BPD & Trying in LA

    QUESTION:

    Doctor Heller-

    First off, let me apologize for taking your time on something that may seem trivial. However, I have searched for over six months for a psychiatrist or therapist in my area who is trained in DBT, and a psychiatrist that knows and understands your philosophy to BPD. You see, I am a successful licensed Marriage, Family, Child Therapist and after 15 years of struggling, have finally accepted the fact that I am BPD. It is not a self-diagnosis, but one confirmed by the many therapists I have worked with over the years. Your theory regarding DYSLIMBIA brings me hope that there may be end to the internal pain that I suffer. I am somewhat unusual in that I have held a successful career, however, I chose to leave my profession to “practice what I preach” and work on my own marriage and family. I have a wonderful husband and four children. I have all the criteria for BPD with one exception: I don’t go into any psychosis (that I know of). My childhood was extremely traumatic, with my mother–who SIed–cutting me along with herself, and trying to kill me on four different occasions. These things have all been processed and worked through in therapy~~however, the damage from the storm is evident. I desperately want to get on the appropriate medications and went to my Internist regarding the matter–loaded with the algorithms and the various articles you have written. She did not believe me. She did prescribe Paxil, and I had tried Prozac six months ago (was on it ten years ago and it was wonderful) but the Prozac stopped working. The Paxil gives me tremors, or shivers continuously and creepy crawly skin. I am interested in getting more information regarding Depakote or the other medications that you talked about, however, the psychiatrists that I have interviewed–and there have been more than several–are all from the “old school.” Do you know of ANYONE in the LA area who prescribes to your view regarding BPD? Anyway, after 20 years of struggling, I am certain that the “psychological” basis for my illness has well been dealt with but I cannot control my brain and the reactions thereof. I have migraines, IBS and TMJ and daily functioning is an ongoing struggle. I am as content as I can be in my life, and yet…I can never fully enjoy the wonderfulness of my life. I just want to not continually be in crisis. I hope you can help. Any referrals will be greatly appreciated. Blessings to you and your wonderful work,

    BPD in L. A.

     

    ANSWER:

    I assure you it’s not “trivial.” I have learned that there are many, many wonderful human beings desperately struggling with BPD. What I’m doing is in no way unique – I’m simply making the medically treatable diagnoses and treating them comprehensively. I’m working very hard to make a difference, particularly by making this information available on the Net. I’d love to hear from colleagues who are like minded in this regard and I will add an area on my site for these individuals who do contact me. A psychologist in Canada may be teaching a course with my first book “Life at the Border” as the textbook. In my correspondence to other physicians I have explained my rationale about what’s going on. I modified it slightly and it will be in the “Borderline Personality Disorder” section under the title “How I Treat the Borderline Personality Disorder (BPD) and Why.” This may be useful to you as well. Like everyone else you need all the diagnoses I use in my screening test evaluated and treated comprehensively. Prozac doesn’t “stop working.” What happens is that either panic disorder develops or more commonly BPD dysphoria develops – anxiety, rage, depression and despair, which requires temporarily a dose of a neuroleptic and/or epilepsy drug. By far in my experience low doses of Haldol, Tegretol and Risperdal are the best.

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