Q. Dear Dr. Markovitz:
Ever since I read an article in Men's Fitness (Jan. 99) by Dr. Mark Goulston, I have wondered if my wife of two years has the BPD. Our marriage has been an emotional roller coaster. This is her third marriage and my first. She has two daughters, and recently gave birth to our son. My wife has a history of volatile and disappointing relationships.
My marriage has been gut wrenching. We've tried counseling but she runs from issues and now refuses to return to counseling. She often feels "dead inside," or "like an empty shell." She places all of her life problems -- from her no longer "being a good mother" to her suffering relationship with God -- on my shoulders. She is prone to emotional swings; spews forth extremely caustic verbal abuse (both toward me and her daughters); has on occasion hit me or her daughters; in the past has threatened (and once claimed to have attempted) both suicide and killing her daughters; has tried to manipulate me with all sorts of highly irrational and disturbing behavior; constantly calls me a "control freak" and threatens to take me to court to take my son away and "take me to the cleaners"; and shows disproportionate rage toward me, often taking days to cool down. She has been treated for Graves Disease for half her life now. She is often very depressed, yet too proud or stubborn to seek medical help or to talk to a trained professional.
There's so much more I could write. Could my wife be suffering from BPD?
A. It sounds as if your wife has many of the behaviors we see in patients with BPD. It is impossible to tell without a good medical (psychiatric) evaluation. The reason a good psychiatric eval is needed is to rule out other causes of her problem. As an example, there are forms of thyroid disease which can cause mood problems and liability. Find a good biological psychiatrist in your area who is comfortable with BPD. Talking to BPD without medications is like talking to diabetes to get the blood sugar down. It won't work. Medications are imperative.
