Question:
I've been researching BPD lately. I have never been
diagnosed with this disorder but I was diagnosed
with GAD and my doctor put me on Paxil. That just
made everything a lot worse. My cutting tendencies
became worse and I felt like I was going crazy so I
immediately stopped it. I have had BPD symptoms as
far back as I can remember. I have a really bad
temper and I get so mad that I feel like I can't
even control myself. When I calm down I don't ever
understand why I went off. And I always feel guilty
about it but I'm too ashamed to apologize. I ended
up turning to drugs to self medicate and I became a
Meth user for about 2 years. I found happiness in
this drug. It seemed to regulate my moods. It put
me in the middle. I didn't feel down but it didn't
make me hyper. Is it a possibility that I could
have ADD that is causing my extreme highs, making a
stimulant like Meth to bring me down and regulate
me? And how do you treat someone with BPD and ADD
Dr. Heller's Answer:
First of all, methamphetamine will make everything
worse. Drugs like heroin work too, but they are
horrendous.
Paxil (paroxetine) and other SSRI's work for the
GAD that doesn't include genetic worry. If you
were born with genetic worry ("cognitive"
generalized anxiety disorder) all SSRI's including
Paxil (paroxetine) will make you worse. BuSpar
(buspirone) is the key medication here. Once it's
taken for a few weeks, SSRI's like Prozac
(fluoxetine) and Paxil (paroxetine) can be taken.
For the BPD, Prozac (fluoxetine) is far superior to
the other SSRI's.
Approximately 50% of adults with ADHD have BPD. Conversely,
50% of those with BPD have ADHD. Amphetamines do
improve ADHD symptoms significantly. Once the
other problems are treated, the ADHD can usually be
treated successfully, primarily with
psychostimulants. Individuals with substance abuse
problems sometimes see their substance problems get
worse with psychostimulants, others see a decrease
in substance use.
BPD criteria:
http://www.BiologicalUnhappiness.com/DSM.htm
ADHD criteria:
http://www.BiologicalUnhappiness.com/AD-H-Dcr.htm
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