# Wife Severe Anxiety Depression



## synaptic (Dec 24, 2012)

First time poster. Need some advice. Will try to summarize the situation.

Been married to my wife since 2006. In 2007, we had our first child. He had some problems and was hospitalized for over a month with a collapsed lung. During the pregnancy, I noticed a change in my wife that consisted of high anxiety, anger, and depression. I chalked it up to hormones. She was released from the hospital less than 24 hours after a C-section, and she would not take her pain meds or anything of the like.

I had been up for 46 hours straight at another hospital where my son was when her family brought her by. They left her and she started to have issues. I took her home so I could rest too and in the driveway she had a nervous breakdown requiring me to call an ambulance. We dealt with that situation accordingly. I had her talk to a doctor and they too chalked it up to hormones.

She's had an ectopic pregnancy in 2008 (which didn't help matters), and we had a 2nd child in 2011. My daughter was a relatively painless pregnancy; however, the same behavior patterns surfaced.

Now, she had her gall bladder removed and I have found that she is out of control. She lashes out at everyone (per her parents, this was surfacing in late teens), and has even gotten physical at times with me when I've tried to take the rational perspective on a situation and offer her a realistic opinion of matters. She wants a third child, but I don't think we can handle it.

This gall bladder surgery has finally made her aware of the issues everyone around her see. I'm hoping that she is open to help, because she wasn't before.

I've started to get distant due to the emotional and physical abuse (there's been hitting, throwing things at me, and she shoved me off the bed forcefully enough to dislocate my shoulder). Today, on Christmas Eve, I pleaded with her to lay down and rest. She off-hand asked me if I wanted her to kill herself. I said no and that I love her, but immediately consulted with her parents on the matter. They are equally concerned.

Sorry if this confuses everyone, but I need some suggestions. I know I want her to see a shrink because of her issues, and possibly get some medication; however, I can't have a recurrence of this anymore. Today's episode she threw a gift bag at me containing a present and it hit me square in the face in front of her parents.

There isn't any doubt I love her, but this has to stop. I would appreciate any suggestions. I've been as patient as I can - dealing with this for 5-6 years really takes it out of you. As a rational, I tend to not lose my temper, only to get onto my 5 year old son for acting up, but who doesn't? I consider that normal anyways.

Help?


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## Twofaces (Dec 5, 2011)

I really dont know what to say except that the do you want me to kill myself remark os a huge RED FLAG. 

Do not leave her alone at all until you can get some advice from a mental health professional. Even if her parents have to come, someone needs to be with her around the clock until after christmas when you can get some help. 

She may need to be hospitalized and evaluated. Right now she is a risk to herself. Dont take this lightly. I do have some personal experience in this area. 

Im sorry for what you are going through


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## synaptic (Dec 24, 2012)

Thanks for the feedback.

Right now she feels like if we just went on a vacation by ourselves without the kids, we'd be fine. I don't think its a good idea to go, but our anniversary was on Dec 1st, and we promised that we would go somewhere. 

Of course we didn't plan for her to have gall bladder surgery 1 week before Christmas. 

I don't really know how to proceed here, having never done any of this before. I honestly don't know what hospitalization means and where she would go. I don't know how to proceed in that direction without devastating her and likely permanently ruining my relationship with her.

The other situation is my kids. I don't know how I would get them taken care of while I work.

I also don't know how long she would need. 

There are literally a million questions going through my head. She seemed fine after that episode today, enjoying time with the family on the couch this evening, but in the back of my mind, that comment is still there.

Whats worse, is that she said she was joking.

I'm really torn here.


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## Uptown (Mar 27, 2010)

Synaptic, welcome to the TAM forum. I agree with you and TwoFaces that your W should be evaluated by a psychologist. The behaviors you're describing -- verbal abuse, physical abuse, temper tantrums, implied threats of suicide, and emotional instability -- are some of the traits in several well-known patterns of behavior. 

Yet, if your W has one of those behavioral patterns, she also would exhibit many other related traits. I therefore ask whether you have often seen most of the following behaviors and, if so, which are the strongest:


1. Black-white thinking, wherein she categorizes everyone as "all good" or "all bad" and will recategorize someone -- in just a few seconds -- from one polar extreme to the other based on a minor infraction;
2. Frequent use of all-or-nothing expressions like "you always" and "you never;"
3. Controlling behavior that tries to isolate you away not only from close friends but also from close family members;
4. Irrational jealousy and inability to trust you for extended periods;
5. Flipping, on a dime, between adoring you and devaluing you;
6. Frequently creating drama over issues so minor that neither of you can recall what the fight was about the next day;
7. Low self esteem;
8. Verbal abuse and anger that is easily triggered, in seconds, by a minor thing you say or do (real or imagined);
9. Fear of abandonment or being alone;
10. Always being "The Victim," a false self image she validates by blaming you for every misfortune;
11. Lack of impulse control, wherein she does reckless things without considering the consequences (e.g., binge eating or spending);
12. Complaining that all her previous BFs were abusive and claiming that you are the only one that has treated her well;
13.Mirroring your personality and preferences so perfectly (e.g., enjoying everything and everyone you like) -- for the first six months of your relationship -- that you were convinced you had met your "soul mate;"
14. Relying on you to center and ground her, giving her a sense of direction because her goals otherwise keep changing every few months;
15. Relying on you to sooth and calm her down, when she is stressed, because she has so little ability to do self soothing;
16. Having many casual friends but not any close long-term friends (unless they live a long distance away);
17. Taking on the personality of whatever person she is talking to, thereby acting quite differently around different types of people; and
18. Always convinced that her intense feelings accurately reflect reality -- to the point that she regards her feelings as self-evident facts, despite her inability to support them with any hard evidence.
If any of those behaviors ring a bell, it would be helpful if you would tell us which ones are most accurate. It also would be helpful to know how persistent her temper tantrums have been. Specifically, did they start appearing about six months into the marriage and then persist (about every two or three weeks) for the next five years? Or, instead, did they only seem to coincide with pregnancy or post partum and the surgery? Take care, Synaptic.


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## Hope Springs Eternal (Oct 6, 2012)

Uptown said:


> Synaptic, welcome to the TAM forum. I agree with you and TwoFaces that your W should be evaluated by a psychologist. The behaviors you're describing -- verbal abuse, physical abuse, temper tantrums, implied threats of suicide, and emotional instability -- are some of the traits in several well-known patterns of behavior.
> 
> Yet, if your W has one of those behavioral patterns, she also would exhibit many other related traits. I therefore ask whether you have often seen most of the following behaviors and, if so, which are the strongest:
> 
> ...


Uptown, I though BPD as soon as I read this, too. OP, you have got to get her, somehow, on board with getting treatment. Do whatever it takes, for your sake, and for hers.


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## synaptic (Dec 24, 2012)

Hope Springs Eternal said:


> Uptown, I though BPD as soon as I read this, too. OP, you have got to get her, somehow, on board with getting treatment. Do whatever it takes, for your sake, and for hers.


Uptown,

Thanks for the feedback. Oddly enough she has exhibited every single one of the behaviors you mentioned. Every 6 months or so she would have an additional behavior you described. This has been ongoing and I've tried to get her help in the past but she was never receptive until this latest gall bladder issue.

She happened to mention to the Er doctor that she had the anxiety problems and they prescribed lorazepam (sp).

Bpd I am assuming is bi-polar disorder? If that's the case then it fits. We're going to try and see someone immediately after Christmas but I'm not sure that will be possible. I will do what I can but I'm at my breaking point now and can't handle another setback. 

Thanks for this. It has helped me gain some insight on the situation and I think I know how to proceed. Her parents feel like she may need to be hospitalized. I have a medical p of a for her so I may need to act fast.
_Posted via Mobile Device_


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## Uptown (Mar 27, 2010)

synaptic said:


> Bpd I am assuming is bi-polar disorder? If that's the case then it fits.


No, Synaptic, all of the 18 behaviors listed above are classic traits of "BPD," i.e., Borderline Personality Disorder. It arises from damage done to the child's emotional core, usually before age 5. It causes the child's emotional development to freeze at about age 3 or 4, leaving the person stuck with the ego defenses available to young children. 

The dysfunctional traits, however, usually do not become apparent until the teens, as occurred with your W (according to her parents). I asked you whether her issues had persisted throughout your marriage because BPD traits do not vanish for a couple of years. Rather, they usually disappear only for about 3 to 6 months during the courtship period because the BPDer's infatuation over you will hold her two great fears (abandonment and engulfment) at bay. As soon as the infatuation evaporates, however, those two fears return. This is why it is common for a marriage to a BPDer to start going off a cliff soon after the wedding, if not before.

Significantly, BPD is a "spectrum disorder," which means that everyone has it to some degree. That is, every adult on the planet occasionally exhibits all 9 of the basic BPD traits, albeit at a low level if the person is emotionally healthy. These traits do not become a problem unless they are so strong that they start distorting one's perceptions of other peoples' intentions, thereby undermining all LTRs. An important question, then, is whether your W is a "BPDer" (i.e., has strong BPD traits).

I don't know the answer to that question. I haven't even met the lady. I nonetheless am confident that you can learn to spot the red flags if you will take time to learn what warning signs to look for. Of course, you won't be able to diagnose your W's issues. Only a professional can determine whether her BPD traits are so severe as to meet 100% of the diagnostic guidelines for having full-blown BPD. Simply spotting the red flags, however, is not difficult to do, especially when you've been living with a person for over six years. There is nothing subtle about traits such as verbal abuse, temper tantrums, and rapid flips between loving you and devaluing you.

I therefore suggest you read my brief overview of BPD traits in Maybe's thread at http://talkaboutmarriage.com/general-relationship-discussion/33734-my-list-hell.html#post473522. If that description rings many bells, Synaptic, I would be glad to discuss it with you and point you to good online resources.


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## Uptown (Mar 27, 2010)

Synaptic, although you are primarily describing BPD traits, this does not rule out bipolar. About 40% of BPDers also suffer from bipolar disorder (32% have bipolar-1 and another 8% have bipolar-2). The "advantage" of bipolar is that, because it arises from gradual changes in body chemistry, the vast majority of bipolar sufferers can be treated quite successfully with medication. 

In contrast, BPD is not caused by body chemistry changes but, rather, by a personality disorder that has been in place since early childhood. Hence, although meds may be prescribed to reduce the associated anxiety or depression, the meds cannot touch the BPD. It cannot be cured. It typically takes many years of therapy for a BPDer to learn how to control their traits and fears. Sadly, although many good therapy programs are available throughout the nation, it is rare for a high functioning BPDer to be willing to stay in therapy long enough to make a difference.


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## synaptic (Dec 24, 2012)

Thank you for the details. It helps me as I work a plan to get her improvement. 

As for something happening to her < 5 years old, I believe it has to do with the fact that her mother was physically abused. I don't know the timeframe to that, but it was right around the same time.


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## Uptown (Mar 27, 2010)

synaptic said:


> Thank you for the details. It helps me as I work a plan to get her improvement.


Synaptic, if you decide she likely has most BPD traits at a strong level (i.e., has most of the red flags) -- after reading the description I linked to above -- I offer the following suggestions:

*As an initial matter,* if you suspect your W has strong BPD traits, I recommend that you NOT tell her. If she is a BPDer, she almost certainly will project the accusation right back onto you, believing YOU to be the BPDer. Instead, simply encourage her to see a good psychologist (not a MC) and let the psych decide what to tell her.

*Second,* if you think you may stay with her a while, I suggest you get _Stop Walking on Eggshells_, the best-selling BPD book targeted to abused spouses like you. Or, if you ever decide to get a divorce instead, get _Splitting: Protecting Yourself when Divorcing a Borderline or Narcissist._ Both books are written by the same author.

*Third,* I suggest you start participating (or at least lurking) at BPDfamily.com -- the largest and most active BPD forum I've found that is devoted fully to the spouses and family members of BPDers. This issue is such an enormous problem that that website is growing by 20 new members every day. The result is that it offers eight separate message boards on various BPD issues. The ones that likely will be most helpful to you are the "Staying" board, "Leaving" board, and "Raising a Child when One Parent Has BPD" board.

*Fourth,* while you are at BPDfamily.com, I suggest you read the excellent articles in their resources section. My favorite is article 9 at T9 Surviving a Break-up with Someone Suffering with Borderline Personality Disorder - Columbia University, New York.

*Fifth,* I suggest you see a clinical psychologist -- for a visit or two by yourself -- to obtain a candid professional opinion on what it is you are dealing with -- and how likely it is she may pass it on to your son. As I've explained in many other threads, your best chance of getting a candid opinion regarding a possible BPD diagnosis is to NOT have the BPDer along. Therapists are loath to tell high functioning BPDers the name of the disorder (for the BPDer's own protection).

*Finally*, Synaptic, please don't forget those of us on this TAM forum. We want to keep trying to answer your questions and providing emotional support as long as you find our shared experiences helpful. Moreover, by sharing your own experiences here, you likely are helping many other members and lurkers.


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## synaptic (Dec 24, 2012)

She already projected it on our son. He has clear similarities in personality with hers. He's horribly defiant with me, and has a big lack of disrespect for other people (i.e. hitting people when angry, kicking puppies, etc).

Thanks for the further feedback.


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## Uptown (Mar 27, 2010)

At risk of overloading you with too much information, Synaptic, I note that I identify 12 differences between bipolar and BPD behavior in my post at http://talkaboutmarriage.com/anxiety-depression-relationships/59344-confused.html#post1175425. I am not a psychologist. Those 12 differences are based on my 15 years of living with a BPDer exW and caring for my bipolar-1 foster son -- plus my experiences in taking both of them to weekly meetings with psychologists throughout that period.


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## synaptic (Dec 24, 2012)

Thanks Uptown.

I'll keep everyone posted on what's going on to see if there are any issues between now and the time I go to get her seen.

If that fails, I'll be forced to look out for my kids.


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## synaptic (Dec 24, 2012)

So we haven't had any issues since Christmas Eve. I think her mom's comments to her about getting help scared her. This is pretty common though for us to not have any issues for a little while and then it happen really hardcore all of a sudden.

I can't get her seen until after the new year though. In the meantime I've been utilizing the resources you provided me with, Uptown. Thanks for all the help.

I've also been advised to keep a journal of the days events, regardless if shes okay or not. It makes me feel like I'm building a case against her.

She's continually pushing me for a 3rd child though, and I'm not sure we should have one at this point.


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## Uptown (Mar 27, 2010)

synaptic said:


> This is pretty common though for us to not have any issues for a little while and then it happen really hardcore all of a sudden.


Yes, that's why, in the very unlikely event your W agrees to stay in therapy, it will be extremely difficult to see if any real progress is being made. If she is a BPDer, it likely will take several years for significant improvement to occur. Meanwhile, she will be exhibiting dramatic improvements every two or three weeks. Unstable people are "always improving" in the same way that addicted smokers are "always quitting" -- it happens hundreds of times, occurring every few weeks, but usually doesn't mean any lasting improvement has occurred.


> I can't get her seen until after the new year though.


Synaptic, getting your W seen by a psychologist is important. Yet, if she actually has full-blown BPD or strong traits, it is very unlikely her psych will tell her the name of the disorder -- much less tell you (even if you are paying the bills). Doing so would mean that the insurance company will refuse to cover treatment costs. It also would almost certainly mean that your W would immediately refuse to go back to that psych. 

It is widely known, both inside and outside the psychiatric profession, that candid information about BPD is routinely withheld from BPDers and their spouses -- for the protection of the BPDers. Remember, your W's psychologist is NOT YOUR FRIEND. He is ethically bound to protect his sick patient. For a more detailed explanation of why you cannot rely on her therapist for candid information, see my post at http://talkaboutmarriage.com/genera...-official-im-getting-divorced.html#post811909.

The result is that, if your W has strong BPD traits, she likely will only be told about the associated Axis-1 disorders (e.g., PTSD, bipolar, anxiety, or depression) -- all of which are covered by insurance. In contrast, BPD and most other PDs (all of which are "Axis-2" disorders) generally are not covered by insurance. Hence, when BPD is a serious possibility, _relying on your W's therapist for candid information during the marriage is as foolish as relying on her attorney for candid advice during the divorce._ 

It therefore is important, for you and your two children, that you obtain candid advice from a psychologist who is ethically bound to protect only YOUR interests, not hers. To accomplish that, see a second psychologist -- one who is not seeing her.


> She's continually pushing me for a 3rd child though, and I'm not sure we should have one at this point.


At a time when you are unsure your marriage will survive, and are unsure as to whether your W has a personality disorder that could be passed on to your children, having a third child is the LAST thing you need in your marriage.


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## synaptic (Dec 24, 2012)

Uptown said:


> Yes, that's why, in the very unlikely event your W agrees to stay in therapy, it will be extremely difficult to see if any real progress is being made. If she is a BPDer, it likely will take several years for significant improvement to occur. Meanwhile, she will be exhibiting dramatic improvements every two or three weeks. Unstable people are "always improving" in the same way that addicted smokers are "always quitting" -- it happens hundreds of times, occurring every few weeks, but usually doesn't mean any lasting improvement has occurred.Synaptic, getting your W seen by a psychologist is important. Yet, if she actually has full-blown BPD or strong traits, it is very unlikely her psych will tell her the name of the disorder -- much less tell you (even if you are paying the bills). Doing so would mean that the insurance company will refuse to cover treatment costs. It also would almost certainly mean that your W would immediately refuse to go back to that psych.
> 
> It is widely known, both inside and outside the psychiatric profession, that candid information about BPD is routinely withheld from BPDers and their spouses -- for the protection of the BPDers. Remember, your W's psychologist is NOT YOUR FRIEND. He is ethically bound to protect his sick patient. For a more detailed explanation of why you cannot rely on her therapist for candid information, see my post at http://talkaboutmarriage.com/genera...-official-im-getting-divorced.html#post811909.
> 
> ...


I'm going to utilize my employee assistance program. They provide me with a psychologist free of charge for 6 sessions. The psych can be anyone I choose. I simply provide a voucher. I'm currently researching good candidates near my place of work (which is some distance from my home). 

She will utilize someone close to home. That way I don't have to worry about her traveling long distances (especially after a major surgery - she has to be cleared to drive first). Her mom is also volunteering to help ensure she goes in my absence. I'm getting a lot of support from them on this. Insurance should cover, at least 80%. I reviewed my policy, which was changed to PPO, and they will bill me the rest with a 45 dollar co-pay. I called them to confirm.

As for a 3rd child - my gut tells me no anyways, and I don't betray it. No brainer there. I don't feel comfortable anyways bring a 3rd child in with my son's anger issues and stuff.

I think what really scared her, was the fact that we talked about the physical abuse and I told her that there will come a point in time where I will need to worry solely about the kids in those situations. Kind of a "straighten-up, you won't get another chance" comment. Her parents have a lot of experience with her on this and told me that saying that will make her realize what she's doing is wrong. As such, she has been way different with her behavior.

If divorce is my only recourse, my employer has offered several attorneys in the area who will focus on me. They've offered to cover up to 50% of the total cost, plus retainer. I don't want to go that route. It is likely that if she does get help, and does make the necessary improvements, I could lose custody of my kids. Texas is very unforgiving for husbands/fathers. There's a really bad track record in my area for that.

She doesn't know I'm considering divorce. I intend to keep it that way. I don't want her going off on me or the kids or having another mental meltdown.

Thank you for continued support / discussion Uptown. I'm utilizing your posts as good research.


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## Uptown (Mar 27, 2010)

Synaptic, that sounds like a good plan to me. A very good plan. Yes, I know how "pro wife" the courts can be in Texas. I once lived in Houston area for several years. Hopefully, you will never have to fight for child custody. 

Yet, because that is a serious possibility, I suggest you buy a VAR and keep it hidden nearby. During her tantrums, you can slip it into your breast pocket and record the exchange. This will be useful because, if your W has strong BPD traits and is high functioning, nobody outside the immediate family will see her dark side. 

With high functioning BPDers, the two fears are threatened -- thus triggering the rage -- only when you draw close enough to cause engulfment or pose a threat of abandonment. It therefore is difficult for casual friends of hers to believe the dark side exists.


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## synaptic (Dec 24, 2012)

Well, I guess I spoke too soon.

I'm holding out until the psychologists are opened up in my area, but its really hard. She doesn't quite understand the meaning of rest, especially after a major surgery. She was up since 4 am last night, and said she had too much on her mind. No other reason - not stress, not anxiety.

Today, she really turns a blind eye to how the kids act, and when a friend is over, she completely disregards anything happening around her. 

My son acted up hardcore, and, since no discipline is handed out from her, I did so. I didn't yell, scream, or do any type of "verbal abuse" that she said I did.

I feel defeated right now.


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## Uptown (Mar 27, 2010)

synaptic said:


> Well, I guess I spoke too soon.... I feel defeated right now.


No, despite how you feel, you've got a plan and you're implementing it. You are on course. Of course, executing a plan doesn't mean you are not going to feel awful some days or that you have any control over her. Some days you will even feel like you are back at step one. But those are just feelings. Don't believe them. You are making good progress. If she has strong BPD traits, leaving her is going to be a messy, nasty, vindictive process.


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## synaptic (Dec 24, 2012)

Here's what I can't figure out.

There are many psychologists in my area. There are also psychiatrists, clinical psychologists, and clinical psychiatrists.

What do I send her to? A psychiatrist? It seems like she's going to need anxiety medication for sure, so that seems like the place she needs to go, but I'm just not sure.

Research seems to indicate that the 2 fields overlap somewhat, which makes it kinda blurry when it comes to getting her into the right place.

Any insights?


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## Hope Springs Eternal (Oct 6, 2012)

synaptic said:


> Here's what I can't figure out.
> 
> There are many psychologists in my area. There are also psychiatrists, clinical psychologists, and clinical psychiatrists.
> 
> ...


Diagnosed bipolar here, and was a psych major in college.

Ultimately, she will need to see both. The psychologist for (hopefully) ongoing counseling, and the psychiatrist for medication management. Some psychiatrists also do some amount of counseling, but typically, it's not as in-depth as what a psychologist will do for your wife. Either of those professionals is in position to diagnose your wife. 

Wish I could give you good advise on how to get her to buy into all this, though. Without her buy-in, you will have a rough time. If she doesn't see her condition as a problem for her, she may not see a reason to seek treatment. 

Just let her know that it's for you and your family, and hopefully that will tug on her heartstrings. If she's borderline, it's really a challenge. 

Best to you.


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## Enchanted (Jan 2, 2013)

synaptic said:


> Here's what I can't figure out.
> 
> There are many psychologists in my area. There are also psychiatrists, clinical psychologists, and clinical psychiatrists.
> 
> ...


In my experience I couldn't even being to use therapy until I was somewhat stabilized on meds. If your wife has BPD she probably has severe anxiety and depression as well. Get her to a psychiatrist ASAP.


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## Uptown (Mar 27, 2010)

Synaptic, I agree with Hope and Enchanted. Your W likely will need to be treated by both a psychologist (for the therapy) and a psychiatrist (for prescribed medicines to address the anxiety or depression). Hence, no matter which of them she sees first, she likely will get a quick referral to see the other. 

As a general rule, the psychiatrists cost at least twice as much per hour (compared to psychologists) because you're paying for a medical degree as well as a psychology degree. And, generally, the psychiatrists have less experience in actually treating clients with psychotherapy. 

I agree with Hope that, although your W can begin with either a psychologist or psychiatrist because she likely will need both, it may be advantageous to start with the psychiatrist. That way she can get meds to calm her down and thus increase her chances of actually wanting to see a psychologist for therapy. 

Yet, if she does not badly want the therapy for herself, it likely will be a waste of time to insist she remain in long-term therapy with a psychologist. The danger is that she will play mind games for years with a therapist, at enormous expense to you. That's what my exW did to me for 15 years, seeing six different psychologists in weekly meetings throughout that period.

*As to yourself,* I again suggest you see YOUR OWN psychologist because -- as I discussed earlier -- there is little chance your W's therapists will tell you the name of her disorder if it is BPD. For you, I suggested a "clinical psychologist" because -- if your primary objective is to find out what is causing your W's abusive behaviors -- there is no need to double or triple the cost by seeing a psychiatrist. 

Finally, I note that the APA defines over a dozen different types of "psychologists." The two that you will see most frequently in the yellow pages are "clinical" and "counseling" psychologists (the latter may simply say "psychologists"). As a general rule, the clinical psychologists tend to treat more severely ill clients such as those having strong traits of a personality disorder. This is why I earlier suggested you see a clinical psychologist by yourself.

There nonetheless is great overlap in the experience of those two groups and, as with any profession, there is great variation in skill sets among the individual psychologists. Hence, if you learn that one of them is very experienced in diagnosing PDs like BPD, I suggest you not pay much attention to the distinction between "clinical" and "counseling." This, at least, is my understanding.


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## synaptic (Dec 24, 2012)

I found an office that has pretty much everything. There are several therapists there, along with 2 psychiatrists and 1 psychologist. They take my insurance.

When my wife was in the hospital, she was convinced she had to have a medical power of attorney filled out for herself. She named me as the primary. 

When I went to the office, I consulted about that, and given the PoA, I have full access to what the doctors determine. I even have a written document from them explaining that (its a pamphlet). 

All in all, it looks good, but they're booked solid until February. I've tried about a dozen different doctors in the area (psychiatrist first), and a lot of them don't even take insurance. Their rates are astronomical (200 - 400 an hour).

I'm waiting for a call from one of the doctors to discuss more details about her. The initial discussion was that she may not have BPD, but something slightly more common. They said it could be something along the lines of DPD, which is dependent personality disorder.

We won't know more until we get her in there. The good thing is that multiple people will be speaking with her, so I will be getting the therapy and the medication. What's better... 45 dollar copay, then 100%.


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## Uptown (Mar 27, 2010)

synaptic said:


> When I went to the office, I consulted about that, and given the PoA, I have full access to what the doctors determine. I even have a written document from them explaining that (its a pamphlet).


I hope that works for you and they are forthcoming. My experience, however, is that "BPD" will never be recorded in writing as the diagnosis if that is what your W suffers from and she is high functioning. I explain my reasons for saying that at the link I provided in post #15 above. (One reason is that insurance will not cover such a diagnosis and another reason is that high-functioning BPDers typically will quit therapy on hearing it.)


> They said it could be something along the lines of DPD, which is dependent personality disorder.


Perhaps so. But that would not explain why you are describing intense anger, verbal and physical abuse, and emotional instability. All of those traits are characteristic of BPD, not DPD.


> The initial discussion was that she may not have BPD, but something slightly more common.


A recent study of nearly 35,000 American adults (pub. 2008) found that 6% of the population has full-blown BPD. In contrast, the prevalence of DPD is much smaller. Most sources I've seen cite 0.5% and I've seen estimates as high as 2.5% -- still far below that of BPD. 

Moreover, the last draft I saw (last year) for the upcoming DSM-5 showed that the APA is reducing the number of PD categories from 10 down to 6 -- by eliminating some PD categories such as DPD, which is being buried in the residual catch-all category. BPD, however, is being retained as one of the major categories. I therefore am puzzled by the psychologist's remark to you that DPD somehow is more common than BPD.


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## Hope Springs Eternal (Oct 6, 2012)

synaptic said:


> I found an office that has pretty much everything. There are several therapists there, along with 2 psychiatrists and 1 psychologist. They take my insurance.
> 
> When my wife was in the hospital, she was convinced she had to have a medical power of attorney filled out for herself. She named me as the primary.
> 
> ...


synaptic, you are doing all the right groundwork here, and are to be commended. Try and hang on 'til February (you've made it this far, right?), and go with insurance covered-services if possible. Unless money is no object...

Best to you!


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## synaptic (Dec 24, 2012)

Uptown said:


> I hope that works for you and they are forthcoming. My experience, however, is that "BPD" will never be recorded in writing as the diagnosis if that is what your W suffers from and she is high functioning. I explain my reasons for saying that at the link I provided in post #15 above. (One reason is that insurance will not cover such a diagnosis and another reason is that high-functioning BPDers typically will quit therapy on hearing it.)
> Perhaps so. But that would not explain why you are describing intense anger, verbal and physical abuse, and emotional instability. All of those traits are characteristic of BPD, not DPD.A recent study of nearly 35,000 American adults (pub. 2008) found that 6% of the population has full-blown BPD. In contrast, the prevalence of DPD is much smaller. Most sources I've seen cite 0.5% and I've seen estimates as high as 2.5% -- still far below that of BPD.
> 
> Moreover, the last draft I saw (last year) for the upcoming DSM-5 showed that the APA is reducing the number of PD categories from 10 down to 6 -- by eliminating some PD categories such as DPD, which is being buried in the residual catch-all category. BPD, however, is being retained as one of the major categories. I therefore am puzzled by the psychologist's remark to you that DPD somehow is more common than BPD.


Hence why I'm coming here first. You've been a good resource for information. I think financial constraints are going to keep me going with this group though. The money required to cover a lot of the other doctors in the area is just insane. I have a small safety net, but it will quickly run out, and that will cause her to quit the therapy for sure.

Anyway, I'm continuing forward, so we'll see what happens.


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## Uptown (Mar 27, 2010)

synaptic said:


> Hence why I'm coming here first. You've been a good resource for information.


Thanks for the kind words, Synaptic. Yet, if what is said here contradicts your psychologist, my advice is to believe what _your psychologist _is telling you. He is the professional. 

In that regard, I offer only two cautions. One is that it is prudent to take care in selecting a psychologist because, as with the members of any profession, there is a wide range of skill sets (but even the lowest skill set likely far exceeds what is available to you on a public forum). 

My other caution, as I noted earlier, is that relying on your wife's psychologist for advice during the marriage would be as foolish as relying on her attorney for advice during the divorce. It is important to see a professional who is ethically bound to protect YOUR interests, not hers, when seeking candid information on what it is you are dealing with.


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## argyle (May 27, 2011)

Dialectical Behavioral Therapy has shown efficacy with BPDs. The additional cost is relatively small. (Weekly small group sessions)

I found it useful to check whether or not my wife's future therapist would actually treat BPDs. (Many won't - and being rejected tends to trigger abandonment...)

I also found it useful to enroll in marriage counseling and share information with my wife's other therapists. If you do this, choose a PhD counselor and expect an extremely frustrating experience. Very little useful marriage counseling may be expected - and the counseling will tend to trigger rages. However, the issues you raise will serve as a reality check on your wife's therapists and as useful testimony assuming you eventually proceed to divorce. My approach was to use my insurance for MC and hers for individual therapy.

A psychiatrist may be useful - however expect very uneven reactions to medication. My wife has shown many 'rare' side-effects from various psychiatric medications.

--Argyle


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## synaptic (Dec 24, 2012)

Latest update.

Wife went to appointment without a hitch. After a long consult with her, they found out that over 1 year ago, she had a really irregular thyroid count, and want her to get it checked out before they prescribe her any additional medication.

Keep everyone posted.


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## Uptown (Mar 27, 2010)

Synaptic, thanks for the update. I'm glad to hear that they caught the thyroid problem. Catching it can be very difficult to do. The problem is that, when the thyroid is failing, it operates sporadically -- some days producing the correct amount of thyroid hormones.

In my case, for example, I had radiation that damaged my thyroid but it took many years of blood tests before it ever showed up. One day, however, I just happened to be taking a blood test as part of my annual physical and my thyroid hormone was extremely low that day. Ever since, I've been on a supplement.

My understanding is that the thyroid hormone not only affects our metabolism but also can magnify the effects of our other body hormones. If so, your W's thyroid problem could have exacerbated the hormone problems she was experiencing during postpartum.


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## synaptic (Dec 24, 2012)

I have later found out that her family has a history of thyroid problems. Her mom has to take a pill every day for hers, her grandmother has issues, and there are documents suggesting that her great grandmother suffered from the same.

After stabilizing this, I think my wife should get better; however, I don't think it will solve all of our problems. I'm still getting pushed for another child, despite my expressing my concerns about workload and the fact that with our current 2 kids, we have no structure to speak of. It's a hot-button topic for her at the moment, and everyday, there's something she says that basically backs me into a corner about it.

Anyway, thanks for all the help and feedback. I'll continue to keep everyone posted about what's going on.


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## Anon Pink (Jan 17, 2013)

Hi Synaptic, Stabylizing on synthroid will take several weeks, app 6 if all goes perfectly. While its great that you are feeling more hopeful, thyroid problems, do not cause the level of dysfunction you attribute to your wife. As Uptown said, they can magnify ... possibly Anxiety/depression, but thyroid imbalance can't be the cause of PB and certainly not BPD. 

I just read the whole thread, my heart goes out to you. Uptown has recommended that you seek your own PhD therapist, several times. I want to underscore how vital that is for you. But I don't want to overwhelm you, especially while your feeling so hopeful. You deserve to feel good!

Take care of yourself, your kids need you.


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## synaptic (Dec 24, 2012)

I have utilized my EAP (employee assistance program) and have been talking to a therapist for several weeks now. The sessions are free and I'm taking advantage of them.

I've been told on several occasions that in order for me to be mentally healthy, I need to stick to my guns and not cave in to others when they demand something. That seems to be working for the most part; however, my wife doesn't like the sudden abrasiveness that has arisen when she asks for something.

I am not without my faults, and I accept that. 1 goal of these sessions is to learn those faults and find out the best way to resolve them in a manner that helps improve my marriage.

Anyway keep you posted and thanks.


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## Uptown (Mar 27, 2010)

Synaptic, thanks for giving us another update. Is the therapist you are seeing a psychologist or a MC? Also, is this the same therapist that speculated she has strong DPD traits? When you are seeing a therapist on your own to obtain information about your W's behavior and thus do not need medication, I would recommend using a psychologist -- which typically is a third or half the cost of a psychiatrist because you don't have to pay for the medical license skills.


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