Question:
Hello Dr. Heller,
You have probably received thousands of emails with a
subject like that from lots of people with BPD. I
really need help in the form of advice or something
that I can show to my husband or parents who are
trying to help me. Here is a short version of my
problem:
My mom tells me I'm one of the lucky ones with BPD. I
made it through high school and earned a 4 year
degree in only 6 years... yeah. I laughed too. But I
did it. She told me that many BPD's can't do it, but
I did.
I was diagnosed in August 2000 with BPD by Dr. Ahmed
in Eau Claire, WI. I have all the DSM-IV symptoms of
BPD. But after being on Prozac for 4 years, it
stopped working. Then in 2000, I was put on Celexa
which worked for another 3 years. Now I'm taking
Lexapro. The medication is working pretty well, but
after my boyfriend and I read your website and both
your books, we talked to my doctor about putting me
on Tegretol (S/P?).
The problem is, it's come too little too late. I'm 25
years old and now I can't find a job that I can hold.
I've had 5 jobs in 5 years and my longest running job
was for 1 year which I got fired from. My last job
was a dream job - selling insurance, but the rate of
rejection was really difficult. After being
confronted by coworkers about my issues of
"sensitivity" and "overreacting", I left the building
crying and cursing. The next day I was told to pack
my things and leave. I wanted to apply for SSI, but
my father who also has BPD, has told me that this is
not the answer and that I am fully capable to work.
He wants me to start a lawsuit against my previous
employer stating that they knew of my issues before
they hired me and it was because of my issues that
they fired me. And it was.
I realize that I am solely responsible for my own
tantrums and my outbursts, but when I can't stop
them, why is it still my fault? I want to go back to
work. I want to find a job where people will
understand that I have a disorder that messes me up.
This is the short version of what I am going through.
Can you please give me your input on this? I live too
far away and have no income to be able to go see you,
otherwise I would be in Florida in a heartbeat.
Thank you...
Dr. Heller's Answer:
You are responsible for what your body does, but you
didn’t cause the BPD. Without the right medications
you won’t be able to control your mood.
You likely would benefit greatly by the addition of
Tegretol (carbamazepine). Also having Haldol
(haloperidol) available as needed makes a huge
difference. Without control of your moods you’re
going to have a hard time holding a job. This is the
dysphoria instruction sheet I give to my patients:
Instruction Sheet
for Dysphoria
The dose of Prozac (fluoxetine) may be a problem. I
use whatever dose is necessary to completely
eliminate unprovoked mood swings, chronic anger or
irritability, emptiness and boredom. Prozac
(fluoxetine) doesn’t "stop working" for the BPD. What
happens is the development of chronic dysphoria
(anxiety, rage, depression and despair) or an
imbalance that requires the temporary addition of
Wellbutrin (buproprion).
Approximately half of my BPD patients have attention
deficit disorder, which could easily explain many of
your symptoms. If ADHD or ADD is present it will
need to be treated as well. Impulsive anger is a
symptom of ADHD that borderlines must avoid. Click
here for the
ADHD Criteria.
You are young and when the medications are right you
are capable of a very successful life. Please
click here to see the
Goals for my BPD patients.
There definitely is hope.
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