# Untreated, can it get worse?



## AgentD (Dec 27, 2010)

If people who have such things like Bipolar, OCD, BPD etc, if left untreated does that get worse as one ages? If so, how worse can things get?


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## john117 (May 20, 2013)

There is some thought that some (like BPD) get better as one gets older (i.e. as they get better at hiding it ) but in general no, it does not get better. It may reach a steady state where the rest of the family can better deal with it but in absolute terms, without intervention, it generally does not.


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## unbelievable (Aug 20, 2010)

I'm no expert, but it's my understanding that treated or not, bipolar is likely to get worse.


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## AgentD (Dec 27, 2010)

john117 said:


> There is some thought that some (like BPD) get better as one gets older (i.e. as they get better at hiding it ) but in general no, it does not get better. It may reach a steady state where the rest of the family can better deal with it but in absolute terms, without intervention, it generally does not.


Thanks john! Well, my husband has never really be diagnosed, as in he hasn't been to a therapist to get a diagnoses. However, my counselor, just from explaining the way things have been with him for as long as I have known him (20 yrs) has told me, it sounds like he has possible bipolar with maybe some strong BPD traits. He is on Celexa for depression. In which, the last time it was uped was a year ago to 40mgs. It doesn't seem to be helping much anymore, kinda at a stand still. However a few weeks ago he decided to stop taking it all of a sudden just because he felt he didn't need it. That lasted about 5 days and I think maybe the withdrawal symptoms scared him enough to get back on it. He never mentioned it to his doctor. 

The Celexa came from his regular medical doctor who he told he did feel depressed. As far as seeing a therapist for other possible things going on, he wont go. His moods seem to switch more frequently now, that is why I had asked if things could get worse. He has never really been one to show a lot of mania but more depressed episodes than anything. However, all can be well for a bit then all of a sudden it changes, and we are left wondering why the sudden change all of a sudden. Its been like this for a long time, but the mood changes just seem to happen more frequently now.


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## trey69 (Dec 29, 2010)

A lot of people get worse. So if divorce isn't an option, you need to arm yourself with good knowledge of detachment and how to cope while living with someone who is untreated.


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## Mavash. (Jan 26, 2012)

I've read BPD gets better with age.

In my toxic, dysfunctional family people got worse.

All of them lost their jobs before 60.

All of them got addicted to drugs or alcohol in their older years.

All of them became largely bedridden hermits.

All of them were verbally abusive to their spouses while under the influence.

They all died before the age of 75 due to their addictions.


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## Sanity (Mar 7, 2011)

Life is too short to waste your time finding out. The only thing worth waiting 20 years to finally cash in is a high interest CD.


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## Sanity (Mar 7, 2011)

john117 said:


> There is some thought that some (like BPD) get better as one gets older (i.e. as they get better at hiding it ) but in general no, it does not get better. It may reach a steady state where the rest of the family can better deal with it but in absolute terms, without intervention, it generally does not.


I have an aunt who has mental issues and my counsin (her daughter) looks to have the same mental issues. The only way we get alone especially during family gatherings is because I just say hi and hang out with my non-nuts family members. At some point you just have to cut "crazy" from your life.


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## argyle (May 27, 2011)

...overall, as we get older, neurons die. Eventually, barring change, we all get worse.

BPD is reasonably treatable, so there's that.

...there is some evidence that untreated BPD improves with age. This is reasonable, as most humans respond to a kick in the teeth and BPD earns people many kicks to the teeth. But, I would take those studies with a grain of salt.
(a) These studies probably tend to be biased because acute sufferers of BPD tend to kill themselves. 
(b) Old, acutely toxic people tend to be cut out of social networks and many BPD symptoms are hard to express if no one in the world will speak to you.
(c) It seems likely, at least to me, that BPDs in long-term R/S may be less subject to improvement, as they are likely to be stabilized in unhealthy ways by codependent partners.

--Argyle


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## Mavash. (Jan 26, 2012)

argyle said:


> ...overall, as we get older, neurons die. Eventually, barring change, we all get worse.


Isn't this some truth? 

We all do get worse.

So it stands to reason if you start the aging process behind the dugout you will not handle it as well as a healthier person.

Brilliant insight.


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## john117 (May 20, 2013)

There is some cognitive and behavioral feedback that stems from interacting with a (cough) normal group of people and the lack of such validation or invalidation is what causes the deterioration at the end.


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## soulpotato (Jan 22, 2013)

argyle said:


> ...there is some evidence that untreated BPD improves with age. This is reasonable, as most humans respond to a kick in the teeth and BPD earns people many kicks to the teeth.


Yes, I've also heard that BPD sufferers tend to see the severity decrease as they age, and have heard it posited that this occurs due to stabilizing life circumstances, etc. I was definitely worse as a teenager and have mellowed out as I've gotten older (and not because of getting kicked in the teeth - that actually makes things worse). 



argyle said:


> (c) It seems likely, at least to me, that BPDs in long-term R/S may be less subject to improvement, as they are likely to be stabilized in unhealthy ways by codependent partners.


This is definitely not always the case. My LTR with GF has actually stabilized me a great deal and calmed me down. She also taught me to be gentler with people and to hold back on the rage and smiting. She gave me the kind of love and acceptance I had never before experienced in my life, but had always longed for. That is part of the reason why I'm willing to work so hard to be better for her, including sticking with therapy and treatment of my BPD.


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## soulpotato (Jan 22, 2013)

OP, BPD and bipolar DO definitely need to be treated to avoid general destruction (including self-destruction). In the case of the BPDer, sure, they may see a reduction in severity of symptoms as they age, but what will be destroyed and lost in the meantime? Treatment is really essential. 

I've heard with bipolar that the meds do need to be adjusted from time to time, and that people will often stop taking their meds because they feel they don't need them anymore. I don't know as much about bipolar as I do BPD, but I know that bipolar does not always manifest as it is classically depicted.


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## TiggyBlue (Jul 29, 2012)

My father my father was bipolar (diagnosed but not treated properly) and it got A LOT worse, the worse it got was hallucinations, suicide attempts then suicide (not saying that would happen in every case but that was my experience).


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## Uptown (Mar 27, 2010)

AgentD, with regard to bipolar, my understanding is that it generally gets worse as a person ages if it is not treated. With regard to BPD, it is significant that the only studies showing an improvement in untreated BPDers were studies of *low-functioning *BPDers. I have two objections to those study results, which find that many LF BPDers "no longer have BPD." 

My first objection is that BPD is not something a person "has" or "does not have." Instead, it is a spectrum disorder that everyone has to some degree. Hence, it is unclear that a 60-year-old BPDer satisfying only 90% of the diagnostic criteria (and thus "no longer having BPD") is any easier to live with than she was when, during her thirties, she satisfied 100% of the criteria. That is, because the AMA's binary approach to diagnosing BPD makes no sense for a disorder that varies in intensity, it is unclear whether the LF BPDers are substantially improved when they are no longer found to "have BPD."

My second objection is to the misguided belief that these study results cast light on what great improvements must lie in store for the abused spouses of aging BPDers if they remain married into old age. Importantly, it is unusual for a "Non" (nonBPDer) to _even date a LF BPDer_, much less marry one. 

Hence, even if the study results did show that LF BPDers eventually stop cutting and attempting suicide, such a finding would NOT imply that the high-functioning (HF) BPDer you marry is going to get any better at all. In this regard, Randi Krieger (author of _Stop Walking on Eggshells_) states:_There is no research on higher-functioning BPs. It doesn't exist. This population is invisible to 90% of the clinical world, and as they get higher and higher up the food chain there is less and less awareness of this population. In a phone seminar conducted by Robert Friedel, MD (who is on the board of the National Education Alliance for Borderline Personality Disorder, NEABPD.com) echoed the fact that while this population is "invisible to the clinicial population," every else knows about them._ See 2/5/10 post at Age: Do the symptoms of BPD improve/worsen with age?.​For what it's worth, my personal experience with untreated HF BPDers is that their abusive treatment of spouses gets worse over time. I found in my 15 year marriage that, as the years go by, the BPDer becomes increasingly fearful of abandonment as she sees her body aging and the kids leaving home. 

Moreover, her abandonment fear will go through the roof when, in the later years, you start establishing stronger personal boundaries -- which she will perceive as proof that you are secretly planning to abandon her. On top of that, as the years go by she will become increasingly resentful of your inability to make her happy or fix her.


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## argyle (May 27, 2011)

Dunno. For the purposes of the spouses of BPDs, I've also seen significant escalation in abuse over time.

Part of the problem is that the LF (self-harming) population has a natural negative feedback mechanism. (pain, hospital stays, mandatory treatment after suicide attempts). 

OTOH, the HF BPD is actually relatively well-adapted to society and doesn't really show up in the clinical population, kind of like NPD. The same sort of strong negative feedback mechanism doesn't always exist.

My suspicion is that most of the escalation is simple adaptation, similar to what happens in the general population (see, cycle of abuse) if abuse is ongoing in a R/S. With the difference that the BPDer has far greater stresses and less control than the general population. I suspect escalating abusive behavior isn't primarily a function of disease progression and that, in general, requires being in a stable or semi-stable R/S.

--Fred


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## Cee Paul (Apr 11, 2012)

If anyone saw the movie "Silver Linings Playbook" that was what I lived with for almost 3 years with my ex-wife, and she was great WHEN she took her proper medications but the problem was that she kept jumping back off of them and that's when she turned into a total nightmare!


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## Runs like Dog (Feb 25, 2011)

Untreated manic depression ends in jail, institutionalization or death.


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## synthetic (Jan 5, 2012)

From my own observations and experience, a high functioning Cluster B (BPD and other variations of 'crazy') only inflicts more abuse on loved ones with age.

It is unfortunate that the long-term abuse of a high functioning disordered person can cause exponentially bigger levels of damage to loved ones than the seemingly harsher episodes of a low functioning one. This is overlooked by professionals all the time.

There is also another aspect to long-term relationships with untreated disordered individuals. The NON learns reactionary abuse and makes it a way of life, further contributing to the craziness. Unfortunately such learned tactics are extremely hard to untie from the NON's personality when the relationship ends.


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## Cee Paul (Apr 11, 2012)

synthetic said:


> From my own observations and experience, a high functioning Cluster B (BPD and other variations of 'crazy') only inflicts more abuse on loved ones with age.
> 
> It is unfortunate that the long-term abuse of a high functioning disordered person can cause exponentially bigger levels of damage to loved ones than the seemingly harsher episodes of a low functioning one. This is overlooked by professionals all the time.
> 
> There is also another aspect to long-term relationships with untreated disordered individuals. The NON learns reactionary abuse and makes it a way of life, further contributing to the craziness. Unfortunately such learned tactics are extremely hard to untie from the NON's personality when the relationship ends.


This is probably why there is a high divorce rate amongst those who are bi-polar and manic depressed.


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## bunny23 (May 19, 2011)

I would tend to agree that BPD is very hard to diagnose, and really if someone has those traits the diagnosis is really a secondary thing.. because they will consume you regardless of diagnosis.

As for your H and Bipolar disorder. Believe it or not I was diagnosed with major depression at age 18 or so.. but I also had "mania" aka night after night of energy for weeks at a time etc etc.

Some physicians suspected Bipolar but the frequency of "mania" was VERY frequent... anyway.. I finally MYSELF saw a sleep doc. Turns out I have narcolepsy! I most likely never had major depression and never had mania.. but an insomnia typical in narcoleptics. I have not had these "moods" since I started on the narcolepsy medication.

I'm not saying that your spouse has narcolepsy btw...what I am saying is that most physicians don't look beyond their "box".

The fact that he is getting medication from a medical doc is concerning. First of all if he had manic states wouldn't the anti-depressants make those WORSE?
Second of all I don't think bipolar disorder is as "dramatic" as we think it is. Meaning, most people do not experience mania on a regular basis.

He is either depressed and possibly has BPD which the depression meds are enhancing.. or he just has BPD.

I left my "suspected" BPD spouse a year ago, and I also liked to tell myself that he was depressed or whatever.. truth be told he had serious ANGER issues.

I guess if he is not abusive to you (I don't know if this is possible?) and you want things to work you need to find a psychiatrist and get some firm diagnosis, then probably get a second opinion.

I wish you the best.. but if you plan on staying please don't expect it to get better... it may for a month or 2, but without pro help that he WANTS I just don't want you to destroy yourself over someone who is incapable of having a healthy relationship. Because I promise you, you will destroy yourself.


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## argyle (May 27, 2011)

...I think it is more accurate to say that you'll pay a cost and that it will be a high one, with no guarantee of a successful, enduring, or livable relationship.
...and that, if you are sensible and sufficiently stable...
...you should be able, over the course of several years, be able to change your own behaviors to deal with BPD behaviors in healthier ways than you are currently doing. This typically can result in BPD behaviors reminiscent of the first year of the R/S.

Still, leaving is generally the healthiest response.

--Argyle


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## Sanity (Mar 7, 2011)

AgentD said:


> If people who have such things like Bipolar, OCD, BPD etc, if left untreated does that get worse as one ages? If so, how worse can things get?


The better question might be "Why waste your life finding out?"

I don't think its honestly worth wasting 10-15-25 years of your precious youth with somebody that abuses you and can do some major damage. 

Ask anybody here who has left or is thinking of leaving a BPD, NPD, etc spouse if they could go back in time and tell themselves to stay the hell away from them. I love my son but if there was a way to have him with another woman the way he is I would have done it already. 

I know it sounds terrible, but folks that have BPD, and NPD or some other mental illness and know it have a moral obligation to disclose this to any potential partner so they can make an informed decision.


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## Sanity (Mar 7, 2011)

argyle said:


> ...I think it is more accurate to say that you'll pay a cost and that it will be a high one, with no guarantee of a successful, enduring, or livable relationship.
> ...and that, if you are sensible and sufficiently stable...
> ...you should be able, over the course of several years, be able to change your own behaviors to deal with BPD behaviors in healthier ways than you are currently doing. This typically can result in BPD behaviors reminiscent of the first year of the R/S.
> 
> ...


Amen brother. 

Look at this video and specifically listen to the non's statement on how it feels to be with a person with BPD.

"Back From the Edge" - Borderline Personality Disorder - YouTube

At 9:59 she says something that really touches the core of what it is to live with somebody like this and how you lose yourself.


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## Claufjdia (Sep 26, 2013)

it generally does not.


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## Boottothehead (Sep 3, 2013)

I tried to deal with my OCD on my own (trichotillomania), and I couldn't. It does get worse over time.


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