Family member with mental health problems

[V12biTurbo]

paulmakin said:

Dialectical therapies were specifically formulated for treating BPD.

until quite recently, even psychiatry didn't want to have anything to do with the personality disorders (which misses the point that keeping them at bay merely reinforces their underlying psychopathology).

assuming consent and cooperation, start point would be your local secondary MH services. the personality disorders usually have a diagnosis specific service - it'll be called "Complex Needs" or similar. the fact that they have their "own" services might suggest to you that this is not something you'll deal with unilaterally.

if you have access to funding for private healthcare, DBT (dialectical behavioural therapy) is what you should be looking for

paul

Thank you Paul, very helpful.

Suggested looking in to DBT after doing some reading myself last night.

She's denying she has BPD although it was the official most recent diagnosis from the psychiatrist, and it is a scarily accurate description. A doctor once thought she was showing schizophrenic symptoms so she's convinced the psychiatrist is wrong now and won't entertain any more 'rubbish therapies that don't work'. I'll try again when she's in a better mood.

[V12biTurbo]

So it's been a tough week, she's had a chest infection, convinced she's dying of cancer or pneumonia, with barely any symptoms each time we've been to the docs, not even a temperature.

I ruined my weekend plans with GF so I was around, silly me again, but it's better than the grief Id get if I didn't. Various running around whilst trying to get enough sleep to sustain my nightshifts, lots of abuse when I dare say I don't have time for this, put my back out walking her dog yesterday. I had a moments sympathy but today was expected to go to the shops because she's too unwell, I've been shouted at to take a cat to the vets who is apparently mine even though I was a child when we got it, and shouted at again when I wouldn't go and get her dustbin in. I didn't manage to take my own bin out today cause of my back, and haven't managed to go to work, so how can I get her bin, and why should I hurt my back even more?

Home now for some peace and quiet, but various text messages ensued, basically saying how the argument was all my fault, along with all of life's other problems, putting it mildly, and basically I'm mental (starting to wonder if I am!!) and I've been told she's burned herself with a cigarette and it's my fault.

Standard week in my life then. Something has to change soon and I don't think it's going to be easy.

[andy-xr]

You possibly could be mental. But so what, you've still got a life to lead and make what you can of it.

Your Mums showing every sign of BPD even down to claiming not to have it

Its a name given to a condition, doesn't matter if it's called BPD or Giraffes R us. Its up to her to come to terms with it and its up to you to set your limits - the I hate You Don't Leave Me will be at its strongest, but you don't have the qualifications or experience to give her the care she needs
Your jobs to support her

Edited by andy-xr on Thursday 19th January 21:37

[paulmakin]

BPD and psychosis can/do present with similarities - that's the "borderline" bit - and longitudinal assessment is required to establish diagnostic clarity. the "psychosis" experienced by BPD sufferers is almost always related to disorders of internal speech, misidentification of their own thought content etc.

the difference between functional psychosis and "borderline" is relatively easy to establish, provided the patient makes themselves available for assessment.

the personality disorders get a bad press and joe public tends to interpret the diagnosis as being akin to an axe-wielding murderer. we know this isn't so but persuading the sufferer to acept the implications of the diagnosis and the implications for treatment is extremely difficult as they (always) carry their own preconceptions.

the aetiolgy is simple. we are all products of, essentially 3 things. our genetics, our environment and our experiences. these elements shape personality/character and if any of them are "faulty" then it follows that our "personality" will be faulty.

PD's learn to experience the world differently to you and i. Their emotional development has been disrupted and commonly they respond to life in ways that are emotionally immature. the problem you have is that you are responding intellectually and she is responding emotionally (iucwim). themes of rejection, abandonment, fear of others' motives will be very common for the sufferer and the world has become a very scary place for her.

don't misunderstand me, i'm not an apologist for bad behaviour and i certainly do not seek to medicalise it (check my colleagues for confirmation of that !!) but i firmly believe that services are not well geared to meeting the needs of this patient group. i work extensively with them so feel able to comment.

once you establish in your head the demarcation of responsibilities for her well-being, life will become easier (although by no means easy). i frequently tell my patients (to the abject horror of colleagues) that i want them to do well but it makes zero difference to my life if they stand or fall. difficult/perhaps impossible to do with a family member but it helps to establish the boundaries and responsibilities.

paul