Why Do I Want To Kill Someone?

QUESTION:

Dear Dr. Heller,

I really needed to get this off my chest to a professional.  I've tried going to different websites related to mental illness but I can't seem to get any advice other than "go to a mental hospital" which I think may be a little extreme.  I've tried telling my mom and dad that I want to see a psychologist because I'm truly scared that there is something seriously wrong with me.  My dad sort of understands, I think since he took psychology as a major in college and knows what mental problems are about.  But my mom seems to be in complete denial, seeing as how she refuses to even acknowledge the fact I may have a problem.  I told her how I took an online test and was diagnosed with Schizoid Personality disorder and Borderline Personality Disorder (at mentalhealth.com) and she said, "Oh you're too young to have anything like that wrong with you".  When I told her some of the symptoms she said, "Oh that's how everybody feels", or, "Its just a phase because you're a teenager".

I'm 16 by the way.  Anyway, I think her problem might be that she has an issue with me having a sickness not because she's worried about me but because she feels threatened.  I think she may have a problem too, which causes her to always need to be sick.  It's weird...I mean she has a partial paralysis due to some faulty medication given to her during my birth and so she can't run but she can walk.  Due to that, her back always hurts.  Plus she always seems to have headaches and is always sick and never feels up to doing anything except for once in a rare while.  I feel very deprived of a social life because she doesn't want me going out with friends or anything except for sometimes when I'm allowed to go to the movies or something.  But that's it.  No parties or anything.  She won't even let me get a drivers license.

My dad is rarely home and when he is, we seem to argue a lot since we're both very stubborn and opinionated.  I'm an only child and so when my dad is away at work or on the weekends when he works doubles for the money, I'm stuck at home with my mom since she doesn't work because of her leg.  Don't get me wrong, I love both of my parents very much, but now that I'm 16 I really think I need to get out more!  The strange thing is, is that lately I've stopped wanting to.  Since I was 15, I have been starting to like being alone and doing things by myself.  Like when my parents go out on the weekends and ask me to go, I don't want to and I just stay home.

Anyway, getting to the point: For the past few months my condition has been worsening and, well, I don't know if this has anything to do with it, but I've been starting to read a lot about criminal psychology and serial killers.  My parents think its because I want to prevent people like that from being around and things, and I don't tell them any different; but the real reason is because I am fascinated with them and want to be like them.  I want to have that power and I want to hurt people like that.  Kill them even.  I have fantasies about torturing and killing and then sometimes I even get turned on by these fantasies.  Also lately I've ben turning really cold towards my parents especially mom.  Like I say things that are really out of line and then I go to my room and laugh about it.  But then I feel sort of bad...Almost like in my mind there's conflicting feelings about what I'm doing.

I don't know what's wrong with me but I know that something is.  What I need from you is maybe a diagnosis of some kind that I can print out and show my parents so they know that a real doctor has sensed something wrong with me.  And maybe they'll let me get the help I need.  I think it's good that I even realize I need help, right?  Oh, speaking of which, sometimes I have like - conversations in my head as if there were two people.  Like I tell myself that I need to get help, that what I'm thinking is wrong!  And then I think, "No, but if you do get help then everyone will find you out and you wont ever be able to do what you're destined to do", and that means I won't ever have the chance to kill.  Also after I have killed a lot of people, I want to actually be caught and tried and imprisoned and sentenced to death.  I crave that!  I want to walk into court someday and see the families of the people I murdered and laugh in their faces and say, "They're DEAD, you fucking like it!!!!!".

I have these emotions and feelings all bottled up since I don't have anyone to talk to, and lately...It's like when I'm with my friends I have to put up false feelings and emotions because I just don't care anymore.  I'm however, NOT suicidal in any way and don't self mutilate.  I want to hurt and kill others, not myself.  Anyway please help me out before I get any worse and do something uncalled for.  And I thank you for even getting this far in my letter.

I'm sorry for it being so long, and thanks for your time.

ANSWER:

You do indeed need help ASAP!  You are at high risk of following through on your thoughts, which would ruin your life and that of many, many others as well. 

If you do have the BPD you're likely experiencing chronic dysphoria (anxiety, rage, depression and despair) - and the "trapped, wounded animal" instinct is kicking in.  The right combination of medications could have a profound effect quickly.  My patients with similar complaints are immediately started on Prozac, adding Tegretol a week later.  I will usually prescribe a medication like Seroquel for that first week. 

The BPD begins at puberty, so you are clearly not too young to have this diagnosis. 

You need to take your feelings and thoughts seriously.  You should show this letter to your parents and if they don't get you help, to your school guidance counselor.  This is not a normal adolescent phase.  It's also very treatable.