How to manage Borderline Personality Disorder?

Question

Hello doctor,

I am a mother in the early thirties of a 5-year-old. My child has been diagnosed with a moderate autism spectrum disorder. I have no motivation to do anything and cannot do any daily activities. I feel like I have all negative characteristics within me, and I have failed in every role- as a daughter, a sister, a mother, and a wife. I am anxious to meet anyone and unable to talk with anyone. I feel like everybody else in this world has something to do and is happy with what they have except me. I am taking my child to occupational therapy and speech therapy, but I am unable to spend quality time with my child and help them with their development. I am in a very critical position such that I am unable to even attempt suicide. Please help me with suitable advise on affordable therapy. Currently, I am on medication and taking tablet Frisium 10 mg, Feliz S Plus tablet, and Clobazap 10 mg tablet. My T4 value is 4.86 µg/dL.

I have been struggling with my life since I got married six years ago. I attempted suicide shortly after marriage, and I regret why I did not end my life at that time. Things would have been far better today without me. Now I am a mother, but I am unable to do anything that a mother should do. We had diagnosed the risk of autism for my child at an early age, but still, I have done nothing to help my child. Everyone else in my family is good except me. I have been ignoring all my duties and simply wasting others' time. I want to help my child and be a good mother. But I do not know how to do it. Where to start? Whom to approach? I feel like I have many negative characteristics within me, and I have to rebuild myself to change all the negativity into positive thoughts and actions. There are a lot of day-to-day conflicts between my mind, body, and soul. I require a life coach and counselor who could bring the change inside me.

Answer 1

Hello,

Welcome to icliniq.com.

I read your history, which reflects major depressive disorder, but you are right; you have a personality issue that may be a disorder or personality trait called borderline personality disorder. Symptoms of borderline personality disorder are fear of abandonment. People are often terrified of being abandoned or left alone, unstable relationships, unclear or shifting self-image, impulsive, self-destructive behaviors, deliberate self-harm, chronic feelings of emptinesses and emotional instability, which may lead to severe depression, anxiety, extreme impulsive behavior, suicidal thought, intentions, and attempts and minor provocation can lead to severe behavioral problems, as when suffering from borderline personality disorder we expect a lot from everyone around use but if things do not go according to the expectation we easily get annoyed, impulsive and show a reaction. You have a long history of psychiatric illness, and there is a treatment history but limited or no response; this may be due to your psychosocial issues, which you have highlighted here. It has not been raised in a therapeutic way, and I think you have to go through psychometric testing to diagnose personality disorder. It is evident that many patients with one personality disorder have an overlap with another personality disorder. Medications only impact symptoms, not the way of thinking, opinions, or coping mechanisms, which means the way of dealing with our day-to-day issues or stressors. Here the patient needs high-intensity counseling sessions based on CBT (cognitive behavioral therapy), DBT (dialectal behavioral therapy), stress management, and anger management. As for the medications required, the patient needs a combination of antidepressants, mood stabilizers, and/or antipsychotics.

Last but not least, supportive therapy so that the patient and the family members can handle the issues in a healthy way. I would recommend taking another expert psychiatric opinion and psychotherapy sessions as soon as possible, considering your current mental health with suicidal thoughts. I cannot prescribe you medication because you have to reach out to the psychiatrist in your locality, and you need a professional psychotherapist for the above-mentioned counseling sessions. If you have any other queries feel free to ask.

Thank you.