QUESTION:
Dear Dr. Heller,
Hello, I stumbled on your site a while ago and the first couple times got distracted by family needs, well I am back and have pretty much read everything here, and on other sites. I am in my upper 20's, a mother of 2 under 7, a student, daycare provider...so on and so forth. I have been on several meds including Celexa, Effexor, Prozac, Zoloft, Wellbutrin. Right now I am on 60 mg of Prozac and 225 mg of Effexor. I have several concerns that have been happening over the past few years including mood swings (as many as a few an hour), outbursts, suicidal thoughts, massive spending, lying, guilt, feeling paranoid, and anxiety attacks.
Just reading through these site causes my heart to race and plunge erratically. I also wonder if there is a form of Tricotillomania that can be expressed as scalp picking. I am so disgusted I doubt I will even mail this to you. At least if its on my scalp, no one notices like when I picked at other areas like my arms and legs! I have been seeing the same psychiatrist for a few years but there are even things I cannot tell her. It seems in an hour app., I get to my true problems about 15 minuets until the end, leave and am so down that I don't know what to do. I don't enjoy feeling this way and don't exactly want to voluntarily do it often but I know I have to figure out the problem.
My marriage is in jeopardy, I worry about the effects on the kids, and I don't get along with my parents. Focusing on my studies works well, but than the rest of my life falls to pieces. This cannot be normal, and I don't know how much longer I can keep this up. Help, any little suggestion would be appreciated!
ANSWER:
It sure sounds like the BPD. I’d highly recommend looking at the screening test to see if you have other diagnoses that need addressing. Even though Effexor helps some with the BPD, I haven’t found it particularly effective. The addition of Tegretol would probably make the biggest difference - and in three hours. Both the medical treatment of the BPD section and the studies and Medline research
Picking at the skin is a common form of self-mutation that has lifetime repercussions. In the FAQ section, the first one should be looked at.
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