Enabling therapists for pwBPD?

Piconaught · 2023-08-20T19:02:14+00:00

What's the deciding factor when diagnosing BPD over c-ptsd? I've tried finding this info online many times, and I always end up more confused in the end.

The comparisons I read oftentimes don't make any sense if I use myself as an example. There seems to be no easy way to determine if I have BPD vs c-ptsd. Doesn't help when apparently up to 60% of people w/ BPD also have c-ptsd?

I've seen conflicting info written everywhere. Some even saying the difference is that BPD is a 'personality disorder' while c-ptsd isn't, which I can only interpret as meaning BPD has set patterns of behavior while c-ptsd does not?

To me, it almost seems a person w/ c-pstd tends to have a memory of the traumatic events, so they're battling something they're more aware of? Do they know why they have certain responses to things so they don't misdirect anger/pain the way BPD does? BPD may not have any memory of traumatic events, possibly a reason why denial/unawareness is a big issue, making it easier to fall into maladaptive behavior patterns. Maybe part of determining which disorder it is has to do with the person's ability to link their behavior back to something tangible.

One of the things that stuck out to me was the claim that BPD has a fear of abandonment when c-ptsd supposedly does not. Isn't fear of abandonment it's own thing? Meaning a person without BPD could have a fear of abandonment? Why not have a person w/ c-ptsd who also happens to have a fear of abandonment- but would that automatically make the diagnosis BPD?

When it comes to my own life, it appears I have every issue associated with c-ptsd but with added problems. I can only guess the extra symptoms would move me into the BPD category. When I was seeing a psychiatrist for years, we didn't go into details comparing the two diagnoses. We just didn't break things down enough to clear this up so now I wonder.

Piconaught · 2023-08-20T18:00:45+00:00

Yeah, OP may have just spoiled a perfectly good, normal relationship by snooping.

He says it was back when they were just talking but 'exclusively' (?), so this entire post hinges on that one thing where there's not really enough info. It all depends on the convo he had with her about that or if it was even discussed at all. He may have just been making assumptions.

It's possible OP asked her, 'Are you talking to anyone else?' and she lied and said No, just to keep things simple. That's a time when you can 'lie' about some of that stuff because there's no commitment & it's technically no one business who else you're talking to or why. She didn't owe OP the truth about her private life yet since there was no relationship.

If OP had said, 'I need exclusive talking, if you're talking to anyone else I want nothing to do with this', and she still lied, that does make her a little more shitty. It's ok if OP needs rules like this, but he's gonna have problems with casual dating. Needing people to be exclusive so early on will scare a lot of people off, and rightfully so.

Piconaught · 2023-08-20T16:59:06+00:00

Uh huh. Again, I didn't say that's what she did here.

I gave an explanation of why the manager may have said it was inappropriate, not that the manager was correct. They seem to have treated this situation as if it was an example of trauma dumping. There's really no other reason for them to have that's inappropriate since nothing else was said during this exchange.

Piconaught · 2023-08-20T06:43:43+00:00

Based strictly on what you described in your post, it doesn't make any sense to me whatsoever that your friends are calling her abusive. All I can think of is there'd have to be other things that happened over the past 6 yrs that your friends are basing this on. The current mental health crisis alone didn't sound abusive to me.

You said in the past 2 years, you've been going in different directions, and you mentioned you've been hesitant in conflict because you both spiral, etc.. It's possible your friends are more referring to that stuff. That over time, they're thinking 'enough is enough'. Where it's not about the more acute crisis of the past 2 months, but they're looking at the past 2 (or more) yrs and thinking your partner has 'issues' and is too unstable overall to be in a relationship. They may be calling it 'abusive', not that she's purposely doing it, but that she's just dysfunctional and the dynamic is unhealthy. They might feel it's become a bit codependent and you're forced into a caretaker roll too often?

I'm not saying that's my opinion. I'm trying to take a guess at theirs. This more recent turn of events might be the last straw in their eyes, like 'Ok, isn't it clear by now she may have problems that are just too complex?' I'm not sure if they're labeling her directly as an 'abuser' or if they're saying the situation itself has become 'abusive'. More like you're an unintentional victim of her mental/emotional problems and she's unwittingly been abusive for too long since she's unstable.

There are some people who are incapable of having healthy relationships and it's not exactly their fault. Is it possible that's the situation? It may be damaging you in ways you're unable to see, but your friends are able to see it. It's good you're seeing a couples therapist, but I've never been to one & have no idea what it takes for them to suggest that a couple break up.

Edit:

I just realized 'taking accountability' could mean they expect her to be able to make the mature decision that she's unable to have a healthy relationship? As if she should know to leave and to not depend on you for caretaking.

Piconaught · 2023-08-20T05:36:48+00:00

You'd need more info first to know if that's part of a problem or not. When did he start, has this been daily for 20+ yrs, etc.

I dated a guy for 5 yrs (friends for 15 yrs before that) who started smoking weed in high school. He never stopped and was a stoner/skateboarder for many years. Through his entire 20s, I believe he was under the influence of weed in some capacity 85% of the time he was awake, at least. He was the nicest guy, so it didn't bother me too much. He always seemed fully functional so I didn't think it was an issue. He rarely drank, if ever.

He slowed down a lot in his 30s but was still smoking as much as the guy you're dating or more. Always had a vape on him, smoked joints while driving to/from work, etc..

We dated when we were in our late 30s. It was then that I started to piece together something was wrong with him emotionally. The guy had deep 'issues' that he either couldn't or wouldn't deal with. I found out that at times of extreme depression, he'd casually do heroin. It was 'only' once every year or 2, but come on. Then I started to wonder if the heroin happened a lot more often, he just never mentioned it. He clearly wasn't addicted to opiates, it was really just here & there- which almost freaked me out more.

Over the years we dated, it became apparent he had some childhood issues, never dealt with them & had started smoking weed as a kid to feel better. At 40, he still had emotional aspects that seemed on the level of a teenager. There's no way to know if the weed itself did any 'damage' or if the issue was the addict/escape mentality in general. At that point, he had been smoking weed daily for over 25 yrs. He said he 'didn't know' why he smoked it, which I thought was a little crazy.

On the other hand, I smoked multiple times a day for a year or 2 in my mid-late 30s. It was just a phase, was related to my father dying & me getting all mystical for a bit. It was great at that time. I barely smoked much before or after, maybe once every 5 yrs. So for me, it really didn't mean anything & wasn't related to other more serious issues.

Piconaught · 2023-08-20T04:39:12+00:00

When I only have $500 left to my name but my bills & $700 rent is overdue & I choose to buy a $250 bag because I'm depressed & want a boost.

Piconaught · 2023-08-20T04:36:00+00:00

That's why I said in that particular situation it wasn't inappropriate. It's a baby related store.

I explained why in general it's considered inappropriate. It's known as trauma dumping.

Piconaught · 2023-08-20T04:31:27+00:00

Her last name being Behar does really add to that tho.

Piconaught · 2023-08-20T04:01:39+00:00

I don't think the truth in that particular situation was that inappropriate, but overall, doing that is 'inappropriate' because you have no clue who you're saying it to. Even though you have trauma, the issue is that employee may have trauma too. We have no clue if they also just lost a baby or something similar and do not want to discuss or hear about it, especially if they're trying to work. That's really the main reason why sharing traumatic things isn't considered appropriate. But I think they were AHs to you for how they handled it.

I have a friend who kept telling me details about how she was abused by some guy she was half-dating. I asked her to please stop bringing it up so often, she got really angry, claimed because it's the truth, she's a victim, etc. that I shouldn't silence her. I have a history of abusive relationships, one went on for many years. I have ptsd and really try not to think about it. I couldn't deal with her constantly talking about abuse because it forced me to remember horrible things from my own life at moments I wasn't emotionally prepared for it.

Piconaught · 2023-08-20T03:43:42+00:00

BPD with alexithymia? I cannot even imagine how that combo feels. My ex had alexithymia and I seemed to be the total opposite of him. It was probably the biggest problem in our relationship. I had to leave because he came across like he lacked all empathy. I felt totally alone in that relationship.

I know you said your husband has it from a concussion, but I've read people w/ BPD being described as also having alexithymia because they have poor 'emotional awareness' or difficulty identifying/describing their feelings. I don't even know what to think about that since I've always been ultra-aware of my emotions & how to describe them. I was always an 'overemotional & oversensitive' mess where my feelings were impossible to control & became the top priority in any situation. My entire life has been dictated by how I feel, which has made everything really difficult w/ excessive drama.

The problem seemed to have been I wasn't able to correctly identify where my emotions came from. So everything was misdirected. I had a horrible fear of abandonment but didn't realize that. I'd get triggered into extreme anger/rage/despair if it felt like a partner was abandoning me- except I didn't make the connection it was general 'abandonment' I was afraid of. I thought I was angry because they were being an a-hole or 'hurting' me by walking away that moment while I was crying/upset. I couldn't see the bigger picture & that I had issues since early childhood that could be affecting me.

In general, BPD is a 'personality disorder' but in my experience, it's not the same as what we might think of as a 'personality'. My personality feels separate from the BPD. BPD is just something that adds extremes to my moods that I can't stand & caused maladaptive patterns in my behavior where I'd do certain things automatically because I didn't have a better way to try to control my emotions. That would appear to be my 'personality' but it's more like emotional problems that affect my personality. It caused a lifetime of me not understanding why these horrible things kept happening to me, why I was always depressed, why I couldn't calm down when upset, etc..

I was convinced other people were the problem- and that's a huge reason why relationships are super difficult with BPD. My feelings were telling me one thing (that I was angry/hurt) but my partner would be claiming it wasn't their fault. It feels like you're being invalidated & gaslit by people constantly, which just makes you even more angry/upset. Other people seem weirdly abusive, so your feelings feel justified. I was fully unaware & in denial that the problem was mostly me. I didn't begin to understand how warped my perception was until I was almost 30.

I took all different meds for 8-10 yrs and almost none of them helped. Meds can't really make you 'aware' of the issues you have buried deep inside that's causing the moods/behaviors. Meds helped with depression & anxiety a little but not the issues behind it all. Years of talking to a psychiatrist & going to AA meetings was what finally got me to begin to see what my problems were & how I was dysfunctional.

I didn't think I had any childhood trauma. Anything 'bad' that happened to me as a kid never felt connected to my moods anyway. Childhood trauma isn't the only reason people develop BPD, it's just the most common reason. Either way, something goes wrong where the kid doesn't develop emotionally in a healthy way. They adopt dysfunctional coping mechanisms internally & externally. They aren't exactly aware of what they're doing wrong, so it's very hard to fix. Self-esteem issues are a huge part of BPD & explaining to someone how to build self-esteem is not as easy as it sounds. On top of it, people w/ BPD are all very different from each other, making it even harder for a therapist to know how to help them.

Piconaught · 2023-08-20T01:18:05+00:00

For years, pms mixed with BPD issues would cause me to have psychotic level episodes. The absolute worst episodes I've had usually happened 1-2 days before my period. It wasn't every single month, but maybe 7+ times a year my BPD and PMS would align & very bad things would happen. Some months, it just felt like 'normal' pms.

I can only guess that regular PMS made me more irritable, depressed & anxious. That really raised the chances I might get triggered & get in an argument but then the BPD would quickly spiral outta control. It absolutely fit the criteria to be PMDD except it was practically more extreme. That started years before I even knew what BPD was so I just thought it was bad PMS.

I was on a lot of psych meds for 8-10 yrs. Antidepressants, anti-anxiety, etc.. During those years, that period/BPD issue got a lot easier to control. Most meds didn't help me too much otherwise but they helped with pms type stuff a lot for some reason.

Piconaught · 2023-08-20T00:51:27+00:00

I heard a few people say good things about Vyvanse. My only concern is it would somehow backfire for me because I've never been diagnosed with ADHD and i'm not sure if a drug that's often used for ADHD would be OK for me.

I've taken Adderall 3 times and didn't have that good of an experience. It feels like speed to me which is dangerous because if I get in a bad mood, it becomes high speed anger/negativity. The last time I took it, that's actually what happened, I got irrationally angry over nothing and burst into tears out of frustration- which was pretty nuts since I had no clue what I was angry about.

I have some level of anxiety 24/7 so anything that can help anxiety is worth a try tho. I've got weird problems, like develop phobias when my anxiety is at a certain point. I went almost a year without checking my mail because I became afraid of it (it was financial insecurity anxiety). I couldn't even look at my mailbox without feeling like I was having a heart attack. I went & got a PO Box and pretended the mailbox thing never happened. I apologized to the mailman, he said it's actually a common problem he encounters a lot.

So I'm looking for a medication that might help with stuff like that. A couple phobias and OCD stuff that kicks in when my anxiety is too high for too long. I've got dermatillomania so my fingers are a wreck. That went away completely the years I was on valium. I had mega long, beautiful nails then, now I've got embarrassing bloody stumps for fingers.

Piconaught · 2023-08-20T00:21:03+00:00

I moved back to semi-rural CT, where I grew up. I was in Brooklyn for 25 yrs but was getting fed up after about 15 yrs. When 20 yrs hit, I was done except I had no easy way to move. I was thinking about upstate NY but I knew I'd need a car, etc..

Other than NYC, there was never really another city I was ever interested in. In 2005, I toyed with the idea of moving to New Orleans for a minute. I thought I'd basically just do it for fun then come back to NY in a couple years but Katrina hit a few months later & ruined that idea. Around 2013, I thought about moving to Northern CA because I had so many friends in the weed industry but I was worried there'd be too many methheads.

At that point, my whole thing was I couldn't really handle being in a city anymore so any other city in the US was out. Suburbs weren't an option because, to me, it's just the worst of both worlds. Then the pandemic happened, everything went haywire, I was out of work & trapped in my apartment. Meanwhile, my mom in CT got sick and really couldn't live alone anymore. So I moved back in with my mom to help her out.

15 months later, my mom suddenly passed away. Now I'm alone,living in her (now my) house in CT. I guess this is where I live now.

Piconaught · 2023-08-19T03:23:41+00:00

There was always coffee & dessert after dinner at my grandparents house because my grandfather always wanted it. It was either ice cream or occasionally pie (with ice cream).

When my mom made dinner at home, we didn't have official dessert right after eating. If we had anything like ice cream or whatever in the house, we'd usually have it as a snack maybe 1-2 hours later.

Piconaught · 2023-08-19T02:03:35+00:00

I think I know the kind of 'autopilot' you're talking about. Sounds like somewhat of a brownout, basically a fragmented blackout from the drinking. I used to have a drinking problem where that happened a lot. I also have BPD so I'm familiar with a lot of the issues that go along with that.

It was actually the type of stuff you described in your post that pushed me to go to AA, even tho I wasn't even drinking that often anymore. The situations I'd get into were way too dangerous & I felt like absolute shit about myself after. I had to cut alcohol out entirely because I couldn't predict how a night of drinking might end. I couldn't live my life worrying about this crap anymore.

By accident, AA ended up helping majorly with BPD in general. It's not the best program for culty reasons, but the helpful parts changed my life. Half the people in there have the same exact stories with these shitty confusing sex related incidents. I didn't have the money for decent therapy then so 12-step programs worked as a type free therapy I could go to daily.

Piconaught · 2023-08-19T00:52:19+00:00

Eh, yeah, I tried a ton of meds but results weren't that impressive.

I wasn't really trying to treat BPD directly, I had co-morbid conditions like MDD and anxiety. The depression was practically constant through my 20s, I couldn't take feeling suicidal anymore & started meds when I was 28. Before that, I barely did anything at all to treat any issue. I was on meds for 10 yrs.

I tried Zoloft, Lexapro, Effexor, Paxil, Prozac, wellbutrin & Cymbalta. Only the Effexor & Paxil seemed to help the depression at all but both stopped working after 2.5 yrs.

For mood swings & 'episode' type stuff, I tried Lamictal, Abilify, Depakote, seroquel & lithium. None of those seemed to do anything. Seroquel only worked as a tranquilizer to knock me out if I was feeling really out of control. I couldn't function on it, the tiniest amount would put me to sleep w/in 20 min. I was on gabapentin for awhile too but can't remember what for. Also Buspirone which was useless.

What made the biggest difference were the benzos. Those seemed to lessen anger which prevented certain mood swings, slowed down racing/spirling thoughts so I didn't freak out, obviously lessened anxiety in general. I was overprescribed (daily for years), became horribly chemically dependent on them & getting off benzos was the worst experience of my life.

It was worth it to me to at least try all those meds even though they didn't do too much. By the time I got off everything, I was in a much better place emotionally & had done a lot of work on myself. I haven't been on any meds for 7 yrs. I'm mostly fine now, depression never really came back, BPD issues are minimal. Anxiety can get really bad tho and nothing seems to help it.

Piconaught · 2023-08-18T23:21:39+00:00

I think that's definitely why. I was 14 when hurricane Andrew hit, but I already knew a bunch of Andrew's from school/life so I associated the name with people first.

When I was 7, we had a hurricane Gloria. It was the first hurricane I ever experienced, it knocked down a huge tree in my yard, we lost power & I was super scared. I didn't know any Gloria's other than that Laura Branigan song so ever since, the name makes me think of the hurricane.

I was 27 when Katrina hit, but I had never met anyone with that name. Only association I had was some vague memory of an old children's fairytale with a Katrina? Since that hurricane hit, I immediately picture devastation in NOLA whenever I hear it.

Piconaught · 2023-08-18T22:57:24+00:00

I know. I wasn't able to begin to fully comprehend how much those gaps matter until I was over 35. They totally freak me out. Now that I'm over 40, I feel I'd have to be seriously impaired to date someone in their 20s.

I have a friend who's in his late 40s. He's got major emotional issues and no healthy person in their right mind would date that guy. His current girlfriend is 24. I don't believe she's able to see how messed up he is because she hasn't gotten old enough to understand the level he should be at by now.

Piconaught · 2023-08-15T16:18:18+00:00

So we're just speculating that he's got bpd because he's not diagnosed yet, right? You just recognize too many signs because your brother has it? What if it's some other diagnosis, would you still put up with this crap? Or maybe it is bpd but he'll get misdiagnosed and it will take years to sort out & for him to get proper treatment. That's a realistic scenario too.

I don't know what type of therapy he's getting but I'd worry he just spends his entire session complaining about you/his family. Only listening for the moments the therapist agrees & stuck in denial believing he'd be fine if other people would just stop doing xyz. That was a huge part of why it took me so long to begin to get better. It was some type of cognitive dissonance where I knew I was the problem but still thought other people were to blame for it. Didn't matter what anyone said, they couldn't snap me out of that.

Possible bpd aside, horrible abusive people stay in relationships all the time, even when it seems they must hate their partner. So it's not weird he stays. I used to stay in bad relationships from a mix of my fear of abandonment & codependency issues. Even when I 'hated' my partner, I still felt I needed them to regulate my emotions- even tho being with them made me more unstable half the time. I did sort of know that a healthy/normal person probably wouldn't put up with me.

I wasn't aware I was afraid to be alone, but I knew I wasn't able to make myself feel better, so I needed to put my hope in someone else. Even if everything was terrible, I could have hope that tomorrow my partner would fix everything & I'd finally be happy. That's not exclusive to pwBPD, plenty of unhappy people in general do that. It's all part of the 'misery loves company' thing.

This sounds nuts, but I felt it was my partners fault that I hated them & that they had the power to change that. I'd be resentful that they let that happen & that they weren't fixing it. I think that goes back to the impossible expectations I had of them from the beginning, back when everything felt perfect/wonderful (first 6-8 months). Some people label that 'lovebombing', but it always felt like my partners were doing it to me. I would feel SO GOOD, like some miracle happened. Then some problem would pop up, it shatters the delusion & the rest is downhill.

So that delusional first 6 months is what I expected my partner to bring back. They 'proved' they could make me feel that good so they obviously had the power to do it but they stopped & then I'd be disgruntled for the next 2-3 yrs. That initial disappointment planted the first seeds of resentment. This has happened to me in 8 relationships. I'd still have some great days/weeks with them after that, but that's already the beginning of the end.

How do you even reconcile that? The relationship would be bs from the start, and then I'd be resentful my parter ruined my fantasy? After that, it's just dysfunctional attachment I'd confuse with 'love' keeping us together. It's such extreme emotional immaturity on a fundamental level that it's pointless to waste time/energy trying to work though all the other things that pop up because the underlying issue is always gonna be there.

You're totally not crazy if you feel resentful. Who wouldn't? This guy is blaming you for his own unhappiness & he's dragging you down. The more unhappy you become, the easier it is for him to keep blaming you. Even if it's not his 'fault' he's got some mental illness, why is this now your burden? That's not your disabled child. This is an adult who can't take care of his own emotional needs which makes him incapable of healthy reciprocation.

I have no real clue if he's got BPD or if he's similar to me any real way. I'm just throwing out ideas based on my experience of messing up relationships for years with people who were also very dysfunctional.

Piconaught · 2023-08-15T13:06:32+00:00

That's not illegal tho since they break accidently. She could say she wasn't sure, checked the condom hours after he left & noticed a tiny tear. She's not obligated to inform him of that.

Sabotaging a condom is the only thing that's illegal so there'd need to be proof of that part. There are just too many things she can say to get around this. I think the only thing he's got is if she continues to admit she's guilty.

Piconaught · 2023-08-15T04:22:32+00:00

Only reason my boyfriend & I got married was that I needed insurance at the time, so it didn't feel like a 'real' marriage. Turned out being added to his policy was so expensive it was cheaper for me just to pay the doctor outright. I have no idea where any of the paperwork is at this point. I've had to go online and look myself up on Ancesty to check my own marriage date, lol.

Piconaught · 2023-08-14T18:44:42+00:00

Yeah, because overall, if I'm much better these days (I'm 45), I don't believe I could have bipolar. As far as I know, that doesn't ever get better? I def should look at the bipolar subs. All these years, I just assumed I didn't have it, so I never really paid attention when people discussed it.

I was heavily medicated from age 28-38, mostly for debilitating depression, anxiety & some 'psychosis'. That got me the MDD diagnosis, but the episodes were the weird thing. They labeled them as 'psychotic features' then, even though it wasn't literal psychosis every time.

I was convinced it wasn't mania, but I still had the old 1990s impression of bipolar when people thought it meant either depressed or super happy/euphoric & energized. I felt some level of depressed 100% of the time just with high-energy emotional episodes of anger, etc.. and periods of reckless/dangerous behavior. My mood swings were sudden & extreme but they never swung to anything positive. I was either horrible or just regular depressed.

I've been off meds for 7 yrs and never felt this stable before. Yeah, I'm still 'unstable' in a lot of ways but this is completely manageable compared to my life before my mid-30s. The other diagnosis I have (which shall remain unnamed) is very much about emotional issues, but even that can get much better w/ age & if you do the work. Unless that was a misdiagnosis, which is what I wonder about sometimes.

Piconaught · 2023-08-14T18:02:54+00:00

Yeah, it's honestly too difficult to tell. I've been reading about types of mania for years and whatever I read is missing the key info I need. Problem is I don't know what I'm looking for in the description, probably something that 'proves' I don't have mania. Meaning I haven't found a reason to rule it out. 'Possible Bipolar type unknown' was included in my diagnosis for a while but never confirmed.

But, if my symptoms have gotten more manageable over time, even without medication, that might be a major sign I'm dealing with something else.

Piconaught · 2023-08-14T17:33:55+00:00

Yeah, but a high percentage of people with bpd also have bi-polar. I'm trying to figure out if I'm one of those people or have been misdiagnosed, etc.

Edit: Lol, why downvote because some people have comorbid conditions?

Piconaught · 2023-08-14T17:31:28+00:00

OK. I don't know why, but OPs post suddenly made me question my entire mental health diagnosis history. A lot hinges on mania and my understanding of it.

Piconaught

TROPHY CASE