QUESTION:
Dear Dr. Heller,
Dr. Heller, I have been diagnosed with BPD for 10+ years. Been through many types of therapy and medication. HOW CAN YOU, AS A DOCTOR, SAY THE MEDS ARE NOT ADDICTING? HAVE YOU EVER TAKEN THEM? I am also chemically dependent, so I know what withdrawal is about.
My first experience was with Paxil quite a few years ago. It was nothing like how I felt trying to get off the Effexor in Jan 2000. I lowered my dose, as prescribed. I still went through 5 days of the worst withdrawal I have ever went through. I couldn't work because all I could do was sit on the couch because of the electrical brain pulses going on. It angers me to no end that you doctors are prescribing addicting medications to people who are in need of much more than a pill. You also say that a borderline cannot be cured and will have to be medicated for life. How much money are YOU making from the drug companies? Or do you just own stock?
I have another question. How come BPD is genetic when a large population of us have been abused as children? I will try to keep my explanation short. I was abused physically, emotionally, and sexually. I do not believe I was born with these strange thought patterns. My family taught them to me. What I have to do is unlearn what I was taught and find out new ways to think - my ways. Do you know how hard it is to find a therapist who is willing to just talk and not medicate since this new revolution of "genetics" has come about?
I have been off the drugs for 7 months and HAVE NOT SELF HARMED. My therapy has been discovering myself and what I believe in, and undoing the damage done by my family. I am not "cured," but I am on a better road than being numbed by medication. The times I have chose to be medicated were times I felt I needed to be, otherwise I would have done more harm to myself. But medicated for life??? You are respected by many because of your position and I am leaving this on your conscience. Better yet, if the drugs aren't addicting, why don't you try them? Disgruntled by your site.
ANSWER:
1) Except for the benzodiazepines (Xanax, Valium, Klonopin, etc.)
they aren't addicting. There is a withdrawal syndrome with the SSRI's except for
Prozac - in fact Prozac is often temporarily prescribed when a person is tapering off
another SSRI. Effexor clearly has withdrawal symptoms for many people. Having withdrawal
syndrome doesn't mean addiction - addiction involves many things including drug
seeking behavior, wanting higher and higher doses, etc.
2) I have absolutely no association with any pharmaceutical corporation
in any way. I am not compensated by any of them. I am not on any advisory boards. I have
no stock in any pharmaceutical company.
3) With extremely rare exception individuals with the BPD will need some
form of medication lifetime - although it may only be as needed.
4) The genetic component is approximately 50% - which may be more
correlated with attention deficit disorder. The genetics for BPD have to do with attention
deficit disorder and the RISK of getting the BPD - especially when traumatized.
5) I'm happy for you that you are doing better, but the angry tone
of your letter implies anger is still a problem for you. The medications do not
"numb" an individual. My goals are significantly higher for my BPD patients than
just not self-mutilating. They are listed on the top left, second from the top, of my home
page.
6) There is no valid reason a physician should take every medication
he/she prescribes for patients - no different than taking diabetes, high blood pressure,
or arthritis medication. The risks do not outweigh the benefits - and that's always
the decision when giving medication to a patient.
