensely.

 

In contrast, psychosis goes far beyond that. It not only produces a distorted view of other peoples' intentions but also a distorted perception of physical reality. Hence, unlike bipolar and BPD, psychosis constitutes a break from physical reality. Examples would be the belief that the TV news announcer is speaking to you personally -- or that you are seeing someone in the room who is not really there. Granted, you do report that your W said "someone outside is watching her." But that is paranoia, not psychosis. The latter would occur if she had claimed to actually see someone standing outside the window who was not really there.

 

Moreover, psychosis is a diagnosis of exclusion. This means that a new-onset episode of psychosis cannot be considered a symptom of a psychiatric disorder until other relevant causes of psychosis are properly ruled out. For this reason, biological tests typically are performed to exclude psychosis associated with or caused by substance use, medication, toxins, or other medical illnesses.

 

Even when psychosis is a symptom of psychiatric disorder, it is insufficient to identify this one symptom. What you want to know is what disorder (i.e., what pattern of behavioral symptoms) it is a part of. My bipolar-1 foster son, for example, has suffered more than a dozen psychotic episodes, each of which lasted for more than two months. His fundamental diagnosis, however, is not "psychosis" but, rather, "bipolar-1." Whenever he would get into the manic state of bipolar-1, he would slip into psychosis within a few days. Because psychosis is produced by bipolar-1 and many other disorders, a person's diagnosis is not simply "psychosis" unless those many potential causes can be ruled out.

[Stormie32]

Hi Downtown!

 

Thanks for your analysis & feedback yet again

 

Yes I too was surprised about the diagnosis labelling it as Psychosis.

 

I guess the logical next steps still remain to find out from more sources on the identity of this disorder. As mentioned earlier, will again speak to her current doctor. No harm in taking more opinions from other sources as well - I will try to setup a session with another psychologist/psychiatrist.

 

Meanwhile, the current medication continues for my W. She has gotten a bit better in the last week...at times came close to complete normalcy...but still I would not state her as being completely cured yet...

[Sweetfish]

Hmmm. Sorry I really don't want to make this a battle of the what personality disorder this person has... but maybe its in your best interest to take her to see a psychologist.

 

Everything your posting is NOT what BPD looks like at all. Also, CLUSTER B traits are usually not diagnosed with prescription medication and its most often done using CBT.

 

What it does look like is schizophrenia, division of schizophrenia or a cluster A disorder and these disorder are usually prescribed medication.

 

These are how the different clusters are broken down.

 

 

• Cluster A (Odd, bizarre, eccentric)
  
• Cluster B (Dramatic, erratic)
  
• Cluster C (Anxious, fearful)
  

She clearly fits into Cluster A type traits

 

 

Cluster A: Paranoid, Schizoid, and Schizotypal Personality Disorders.

Cluster A is called the odd, eccentric cluster. It includes Paranoid Personality Disorder, Schizoid Personality Disorder, and Schizotypal Personality Disorders. The common features of the personality disorders in this cluster are social awkwardness and social withdrawal. These disorders are dominated by distorted thinking.

 

 

 

 

Hopefully its just a psychotic disorders and not a resultant of a bigger disorder like schizophrenia as it may get worse!

 

• Hearing or seeing something that isn’t there
  
• A constant feeling of being watched
  
• Disorganized or bizarre speech or writing
  
• Inappropriate or unusual behavior
  
• Strange body movements or positioning
  
• Feeling indifferent or numb about important situations
  
• Deterioration of academic or work performance
  
• A change in personal hygiene and appearance
  
• A change in personality
  
• Increasing withdrawal from social situations
  
• Irrational, angry or fearful response to loved ones
  
• Inability to sleep or concentrate
  
• Extreme preoccupation or fears that seem bizarre
  

 

These all match up to what your wife is going thru... It may get worse, it may get better. It all depends. Im sorry this happen to you.. I would have no idea how I would personally handle your current situation

[Stormie32]

Thanks for your feedback, Sweetfish!

 

Your PoV is interesting as well....I guess its just a matter of meeting more psychiatrists & psychologists to get a better idea of this disorder.

[anika99]

I agree that you should rely on professionals in real life, not on annonymous people online who have never even met your wife.

 

I will say, having spent years with someone with borderline personality disorder, that the behaviours you describe don't sound like BPD to me either.

[Sweetfish]

I agree that you should rely on professionals in real life, not on annonymous people online who have never even met your wife.

 

I will say, having spent years with someone with borderline personality disorder, that the behaviours you describe don't sound like BPD to me either.

 

 

Interesting you said that as the first professional misdiagnosed the issue the first time and put her on meds.

 

We are simply giving our advice and perspective. just as many give life changing and legal advice from everyone else here. As a community we are helping someone else who seeks help. Hopefully, the right doctor will guide them in the right direction!

 

imagine if he didn't ask strangers for help and continue to believe she has BPD or that the parents are lying. She would continue to take the wrong meds. Your lack of knowledge in something does not mean others lack knowledge. that is what a community is for.

Edited April 17, 2017 by Sweetfish

[Downtown]

I agree that you should rely on professionals in real life, not on anonymous people online who have never even met your wife.

Certainly that is true, Anika, if you're talking about diagnosis and treatment -- which are the province of professionals. Sweetfish and I, however, have been discussing behavioral symptoms -- which is the province of laymen. After being married for three years, Stormie likely knows more about his W's behavioral symptoms than anyone on the planet. It may take a psychologist three years of weekly visits before he sees symptoms that Stormie sees all week long.

 

This is why Sweetfish and I have been encouraging him to not only see a psychologist but also to protect himself by learning how to spot the behavioral symptoms for bipolar and BPD. It is easy to do because there is nothing subtle about temper tantrums, depression, mania, verbal abuse, and wild mood swings.

 

This is why hundreds of mental health centers have posted lists of these behavioral symptoms on their public websites -- in an effort to educate the lay public about what warning signs to look for. And this is why, when Stormie goes to a psychologist, the first thing that professional will ask is "What behaviors have you been seeing?"

 

Likewise, when Stormie goes to a medical doctor, he does not go there to be told what symptoms he has, how strong they are, or how long they have lasted. That is information that a doctor relies on a patient to tell him. Indeed, when a patient cannot identify the symptoms, the disease or disorder is said to be "asymptomatic," -- i.e., without symptoms. Hence, by definition, symptoms are things that laymen can spot on their own.

[Stormie32]

Hi there!

 

Have been able to have sessions with yet another psychologist and her current doctor too:

 

As Downtown suggested, I found out an experienced psychologist in the area where I stay and went there anonymously, and subsequently explained the background of this case and the list of abnormal behaviours. The psychologist stated that it would be unethical to provide a diagnosis before seeing the patient, and that if proper medication is taken at the right time the disorder should not be an issue.

 

Meanwhile, went to my W's current doctor for her monthly VitaminB12 injection. The doctor stated it would take around 3 more months for her to be completely cured, and reinstated that the disorder was indeed BPD. My W has been relatively stable so far this month, but not completely back to normal yet - she does display mood swings & abnormal behaviour from time-to-time.

[Downtown]

I found out an experienced psychologist in the area where I stay and went there anonymously, and subsequently explained the background of this case and the list of abnormal behaviours. The psychologist stated that it would be unethical to provide a diagnosis before seeing the patient, and that if proper medication is taken at the right time the disorder should not be an issue.

No, if your W has a personality disorder, taking all the medication in the world won't make a dent in that disorder. Hence, until he knows for certain that her illness is a "clinical" (non-PD) mental disorder, he has no way of knowing that meds will be successful.

 

As to him providing a diagnosis without seeing the patient, he is correct that it would be unethical. But that was NOT what you were asking him to do. Rather, you were asking what the warning signs you've observed are symptoms for. That was a simple request and, for the $150 to $200 you likely paid him, he should have done that much.

 

Without seeing a patient, anybody who can read can tell you whether a set of behavioral symptoms is on the list of warning signs for any of the 157 mental disorders listed in the American diagnostic manual (DSM-5). To be clear, it is a statement of fact -- not a diagnosis -- as to whether the behaviors you see are on a list of symptoms or not. Moreover, the notion that it is "unethical" to tell you which list they are on is absurd. Hundreds of mental health centers post those list of symptoms for mental disorders on their public websites. They are trying to educate the lay public on the warning signs (symptoms) so folks will be able to spot them.

 

Likewise, he can tell you that shortness of breath, upper-body discomfort, and chest pain are warning signs for a heart attack. And he can tell you that speech difficulty, one side of the face drooping, and arm weakness are warning symptoms for stroke. These are factual statements that are not unethical and do not constitute a diagnosis of anything.

 

Meanwhile, went to my W's current doctor for her monthly VitaminB12 injection. The doctor stated it would take around 3 more months for her to be completely cured, and reinstated that the disorder was indeed BPD.

Her medical doctor is not qualified to determine whether her issue is "indeed BPD." Only a professional with psychology training (ideally, a psychologist or psychiatrist) is qualified to do such a diagnosis. As to the B12 injections, I have never heard of it being used to successfully treat a personality disorder that started in early childhood.

 

Granted, temporary flareups of our BPD traits can be caused by hormone changes, drug abuse, and perhaps even a B12 deficiency. Yet, when professionals are mentioning "BPD," they are referring to the lifetime disorder, not a temporary flareup of BPD symptoms (as is common during puberty, pregnancy, postpartum, PMS, perimenopause -- or, LOL, any other life event starting with a "p").

[Downtown]

Stormie, one more thing. Just to be clear, I believe that the psychologist you saw likely is very good in his field, given that you had heard he is very experienced. The universities in India provide very good training, particularly in the sciences and social sciences. Hence, if BPD is involved -- despite my skepticism that you're describing BPD -- the problem likely is not a lack of training/experience but, rather, a lack of candor.

 

To protect their BPDer clients, psychologists and other therapists typically are LOATH to tell a BPDer the name of her disorder (unless she is very low functioning). This means therapists also are loath to tell the abused spouse -- even when that spouse is paying for all the therapy bills. The therapists know that, during the BPDer's very next temper tantrum, the first thing out of the abused spouse's mouth will be "Even your own psychologist says you have BPD."

 

There are several reasons why withholding this information is in the best interests of the high functioning BPDers (who likely constitute roughly 2/3 of all BPDers). One reason is that, on hearing the diagnosis, a BPDer almost certainly will immediately terminate therapy. A second reason is that recording the diagnosis as "BPD" likely means the insurance company will refuse to pay for therapy treatments.

 

Here in the USA there is a federal law requiring them to cover effective, proven treatments for mental disorders, including PDs. The companies nonetheless routinely withhold payment, arguing that no treatment of PDs is proven to be effective. Therapists thus avoid a costly legal battle in the courts (which they likely could win one patient at a time) by simply listing one or two of the co-occurring "clinical" (non-PD) disorders as the diagnosis. They typically don't list BPD even if it is diagnosed.

 

The third reason is that, in the unlikely event that a BPDer believes the psychologist when she is told the disorder's name, her being told can make her behavior worse instead of better. Because BPDers have a fragile weak sense of self identity, they look to other people (e.g., their spouse or therapist) for clues as to how they should be feeling and behaving. BPDers thus are attracted to partners having a strong personality that is able to provide the missing sense of self identity. This means that, when telling a BPDer the name of her disorder, the therapist is providing her a new identity of sorts. The result can be that a BPDer who had been exhibiting 5 or 6 strong BPD traits will start exhibiting 8 or 9 BPD traits.

 

Given this predicament, your best chance of obtaining a candid professional opinion is to see a psychologist who is ethically bound to protect only YOUR best interests, not those of your W. This is why I earlier suggested you see a psychologist for a visit or two all by yourself. Moreover, it is important to make clear that he/she is YOUR psychologist who will not be treating or seeing your W. Make it clear you are seeking a candid second opinion on what warning signs you are seeing -- because both you and your child are adversely affected by the situation.

 

Note that I said this approach offers "your best chance" of obtaining a candid opinion (not a diagnosis). It certainly is no guarantee of obtaining it, however. Your psychologist may mistakenly believe that you eventually will be bringing your W to him for treatment. If so, he likely would not want you to know about the BPD potential because, when he is later treating her, there is great risk that you would reveal it during a heated argument with your W.

 

Moreover, even if you convince him that you will never bring your W to him for treatment, he may be concerned that you will reveal his suspicions to her during an argument and she, in turn, will tell her own psychologist. In that case, your psychologist could find out that one of his colleagues is angry with him for revealing information that should be withheld from the BPDer -- never mind that he did not do a diagnosis and did not speak directly with the BPDer herself.

[Stormie32]

Hi Downtown!

 

Thanks for your feedback.

 

Yes I agree with you that the new psychiatrist I went to should have mentioned the disorder they felt was the best match for my W. I did visit this psychiatrist all by myself.

 

Also would like to clarify that her current doctor is an experienced psychiatrist.

 

I will attempt to speak to more psychiatrists & psychologists. Meanwhile, my W has not been displaying any abnormal behaviour or mood swings for a week. It had been diagnosed that she would take 3 months to be completely cured, as I mentioned in my previous post.

 

Unfortunately I don't feel I have any patience left. Personally, my marriage has been going nowhere for the last 2 yrs now, and I don't see any progress or future being together. I feel it is time to break the news & at least tell my W I want to separate. It's just that I'm a little confused over the right time - she is seemingly normal now, though the current psychiatrist said she will be completely fine by this August. Any ideas?

[Downtown]

It's just that I'm a little confused over the right time - she is seemingly normal now, though the current psychiatrist said she will be completely fine by this August. Any ideas?

Stormie, no, I have no idea what you should do because you don't yet know what is wrong with her. The only disorder she has been "diagnosed" with -- BPD -- is a personality disorder that cannot be treated with medication. It cannot be cured in 3 months. Indeed, it cannot be cured at all.

 

Until scientists discover proof as to what causes life-long BPD symptoms, they are unable to describe the "disorder" causing those symptoms. If they cannot even describe the characteristics of that disorder, there is no way they can cure it. The best that can be done with BPDers is to provide years of intensive therapy that teaches them how to better manage their own emotions.