Q. Dear Dr. Heller,
First, I want to thank you so much for your research and assistance in treating and understanding this disease. Thank you also for providing a web site for those of us that would like to ask questions. I have been suffering from depression for some time and I was hospitalized once for 10 days in 1991. My MMPI showed depression but also it showed BPD. The Dr. allowed me to read the MMPI report and I was very concerned about the BPD diagnosis, but the Dr., did not tell me anything about it and told me not to worry about it! I know, as a RN, that personality disorders are more difficult to treat then depression, at least that is what I was taught in school. I have had several marriages and the last one only lasted 1 and a half years. I was diagnosed with Severe Arachnoiditis, which is a disease that causes severe nerve clumping and chronic intractable pain. The pain is so severe that sometimes I cannot even stand clothes to rub against my back and legs. I have never had problems in school or work related problems although sometimes, I felt panic about going to work and called in sick. At work, I had no problems and was thought to be very easy going with a good sense of humor. However, after my diagnosis of Arachnoiditis, 2 years ago, I spent most of the time in bed. I felt all the symptoms described in BPD, especially anger and would instigate fights for no reason.(not physical, verbal). I became withdrawn and would not even venture out to the grocery store. I was in and out of the hospital about 9 times for the arachnoididtis and stomach problems that first year. Since then, I have been divorced and I am on total disability due to the Arachnoiditis and cannot work. My family does not help me and I live alone. I have been virtually a recluse for the last year, alone and I do not go out except to the grocery store, to pay bills, or to my pain doctor. I am now on Medicare as of this month. (one must be on Social security disability for 2 years before qualifying for the Medicare card). I feel all the symptoms described in BPD except I do not do any type of self mutilation, nor have I ever attempted suicide. I can tell you I feel like I am living in a virtual hell and at the bottom of a dark pit. I have thought of suicide but I am really too chicken to do anything like that and I have never ever thought seriously about it. Even as bad as it is, I do not have the desire to check out! To make this all end yes, to die, no. I saw a counselor last year, but they did not really help at all. I can honestly say, as a RN, knew more about BPD then they did. I told them I had had a MMPI in 1991 that showed depression and BPD, but they did not talk about it at all. The anger that BPD causes is most uncomfortable, as well as the anxiety, panic and depression. I have a fraternal twin sister that has had problems with depression since she was 14 yrs. old. She has been hospitalized about 4 times for the depression and she also has the binge spending problems. She even embezzled money over a 5 year period from a Realtor she worked for. I have never broken the law, nor even considered it. I made excellent grades in RN school and graduated with honors, even while working full time as a LPN. As a RN, I have always been very calm in emergencies and considered to be very on top of things. I never had any problems until 1991 after I went through divorce for the 4th time! Although looking back, I did have many of the BPD symptoms, although they were not as acute as they have been for the last 2 years. Needless to say, I am on limited income and I need to get help. I live in Florida, in Fort Walton Beach(east of Pensacola). When I was hospitalized in 1991, I was the one who asked to go in as I was so miserable. I have no help from family or friends and if I go into the hospital now, I have nobody to pay my bills or keep my duplex, which I rent. I know that I cannot live like this, isolated from the world, but I have withdrawn to such an extent, I am afraid to venture out at all. Once out, I am fine, but I go home as soon as my errands are done. Please tell me what you think may be the right course of action to take. Not only am I suffering from this terrible chronic nerve pain from Arachnoiditis, I am suffering from the depression and symptoms that seem to be consistent with BPD. I am sorry that this is so lengthy and I appreciate your input. I would like to add also that I was placed on Prozac 20 mg. QD, then it was increased to BID, but I was having so much trouble with nausea and vomiting they changed me to Elavil 75mg at HS.(the neurosurgeon put me on the Elavil). It does not seem to be helping although it may be helping with the nerve pain some, but not the depression. The Prozac made me a bit jittery. My sister was put on Prozac and it did help her, although I do not think she is on it now. Thank you so much for your assistance. You seem to be a very caring doctor by what I have read on the Internet. As a RN, I have worked with Md.’s that seemed to not care much at all. I came upon a question about ADD and BPD. My daughter is 24 and was diagnosed with ADHD as a child, (she was very hyper), and also conduct disorder. She has had a real problem with her temper, attention and authority of any kind and is now in jail for the first time as a result of her temper. Could it be that she also has BPD as I do? Is this disease hereditary? I want to find help for myself but also for my daughter when she comes home in about 1 year. As I said in my last e-mail, I am living a life as a recluse almost and suffering from the pain of Arachnoiditis, which is very severe and involves several levels of my spine. I was also diagnosed with Fibromyalgia and Osteoarthritis as well. Thank you for your time.
A. You've certainly had more than your share of misery during these past few years. There are multiple possible causes of arachnoiditis, however having your neuropsychiatric system over stressed and poorly functioning makes them worse.
The information you sent implied there is more going on than the BPD. I'd especially look at the generalized anxiety disorder - it's almost always the reason for Prozac causing problems and in association with fibromyalgia.
In my website - "biologicalunhappiness.com" - there is a section from my new book called "screening tests" - which could give you some clues. The BPD rarely exists on it's own and to be successfully treated must have everything else successfully treated as well.
There is a strong hereditary basis to most of these "diseases."
I suspect you are feeling a great deal of hopelessness and powerlessness. Some of that may be chronic BPD dysphoria. Much if not all of your suffering is resolvable.
The single best thing you can do for your daughter is to get well yourself, so she has a role model