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I have a 60-something year old relative by marriage who is currently committed to an inpatient treatment facility for a personality disorder and depression. Actually they have been diagnosed with NPD and BPD (narcissism, borderline) and major depressive disorder. This individual has been acting out, gas lighting, alienating family and scapegoating their children, self medicating, destroying property and generally seeking around the clock attention for years. In addition, there is a need for constant fact checking if they tell you something as it might sound plausible but is in reality a falsehood usually constructed for attention or chaos creation.
After a battery of physical tests to rule out a neurological or physical cause for this behavior during a recent trip to the emergency room, a full psych eval was done and the aforementioned diagnosis made. I have been reading up on these issues and have history dealing with someone with NPD in my family of origin (untreated.) The prognosis looks very poor.
Does anyone have experience with this? Can progress be made? We are all very happy that this person is finally getting some appropriate care, but not optimistic that it will change much of their behavior. As you might intuit, its been devastating and exhausting for the family who comes into contact with this person.
Dialectical behavior therapy can work extremely well for many patients with borderline personality disorder, but there are no guarantees. And someone with BPD who's made it to age 60 without seeking out any treatment is likely to be quite resistant to it. Hope for the best, but realistically you need to be prepared for the worst (which is of course that this person's behavior won't change much, if at all, despite treatment).
I've always read that people with these disorders are a nightmare for therapists, and most will not seek treatment because they don't think they have a problem.
I've always read that people with these disorders are a nightmare for therapists, and most will not seek treatment because they don't think they have a problem.
I’ve read similarly, though healing is possible when one can see how they contribute to the problems and really commit to overcoming or fixing their part. That just seems rare with BPD.
My mom was diagnosed with BPD - but of course she didn’t believe the diagnosis. It’s always someone else’s problem. Recently I had to reestablish boundaries. The thing with her (& I’ve heard with others with BPD) is they can be so nice to some people but anyone who gets on their bad side - watch out! This makes it difficult sometimes to feel validated, but luckily, others have seen her bad side too, so she can’t make me feel like it’s my problem that I see her problems.
We get along best when in groups and less often. Sad that she pushes everyone away when she deep down feels lonely. She had a tough childhood in a way - but also was kind of spoiled - so she has a lot of baggage that she hasn’t dealt with. What I don’t understand is why she doesn’t try to resolve problems when they keep reoccurring. So much pride - or is it just an inability to see her own response-ability? Maybe a bit of both.
I've always read that people with these disorders are a nightmare for therapists, and most will not seek treatment because they don't think they have a problem.
Don't mind trashing the mentally ill, do you?
I have BPD, have been in and out of therapy, on multiple meds for depression and anxiety. There are I believe 9 criteria that are associated with BPD. I currently am not experiencing only a few of these and am considered in remission. Never have I had any violent tendencies or horrible relationships. Was married 25 yrs, etc. so not all are a "nightmare" for therapists.
I fully except my diagnosis and have clear understanding regarding the reason for onset and my part in the illness.
Dialectical behavior therapy can work extremely well for many patients with borderline personality disorder, but there are no guarantees. And someone with BPD who's made it to age 60 without seeking out any treatment is likely to be quite resistant to it. Hope for the best, but realistically you need to be prepared for the worst (which is of course that this person's behavior won't change much, if at all, despite treatment).
I'm over 60 and was quite happy to finally learn the root causes of my BPD in THERAPY.
I have a 60-something year old relative by marriage who is currently committed to an inpatient treatment facility for a personality disorder and depression. Actually they have been diagnosed with NPD and BPD (narcissism, borderline) and major depressive disorder. This individual has been acting out, gas lighting, alienating family and scapegoating their children, self medicating, destroying property and generally seeking around the clock attention for years. In addition, there is a need for constant fact checking if they tell you something as it might sound plausible but is in reality a falsehood usually constructed for attention or chaos creation.
After a battery of physical tests to rule out a neurological or physical cause for this behavior during a recent trip to the emergency room, a full psych eval was done and the aforementioned diagnosis made. I have been reading up on these issues and have history dealing with someone with NPD in my family of origin (untreated.) The prognosis looks very poor.
Does anyone have experience with this? Can progress be made? We are all very happy that this person is finally getting some appropriate care, but not optimistic that it will change much of their behavior. As you might intuit, its been devastating and exhausting for the family who comes into contact with this person.
Yes I have experience firsthand and yes it's possible to improve...you may DM me if you wish...
I have BPD, have been in and out of therapy, on multiple meds for depression and anxiety. There are I believe 9 criteria that are associated with BPD. I currently am not experiencing only a few of these and am considered in remission. Never have I had any violent tendencies or horrible relationships. Was married 25 yrs, etc. so not all are a "nightmare" for therapists.
I fully except my diagnosis and have clear understanding regarding the reason for onset and my part in the illness.
I'm sorry. I wasn't trying to be insensitive to people with BPD. From my research (and I have done research), you are the exception. Even people who are aware of their illness talk about how difficult it is for patient and doctor.
ANYONE who doesn't realize they have a problem is a potential nightmare. I wasn't singling out people who are mentally ill. I've dealt with narcissists. They are draining and destructive, so I can empathize with anyone who is tasked with trying to heal them.
Dialectical behavior therapy works somewhat for a minority of borderline types. It is intensive with many many hours spent in "therapy". I was hot into it at first, until I looked deeper. The effects don't last once they leave therapy and some of the early reported "benefits" were probably attributable at least as much to the aging of the client - as people who have personality disorders get older, they usually seem to get less crazy, probably mostly due to not having the energy to keep the crazy going full speed any more.
Therapy is usually not very effective with personality disorders because it requires insight and a willingness to change and people with personality disorders don't have a lot of either (if any). Medication doesn't work on personality disorders but can be helpful with some of the side issues such as depression and anxiety. These folks do suffer, they just have absolutely no idea why. They really really believe that everyone else is the problem.
I don't know who told you your relative has both borderline and narcissistic personality disorder, but they should have been diagnosed with one or the other. They are mutually exclusive. Kind of like diagnosing someone with both depression and bipolar disorder - bipolar encompasses the depression. You don't diagnose both. Somebody needs to poop or get off the pot.
If you think you have borderline or another personality disorder and you think you are "in remission" or "recovering" my bet is you were misdiagnosed. Some therapists are terrible at diagnosis. I've know some who threw diagnoses around like confetti. Some have their own biases and misconceptions - I've known therapists who won't conform to the DSM diagnoses. I can sort of understand that with the latest version, it has some really over the top stuff in it - but if you're not going to conform to the diagnoses the way they are written up (and billed for) then you shouldn't use the labels. I knew a guy once (terrible therapist) who diagnosed almost every woman who set foot into his office with Borderline Personality disorder. When questioned about it, he opined that all women are crazy and they nearly all have BPD. He got fired. I've known a lot with similar bents though they were at least smart enough to be a bit more circumspect about it.
Clinical psychologist here.
Last edited by Pyewackette; 08-25-2018 at 05:28 PM..
Dialectical behavior therapy works somewhat for a minority of borderline types. It is intensive with many many hours spent in "therapy". I was hot into it at first, until I looked deeper. The effects don't last once they leave therapy and some of the early reported "benefits" were probably attributable at least as much to the aging of the client - as people who have personality disorders get older, they usually seem to get less crazy, probably mostly due to not having the energy to keep the crazy going full speed any more.
Therapy is usually not very effective with personality disorders because it requires insight and a willingness to change and people with personality disorders don't have a lot of either (if any). Medication doesn't work on personality disorders but can be helpful with some of the side issues such as depression and anxiety. These folks do suffer, they just have absolutely no idea why. They really really believe that everyone else is the problem.
I don't know who told you your relative has both borderline and narcissistic personality disorder, but they should have been diagnosed with one or the other. They are mutually exclusive. Kind of like diagnosing someone with both depression and bipolar disorder - bipolar encompasses the depression. You don't diagnose both. Somebody needs to poop or get off the pot.
If you think you have borderline or another personality disorder and you think you are "in remission" or "recovering" my bet is you were misdiagnosed. Some therapists are terrible at diagnosis. I've know some who threw diagnoses around like confetti. Some have their own biases and misconceptions - I've known therapists who won't conform to the DSM diagnoses. I can sort of understand that with the latest version, it has some really over the top stuff in it - but if you're not going to conform to the diagnoses the way they are written up (and billed for) then you shouldn't use the labels. I knew a guy once (terrible therapist) who diagnosed almost every woman who set foot into his office with Borderline Personality disorder. When questioned about it, he opined that all women are crazy and they nearly all have BPD. He got fired. I've known a lot with similar bents though they were at least smart enough to be a bit more circumspect about it.
Clinical psychologist here.
No, truthfully, I agree with her and also have depression and anxiety. I am the one who asked about remission, as I'd seen it in one of the many books I bought on BPD years ago and one or two after diagnosis. All were written by psychologists...but I know even the books might be a very brief overview.
I have fit ALL the criteria at some point. She and I pinpointed times when these were exhibited in my lifetime. The therapists I've seen, mostly psychologists, felt I did have good insight, working in the med prof field and so I've studied and worked hard to accept my responsibility in this illness. I still have issues dealing with physical and emotional abuse by my mother since childhood and right or not, she does get some of the blame. How I responded to her abuse as a young teen, young adult was problematic in itself...but that's what happens when you are overwhelmed with your own serious issues and no way out, in your young mind.
Between finally finding the correct meds that work for me for depression, and more therapy I'm at a place where I'm no longer in pain without knowing WHY or how to attempt to remedy the situation. I don't expect to ever have better interpersonal relationships. I don't expect to always be able to stay away from activities that can cover up pain but at least I no longer use alcohol in this way. I don't expect my thinking patterns to have all improved. But I am happy to have an idea why I spent most of my life with deep emotional pain.
Thanks for your comments.
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