Does my loved one have BPD?

On a separate forum somebody suggested that an extended family member of ours might have BPD. Reading up on it a lot of things match although not everything fits perfectly.

Basically the situation here is a family member who has some serious issues and seems to take very little advice from family and friends. We would at least like to attempt to get a handle on what's going on (obviously we can't force her to get help or get a definitive diagnosis). In so doing maybe it can help us to help her (maybe that is wishful thinking). Any insights would be helpful (i.e. does this sound like BPD or are we barking up the wrong tree).

Looking at the standard criteria here's how she fits.

[b] 1. frantic efforts to avoid real or imagined abandonment. (not including suicidal or self-mutilating behavior covered in Criterion 5)[/b]

Most efforts have not seemed "frantic" but she has viewed both of her husbands as "father figures" and has gone to sometimes unreasonable lengths to make them happy. She certainly developed abandonment issues as a result of how her first marriage broke up.

[b] 2. a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.[/b]

With her parents and siblings she has over the years alternated between trying very hard to prove she is better than her family and doesn't need them to pulling them very close and leaning on them for support. With her first child she has gone back and forth between obsessing about specific issues to almost completely neglecting him for extended periods (the child has developed severe emotional problems of his own). Apart from that she has repeatedly brought home new pets, obsessed about them for a few weeks or so and then all but neglected them from that point forward.

The friendships she has seem to have fallen apart in the last few years (in some cases apparently because she tends to "pawn off" her child).

[b] 3. identity disturbance: markedly and persistently unstable self-image or sense of self.[/b]

Her self image has definitely varied a great deal. She has frequently displayed narcissism in various forms as well as alternating between vanity and superiority to a sense of failure and helplessness. She has grown increasingly prone to lying about her life to make it sound better than it is.

[b] 4. impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating; [not including suicidal or self-mutilating behavior covered in Criterion 5]).[/b]

She and her current husband together have been very irresponsible financially (not horrifically so but certainly some of their decisions are scary). Both are to blame although it is unclear who is the bigger culprit. She has had some significant issues with food alternating from binging to avoiding eating or obsessing about what or how she eats. There may be other factors with the eating that we are not aware of. We are not specifically aware of other areas where she has been reckless (she doesn't abuse substances that we know of).

[b] 5. recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior[/b]

She was somewhat suicidal after her divorce several years ago. We have not been specifically aware of suicidal activities or self-mutiliation. Some of this, however, may be masked by her tendency to exaggerate or lie about how good her life is.

[b] 6. affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)[/b]

She does have anxiety issues that come up quite often and she has had frequent fairly severe bouts of depression that last for a few days at a time.

One symptom along these lines has been that there have been a few episodes in the last couple of years where she was away from her children for a few days and then either the day before or the day after she was reuinited with them she had stroke-like symptoms in terms of numbness, diziness, and mild paralysis. The first attack was originally diagnosed as a panic attack but she has managed to find a neurologist who is giving her medication of some sort.

[b] 7. chronic feelings of emptiness.[/b]

I have never heard her say anything like this. However, she frequently seems to be trying to "fill her life" taking on new hobbies even while she is neglecting other responsibilities (like her children).

[b] 8. inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).[/b]

She has never been prone to overt displays of anger. In fact her demeanor even when acting irrationally has been a fairly calm one.

[b] 9. transient, stress-related paranoid ideation or severe dissociative symptoms.[/b]

I am not precisely sure what falls in this category but have not seen any of the more steriotypical examples of this. The closest we could say is that she has at times seemed oblivious to things that would seem to be impossible for her to ignore. For example, she has a background in psychology and yet was oblivious to the fact that her son's refusing to eat solid food was a serious issue until he entered kindergarten and the teachers told her he needed therapy. Her family, of course, had been raising the issue for a long time.

One other thing. I have read that BPD normally tends to resolve itself by middle age. Our family member is already middle aged and her issues seem to be getting steadily worse. Among other things, she recently adopted two children from a situation that had "children with problems" written all over it. Since almost the first day she has looked for ways to avoid spending too much time with them (in fact on the first day she complained about a severe bout of depression because of the problems she was having). She finally "gave" one of the children to another family that she knows virtually nothing about (read into this that how this was handled was tremendously irresponsible) and, rather than at least temporarily feeling "guilt" or at least "sadness" for the way things turned out she was instead elated by how the situation had improved.

Is this truly BPD? If so, any particular "type" (i.e. what should we look for in terms of advice on what to expect and how to help)?[color=red][/color][color=#444444][/color]

It could be, but then again it might not. BPD shares many of the same traits that other personality disorder share. He should see a psychiatrist for a diagnosis.

Thanks.

As I say we have little influence over her. Hence the reason for this post.