Question:
Was wondering if you could have both bipolar and
borderline personality disorder? I have been in
treatment for 8mos for BP and had been Dx when I was 15
with BPD and was wondering if I still had it along with
the BP since I have symptoms of both. I am angry all the
time and have rages over nothing, I self mutilate not
often but when things get so bad, I've been in a
depression for 18yrs and nothing they have tried seems
to bring me any hope. Until 8mos ago, I would not get
therapy stemming from when I was 15 and spent a year in
psych hospitals for major depression and BPD. I had
given up on it since I thought if I opened up to anyone
about how I felt I would go back in and with having 2
children and being on my own that's not possible. I still
can't tell them everything because of being so paranoid
about the hospitalization. So is it possible to have
both BP and BPD. My symptoms of BP are severe mood
swings and having maniac episodes where I spend
uncontrollably, very promiscuous. Thank you for any help
you can give me on knowing if it can be both BP and BPD.
Dr. Heller's Answer:
Many individuals have both bipolar and the BPD. The BPD
is a chronic condition whereas bipolar is an
intermittent condition. Most of my patients with both
disorders do extremely well on the Prozac (fluoxetine) /
Tegretol (carbamazepine) combination. Prozac stops the
unprovoked mood swings, chronic anger and emptiness from
the BPD. Tegretol markedly improves stress tolerance,
depression and the severity of losing control when
experiencing dysphoria (anxiety, rage, depression and
despair). It's also an outstanding anti-manic drug.
Periodically and sometimes chronically antipsychotic
medications like Zyprexa or Abilify are needed for the
combination.
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