Tag: Abusive

Does My Father Have BPD?

QUESTION:

Dear Dr. Heller,

My question is about my father.  Ever since I can remember, my father has experienced extreme mood swings – from a calm easy going person to absolute rage.  He will often reflect back on instances that happened as much as ten years in the past and enrage himself.  Most of the time it is clear that he has misinterpreted the motive of the person he is raging about.  This usually occurs in stressful situations.  He often avoids social gatherings and does not have many friends.  My father is suspicious of almost everybody.  Recently my father was treated for severe headaches and consequently become addicted to vicodan, and has been now for two years.  He is also taking Xanax and Remeron.  These are the only medications that I know he is taking for sure, because he has shut the family out and refuses to discuss his medical affairs.  Within the past year he has began chanting and making loud shrieking outbursts.  Most of the time he chants “mama”.  Before the headaches he only had many of the symptoms of BPD that you describe in your website (anxiety, rage, occasional depression, misinterpretation of motives etc.).

Firstly, does this sound like BPD?  If so how do I approach him with it?  What can I do for him?  My grandfather was an alcoholic and verbally abusive.  Could this have amplified his problems?  Secondly, I see some of the traits you have described in myself (such as a feeling of incompetence, anxiety, a mind that never stops, and feeling like something is medically wrong).  Are they due to genetics or the environment that my father created while I was growing up?  If so, what should I do and how can I break the cycle?

 

ANSWER:

I don’t know if your dad has BPD, but his symptoms are consistent with it.  He probably has other diagnoses as well.  http://pks.947.myftpupload.com/AskDoc/q1.htm will help you with how to tell him. The BPD appears to be 50% genetic so the same answer would apply to you: Get your medically treatable diagnoses treated.  The screening test should be of help. It’s critically important to recognize that most of these problems are biologically based, often genetic, and medically treatable.  I believe strongly in mind/body/spirit – so every aspect needs to be healed.

Borderline Personality Disorder: Dealing with BPD Mother

Q. I have a mother who is definitely borderline, though undiagnosed (at least to my knowledge). She lives 600 miles away, and has for 14 years had major heart disease after a major and destructive MI in 1986 with recurrent, serious complications. She has kept the rest of us (my young sister, stepfather and I) in thrall- there is no better word- ever since. Waiting on her every whim, putting ourselves in jeopardy to satisfy her demands which efforts are invisible anyway, accepting her limits on us as well as her. I have just been diagnosed and am being treated for PTSD, am 50, single ,desperate and very worried what to do if my poor devoted stepfather goes before her. ( I have been sick that he is suffering, but am told he must be responsible for his choices). Two weeks ago, he had to be in CCU for 6 days after, as part of my treatment, I sent a letter questioning something she said, and she took her rage out on him. Now he is back with her, and my hope is that since I am the Bad One, he can get some relief.

Right now, I have not been in touch (my therapist says I must not call back while I am likely to give in). I am trying to find support on BPD central, but feel the advice to set boundaries, and “what are you getting out of this mistreatment” very harsh, considering that my parents are both ill and aren’t going to change; at this point, (mother 74, stepfather 79). At the same time, my life has been on hold for them, I have made too many sacrifices and I am on leave from work to find some recovery. If I could move to Australia, or better another planet, I would.

Have you any advice?

Any information or tips on this convoluted situation would be appreciated. Mother has however rejected any form of psychotherapy as inappropriate for her, refuses to take prescribed antidepressants, and lashes out in ferocious rages at any imagined slight. Is there any hope? What can I do?

A. Yours is not an uncommon problem. There has been some recent data that the BPD goes away with age, others believe it changes and reflects itself in different behaviors. Assuming your mother’s diagnosis is correct, her problems are clearly out of control. There’s also more than just the BPD going on.

Doctors refer to her placing manipulation and control ahead of getting well as “secondary gain.” She appears more interested in attention and being in control than she does getting better. She’s doing what she believes is best for herself.

I don’t know what all your diagnoses are, but your therapist appears to be very wise. People like you and your stepfather often suffer enormous consequences from her illness, especially health wise. You are at a significantly increased risk of heart disease and cancer because of this stress.

There’s an old saying that fits this situation well: If someone is drowning, it’s very noble of you to jump in and try to save her. But if she determined to drown, and she insists on taking you with her, you have to let her go. You seem to understand this based on your comments about moving to Australia or another planet, yet you also feel responsible for her.

It appears you are still desperately seeking her kindness, love and approval. You are not going to get that from either helping her or abandoning her. It will have to come from within. She is likely too ill to give you what you want and feel you need from her.

A problem children often have with abusive and irrational parents is how to obey the biblical commandment “thou shalt honor thy mother and thy father.” Included in the biblical passage is a responsibility to take care of parents in their old age. The dilemma many individuals have is trying to help an elderly parent who is extremely abusive and toxic, injuring the health of the child. It’s not your job in life to be abused or suffer ill health when your parent refuses to seek health, kindness and love.

My usual recommendation in this situation is: 1) Understand that she’s ill! She has been hurt as much as you, or she wouldn’t be like this. 2) Consider the possibility that some day a magic medication may become available that makes her completely, totally and absolutely mentally well. You need to be the kind of person that she would be proud of should she become well. In this way you truly honor your mother by being the child she always really wanted, but was too ill to have. 3) Help the physicians with plans, but realize that’s really not your mother there. It’s an extremely ill person who doesn’t realize or care what she’s doing or saying. Since there’s no magic potion yet, you must honor your mother by taking care of yourself and not getting involved in her pathology.

Seniors often become psychotic in the hospital (particularly the ICU), and believe very delusional things. Mentally healthy children understand that it’s not their parent doing that, but an illness distorting reality and thinking. You need to do that.

As long as your mother has the legal right to make her own decisions, she has the right to refuse antidepressants or any other medication. There is no reason to presume she’s going to change, only you can. The hope you’re looking for rests with you. The only hope you really have is to become a totally peaceful, serene and loving individual who doesn’t react to your mother’s remarks & actions.

While no guarantee of success with her, it’s a guarantee of success for you – and it offers your mother the best hope possible.

Instead of focusing on how to change your mother, which you are highly unlikely to do based on what you wrote, you need to focus on making your life happy and peaceful. I’m sure your therapist will agree. Learn to live your life instead of living your mother’s life. When you were born she wanted you to be happy and successful. Honor your mother’s wish!

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Borderline Personality Disorder: Medication Questions and Discussion of BPD Symptoms

Q. Thanks for your wonderful website. I am beginning to understand my diagnosis of BPD with the help of your website even if I am not yet ready to fully accept it. It helps me to see that I am not alone and that others like you are surviving and getting better. I am hungry for knowledge about BPD but it is sometimes difficult to read about it and see yourself in the mirror. Here are my questions for the Doctor.

I am a 41 year old male. I was diagnosed with BPD two years ago at the age of 39. I was also told I had dysthymia (I was told this often goes hand-in-hand with BPD) and elements of Generalized Anxiety Disorder, Panic Disorder, Obsessive-Compulsive Disorder, and some Avoidance Personality Disorder. I sought counseling and medical help and a 12-step group (SA) after a disastrous extramarital affair that almost destroyed my marriage, career and almost ended my life. Five years prior to this, I had severe panic attacks that led to my hospitalization and a heart catheterization and suicidal thoughts. Other background – I was physically abused by my mother as a child.

I am currently taking a daily dose of 450 mgs. of Nefazodone HCL (a generic for Serzone) under the supervision of a Doctor (Psychopharmacologist) and I participate in weekly counseling sessions with a therapist. The prescribing Doctor has told me he cannot medically treat my BPD, (“only therapy can do that”) but he is treating my dysthymia depression. My questions for you are as follows:

1. You make no mention of the drug Serzone in your writings on this web page. Have you found Serzone to be effective in treating BPD?

A. No. It can help with depression however.

Q. Is the generic equivalent just as effective?

A. Probably, but I don’t know for sure.

Q. 2. Have you had any success with St. John’s Wart and do you recommend it?

A. It sometimes helps with chronic pain, but I’ve not seen significant benefits for most people. I am extremely disappointed with it.

Q. 3. As a young boy, while under stress (such as during a school exam) I would often hear what I can only describe as voices yelling at me in my own head. I could never make out any words, only repetitive noise that got louder and louder. The problem all but went away in adulthood but occurred again within the past two years while under severe emotional stress. Is this what you would describe as an episode of psychosis and have any other BPDs ever reported this?

A. Unless new information comes out to change this opinion, it appears the BPD begins at puberty. What you describe sounds a great deal like a psychotic depression.

Q. 4. When first diagnosed with BPD, I was in denial. For example – I rationalized that I could not be BPD as I did not self mutilate. However, as a young boy (and to a much lesser extent now as an adult), I would chew my nails and bite/pick the skin around my nails until my fingers were raw and bleeding. Is this an example of self mutilation typical of some BPDs?

A. Possibly, but there are other explanations for this behavior, including anxiety problems.

Q. 5. I am functioning relatively well now thanks to the treatment I have sought and am receiving. One thing has been very difficult for me to accept though and perhaps you can help me better understand this aspect of my diagnosis. I have been very successful in my life in both my career and marriage. I always had feelings of emptiness and unhappiness but I seemed to function pretty well. Three years ago, I embarked unknowingly on what was to become an obsessive and tumultuous extramarital affair that was totally disastrous for me as a person. The woman I had the affair with is most likely a BPD as well and was emotionally and verbally abusive and demeaning toward me at times. I have had great difficulty in understanding why I “functioned” so well for most of my life with significant education and career accomplishments only to literally ‘come apart at the seams’ in such a short time. Was it that my Borderline Personality Disorder just became ‘active’ during this stressful affair or is it possible that all the ‘facades’ of my personality just came tumbling down? I have really struggled with this aspect, feeling like I just went crazy over a woman and have confused that with meaning I must have really deeply loved this woman. My counselor seems to dodge this issue and just told me it is possible I regressed during the stormy relationship.

A. If the diagnosis is correct, I doubt you functioned as well as you think in every area of life. Many borderlines have successful careers, but interpersonal relationships are a problem. The most successful borderlines I know hire others to do the work that the moodiness and anger interfere with.

If your marriage and personal life were so successful, why did you search for a new relationship without getting a divorce first? This is particularly so with a woman who seems so dysfunctional and abusive.

The BPD doesn’t go away, but the severity comes and goes depending upon stressors. I think if your BPD and other symptoms were effectively treated you’d have a different perspective on how well you’ve done during your adult life.

By the way, it’s critically important to get this terminology correct: no one “is BPD” – but one can have the BPD. Likewise no one is a strep throat, an appendicitis or a depression.

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Borderline Personality Disorder: Self Mutilation and Temporal Lobe Epilepsy

Q. I’m 18 years old and I’ve been in and out of the psych hospital for the past seven months. I’m currently taking tegretol and wellbutrin. I haven’t been officially diagnosed with BPD, but it has been mentioned.

For the past five years I have been self-abusive and it has been getting worse and worse. I had a test done called the B.E.A.M. test and they said that I had frontal and temporal lobe abnormalities. Is this found in BPD?

A. Temporal lobe abnormalities absolutely.

Self mutilation is extremely uncommon outside of the BPD. If you’re doing great, that’s terrific. If not you may want to read this website carefully for information and clues to your diagnosis and getting better. You will be the person you must rely on for your future.

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Borderline Personality Disorder: Partner of someone with BPD and other diagnoses.


Q. I do not have BPD; I am, however, a co-dependent personality (3 marriages – one a schizophrenic, one an alcoholic and the most recent BPD). Although my Vietnam vet husband has been diagnosed as suffering from PTSD, came from an unhappy childhood and has suffered through two major “breakdowns” in the past 10 years, he has never been definitely diagnosed as BPD to my knowledge. He is currently diagnosed as suffering from manic depressive disorder, adjustment disorder, obsessive compulsive personality disorder, and passive aggressive personality disorder.

We have been together for 12 years; I have read the “DSM definition of BPD” and can state that every indicator with the exception of suicide and/or self-mutilation is STRONGLY AND OBVIOUSLY present in my husband.

He is currently taking Depakote, Wellbutrin, Xanax and Zoloft. I don’t understand how his doctors could have missed the diagnosis; he has been hospitalized twice for lengthy periods of times, yet none of the doctors has ever been willing to ask me how I perceived his behavior.

We are currently separated as his most recent incident escalated into a situation where he became violent (although he still maintains he remembers nothing of the violence or threats) and could easily have killed someone. There were numerous witnesses to his bizarre behavior that day, yet he maintains it never happened, that he was the victim.

My question: I am afraid to allow him to return to the home under any circumstances, despite his crying and begging, his promises to seek treatment and change. Yes, he is seeking treatment, but only because I had him forcibly removed from the home and ordered into the hospital by the court. It has now been seven weeks, and it appears to me that his condition is worse than ever. He can’t carry on a coherent conversation, although he is a highly educated man; he sends e-mail that makes no sense, full of misspellings and incomplete thoughts. He “stalks” me telephonically, calling repeatedly despite my insistence that he not call more than once a day, in the evening. He claims that his medications are supposed to “kick-in” after 8 weeks and that then I can “trust” him again.

I don’t know if I love this man; I don’t know if I’ve ever even known who he is, separate from the BPD. He has never been “normal,” although he is extremely attractive and can be very charming and persuasive when he wants. He has been unimaginably verbally abusive to my daughter and I, both. At the moment, my daughter is seen as EVIL (his description, in several letters to me) and I am a goddess, doing what was necessary to preserve our home and marriage.

If he is not being treated for the BPD, if he continues on his present course of medications, how will I know if it is safe to let him return? His is not a mild case; he is totally dysfunctional. While I would not want to throw away a marriage if there is a chance to salvage it, a chance for both of us to have meaningful and rewarding lives, I will not under any circumstances allow a return to what has been happening here. His doctors won’t discuss his case with me, as I said. He presents very well as a victim, particularly to women doctors who apparently have difficulty hearing what he isn’t saying, seeing past the tears and the obvious emotional turmoil. At one point about 10 years ago a tentative diagnosis of BPD was made and a suggestion of treatment in a hospital on the east coast was rejected by my husband and his other doctors. He wants to come home to recover; I have to refuse unless there is some assurance of proper treatment and eventual recovery. What can I do and what should I look for?

A. I treat many people in similar situations, and I am continually reminded of just how much suffering there is in this world. Much of it seems so unnecessary.

You bring up many important issues. First you are not “a co-dependent personality.” There is no such thing. You have self-esteem problems, thought patterns, and behavior patterns that have destroyed much of your life. No matter what happens to your husband, your life will continue to be miserable as long as you live in a manner that ALWAYS leads to misery. Your daughter’s road will be a very difficult one as well, and her best hope is for you to become a happy, successful, peaceful person. There is a consistent fact of life, your adolescent and adult children will only listen to you about life if you’ve got the kind of life they want. Do as I say not as I do won’t ever cut it.

Can you be happy, loving, peaceful and successful? Yes, it’s not only possible, but it’s mostly in your hands. The past only establishes habits and automatic thinking patterns, it has nothing to do with the future.

First you need to find out if any biologically treatable disorders are present in you. Many people with disorders such as the BPD associate with “worse” borderlines so they don’t feel the need to improve themselves, whether that fits you or not I don’t know, but it is common. Get the medical treatment you need, and make sure your doctors and therapists explain the diagnoses and treatments so you know what’s going on. It is your life. The Internet and many books are available for information.

Next is acquiring better information. Most people like you assume you know what to do, and keep trying ineffective plans over and over again. Good psychotherapy can be enormously useful in this regard, particularly if you are determined to succeed and are looking for someone to assist you in your goals, not to be a paid friend.

The next step is reading. I often tell my patients, “when all else fails, read the directions!” I would recommend the following books to you immediately: “Your Erroneous Zones” by Wayne Dyer, “Looking Out for Number One” by Robert Ringer, “How to Win Friends and Influence People” by Dale Carnegie, “Embraced By the Light” by Betty Eadie and “Are You the One for Me?” by Barbara DeAngelis. Most problems have to do with perspective and understanding, not what is actually happening. Everything you do that hurts you hurts you, everything you do that helps you helps you.

You need to retrain your thinking as well. I would strongly recommend you immediately purchase Zig Ziglar’s tape series “How to Stay Motivated.” You need to listen over, and over, and over, and over again. Stop watching the news and listening to painful music, and start listening and learning about how to have the life you want. The 18 tapes cost around $225. Many people consider that to be too expensive, yet waste more than that on alcohol, cigarettes, soft drinks instead of water, etc. A visit to a marriage counselor, or a few visits with an attorney over a DUI or drug arrest for a child or you makes you realize that $225 would have been a great investment. There is no law preventing you from working part time for a few weekends (convenience stores are a good source of income) in order to pay for them. The telephone number is 1-800-527-0306. Tina Downey has been helping my patients. I have absolutely no financial incentive or relationship with Mr. Ziglar or his tapes.

Regarding your husband:

There is no such thing as a “breakdown.” A “bad childhood” is a partial explanation for what happens to us, but it’s only the past. A “bad adulthood” is not necessary. Many enormously successful and important people have had a “bad childhood.” He clearly has multiple neurological problems, that don’t appear to be adequately treated medically – particularly if you review the literature on the BPD. Xanax is sometimes necessary, particularly for panic, but has been shown to make borderlines lose behavior control more often. I did a small study comparing Prozac with Zoloft, and Prozac was clearly and dramatically better. Depakote in particular is excellent for bipolar disorder, but isn’t as effective as Tegretol for the BPD and behavioral seizures (which could cause the memory loss).

Certain behaviors are totally unacceptable: violence, stalking, being nice “when he wants.” Why not all the time? Isn’t that the kind of relationship you want? Those books will help. There are two things necessary for a great relationship, and you can have one: 1) you have to be the kind of person the kind of person you want wants, and 2) you have to know what you want. How can you hit a target if you have no idea what the target is and no idea how to reach the target?

You are having trouble looking out for your own best interests, although you are starting to change this. You wrote “I don’t know if I love this man,” “he is totally dysfunctional,” “he has never been normal,” “he has been unimaginably verbally abuse to my daughter.” You also wrote “while I would not want to throw away a marriage if there is a chance to salvage it, a chance for both of us to have meaningful and rewarding lives, I will not under any circumstances allow a return to what has been happening here.”

The BPD wasn’t effectively diagnosed or treated until a few years ago. Borderlines can have very happy and successful lives, but I’ve never seen anyone reach that point who wasn’t totally committed to happiness and success, read the books, and was well treated medically – and enthusiastically took the medication – grateful for the opportunity to have a great life instead of resentful that medication was necessary. Without question the borderlines who listen to Ziglar the most did the best.

Your last question was “What can I do and what should I look for?” – the last paragraph answered that question. He has to be totally committed to doing the same things I recommended to you. When you do all these things together with commitment and love, you have an excellent chance.

The opposite of co-dependency is self-responsibility. No one has the power to make you feel bad but you. Happiness is a choice, and a happy, successful life is a series of choices, perspectives, and knowledge. Many people like you have trouble acting out of your own best interests, and this recommendation usually clarifies things: “what advice would you give your daughter if she was in this situation?” I wish you well and I hope I was of some help.

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Borderline Personality Disorder: Zoloft; Graves Disease & Helping Friend with BPD


Q. Dear Dr. Heller,

Where are you located? I am seeking help for my friend with BPD. Can you recommend someone within a few hundred miles of the Greater Cincinnati- No. Kentucky area?

My friend has been treated for long standing Graves Disease with radioiodine. We thought many of her symptoms would subside, however, most did not. Is it possible that there is a connection to untreated Graves Disease and BPD? The doctors say it must be something else, since the blood tests now show her in the normal thyroid ranges. I have suggested that she see an endocrinologist. What is your opinion?

I have read literature from the Thyroid Foundation that states that untreated hyperthyroidism can “cause behavior changes such as irritability, nervousness and paranoia, making it appear that the patient has a severe mental disorder.” She has all of the symptoms of BPD. Is it possible that because the thyroid was untreated for so long it may have caused permanent damage, even though the blood test now show in the normal range.

She is 35 years of age. She has had 2 auto accidents in the past 3 years. Since the accidents she complains of chronic migraine headaches and neck pain. She is treated with Midrin and Imitrex.

As a teenager, she was hit in the head over her let eye during a soccer game. It was a serious accident, requiring some surgery. She claims that she has been treated twice for “toxic shock” in the past 10 years.

Her father is critical and verbally abusive towards her. He is sarcastic. He makes humiliating, sexual remarks towards her. Her mother is cold and calculating. She is extremely obsessive- compulsive. Quietly manipulative and demanding. My friend tries to do everything she can to please them. No way. The mother seems to have a lot of influence over my friend. The mother has had 4 thyroid surgeries to remove tumors. She told me one time, that as a child her mother would hit her in the head with her fist, when displeased with her.

I have noticed at times my friend’s left eye jerking. Recently her anger and rage have increased. She said that she “feels detached sometimes” and as if there were “electrical shocks in her head.” I told her to tell the neurologist. She said he ignored her.

She has tried to take Zoloft twice. She became much worse. High anxiety, out of control, and incoherent raving. Constant complaining over and over the same trivial issue. Hysterical.

I have tried to do more than anyone to help and understand. It appears that she has totally devalued me. It is impossible to talk to her. In trying to talk to her or explain something to her. She just says “I am not going to argue.” and she begins the illogical complaining.

She is impulsive, demanding, manipulative, paranoid, constant complaining about everything- no matter how trivial. Never pleased. Refuses to believe what I say, questions everything. Screams but then complains that one’s voice is loud even if whispering. She sees people and things as black or white. Hate or love.

Suddenly she has became verbally abusive and very cruel towards me. She tells everyone that she can about how she is the “victim” in all of her life. To her, everyone has mistreated her. She is also a Chameleon. When she meets someone new , she takes on or imitates their personality. I have seen it many times. She is extremely sensitive and I have “walked on eggshells” for a long time.

She has lived in my house for the past 3 years. She had some stability here. I took her to many doctors, but it was if she slipped away before I could get the right help for her. She decided to live by herself – so she moved out- She found out that she could not stand to be alone so she has moved in with someone else. This person is very cold, cruel, cocky and can be violent. I am very concerned about my friend’s welfare. My friend seems to be controlled by this new person. My friend came to visit and presented the same cocky, violent personality recently. Very disturbing.

I have let her know that I am her friend. That I will help her when she wants my help. That I care about her. Can you think of anything that I can do? She knows that there is something wrong, but I believe she thinks that it is “mental illness.” She fears being institutionalized. I have told her many times that she is not “crazy” that she has a physical disease that is causing this. Sometimes I see a frightened little child inside, but it is rare.

Any opinions or ideas will be greatly appreciated.

A. I’m located in central/south Florida, and no I don’t know of anyone I can recommend in your area. The best thing you can do is arm yourself with information and get help from a concerned, caring physician who is willing to learn about new information.

There is no connection between Graves Disease (overactive thyroid) and the BPD – and I have no way of knowing if the BPD is present. If the labs are normal, and endocrinologist will be of no further assistance – her physician is correct. Sometimes one hopes for answers in something simple like Graves disease, but this is rarely the case with “mental” problems.

If her behaviors was in no way present prior to the Graves disease, clearly some brain damage occurred from the Graves. My suspicion is that her symptoms started before this, but were worsened by the stressors from her hyperactive thyroid.

Chronic neck pain and headaches are extremely common in the BPD, chronic anger and grinding teeth are major culprits. They are commonly seen in the generalized anxiety disorder as well. The head injuries caused their own problems, and may have exacerbated the BPD.

The family background as you described it is awful, and extremely damaging. It sounds like she’s continuing the pattern into her adulthood as did her parents before her. You described the BPD identity problems pretty well with the idea that she “takes on or imitates their personality.” Many of her symptoms would improve with Prozac, but in my experience only if pretreated with BuSpar first.

Those “electrical shocks” may be temporal lobe epilepsy and/or complex partial seizures, frequently associated with the BPD. Neurologist often want nothing to do with medical problems causing psychiatric problems.

If Zoloft made her worse, I will virtually guarantee that she has the GAD (generalized anxiety disorder) – particularly the “cognitive component.” This will need to be successfully treated, usually with BuSpar, before SSRI medications can work (I don’t have a lot of confidence in Zoloft).

It sounds like she does indeed suffer from the BPD and other problems, particularly dysthymia and the GAD.

The best thing you can do is move on with your life. Your friend clearly doesn’t want your help, and you are strongly exhibiting “rescuer” traits. The best thing you can possibly do for your friend is learn how to be a happy, loving and successful person in every aspect of your life – your friend will then likely ask you how get what you have for herself. Read the books I recommend in this Website, and get Zig Ziglar’s tape series and start listening as often as you can.

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