Suicidal thoughts in BORDERLINE PERSONALITY DISORDER.

Resolved question:
just over 2 years old patientago, I lost my dear wife of a blissful 51+ years old patientof marriage. My GP, diagnosed me with a Depression, and Knowing just how close we were, and upon seeing my reactions to my loss, sent an Emergency CPN referral to the local Psychiatric Hospital. I understand that he wanted me to be admitted to prevent, in his words, a double tragedy. After seeing a Psychologist for the 2 interveining years, I have now been given a more formal diagnosis of Borderline Personality Disorder with Narcessistic tendencies. When enquiring the severity it was suggested, taking the 2nd half of the clock face, quite severe around 10-30 so as to speak. At the age of 77, I am getting very interested in what is likely to happen. I have always felt that I had some sort of Psychiatric Disorder, (based upon childhood experiences and abuse etc) even though I have been very successful in life. I am being further referred for long term Psychotherapy. I think that this will be as an out patient. Reading up what I can I see MBT as a form of treatment, but I don't know what this means. What is the liklihood, even for a short term being hospitalised and would ECT be a faster means of recovery. I have had suicidal thoughts, but not of late. I need my golf and fitness to give me a new lease of life, to reduce me as a risk. I am also having a tendency for falls. Are you able to indicate just how ill I am based on the foregoing. As I am now on my way to treatment, other than academic interest.I am not unduly disturbed by my illness, however it would be valuable to quantify even if only to attract my attention to recovery. My cluster is 4 non-psych (severe)

Submitted: 4 Days
Category: Psychiatrist

Expert:  Dr. Srikanth Reddy replied 4 Days.

Hello
Thank you for posting your query at DoctorSpring.com

I have gone through your question in detail and I can understand what you are going through.
Well at age 77 years, having a borderline personality and narcissistic personality traits is nothing much to be worried about. The only thing that you need to bother is comorbid depression if at all you develop them. Depression needs to be taken care of with medicines such as antidepressants and if required ECT if there is suicidal tendency. Otherwise there is not much role of medicines and ECT for personality disorder. Psychotheraoy and that too along term psychotherapy is the only option. You may continue getting it done. But considering the fact that other than your wifes death you have lived your whole life quite comfortably with good relations, then the severity of the persoanality disorder may not be severe. But yes a proper mental state examination is something which will require to gauze the severity.
Hope this helps,
If you have any further query do let me know.
Kind regards
Dr. Srikanth Reddy MD

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Patient replied :

Thank you for you frank reply Dr Reddy. As I have indicated, since my childhood I have always been aware that the way I react and respond to people and problems is wrong and at times irrational. At 77 I am so glad that they have honed in on this as a problem. I must also accept that I do have Narcissistic tendencies. I still do have a depression due to little or no interest in my future life. That is unless I can get my Polymyalgia sorted, so that golf can take centre stage. This is essential fo me to want to live. I feel very dissappointed that I was not admitted to the Psychiatric Hospital when I lost my wife. I still feel that I would benefit enormously to have taken away from me, my freedom, for a limited amount of time. I feel that I could calmly and gradually get my act together and, when allowed to go, start about a meaningful and useful life. It must be so strange for you to read of someone who sees the benefit of being admitted and actually wants it to happen. My new Psychologist has virtually done a mental state examination and has then come to her conclusions for diagnosis. I had to do a Core Outcomes Routine Evaluation, and whilst I do not know what it all means, my scores were (F) 32 /12 (P) 37/12 (W) 13/4 (R) 11/6 (R) being risk I think.When calculated the net result was 10.826. I just feel that I want others to take charge of me and my life for a while. I asked my Psychologist just how severe my Personality disdorder and Narcisstic tendencies were, and she indicated quite severe. Must I consider myself to be Mentally Ill and a Mental Patient for Insurance and legal purposes? Thank you, David


Expert:  Dr. Srikanth Reddy replied 3 Days.

Hello.

Thanks for the additional information. Long term indoor psychotherapy will surely benefit you for personality issues. I think you can seriosly ask your psychologist to get you admitted for the therapy. However what i meant to say was ECT per se will not help you with your personality issues. But yes if depression is still present , it will help resolving your depression. Most of the mild persoanality disorders go mostly unnoticed unless they create problems in life. In your case it was the suicidal thoughts that you had which prompted for indepth analysis leading to the personality disorder. Believe me they are very common. But its good that you have planned to get it treated. Psychotherapy and MBT is the answer to your problem .
Hope this helps,
In case if you have any further queries do let me know.
Regards.

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