In the previous entries of this series, we explored the common mental illnesses of
depression and anxiety disorders. Today, we’ll look to another of the more common forms of mental illness: borderline personality disorder.
This condition, also known as BPD, affects roughly 4 million adult Americans. Like other mental health problems, people can be affected in a variety of ways, and with a range of severity. Borderline personality disorder generally manifests itself conflict and confusion about personal identity, relationships with others, and drastic changes in mood, opinions, outlook, etc.
Some of the common symptoms include:
• Impulsive and/or risky behavior
• Wide mood swings that may last hours or days
• A pattern of unstable relationships, friendships, etc.
• Fear of abandonment
• Extreme measures to avoid rejection or separation (real or imagined)
• Changes in self-identity and self-image
• Rapidly shifting goals and values
• Periodic episodes of paranoia and even “losing reality”
• Feelings of emptiness and meaninglessness
• Intense, unprovoked (or irrational) anger and aggression
As you can see, BPD is as much an “outward” facing set of challenges as “inward.” Where anxiety and depression can cause people to withdraw, borderline personality disorder can cause those suffering to lash out – and this has serious consequences for marriages.
There is a side of BPD, however, that is also reclusive and extremely self-conscious – which makes the condition easily confused for other forms of mental illness. As with all of the mental illnesses we’re covering in this series, if you suspect that your spouse may have an undiagnosed case of BPD (or just exhibits symptoms of mental illness), it’s best to seek professional help.
Borderline Personality Disorder and Relationships
As you might expect, BPD can tear marriages apart at the seams – simply by way of the nature of the disease. As with other forms of mental illness, the person suffering isn’t acutely aware that they are behaving irrationally or that the disease is clouding their thoughts.
This means that verbal abuse, erratic behavior, fear about opening up, accusations, self deprecating comments, and so on are all manifestations of the illness – but that doesn’t make it any easier to be on the receiving end.
For that very reason, recognizing that it IS in fact the disease at work (and not “real” disdain or viciousness from your spouse) is critical for working through BPD with your marriage intact. This requires both incredible patience and likely some thick skin.
Feelings of jealousy, worry about abandonment, drastic mood swings, and the like are all fairly common with BPD, and all of those symptoms (if not recognized as elements of illness) can be triggers for arguments and conflict. In turn, conflict can cause a person with BPD to feel even more isolated, more at risk for abandonment – further perpetuating the cycle.
Patience and tolerance will help your day to day, but it won’t create solutions. Problems will still arise just because, without treatment, your spouse’s problems won’t go away on their own. You may have long periods without incidents or episodes, but the condition remains – and the struggles of acceptance, identity, and instability will reappear, pulling you and your spouse apart again and again.
…So what can you do about it?
Treating Borderline Personality Disorder
The first step, of course, is recognizing that problems are in fact a mental illness, and admitting that professional help is necessary.
As a loving spouse, you can help your partner understand that you ARE NOT threatening to leave, but that if they don’t seek treatment, the marriage will be in jeopardy. Reiterate that you are not blaming them as a person, but rather, the illness that is causing the problems. Reassure them that you are there to help.
Treatment options, like manifestations of the illness, are varied and often unique to the individual. The most common approaches include:
• Medication – Various medications can be used to help treat specific symptoms of BPD, particularly the parts that lead to depression, anxiety, paranoia, and irritability. Depending on the individual, medication may also be prescribed to help with emotional instability and impulse control.
• Hospitalization – Usually only in more extreme cases, when self-harm or threatening behavior is happening, brief hospitalization can help ensure a BPD sufferer’s safety and offer some “in-house” treatment.
• Psychotherapy – While short stints of therapy can help with symptoms, lasting changes in personality often require extended psychotherapy with the right therapist – someone your spouse can trust and build a relationship with. Therapy can help make connections between past trauma and present struggles, help recognize patterns and triggers, and help people learn new behavioral patterns.
• Group Therapy – Therapy sessions that involve multiple people are often effective in developing improved interpersonal skills and helping BPD patients learn to control impulse and gain more awareness about their own behavior, triggers, and overall psyche.
• Marital/Family Counseling – Because BPD can be a source of so much conflict in marriages (and relationships of all kinds), this specific type of therapy can help families learn more about the illness, how to manage symptoms, and reduce conflict. You will learn better communication and conflict resolution – as it applies specifically to borderline personality disorder.
In most cases, these methods of treatment will be used in conjunction with each other to find a program that will be the most effective for your spouse. Throughout treatment, there may be lapses and struggles, but don’t give up!
If you’ve gotten as far as seeking help, you’re on the path to recovery – but you’re not out of the woods yet! It will take time and patience from both of you, but with diligence, real change is possible!
The better you both understand the ins and outs of borderline personality disorder, the better you’ll both be able to manage its symptoms when the need arises. With increased awareness, treatment, and your commitment to one another, BPD doesn’t have to harm your marriage, and you can enjoy a fruitful, loving relationship despite mental illness.
You CAN do it. Seek help and begin the path to recovery.