Can The NPD With BPD Be Successfully Treated?

Written by Dr. Leland Heller

QUESTION:

Dear Doctor,

I am writing to you as a last resort and I'll try to be brief. I married my husband who is bipolar almost 3 years ago. During our brief courtship, my husband was wonderful, communicative, attentive and all that I wanted. He even told me he was bipolar, taking medication and I could not see any problems in his character, personality or mood. He takes Neurontin and Adderall for ADHD.

The problems started immediately after our honeymoon and I have suffered intensely because of his verbal and emotional abuse, very frequent mood swings, hostility, extremely irrational behavior and thoughts, unpredictability, selfishness and cruelty. I did everything I know to help him, love him and support him, but nothing worked. He abandoned me due to very irrational perceptions based on distrust, perceptions of "what I have done" etc.

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My entire family, though supportive at first, want me to stay away from him because of the continued vicious cycle that never changes and because of how much harm he has done through his behavior.

In my effort to help him, I did a lot of research and discovered that his behavior matches EXACTLY the criteria of Borderline Personality Disorder and Narcissistic Personality Disorder. I don't know if he has ever been officially diagnosed, but I was startled at how much of his behavior was precisely according to the criteria (except self mutilation).

My question is this? I love my husband very much but he has filed a legal separation that included a dissolution decree. Does it sound to you like my husband is pretty much beyond help? He is 44 years old and in almost 3 years I haven't seen any change in him. He does not seem to want to save our marriage and he is quite a loner.

I am in a lot of pain, and I just wanted your professional opinion since you deal with BPD.

Thank you and I am grateful for your response.

DR. HELLER'S ANSWER:

The BPD and narcissistic disorders (NPD) are very different. The BPD appears to be a neurologically based illness that responds dramatically to Prozac and Haldol 2mg / Tegretol 200mg / Risperdal 3mg as needed for dysphoria (anxiety, rage, depression and despair). When dysphoric, however, borderlines misinterpret intentions and can permanently "remember" incorrect assumptions. This obviously causes a great deal of relationship problems. The love borderlines exhibit when falling in love can be remarkably intense and intoxicating. It usually goes away after 6-12 months.

To the best of my knowledge no medical basis has been found in the NPD. It's extremely difficult to treat because their dominant psychological defense seems to be that they are superior to others and that their problems would go away if others would recognize their superiority. There are support groups on the Internet for those with the NPD. If he doesn't want treatment and isn't 100% motivated.

I'd strongly suggest seeing a therapist yourself to sort out your feelings and to help you with what most likely will be a transition to another love. I highly recommend reading "Are You the One for Me?" by Barbara DeAngelis. This book could make all the difference in the world for you.

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