Mental Health Finally decided to seek treatment again for Borderline PD and comorbidities, have some questions before I do

[EphemeralOutlet141]

Around 2 years ago I was assessed by my inpatient rehab counselor and she theorized that I most likely have Borderline Personality Disorder as well as ADD and depression. Shortly after that I completed the 28 day program and never did anything with that information. I essentially ignored it until very recently. Lately I am seeing very clear and substantial evidence of it being an eroding force on my life. I dissociate daily and often cannot hold a conversation with anyone or focus on a task, my paranoia and anxiety is spawning some alarming delusions, and I generally feel like a hollow person unable to connect with anyone. I look in the mirror and see nothing behind my eyes.

I'd like to do something about this, but my experiences with mental health professionals have ranged from unhelpful to downright aggravating; simply put I don't trust them. I've done the obligatory round of antidepressants and mood stabilizers and feel they only made things worse, so I often fall back on self-medicating. As I mentioned before I was in rehab for a time. From my past experiences this rehab fact stops my treatment in its tracks and I'm immediately treated differently and on one occasion basically told I was not going to get the best treatment. I am also hesitant to bring up past instances of violent ideation and suicidal thoughts NOT relating to my drug use.

In the past I've used mainly benzos, opiates and other anxiolytics and occasional therapeutic stimulant usage because they make me feel like a full person and an active, willing participant in society and life in general. The dilemma of only responding to these medications while having a record of an addict is also a big put-off to seeking treatment. Don't get me wrong I am entirely open to talk therapy as well, but IME that alone is not enough.

I've considered just not even mentioning my past drug use, intense problematic thoughts, and past bad treatment by "professionals", but I realize that defeats the entire purpose of treatment. That being said, I would like to think that I'm somewhat capable of assessing my treatment needs because I've had nearly every mainstream treatment option thrown at me already.

How can I convey all this effectively to a psychiatrist? I'm beginning to fear that if I do nothing this will certainly culminate in something terrible in the future. My quality of life is miles below where I feel it should be. I feel like I'm stuck between a rock and a hard place.

 

[mtu mwendawazimu]

It's sad to hear that you're suffering bro. You always sound pretty rock solid, but i guess that could be the facade. Do you feel like you have to try extra hard just to fit in?

But back to your question, i'd mention everything. And if you don't like their words, find someone else who will. There are some really good therapists out there. I've plowed through about 12. My most recent one was court ordered and exactly what i needed. Brutal honesty and strong willingness to push someone antisocial into a more healthy life style.

@devilsgospel

 

[EphemeralOutlet141]

You are avoiding the usage of some antidepressants and mood stabilizers and in the same time you take the most addictive substance in the world opiates, I don't mean to stop self medicating because some doctor's don't know really how to treat his patients because she don't self tested the illness, but anyway you should go to them and seek the help you will not help any other one then your self.

I probably should've added that I don't use anything regularly besides kratom anymore.

After being addicted to mind-destroying ADs and APs I really can't do all that again. I'd rather be addicted to something that will actually improve my quality of life.

I realize it's not realistic to think I'll go to a psych and get every medication I want, but I do believe some of them could help me live a much better life, even if just for a short duration of use. I would rather not take anything at all.

 

[Jabberwocky]

You may not even have BPD, your diagnosis at rehab doesn't mean that much if you were really strung out at the time. Plus 50% of people diagnosed with BPD no longer meet the criteria for BPD after 5 years.

I would focus on seeing a doctor about ADD and depression, both of which can be treated with medication and therapy. The problem with BPD is that a doctor may suggest anti-psychotic meds, and from everything I've read anti-psychotics are pretty nasty, like a chemical lobotomy.

 

[EphemeralOutlet141]

You may not even have BPD, your diagnosis at rehab doesn't mean that much if you were really strung out at the time. Plus 50% of people diagnosed with BPD no longer meet the criteria for BPD after 5 years.

I would focus on seeing a doctor about ADD and depression, both of which can be treated with medication and therapy. The problem with BPD is that a doctor may suggest anti-psychotic meds, and from everything I've read anti-psychotics are pretty nasty, like a chemical lobotomy.

See at the time I agreed with that. I thought both my inpatient counselor and the psychiatrist I saw for a while afterwards were just making snap assumptions. I even argued with my counselor about it telling her that she seemed more interested in telling me how I felt than listening to me say how I feel. My psychiatrist was incredibly inept and started me on bipolar meds and antidepressants before I even described my symptoms in person and laughed at me when I suggested that this was the wrong course of action. Some of my rehab counselors were incredibly helpful, but unfortunately those were the 2 people I ended up at the mercy of. I didn't understand how any of this worked at the time so I thought I was stuck.

Like I said lately though I am experiencing the classic BPD symptoms such as dissociation and wildly volatile interpersonal relationships/inability to relate to another person. I feel as though I'm not even speaking the same language as the people around me, whereas a year ago I had no shortage of meaningful friendships and romantic relationships. Like a switch flipped and I became a robot. I think it's worth looking into now as it used to be almost nonexistent.

Yeah I'm certainly not doing APs again, I think chemical lobotomy is an apt description. I MIGHT be willing to try an antidepressant again to at the very least placate my doctor. I think you may be right in saying I should go with ADD and depression instead of a complicated personality disorder (that could just be displaced symptoms of depression/anxiety/ADD).

Thanks for the advice.

 

[AEMTwithMs]

There are some awesome medications out there that can help you. My mother is Bipolar, BPD, manic depressive, anxiety and PTSD and I’m sure I’m missed something. She attempted suicide so she is on medications that can not cause any problems in case of OD’s and with my knowledge in EMS they can treat you with the same type of medications. It’s always a trial and error process when it comes to medications. I don’t know how many times I’ve gotten a new med list from my Mom. Just work with the psychologists be patient and try things. Even if it’s a med you have tried if it’s paired with something else it will have a different effect. Be hopeful. Try saint johns wort until you can get into a dr. Let the dr know if you have taken the saint johns wort also because it can interact with some medications. Just whatever you do get the help you need. You have already taken the hardest steps this one should be a cake walk.

 

[EphemeralOutlet141]

I'm actually doing this right now. I finally bit the bullet and decided to get professional help and now I'm officially diagnosed with bipolar 2 and GAD.

The key is to find a good psychiatrist who knows how to listen and is willing to be flexible and open to suggestions. After I was diagnosed, the psychiatrist explained to me the different types of options I had in regards to medication and let me choose what I wanted to try. I let her know that I'd rather try mood stabilizers before trying antipsychotics, and that I'd rather try something other than SSRIs, so I ended up going with Bupropion, Lamotrigine and Hydroxizine.

It might be a good idea to do a bit of research on psychiatric medications before hand to help you choose what medication you want to try. For example, if all the antidepressants you've tried so far are SSRIs, then mention this to your psychiatrist and insist on trying an antidepressant that isn't an SSRI like bupropion or mirtazapine. Whatever you do end up with keep in mind that it takes a while to start working and you may have to deal with initial side effects that will eventually go away when your body becomes used to the medication.

I wish you the best of luck in finding a good psychiatrist and the right medication!

I have actually tried all those meds you just mentioned in different combinations. Not saying that to discount your advice just stating the fact. I think lamotrigine worked decently for me to an extent and I might go with that again. Everything else, not at all unfortunately.

Your doctor sounds great though especially laying out multiple options for you and working closely to make sure you're on the same page. I'm going to find someone like that no matter how many I have to sort through. My biggest weakness the first time around was being complacent and telling myself I had no options. Thanks bro, hope you're doing well.

 

[Slam_everything]

do you live in the United states

 

[Slam_everything]

borderline personality disorder i thought that didn't exist anymore i thought thats what we now call bipolar id recommend

Asking for lithium carbonate klonopin or xanax and low dose seroquel in morning and bigger dose at night

 

[EphemeralOutlet141]

do you live in the United states

Yes

About the BPD I'm not entirely sure if that's even in the psych vocabulary anymore (I was unofficially 'diagnosed' about 3 years ago) it's just a strong suspicion I want to rule out.

Klonopin always helped me without making me do stupid things like Xanax does, but I'll get laughed out of most offices asking for that off the bat. Can't do seroquel again that made me braindead. I'm sure the right medication regimen will come with time, I'm really hoping to find someone competent and understanding first and foremost.