Reply to IF husband has borderline personality disorder- a death sentence for the marriage?

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Reply to "IF husband has borderline personality disorder- a death sentence for the marriage?"

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[quote=Anonymous][quote=Anonymous]I think it is very concerning that your therapist is diagnosing your husband through your description. Not a good idea at all. there are many mental illnesses that look similar on the surface and an expert needs to do a nuanced assessment to determine what is what.

I doubt you would want your husband's therapist to be diagnosing you based on what he tells them in therapy. I would be hesitant to go back to a therapist like yours who is throwing around very heavy diagnostic labels that are influencing your thinking (hence your title) based on a spouse's description.

And borderline is not a death sentence anyways. It is treatable and no longer viewed the way it once was.

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+1 to this.  Your DH needs a psychiatric evaluation by a psychiatrist experienced in mood disorders.  What kind of doc is your DH presently seeing (general physician, psychiatrist, psychiatrist specializing in  mood disorders?) What meds has your husband tried?  Sometimes depression and ADD can really be misdiagnoses for bipolar depression.  Sadly, the medicines prescribed for depression (anti-depressants) and ADD (stimulants) can actually make bipolar depression worse.  I say this from experience.  IMO, you before jumping to a borderline personality disorder diagnosis, a doctor should be exploring the bipolar diagnosis and trying medication.  Key medications for bipolar would be 1) a evidence-based proven mood stabilizer like lithium or depakote and 2) possibly an anti-psychotic.  Also, if a patient has failed to respond to several different types of anti-depressants, then it is one of the next steps in the treatment algorithm to try adding a mood stabilizer (with or without removing the AD).  The prescribing physician should be talking this through with you both.  FWIW, porn addiction can be a part of the hypersexuality of mania.  Speeding and impulsivity can also be part of mania.  Drug use can often be an attempt to self-medicate.  Hope that drug use is over because it is basically impossible to stabilize a mental illness while someone is drinking or drugging.  Are you seeing any mania symptoms or any pattern of alteration of moods up/down?  Mania can be really irritable instead of happy sometimes (called "dysphoric mania") and mania does not have to be "I can fly" high (lower mania is "Hypomania").  Read up and see what you think.

Even within psychiatry, some doctors sort of wonder if the borderline diagnosis is given to those with bipolar who are inappropriately treated or hard to treat.  Doctors are human and don't like to admit they are failing.  Borderline is a "personality disorder", and docs are more likely to view personality disorders as "untreatable", whereas bipolar is treatable.  Thus, a doctor isn't "failing" when he can't get a patient with a personality disorder to improve.  Of course, I realize that it's a non-treating therapist that is making this suggestion, but still.  (And, anyway, Borderline is thought to have a better treatment/therapy regimen these days.)  I always thought a central feature of the borderline diagnosis was a push/pull fear of abandonment kind of pattern, but I don't see that in the (little) you have mentioned.  Dialectical Behavioral Therapy is supposed to be the most effective treatment for Borderline based on medical evidence last time I read in this area.[/quote]

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