Psycho-Babble Medication Thread 532275

Shown: posts 1 to 25 of 32. This is the beginning of the thread.

 

Is the psychosis in BPD real psychosis?

Posted by Deneb on July 23, 2005, at 17:10:23

I've been wondering about why my p-doc never recommends an AP for me. I think it is because I've never really experienced "true" psychosis...perhaps it more like an emotional explosion then psychosis. Also I don't think my p-doc is much of a "meds" person, at least not for me. We never even talk about meds.

I still have no idea how others get on so many meds. I've been really really weird with my p-doc, but she never ever freaks. There is probably nothing I can say that would get me on an AP or land me in the hospital with her :-). Plus she doesn't even have hospital privileges. :-)

The reason why I do not make rational sense during such episodes is because my emotions have overcome my reasoning abilities. This is still quite dangerous for me, but I guess it is not something meds can fix. So, I'm guessing that the "psychotic-like" symptoms in BPD is not true "psychosis." What do others think?

Deneb

 

Re: Is the psychosis in BPD real psychosis? » Deneb

Posted by Phillipa on July 23, 2005, at 20:53:25

In reply to Is the psychosis in BPD real psychosis?, posted by Deneb on July 23, 2005, at 17:10:23

Deneb, I'm not a meds expert, but I think that it's a psychosis until your meds start working. I would think that unless it happens all the time that you wouldn't need an antipsychotic. Fondly, Phillipa

 

Re: Is the psychosis in BPD real psychosis? » Phillipa

Posted by Deneb on July 23, 2005, at 22:04:53

In reply to Re: Is the psychosis in BPD real psychosis? » Deneb, posted by Phillipa on July 23, 2005, at 20:53:25

> Deneb, I'm not a meds expert, but I think that it's a psychosis until your meds start working.

Huh? I'm not too sure what you mean Phillipa. What's "it"?

I'm just wondering if there is such a thing as a quasi psychosis. How would it be different from "true psychosis"? In what ways would it make meds unnecessary for a quasi psychosis and useful for true psychosis? Or, is it that it doesn't make a difference? i.e. an antipsychotic will make even a "normal" person less emotional/have fewer "strange" thoughts etc.

>I would think that unless it happens all the time that you wouldn't need an antipsychotic. Fondly, Phillipa

I'm just worried about it happening once and being the death of me.

Deneb

 

Re: Is the psychosis in BPD real psychosis? » Phillipa

Posted by Phillipa on July 23, 2005, at 22:31:56

In reply to Re: Is the psychosis in BPD real psychosis? » Deneb, posted by Phillipa on July 23, 2005, at 20:53:25

Deneb, I'm sorry I misread your Thread. I thought you said that you had had psychotic episodes. But you were just asking what would happen if you did? Is this right? Fondly, Phillipa

 

Re: Is the psychosis in BPD real psychosis?

Posted by Deneb on July 23, 2005, at 22:42:22

In reply to Re: Is the psychosis in BPD real psychosis? » Phillipa, posted by Phillipa on July 23, 2005, at 22:31:56

> Deneb, I'm sorry I misread your Thread. I thought you said that you had had psychotic episodes. But you were just asking what would happen if you did? Is this right? Fondly, Phillipa

No need to be sorry. :-)

The thing is, I'm not sure what I had. I don't know if what I experience sometimes is some sort of psychosis or not. I want to know more about the differences, if there are any, between real psychosis and the psychosis sometimes present in people with borderline personality disorder. i.e. How do I know whether or not someone is really psychotic?

Deneb

 

Re: I'm afraid of losing control of emotions

Posted by Deneb on July 23, 2005, at 23:10:06

In reply to Re: Is the psychosis in BPD real psychosis?, posted by Deneb on July 23, 2005, at 22:42:22

Right now I don't want to die, but just wait, I know I will again. :-(

Is there anything OTC that can take the edge off horrible emotions and thoughts? Would alcohol work or would it make things worse?...yuck, I hate alcohol, but I'm desperate. I just know I'm going to go "crazy" again.

 

Re: Is the psychosis in BPD real psychosis? » Deneb

Posted by Phillipa on July 23, 2005, at 23:40:08

In reply to Re: Is the psychosis in BPD real psychosis?, posted by Deneb on July 23, 2005, at 22:42:22

Deneb, Do you see things that noone else sees, hear voices, think the Tv or radio is talking to only you, think thoughts like you're God or Jesus? This should give you a good idea what is a psychosis. It's not complete. Fondly,Phillipa

 

Re: I'm afraid of losing control of emotions

Posted by Phillipa on July 23, 2005, at 23:43:05

In reply to Re: I'm afraid of losing control of emotions, posted by Deneb on July 23, 2005, at 23:10:06

Deneb, Alchohol will only make thing worse. What meds are you on now and when are you going to the doctor. Can you call? What makes you think you will lose your mind? Fondly, Phillipa

 

Re: Is the psychosis in BPD real psychosis? » Phillipa

Posted by Deneb on July 24, 2005, at 0:08:40

In reply to Re: Is the psychosis in BPD real psychosis? » Deneb, posted by Phillipa on July 23, 2005, at 23:40:08

> Deneb, Do you see things that noone else sees,

No, this one I'm almost sure of...I have seen things right before falling asleep, but I don't think that is cause for concern. I also could have been lucid dreaming or something.

> hear voices,

No, I'm pretty sure of this one too. A couple of times I think I maybe smelled something that wasn't there, but I don't think that is cause for concern either...it was probably just my over active imagination.

> think the Tv or radio is talking to only you,

No, I've never thought those things. Once I thought the world was surely going to end because a missile had been launched and I huddled on the floor rocking and moaning to myself and I think maybe hurting myself as well. I wanted the missile to come so badly. I think I was pretty out of it then...I was alone too so I wasn't being "manipulative".

>think thoughts like you're God or Jesus?

No, never thought that. It is unlikely that I would think that because I'm not a religious person at all. For a while I thought that everything in the world was for my amusement and enjoyment...even the bad things were supposed to be good etc. I was pretty darn happy and thought everything was super great. I was laughing at inappropriate things etc. It was a very fun time, but I don't think it was quite normal.

> This should give you a good idea what is a psychosis. It's not complete. Fondly,Phillipa

Off and on I've thought that certain people want me to die. Once here I thought I had to be a martyr and kill myself to save people from being blocked. I'm totally over that now, I hope.

Recently again I thought someone wanted me to die. I don't know if I really truly believed these things, but I know I was extremely extremely upset in all cases (except in the happy case)...upset enough that I think my life was in danger.

Deneb


 

Re: I'm afraid of losing control of emotions » Phillipa

Posted by Deneb on July 24, 2005, at 0:20:58

In reply to Re: I'm afraid of losing control of emotions, posted by Phillipa on July 23, 2005, at 23:43:05

> Deneb, Alchohol will only make thing worse.

That's what I figured. I know that benzos can make BPD worst because of disinhibition causing more impulsivity. I know alcohol causes disinhibition as well.

> What meds are you on now

I've only ever been on SSRIs. Right now Celexa 50mg. I had reduced it to 40mg, but I seemed only to get more unstable. I don't think it had any connection to reducing the Celexa, but I figured I'll just experiment with going back to 50mg since the Celexa doesn't seem to harm me in any way. Who knows, maybe the placebo effect of doing this will help me somewhat.

>and when are you going to the doctor. Can you call?

Right now I don't have any appointments with anyone. My family doctor (the one I dislike and who saw me for an agonizing 1 whole hour each time) even called me back after I ditched her. I guess she was worried about me cancelling everything...but I really cannot stand that person! I'm guessing the p-doc I saw at the university health centre is back from maternity leave, but I didn't do as she said to do and book 4 appts. for when she comes back. I know she is always booked solid unless you make the appts way ahead of time. I'm thinking of just not seeing her again. I don't want to bother her.

>What makes you think you will lose your mind? Fondly, Phillipa

From what I wrote previously in the post above this one.

Deneb

 

Re: Is the psychosis in BPD real psychosis? » Deneb

Posted by fairywings on July 24, 2005, at 9:00:15

In reply to Re: Is the psychosis in BPD real psychosis? » Phillipa, posted by Deneb on July 24, 2005, at 0:08:40


> Off and on I've thought that certain people want me to die. Once here I thought I had to be a martyr and kill myself to save people from being blocked. I'm totally over that now, I hope.
>
> Recently again I thought someone wanted me to die. I don't know if I really truly believed these things, but I know I was extremely extremely upset in all cases (except in the happy case)...upset enough that I think my life was in danger.
>
> Deneb
>
Hey Deneb,

Psychosis is a break with reality. Do you still feel like you're in reality when it happens? I guess what you're describing is being paranoid, at least that's what it sounds like. Have you told your p-doc what you experience, in the words you used above?

Why don't you ask your p-doc about meds. I wouldn't take them if you don't need them, but if you think you do, then you might ask her about it. Sure can't hurt to have a discussion about meds.

Too bad about your GP. Are you looking for a new one? Good luck with all of this.

FW/Jazzy

 

Re: Is the psychosis in BPD real psychosis? » fairywings

Posted by Deneb on July 24, 2005, at 11:29:07

In reply to Re: Is the psychosis in BPD real psychosis? » Deneb, posted by fairywings on July 24, 2005, at 9:00:15

> Hey Deneb,
>
> Psychosis is a break with reality. Do you still feel like you're in reality when it happens?

Yes, I still feel like I'm in reality. Sometimes I feel like reality is strange, but I think that is more derealization than psychosis. I suppose it is not real psychosis then because I am still able to think that what I was thinking made no sense to other people.

> I guess what you're describing is being paranoid, at least that's what it sounds like.

I don't know what I experience...it is more like my emotions go haywire and I can't think straight anymore.

> Have you told your p-doc what you experience, in the words you used above?

Yes I've told her, but I'm not very good at describing things IRL. She didn't think it was a problem.

> Why don't you ask your p-doc about meds. I wouldn't take them if you don't need them, but if you think you do, then you might ask her about it. Sure can't hurt to have a discussion about meds.

Already have, meds not needed, except for an SSRI to maybe help. I think she thinks that I'm avoiding my real problems when I start asking about meds.

> Are you looking for a new one?

No, there are not enough family doctors to go around here and I have to stick with her. I'm just going to avoid her though.

> Good luck with all of this.
>
> FW/Jazzy

Thanks, I think I'm going to need it.

Deneb

 

Re: Is the psychosis in BPD real psychosis?

Posted by med_empowered on July 24, 2005, at 13:59:38

In reply to Re: Is the psychosis in BPD real psychosis? » fairywings, posted by Deneb on July 24, 2005, at 11:29:07

hey! Having taken antipsychotics for a mood-disorder (bipolar) that sometimes had psychotic features in the past I can tell you...don't believe the hype: the new antipsychotics are still similar to the old ones...avoid if it all possible. Some docs do this weird, as-needed medication for borderline "dysphoria" : basically, the guidelines I've seen call for small amount of Haldol (up to 2mgs), up to 30mgs Abilify, or some Tegretol as-needed. The idea is to "defuse" the situation. I say...thumbs down. Antipsychotics are rough...unless you are floridly psychotic or have a god awful mood-disorder that responds well to them, you're usually better off avoiding them. Benzos can make borderline worse, but they can also help calm you down when used on an as-need basis. If you *absolutely* need something, I'd definitely opt for a benzo, even with the risks of disinhobition, before I'd go near an antipsychotic. Your doc sounds good...although it might seem strange to be so slow to go with the meds, its a good approach. Heavy-handed docs often do more harm than good...one shrink had me on 7 psychotropic meds a day when I was 19. It was awful, and it takes a lot of time to undo that kind of "treatment".

 

Re: Is the psychosis in BPD real psychosis?

Posted by fairywings on July 24, 2005, at 14:55:14

In reply to Re: Is the psychosis in BPD real psychosis?, posted by med_empowered on July 24, 2005, at 13:59:38

>>Antipsychotics are rough...unless you are floridly psychotic or have a god awful mood-disorder that responds well to them, you're usually better off avoiding them. I'd definitely opt for a benzo, even with the risks of disinhobition, before I'd go near an antipsychotic. Your doc sounds good...although it might seem strange to be so slow to go with the meds, its a good approach. Heavy-handed docs often do more harm than good

Deneb,

I have to agree with med empowered here. If you need the meds fine, but go with something that will treat what ails you w/o causing more problems. I like the benzos for anxiety, they work, and I haven't had a problem with them. Didn't like the SSRI side effects. And when I was a teen and was on an anti psychotic, all I can say is Yikes! I never want that again! Of course I wasn't on it because I needed it either, so I'm not talking about cases where it's necessary.

Good luck!
FW

 

Re: Is the psychosis in BPD real psychosis?

Posted by Deneb on July 24, 2005, at 15:43:46

In reply to Re: Is the psychosis in BPD real psychosis?, posted by med_empowered on July 24, 2005, at 13:59:38

Thanks med_empowered and fairywings

I certainly don't want to be on unnecessary meds. I'm glad my p-doc is cautious too. I don't know much about the real effects of other drugs. I'm guessing she knows more and I'll trust her when she says I don't need them.

I think maybe I will just have to learn to deal with my emotions going out of control. It's fortunate that these episodes do not last long. Since they are self-limiting, I suppose that it doesn't matter how "crazy" I get, I probably don't need a med for it.

Deneb

 

Re: Is the psychosis in BPD real psychosis? » Deneb

Posted by fairywings on July 24, 2005, at 23:00:24

In reply to Re: Is the psychosis in BPD real psychosis?, posted by Deneb on July 24, 2005, at 15:43:46


>
> I think maybe I will just have to learn to deal with my emotions going out of control. It's fortunate that these episodes do not last long. Since they are self-limiting, I suppose that it doesn't matter how "crazy" I get, I probably don't need a med for it.
>
Maybe therapy would help, at least to understand better what's going on, and maybe reassure you.

FW

 

Re: Is the psychosis in BPD real psychosis? » fairywings

Posted by Deneb on July 24, 2005, at 23:25:26

In reply to Re: Is the psychosis in BPD real psychosis? » Deneb, posted by fairywings on July 24, 2005, at 23:00:24

> Maybe therapy would help, at least to understand better what's going on, and maybe reassure you.
>
> FW

Yes, I think that would be a good idea. I'm not saying that meds are not for me...I just simply don't know. If they work and the side effects vs benefit profiles are favorable, then hey, why not? :-)

Same goes for therapy I guess, risk vs benefits.

I like to keep an open mind.

Deneb

 

Re: Is the psychosis in BPD real psychosis? » Deneb

Posted by fairywings on July 24, 2005, at 23:33:11

In reply to Re: Is the psychosis in BPD real psychosis? » fairywings, posted by Deneb on July 24, 2005, at 23:25:26

>
> Yes, I think that would be a good idea. I'm not saying that meds are not for me...I just simply don't know. If they work and the side effects vs benefit profiles are favorable, then hey, why not? :-)
>
> Same goes for therapy I guess, risk vs benefits.
>
> I like to keep an open mind.
>
> Deneb

I don't blame you Deneb. There have been times when I've found meds to be a great thing. I take one med. every day, and it's made a lot of difference for me. Another, a benzo, I take as needed, which isn't often, but I"m glad to have it when I need it.

I think anyone can benefit from therapy, esp. with a good fit with the therapist, but I guess there is always that risk that you won't find someone you fit with, or that they'll screw up transference, or that they'll terminate you too soon.

FW/Jazzy

 

Re: Is the psychosis in BPD real psychosis? » fairywings

Posted by Phillipa on July 24, 2005, at 23:53:49

In reply to Re: Is the psychosis in BPD real psychosis? » Deneb, posted by fairywings on July 24, 2005, at 23:33:11

Please don't mention transference to me. Besides mess me up with too many meds, putting me on disability, doing his own therapy and not letting me continue seeing someone the only one who ever helped me in therapy, he led me on to believe he was a father figure. Fondly, phillipa

 

Re: Is the psychosis in BPD real psychosis?

Posted by SLS on July 25, 2005, at 2:10:12

In reply to Is the psychosis in BPD real psychosis?, posted by Deneb on July 23, 2005, at 17:10:23

> So, I'm guessing that the "psychotic-like" symptoms in BPD is not true "psychosis." What do others think?

Are you speaking of bipolar disorder or borderline personality disorder?


- Scott

 

Re: Is the psychosis in BPD real psychosis? » Deneb

Posted by alexandra_k on July 25, 2005, at 4:35:14

In reply to Re: Is the psychosis in BPD real psychosis? » fairywings, posted by Deneb on July 24, 2005, at 23:25:26

People with borderline personality sometimes have 'transient' (that is to say relatively short lived) episodes of psychosis when under extreme stress. Usually paranoia. That means that yes, people with BPD can get a little bit psychotic when their emotions get a bit out of control. BPD is now being conceptualised as a mood disorder. A disorder of 'emotion regulation' which means people with BPD have trouble regulating intense emotional states (both good and bad).

The newer anti-psychotics (e.g., Seroquel, resperidone) are very different to take than the older anti-psychotics (e.g., chlorpromazine or injections of dipixol (?sp)).

The older ones are MUCH more sedating. They have a lot of other nasty side affects too. E.g., I needed to have an injection to counter my jaw locking up after having a dipixol injection. My eyes were all blurry for a good week or so. I couldn't read. I couldn't focus. I felt woozy and 'out of it'.

A low dose of one of the newer ones take a couple days to adjust to. For those first few days things can feel a little unreal (but no worse than I experience some other times at any rate!). They can help with sleep and anxiety (if taken before bed). They can help you feel a bit more generally relaxed. Not in a major way - but then if they did that they would be majorly addictive. I think... Because of the 'feeling a bit more generally relaxed' thing they help to minimise the times when your emotions get out of control. They can help you regulate your emotions. Not in a major way but they can help a bit.

Mood stabilisers (e.g., tegratol, epilim) can also have a similar effect.

Anti-psychotics aren't just prescribed for episodes of psychosis. I have known other people with BPD to take them. I have taken chlorpromazine as an alternative to a benzo when under extreme stress. I have used it as a tranqualiser sometimes too - to knock me out, basically when I was in hospital as an alternative to benzos. I used to take them with that dx. Now they say that a small amount of Seroquel might help with dissociation.

 

Re: Is the psychosis in BPD real psychosis?

Posted by alexandra_k on July 25, 2005, at 4:38:36

In reply to Re: Is the psychosis in BPD real psychosis? » Deneb, posted by alexandra_k on July 25, 2005, at 4:35:14

Oh...

Episodes of 'borderline psychosis' typically differ from 'genuine' psychotic episodes because borderlines typically retain their reality testing.

That means... You might think that people wish you harm... But you still kind of know it isn't true or that it isn't definately true. You don't retain the belief 'despite incontrovertible and / or obvious proof or evidence to the contrary'.

When reality testing goes out the window people are supposed to be CERTAIN that their belief is true and their belief is not supposed to be amenable to counter-evidence or reason in general.

But that being said... Sometimes reality testing can go out the window for a little while (usually very short lived) when under extreme stress...

 

Re: Is the psychosis in BPD real psychosis?

Posted by SLS on July 25, 2005, at 6:37:01

In reply to Re: Is the psychosis in BPD real psychosis?, posted by alexandra_k on July 25, 2005, at 4:38:36

Hi Alexandra,

Thanks for the explanation.

Right now, I am seeing a trend in the use of Tegretol, Trileptal, and Zyprexa in borderline. I've seen Trileptal and Zyprexa help turn one young woman's life around. She credits the Zyprexa most for her improvement. She has also engaged in psychotherapeutic work. She continues to grow.


- Scott

 

Re: Is the psychosis in BPD real psychosis? » Phillipa

Posted by fairywings on July 25, 2005, at 6:50:51

In reply to Re: Is the psychosis in BPD real psychosis? » fairywings, posted by Phillipa on July 24, 2005, at 23:53:49

Sorry Phillipa. This is the kind of "therapy" that, when it happens, sucks big time. I just don't get why ppl like that practice, unless they have some kind of psychotic need to make ppl dependent on them. The same thing that happened to you was exactly what my first psychiatrist did, put me on so many meds I couldn't function, made me think he was a "real" father to me, and made me feel dependent. I was a teen ager, and it pretty much ruined my life.

FW/Jazzy

FW/Jazzy

 

bad shrinks

Posted by med_empowered on July 25, 2005, at 7:50:17

In reply to Re: Is the psychosis in BPD real psychosis? » Phillipa, posted by fairywings on July 25, 2005, at 6:50:51

Hey! In my experience, there are a number of not-so good and downright bad shrinks out there. Somehow, though, it seems that women get the short end of the stick. I'm a guy, and I've had experiences with shrinks over-medicating and having obvious problems with me being "different" (one shrink wrote that a sign of my "disorder" was my love of vintage clothes and shaggy hair. He was a conservative, old-school type). But my female friends have had it rough...when one of my friends finally got up the courage to tell her shrink that she had been molested repeatedly as a child by a neighbor, her shrink then saw ALL her problems as resulting from this abuse. This wasn't helful; it basically harmed her by defining her ONLY by her experience of abuse. Male shrinks in general seem to have more ego issues than female ones, or maybe the female shrinks also have ego issues but the male ones have more tact. Who knows.


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