Q. I have just been diagnosed with BPD. Within the past year, I was diagnosed with Bipolar disorder. I took lithium for 8 mos., but stopped b/c of extreme insomnia for 4 mos. - sleeping only 4 hrs. per week. Since then, I have been extremely distressed, swinging between normal moods and deep depression. I feel like I need medication but am bothered by privacy issues and stigma. What should I do? I have cut myself and thought about suicide constantly.

A. You need a thorough evaluation of all your diagnoses and get treated for them all. Self-mutilation is not a bipolar symptom, although you certainly can have both bipolar and the BPD. Depakote is a very reasonable alternative to lithium for bipolar.

As with everyone else, you need a thorough diagnostic evaluation, a comprehensive medical plan, and to "retrain the brain" once the meds are right.

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