Re: My elderly mother's BPD symptoms are becoming more florid in front of my son...

Posted By HFHS M.D.-TB on April 17, 1999 at 20:10:24
Topic Area: Personality Disorder

My mother has suffered from borderline personality disorder for many years, and has been diagnosed with BPD, OCD and depression at various times, although she is in complete denial about this and has insisted that the diagnosis were false, or that the practicioner was incompetent.
My sister and I (both in or 40s) have learned to do "damage control" when she comes to visit our families and so far our children love her very much.  Especially when they are young, she is able to hold herself together more or less when with them.  But, they are growing older (my son is almost five, and my sister's children are school age).  As they develop stronger personalities, this is bringing out some of her symptoms.  In addition, she is now 80 years old, and the aging process is very hard for her.  There is a great deal of anger (rage) about her diminished energy level, and her various ailments.
She visited us recently, and for the first time in quite a while, had a transient paranoid/psychotic episode (not in the presence of my son, thank God).  There were other instances where her symptoms were more florid than usual.
She has made me promise over and over never to put her in a nursing home if she becomes unable to care for herself.  Obviously, I cannot have her live with us if her BPD symptoms (especially anger, paranoia, psychotic episodes, extreme mood swings) continue to get worse.  I know that she might be helped by medication and/or therapy, but in the past she has been totally resistant.  
Is there anything my sister and I can do to help her?  Would it be appropriate to share some of her history with her primary care physician?  The internist has no idea of my mother's emotional problems.  My mother said on this visit that she "puts on a great show" when she sees her doctor and the doctor thinks she is "just great."
If there is nothing we can do to get her into treatment, do you have any suggestions or resources for coping with her behaviours and helping our children to understand her disorder?
My sister and I have both had professional help over the years in terms of our own issues as children of a parent with BPD.  In addition, my sister is a clinical psychologist.  However, she lives and practices in another country.  And, as you probably know, it's a lot harder to know what to do if you are trying to deal with your mother than with a patient.
Any comments or suggestions would be much appreciated.
Many thanks for your time and interest.




Dear Rachel,
You are correct in that psychotherapy and medication may help your mother.  Psychotherapy has been considered the treatment of choice in borderline personality disorder, and medication is used to control symptoms such as anger, hostility, brief psychotic episodes, depressed mood and anxiety.  It sounds as though your mother has been resistant to receiving treatment which complicates your situation.
You and your sister may want to discuss your concerns with your mother regarding her well-being and that you would like to see her get help.  Discussing her history with her primary doctor may be helpful, especially if she has good rapport with him/her, as that could possibly pave a way toward treatment.  You may want to do this with mother present, however, and discuss it beforehand with her to keep a sense of trust between the two of you.  
In coping with her behaviors, I think it is important that you understand the nature of borderline personalty disorder so that you can know what type of behaviors to expect at times.  It is difficult for me to address how specifically you should cope with her behaviors when I have such limited information.  This would best be done by a mental health practitioner who would be working with your mother and in collaboration with the family.
Regarding your children understanding her disorder, they may be too young at this stage to understand specifics about the disorder.  Perhaps telling them that grandmother doesn't feel well if something happens would be most prudent at this time.
I hope that this information has been helpful for you.  It is for educational purposes only.  If your mother wishes to see a mental health provider at Henry Ford Hospital, please call 1-248-689-7476 for an appointment.

[Gretchen__0]

Posted By Gretchen on April 29, 1999 at 19:48:38
Hi Rachel~
I have a sister that has just been diagnosed w/ BPD.  She has three small children that live with my parents.  She is currently not on any medication for it.  I can definately relate to the "damage control" tactics!!  My parents & I are constantly trying to pick up the pieces of the diseasters she creates with her on life and the lives of her children.  In your experience, do you think that it may be possible that the children might ever be able to live with her again?  We are getting quite discouraged.  We pray for her daily...
I hope that you and your sister have happy lives w/ your children and families!  It would give me hope that these three children have a chance at a normal life someday.
Gretchen










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