What Can I Do?

QUESTION:

Dear Dr. Heller,

You probably wont be able to help me either...I can't seem to find anyone to   give me an answer to my question.   I was diagnosed almost 10 years ago with dysthymia; but over the years, and  by doing a little of my own research, I don't feel that is no longer correct. 

I am showing signs of both bi-polar manic depression and also I'm showing  signs of schizophrenia.  I go through times of great euphoric happiness that  comes crashing down suddenly (all I have to do is wake up in the morning).  I  hear that little voice in my head start telling me that I am worthless, fat,  disgusting and everyone hates me or is really pissed off.  and I go through a  paranoid stage driving my friends crazy with questions are you mad at me.

I  get to a point where I start believing the voice in my head that I am horrible   obese person that will never find a husband because I am so hideously fat.    Then all I can do is eat.  Then the voice still nags me how horrible I look,   how stupid and hideous that I am, that I start getting high on "crank" to   prevent my self form eating and also so I don't hear the voice say how lazy I am.    Then all I hear is the voice telling me that I am a disgusting person I am   for putting a needle in my arm.

Every Doctor tells me from this point that   they won't do a damn thing to help me until I go through chem dep.  which I   have gone to, and well, I can't relate to the other people in treatment so I   feel stupid and quite.  I begin to feel a little better over time.  I stop   getting high, which can last almost a year then one day I wake up and that   voice is back telling me all those horrible things.  Last year I went into  the hospital for having a nervous breakdown, I was woke up and I was cutting  myself...I DON'T want to kill my self but I had one episode of blacking out  and waking up hours later with cuts up and down my arms.  And my worst fear  is that I may do something to some one else.  What can I do??

ANSWER:

While it's possible you have schizophrenia, it's more likely you're having auditory hallucinations from your bipolar and BPD.  I'd highly recommend looking at those diagnoses at length. 

The screening test I use for my patients may be particularly useful.  The medications used for bipolar and BPD are very similar.  I encourage you to spend some time on the site and learn more.  My books go into much more detail and are written for people like you.  FAQ #1 in "ask the doctor" will help you as well.