![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 35. This is the beginning of the thread.
Posted by ralphrost2 on November 9, 2010, at 17:08:22
Hi fellows,
It's about 4 years I'm working with therapy in order to improve my mental condition. I'm meds free, but it feels like I just can't have a normal life even after all this time making efforts in order to clarify my twisted mind.
I wonder if you might say what kind of medication treatment could be helpful for this condition. I tried SSRIs in the past and they just don't seem the answer. They really blunt emotions, making me quite flat.
Any experiences/ideas
Much appreciated
Ralph
Posted by sigismund on November 9, 2010, at 20:34:41
In reply to Borderline treatment, posted by ralphrost2 on November 9, 2010, at 17:08:22
Hello Ralph
I read that the symptoms are......
>The major symptoms of this disorder revolve around unstable relationships, poor or negative sense of self, inconsistent moods, and significant impulsivity. There is an intense fear of abandonment with this disorder that interferes with many aspects if the individual's life. This fear often acts as a self-fulfilling prophecy as they cling to others, are very needy, feel helpless, and become overly involved and immediately attached. When the fear of abandonment becomes overwhelming, they will often push others out of their life as if trying to avoid getting rejected. The cycle most often continues as the individual will then try everything to get people back in his or her life and once again becomes clingy, needy, and helpless.
>The fact that people often do leave someone who exhibits this behavior only proves to support their distorted belief that they are insignificant, worthless, and unloved. At this point in the cycle, the individual may exhibit self-harming behaviors such as suicide attempts, mock suicidal attempts (where the goal is to get rescued and lure others back into the individual's life), cutting or other self-mutilating behavior. There is often intense and sudden anger involved, directed both at self and others, as well a difficulty controlling destructive behaviors.
Is this you, Ralph? It doesn't sound like you.
You were taking St John's Wort. No go?
Do you want to be a little more specific about what is (shall we say) wrong with your mental condition?
Posted by sigismund on November 9, 2010, at 20:37:04
In reply to Re: Borderline treatment » ralphrost2, posted by sigismund on November 9, 2010, at 20:34:41
I mean what's this?
>poor or negative sense of self, inconsistent moods,
Goodness me.
There are (no doubt) people for whom this is not true.
Posted by ralphrost2 on November 10, 2010, at 6:22:41
In reply to Re: Borderline treatment » ralphrost2, posted by sigismund on November 9, 2010, at 20:34:41
Hi Sigismund!
Nice to have a reply from you!
Some of the descriptions you provided really seem to be true for me (maybe I'm adding something here):
inconsistent moods, sensitivity to rejection, neediness, poor sense of identity, emotional insecurity...
the sympthoms are mild but very very distressing. maybe working in therapy to diminish my tendency to rationalize things is making me go nuts, as these feelings start to arise again
i feel that it's very difficult to feel connected to people. i rarely have the feeling of being accepted and feeling loved
currently I'm not taking any medication. SJW really screwed up my sleep. the last months I had been taking some bupropion (doctor prescribed), and this seemed to have took me from a state of zen-zoombie state (remember Hoshino? ;) to one of feeling very sensitive and uneasy...
i wouldn't like to take an SSRI, for example. that could help making me feel more balanced, but it seems to kill my personality and will to live
thank you
Ralph
Posted by Dinah on November 10, 2010, at 7:32:08
In reply to Re: Borderline treatment, posted by ralphrost2 on November 10, 2010, at 6:22:41
I'm not sure any medication could do a lot about feeling accepted and loved. None that I know of anyway.
Antipsychotics on an as needed basis help for me with anxiety and agitation, so that if I feel myself sliding into a spiral of bad feelings, it can help boost me out.
Posted by ralphrost2 on November 10, 2010, at 8:37:21
In reply to Re: Borderline treatment » ralphrost2, posted by Dinah on November 10, 2010, at 7:32:08
Hi Dinah,
I wonder if medication could help at least keeping a more stable mood... helping so that I can react in a more smooth way to life events.
I find it hard to keep a stable self-image too. Life events seem to affect me too strongly. So maybe with a more stabilized mood, relationships can be healthier.
I'm currently in the 4th year of a therapist I really trust.
Thank you
Ralph
Posted by Dinah on November 10, 2010, at 9:08:40
In reply to Re: Borderline treatment » Dinah, posted by ralphrost2 on November 10, 2010, at 8:37:21
Antipsychotics aren't for everyone. But they aren't just for psychosis either. They can be pretty effective with regard to stability. They're called major tranquilizers, but I feel no real tranquilizing effects with risperdal - not like klonopin or xanax. I tell my therapist that my risperdal is ego strength in a bottle.
I'm not trying to push them at all. There are health concerns, and they may not be appropriate for you. Some people may have different reactions to them. I've chosen to use them on an as needed basis because of the health concerns. But it might be worth discussing them with your psychiatrist. For what you're describing, I've found nothing near as effective.
Posted by Dinah on November 10, 2010, at 9:09:33
In reply to Re: Borderline treatment » Dinah, posted by ralphrost2 on November 10, 2010, at 8:37:21
You might want to post on the Medication board as well.
Posted by sigismund on November 10, 2010, at 13:47:48
In reply to Re: Borderline treatment » Dinah, posted by ralphrost2 on November 10, 2010, at 8:37:21
> Life events seem to affect me too strongly.
Ralph, I can see that that is true of you.
I assume that moods will be unstable (being moods) and that one's sense of self will be poor (compared to whatever).
Posted by sigismund on November 10, 2010, at 13:50:53
In reply to Re: Borderline treatment » ralphrost2, posted by sigismund on November 9, 2010, at 20:34:41
You read these things and immediately see yourself. As in
>This fear often acts as a self-fulfilling prophecy as they cling to others, are very needy, feel helpless, and become overly involved and immediately attached
Posted by emmanuel98 on November 10, 2010, at 20:07:01
In reply to Re: Borderline treatment » sigismund, posted by sigismund on November 10, 2010, at 13:50:53
This probably belongs on the med board, but my moods were so unstable I could go from 0-100 in a minute. I would have severe panic attacks that would last for hours. My p-doc prescribed risperdal and all of a sudden I felt --this is what most people must feel like, just okay, not high or low or crazy, just okay. I should have taken it PRN. Instead, I took it daily and gained 15 pounds in a month. I was so bummed out. I never felt more even and okay on a drug.
Posted by ralphrost2 on November 18, 2010, at 13:57:19
In reply to Re: Borderline treatment, posted by emmanuel98 on November 10, 2010, at 20:07:01
Hi all,
Thanks for your replies. On tuesday I went to the psychiatrist and he simply said to me: "I don't think medication would help with your condition. Suffering is part of life and self growth, so that's it". I told him that I think my quality of life is not really any good, even though I'm very ok psychologically and clear headed.
He never mentioned antipsychotics along the way. Only SSRIs (harsh flattener) and Bupropion (helps with motivation but worsens stability and anxiety).
I'm really open to try to go on without meds. But as I said earlier, my quality of life is quite poor. I don't really see things that I could change in my life that would have some impact on that. Maybe time could help (I'm 27)? Marriage (I live alone)?
Thank you
Ralph
Posted by sigismund on November 18, 2010, at 15:00:09
In reply to Re: Borderline treatment, posted by ralphrost2 on November 18, 2010, at 13:57:19
> he simply said to me: "I don't think medication would help with your condition. Suffering is part of life and self growth, so that's it".
This is of course true.
>I told him that I think my quality of life is not really any good, even though I'm very ok psychologically and clear headed.
I'm not sure that marriage is the best idea.
You have thought of exploring your part of the world?
I'd be exploring those Amazonian plants.
Ralph, I would have a field day living where you are.
I'd start on Aciai(sp?) berries and work my way up to chewing coca leaves in the market place.
Posted by sigismund on November 18, 2010, at 15:02:57
In reply to Re: Borderline treatment, posted by ralphrost2 on November 18, 2010, at 13:57:19
You used to play a musical instrument, no?
You don't do that any more?
Maybe you don't have time?
Posted by ralphrost2 on November 18, 2010, at 16:44:34
In reply to Re: Borderline treatment, posted by sigismund on November 18, 2010, at 15:00:09
> I'm not sure that marriage is the best idea.
That sounded kinda funny... I mean getting myself some company.
> You have thought of exploring your part of the world?
I have been planning some trips around here. Of course, many nice things to see. I like to dive in the coast.
> I'd be exploring those Amazonian plants.
> Ralph, I would have a field day living where you are.
> I'd start on Aciai(sp?) berries and work my way up to chewing coca leaves in the market place.Açaí berries may taste somewhat odd for some, but for me they go great with banana, honey and some muesli. Do you have them available over there (imported pulp, maybe)?
Thanks
Posted by ralphrost2 on November 18, 2010, at 16:47:11
In reply to Re: Borderline treatment, posted by sigismund on November 18, 2010, at 15:02:57
> You used to play a musical instrument, no?
>
> You don't do that any more?
>
> Maybe you don't have time?I have been playing the piano, Sigismund.
Posted by Free on November 18, 2010, at 20:37:44
In reply to Borderline treatment, posted by ralphrost2 on November 9, 2010, at 17:08:22
Hi Ralph,
I can't tell from reading your thread whether you've been diagnosed as having BPD or you think you might have it because you can relate to some of the symptomatic features of BPD.
Have you been diagnosed by your therapist/psychiatrist with Borderline Personality Disorder?
>
> I wonder if you might say what kind of medication treatment could be helpful for this condition. I tried SSRIs in the past and they just don't seem the answer. They really blunt emotions, making me quite flat.
> Any experiences/ideas
> Much appreciated
> Ralph
>I am completely off meds now, but before then, the meds made my condition much worse. I was constantly vacillating between "too checked out to function" or "too manic to make sound choices". And the worst was I laughed less. For me, the overwhelming emptiness and pain were not lessened by meds. The hopelessness was always there.
As a last resort, I signed up for DBT (Dialectical Behavior Therapy). I've found that it's definitely not a miracle cure for everyone with BPD, but dbt has helped me more than anything else. It's given me a more productive way of understanding how and why this disorder affects me the way it does. And the skills I have learned in DBT have allowed me to better tolerate distress and regulate my intense emotions.
Although my life is still nowhere near ideal, my emotions and thoughts feel less out of control now. I quit smoking and rarely drink, and resort to less negative behaviors. I have long ways to go in reaching how I would like to see my life, but it's miles better than what it was. I recommend DBT if you've been diagnosed with BPD. It's worth a try.
>
> Thanks for your replies. On tuesday I went to the psychiatrist and he simply said to me: "I don't think medication would help with your condition. Suffering is part of life and self growth, so that's it".
>At first, I thought this was a funny if not an odd thing to say for a psychiatrist (because it's not expected), but like Sigismund said, it is true. I wonder if your psychiatrist is a Buddhist.
Acceptance of suffering is true in both Buddhism and DBT: Suffering exists; it has a cause; it has an end; and it has a cause to bring about its end. I find strength and comfort in this.
Posted by ralphrost2 on November 19, 2010, at 6:28:14
In reply to Re: Borderline treatment » ralphrost2, posted by Free on November 18, 2010, at 20:37:44
Free,
My current psychiatrist doesn't like to label symptoms. But I had a former psychiatrist which said the best diagnostic that fitted my problems was a "mild BPD".
I guess it'd be very difficult to find DBT where I live. Mostly what we have here is psychoanalysts (which is my therapist's approach).
I'm not used to have trouble with people, at all. I don't have anger bursts or anything. My main complaint is that one day I'm in a fine mood, and sometimes the next day I wake up in a completely different mood, might be quite withdrawn and not willing to speak a word with anybody. It feels like my life doesn't have emotional continuity... emotions are quite unstable and I tend to isolate myself because of that.
As I think I'm psychologically quite well, I thought... what else is missing? So much effort in therapy (4 years) and still having a poor quality of life? That's why I thought about meds. But they suck (for me), I know.
Maybe I'm lacking having some distraction, as Sigismund mentioned.
Have a nice weekend
Ralph
Posted by Free on November 19, 2010, at 17:42:26
In reply to Re: Borderline treatment » Free, posted by ralphrost2 on November 19, 2010, at 6:28:14
>...But I had a former psychiatrist which said the best diagnostic that fitted my problems was a "mild BPD".
>...My main complaint is that one day I'm in a fine mood, and sometimes the next day I wake up in a completely different mood, might be quite withdrawn and not willing to speak a word with anybody. It feels like my life doesn't have emotional continuity... emotions are quite unstable and I tend to isolate myself because of that.
>
>As I think I'm psychologically quite well, I thought... what else is missing? So much effort in therapy (4 years) and still having a poor quality of life? That's why I thought about meds. But they suck (for me), I know.
>Okay, I see. Sounds like you're doing what you can though. I've been in therapy for a while myself, and it's a painfully slow process.
> Maybe I'm lacking having some distraction, as Sigismund mentioned.
>
> Have a nice weekend
>
> Ralph
>Yeah, I think distractions are good. It's actually one of the skills in DBT. Taking trips, diving in the coast, playing piano, and eating muesli with acai berries, all sound like lovely distractions. I'm slightly envious, these activities are rich with opportunities for practicing DBT skills. :)
I'm not sure which part of the world you're in...maybe Colombia or Costa Rica? But if you can find a DBT program, you might want to look into it. I think you might really benefit from some of the skills that help you to stabilize your emotions. From what I've seen, more people with "mild" cases do better with dbt than the tougher cases. (Sorry, if I sound like a DBT saleswoman...I guess I'm excited that something's actually helping me. :))
Hope you have a nice weekend, too, Ralph. Take care.
Free
Posted by emmanuel98 on November 19, 2010, at 19:33:45
In reply to Re: Borderline treatment » ralphrost2, posted by Free on November 18, 2010, at 20:37:44
My DBT therapist says that pain is part of life, but suffering is the result of not accepting the pain, fighting against it, letting it get the best of you. So she would say that suffering is not a necessary part of life. I've always found that distinction helpful.
Posted by Free on November 19, 2010, at 21:39:52
In reply to Re: Borderline treatment, posted by emmanuel98 on November 19, 2010, at 19:33:45
> My DBT therapist says that pain is part of life, but suffering is the result of not accepting the pain, fighting against it, letting it get the best of you. So she would say that suffering is not a necessary part of life. I've always found that distinction helpful.
>Yes, I think this is another insightful way of looking at pain and suffering. I've always found that distinction helpful as well. I like how your therapist put it, she must have been in her wise mind. :)
Are you currently in Individual and Group?
Posted by sigismund on November 20, 2010, at 1:48:01
In reply to Re: Borderline treatment » Free, posted by ralphrost2 on November 19, 2010, at 6:28:14
>emotions are quite unstable and I tend to isolate myself because of that.
Moods and emotions are unstable, just generally.
When you are not willing to speak a word with anybody, can you say in more detail how you feel then?>As I think I'm psychologically quite well, I thought... what else is missing? So much effort in therapy (4 years) and still having a poor quality of life? That's why I thought about meds. But they suck (for me), I know.
Well,I hate to say it but I might quote Eyschenk (sp?) ....'the evidence that psychoanalysis cures anyone of anything is so thin as to be non-existent'.
Nevertheless I did 15 years of it. In retrospect it seems like child-rearing for those who missed out (a personal perspective, no doubt.)
I ended up reading about human atrocities (history) because I had the time and I wanted some excuse for myself.
And in the process I realised what a wonderful place the world is, and how terribly sad it all is, and in particular where you live, generally I mean, but everywhere really.
Posted by sigismund on November 20, 2010, at 1:51:08
In reply to Re: Borderline treatment, posted by emmanuel98 on November 19, 2010, at 19:33:45
>My DBT therapist says that pain is part of life, but suffering is the result of not accepting the pain, fighting against it, letting it get the best of you. So she would say that suffering is not a necessary part of life. I've always found that distinction helpful.
I was reading one basic Buddhist text that spoke of the advantage of being able to voluntarily shoulder your pain and bear it.
That is why the four noble truths are noble, the truth of suffering in particular.
Posted by Dinah on November 20, 2010, at 7:00:49
In reply to Re: Borderline treatment, posted by ralphrost2 on November 18, 2010, at 13:57:19
From my point of view, there is no virtue in accepting unnecessary suffering. In my point of view, there is virtue in being the best you you can be. Contributing as much as you can to the world around you.
If you feel that you are unable to do that because of the pain, I think that you ought not accept that at all.
Therapy can help definitely, but if I were you, I'd get a second opinion as to whether medications would help. Therapy helped me much more once I had suitable meds on board.
Any psychiatrist who told me my poor quality of life and suffering was just part of life would see nothing but my back. That is a personal philosophy that I would not accept as sound medical advice without at least a second opinion from another medical doctor. Both you and the people in your world deserve better than to accept that which need not be accepted.
(The pdoc from h*ll pushed meds, but he also believed that some aspects of my pain couldn't be treated by medications. The pdoc I saw briefly in between had a similar point of view. My next pdoc promptly found medications that helped my pain. With those medication I was able to fully appreciate gains from psychotherapy.)
Posted by ralphrost2 on November 20, 2010, at 9:24:53
In reply to Re: Borderline treatment » ralphrost2, posted by sigismund on November 20, 2010, at 1:48:01
> When you are not willing to speak a word with anybody, can you say in more detail how you feel then?
I feel really empty. I feel that it is not worth saying anything because nothing really matters. Nothing seems really funny or interesting. And my mind simply doesn't respond even when there's someone nice trying to have some chat. It doesn't resonate, or something.
Go forward in thread:
Psycho-Babble Psychology | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.