Question:
My current psychiatrist has me on Paxil and Klonopin. I
am taking Atenolol 100 mg. which was started by a
Cardiologist three years after going to his office for
what I though was heart problems and turned out to be
anxiety. I am not better. I am frequently out of
control and spending much time doing damage control. My
psychiatrist does not really listen to me. Just writes
the same old prescriptions and says see you in a month.
He also has made two dosage mistakes on my
prescriptions in as many months. I don't like him, but
my psychologist wants me to continue to see him.
I tried to find a new psychiatrist but one said I'm not
taking on new patients and hung up on me. The second
was very nice but insists on doing both med. mgt. and
therapy, which I think is great, but his schedule is
too full to see me. He did have a consultation with my
psychologist and said I was the most severe BPD he has
seen. He spoke to my psychologist regarding suggestions
on how to treat me. This psychiatrist also said I would
be hard pressed to find another psychologist who could
see me twice a week like mine does currently and
suggested I stay with him.
My psychologist, after I freaked out at a Carpal Tunnel
Surgery two weeks ago, told the surgeon that I was a
manipulator. I honest to God have no recollection of
what was said or what I did. But I apparently asked for
them to give me enough drugs to kill me. My
psychologist wanted me in a long-term facility.
Mentioned that I should probably go off my meds because
they're not working. I immediately sent him your articles
about the counter-productive affect long-term
hospitalization would would have on BPD pt. I also
sent him your articles about Prozac. I also sent him an
article about mental health care providers calling
BPD's manipulative.
My psychologist saw me three times
a week in the beginning, made phone sessions on the
weekend and called me when he was on vacation. As time
went on, he began to realize my dependence on him and
cut out vacation calls, then cut out phone sessions,
then said I could not call his office at all unless it
was to cancel or reschedule an appointment and he would
not speak to me except in his office. I wonder why he
thinks I'm (a BPD suffer) is feeling abandoned. I do
have to say he has put up with a lot of junk from me
over the years. But after this last out of control
spell he is making a contract that I will have to sign
with all kinds of strict guidelines and necessary
structure. If I commit a sin against one of those
commandments, I'm out.
I now feel as though I can't say what I feel, I'll do
the wrong thing, make an unnecessary phone call
unknowingly (severe dissociation). I feel as though his
office is not a safe haven anymore. I feel like I'm
being asked to walk a tight rope while blind folded. I
feel like a toddler who is being potty-trained and has
his first pair of underwear on and was told that one
accident and I'll be given away. I've written these
feelings to him. I'm waiting for the "stop writing me
clause".
I cry all the time, I think about suicide all the time,
I feel cornered, abandoned by the one person who gave
me unlimited support for three years. He now treats me,
I feel harsh. He said it's providing structure. It
hurts my feelings. When I called and insisted on
talking to him, he got on the phone and said I was
harassing his staff and he had nothing to say to me and
he'd see me at the next appointment and hung up on me.
I didn't say one word. He didn't even know why I
called. I feel like I don't have his support anymore. I
don't have family support, I'm just lazy, like to
sleep, make my life what it is all by myself, made my
bed now lie in it, etc., etc., etc.
The only thing that has kept me alive this week was
finding your articles on the Internet this week. I'm
sending them to my doctors hoping they'll begin to
treat my disorder correctly, both with medicine and
therapy. But what do I know, I'm just a half wit with a
mental illness who can't make decisions for myself, let
alone for them. I'm scared to death to see this
contract.
I cry as I write this to you, I'm suicidal as I write
this to you and I have no hope as I write this to you.
I just printed the page that has your tape available
for sale on BPD. I'm going to send away for it ASAP. I
have all the BPD disorders, OCD, Self-Injury, addiction
to pain killers (which started after given them after
my last surgery). I'm a 42 year old mess who fears my
tomb stone will read Born 1961 - Departed 2003.
PLEASE HELP ME! WHAT SHOULD I DO? I NEED YOUR OPINION!
THE SECOND OPINION I LOOK FOR WILL BE FROM DR.
KAVORKIAN!
Dr. Heller's Answer:
In my opinion, the BPD is a medical disorder of the
"trapped, cornered, wounded animal" part of the brain痴
limbic system. The right medications will have an
enormous impact on you. The combination of Prozac
(fluoxetine) followed a week later by Tegretol
(carbamazepine) should make a huge difference, especially
since you were described as "severe."
Treating spells of dysphoria (anxiety, rage, depression
and despair) with as needed medication instead
self-destructive behaviors will make a huge difference in
your life.
It痴 likely the Klonopin is worsening the severity of
your episodes of losing control of your behavior. You
need to find out if you have the cognitive generalized
anxiety disorder that will also need treatment with
BuSpar (buspirone).
There are medical literature articles backing up this
medication approach.
It appears you have been through a great deal of misery
and it痴 immensely important that you realize it痴 not
your fault and you do have a chance at a good life once
the medications are right.
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