Question:
I took the screening test and still not sure what I have. I've been on antidepressants for approx 6 yrs now. First Prozac, which worked fine w/increased dosages for about 3 yrs. Then Effexor for a couple of days, which made me more depressed. Then Celexa w/ increased dosages for about 2 yrs worked great. Then Paxil & Xanax for a week, which made me feel dizzy. Now Zoloft for 2 mos...had PMS, which was the worst ever, so put on BuSpar(15mg 2xday) w/Zoloft(150mg day). I am still feeling down and not sure where to turn or give it time I am a 38 yr old female...career/job focused...perfectionist...get it done right away...very neat/clean.
I'm not angry, but feelings get hurt all the time...very moody...very sensitive...very emotional. When my feelings get hurt, my mind keeps going and going--how could they, why, etc.
I've taken many cognitive therapy classes and know it boils down to the way we think, but still my feelings get so hurt when things go wrong. I'm a perfectionist and hate criticism. At work, people think I'm so happy always with a smile. I can't wait to go home where I don't have to pretend. I don't like going out in public because I have panic attacks. Can't sleep at night cause my mind ruminates.
Overall, I've never been really happy. Nothing truly excites me. When things go wrong, I get so depressed and especially when PMS-ing. I don't believe in suicide, but I do get so depressed...frustrated. I'm a very nervous/anxious type of person. I always feel like I have control, but get so down...so sensitive.
Do you feel I'm on the right meds? What category would you classify me in?
I'd really appreciate any advice.
Thx much,
Screening test:
Is everything at home and work (or school) in unfinished piles? Not at all.
Do you have a long-standing history of not being able to stay on task? No.
Are you easily distractible? Sometimes.
Do you seem to alternate between not staying focused and being so focused that a bomb could go off without you noticing it? No.
(Attention Deficit Disorder)
Do you have a history of feeling really great and then getting yourself in trouble because of feeling so great (and being somewhat out of control and feeling invincible)? No.
(Bipolar Disorder)
Are you moody? Yes.
Are you angry all the time, with spells of rage? No.
Are you empty and bored even doing something you enjoy? Mostly.
Do you get paranoid under stress? No.
( Borderline Personality Disorder - BPD)
Do you have ups and downs that you can virtually plan on? No.
Are there times every month when you just can't function (not including PMS)? No.
(Cyclothymic Disorder)
Are you oversensitive to rejection and criticism? Extremely.
Has it always seemed that others find it easy to be happy and you don't? I guess so.
Have you spent most of your life between not quite depressed and not quite happy? Yes...never truly happy, but very depressed when things go wrong or someone hurts my feelings.
("Fractured Enjoyment")
Are you a perfectionist to the point where it keeps you from getting things done? I am a perfectionist, but I don't have a problem not getting things done...I get right on the task and get it done ASAP.
Are you a pack rat? No...very neat.
Do you have trouble trusting other people to do things because you're sure they'll mess it up? Sometimes I do...depends how important it is.
(Obsessive Compulsive Personality Disorder - OCPD)
Do you obsess about something to the point where it interferes with your life? Only when things hurt my feelings or go wrong...I can't get it out of my head...ruminate a lot.
Do you have any ritual behaviors that you can't stop, like washing your hands too much, checking the door lock too much, counting things, etc.? No.
(Obsessive Compulsive Disorder - OCD)
Are you nervous more than you're not? Yes.
Do you always feel scared? No.
Does your mind never shut off, and has been that way since you were a child? Yes.
Did Prozac make you feel very hyper and/or ill? No.
(Generalized Anxiety Disorder - GAD)
EITHER RECENTLY OR FOR YOUR ENTIRE LIFE:
Do you get a sense of impending doom, like everything is going to crash down on you, like you're going to choke, or you're going to die? No.
Do you spend much of your time afraid you're going to feel that way again? No.
(Panic Disorder)
Dr. Heller's Answer:
While I obviously don’t know you and haven’t evaluated you, there are some strong clues. If you were my patient I’d suspect you had the genetic Generalized Anxiety Disorder, the "fractured enjoyment" or "depressed personality," and a mild case of the BPD. BuSpar and Prozac would be key here. I’d be doubtful of the OCPD as your perfectionism probably stems more from a fear of criticism than a medically treatable genetic trait.
I’m suspicious that you may have self-directed anger. I see that commonly in borderlines. If you do have the BPD, whenever your brain interprets - correctly or incorrectly - that you are trapped, cornered or wounded an epileptic phenomenon occurs in the limbic system resulting in dysphoria (anxiety, rage, depression and despair). I suspect that’s the origin of your obsessive thoughts when rejected. If this is the case the use of as needed Haldol or Tegretol should pull you out of your depression spells as is my usual approach for dysphoria treatment.
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