Could I Have All These Diagnoses And How Are They Treated?

QUESTION:

Dear Dr. Heller,

I took the screening test and appear to have OCPD, ADD, and BPD all at the same time.  Is this possible?  I am overly sensitive to most antidepressants, but Zoloft helped me the most (other than worsening my Restless Leg Syndrome).  I am currently on Effexor XR.  Psychiatrists seem to have a hard time diagnosing me.

Thanks for your response.

[From Dr. Heller: Do you have the generalized anxiety disorder, particularly where your mind is constantly going?
Response: I have not been diagnosed as such, but I do constantly think and worry about everything all the time.  It has totally interfered with my ability to do my job as a programmer.  I can't remember basic instructions or tasks and I can't concentrate on my job.  I thought it was my sleep apnea that caused that.]

ANSWER:

Many people have all these diagnoses, and need them all treated.  The generalized anxiety disorder (GAD) is a genetic worry.  It appears to be an overactive serotonin 1 receptor that gets aggravated by SSRI medications and others such as Ritalin or Adderall.

BuSpar is a very important medication here.  It allows individuals like yourself to take high doses of SSRI's and stimulants.  Those who have problems with BuSpar usually have PTSD that needs to be treated at least temporarily with Remeron.