Posted by Racer on April 27, 2006, at 1:36:12
In reply to Labeled chronic losing hope. (Long), posted by tygereyes on April 26, 2006, at 20:56:46
I think you're right, about there not being a happy pill that will make all this go away. But there is hope -- even beyond the usual "where there's life, there's hope" routine.
My dxs are Major Depressive Disorder, Anxiety Disorder Not Otherwise Specified, and Anorexia Nervosa. An I'm a couple of decades older than you are, so I guess you could say it's chronic...
There's good news and bad news about my story, the good news being that I've had long periods of time with only a few symptoms of the anorexia. I'm being honest here -- some of the symptoms have just never really gone away. I've always had trouble with recognizing hunger and satiety, for instance. But in many ways, during those times, I just ate what I wanted, when I wanted. I didn't go through my anxiety attacks about whether or not I could eat something, no automatic calculations of fat/protein/carbohydrate/calories, no consideration of how many calories I burned in any activities -- and I didn't step on the scale if I could help it, and made doctors' offices weigh me backwards so that I wouldn't be triggered. And it didn't bother me.
The bad news being that I have relapsed a number of times.
I figure the fact that I could eat what I thought sounded good, without thinking about it beyond whether something else sounded better, tells me that it is possible.
I admit a strong bias -- I think psychodynamic therapy is probably the most effective model for anorexia. I also think that it might be helpful for your BPD, too, in that it can help you identify how you learned certain behaviors, and maybe that will help you in overcoming them. That's my opinion, and I have nothing to back it up. (Although the ED expert in the area where I live is psychodynamic, so maybe I'm not alone in thinking it...)
I don't know enough about what drugs would be most helpful, although I can tell you that SSRIs have been shown to help prevent relapse in weight restored anorexics, Topomax helps reduce binging/purging behavior for many people (you didn't mention whether you restrict or b/p, but I'm guessing that's an issue for you, too?), Walter Kaye published a study last fall that showed abnormal OVERactivity in the serotonin system of weight-recovered anrorexics (which might indicate that non-serotinergic ADs would be a better choice), Zyprexa has been shown effective in reducing the obsessive compulsive symptoms and the anxiety regarding weight gain, and I'm pretty sure there are some I'm missing.
I hope that's helpful. I didn't answer you on Eating earlier, both because I was short of time, and because I really wasn't sure how to respond. I didn't really feel as though I had anything useful to offer.
poster:Racer
thread:637352
URL: http://www.dr-bob.org/babble/20060423/msgs/637394.html