QUESTION:

Dear Dr. Heller,

I don't understand myself. I love my husband and kids so much and I'm taking my Celexa, but there are times I lose control and can't stop screaming at the people I love and care about. It's getting worse and I'm scared. My husband said he's tired of being yelled at and if I don't stop blaming him for things he would leave me. I don't understand why I keep yelling, and why he denies saying things I KNOW he said. My mother thinks I'm the one who's wrong, and that he's the sweetest man on Earth. How can she know that? She hasn't lived with him. I'm confused, and I'm thinking of suicide at times. My doctor told me to talk to my therapist, but my therapist said my medications were probably wrong. I'm starting to scream at my kids and I'm getting scared. I don't know what to do. Please help!

ANSWER:

What you are describing is called dysphoria (anxiety, rage, depression and despair). It's a stress related symptom where the body's "trapped" or "cornered" animal response is having the equivalent of a seizure (brain cells firing inappropriately and out of control). It's distorting your perception of reality and making you consider suicide. It's also very easily controllable with medication - which is necessary.

My patients with your history would be given Haldol 2mg, and if that doesn't work Tegretol 200mg right away. While Celexa isn't as consistently as successful a medication as Prozac, it usually will give the same response when combined with Tegretol and/or Haldol. The "How I Treat the BPD and Why"  section along with the Dysphoria Instruction Sheet I use for my patients may be of use to you and your physician. There are many articles in the BPD section that could be of use to you and your physician, including scientific documentation of using these medications.

One of the cruelest part of the BPD is misinterpretation of motives. It's probably the main reason for relationship breakup. Sometimes your bad memories and interpretations are correct, sometimes they're not, but both times they will FEEL real to you since the brain cannot distinguish between an actual event and something imagined with feeling. Counseling may be helpful in this regard to sort things out, particularly regarding your husband. You need to understand that your perceptions while experiencing dysphoria are usually incorrect, and that men in particular can't stand being blamed for things they did not do.

Getting all your diagnoses made will help as well. Please look at the screening test, which should be of assistance. Both of my books are designed for people like you, so you can have a sensational life - and yes, it absolutely is possible!