Psycho-Babble Medication Thread 1093549

Shown: posts 1 to 22 of 22. This is the beginning of the thread.

 

New diagnosis: Borderline PD (SLS, your thoughts?)

Posted by zonked on December 17, 2016, at 13:01:10

Hi, all:

I have mixed feelings about this. I am male, I don't cut, I am not malicious and do not intentionally manipulate people - however, a lot of this (fragmented sense of self, fear of abandonment, low distress tolerance, black and white thinking, substance abuse) seems to fit. I also tend to be a people pleaser, because fundamentally I want people to like me, so I (unconsciously, until recently) adapt myself to get a favorable response. The unconscious part was until diagnosis. And what people on the Internet say about borderlines is very hurtful, extreme, and terrible!

I've uncovered roots of the trauma that caused me to be this way, but the good news is that borderline PD is (1). just a label and (2). is highly treatable with CBT/DBT/psychoanaysis.

BTW, I have (believe it or not) done a lot of psychoanalysis on myself which, if I dig too deep, I have found a little bit dangerous - I don't want to relive traumatic memories without the aid of a therapist.

Any thoughts, anyone?
-z

 

Re: New diagnosis: Borderline PD (SLS, your thoughts?)

Posted by LouisianaSportsman on December 17, 2016, at 13:05:38

In reply to New diagnosis: Borderline PD (SLS, your thoughts?), posted by zonked on December 17, 2016, at 13:01:10

I think you may definitely, no doubt, have borderline PD based only of what you shared.

 

Re: New diagnosis: Borderline PD (SLS, your thoughts?)

Posted by rjlockhart37 on December 17, 2016, at 23:30:31

In reply to New diagnosis: Borderline PD (SLS, your thoughts?), posted by zonked on December 17, 2016, at 13:01:10

i am not litterate wiht borderline, but i know a few people who are diagnosed with it, they reject people before they reject them.....like any kinda of sign of rejection, they will immidiatly reject the situation or the person......kinda hurt you before you hurt me

i think borderline is very sensitive to emotions

 

Re: New diagnosis: Borderline PD (SLS, your thoughts?)

Posted by rjlockhart37 on December 17, 2016, at 23:50:04

In reply to Re: New diagnosis: Borderline PD (SLS, your thoughts?), posted by rjlockhart37 on December 17, 2016, at 23:30:31

I met a person in the psych with BPD and also someone I know from a friend

this is the description from the national institute of mental health: https://www.nimh.nih.gov/health/topics/borderline-personality-disorder/index.shtml

 

Re: New diagnosis: Borderline PD (SLS, your thoughts?)

Posted by SLS on December 18, 2016, at 15:16:52

In reply to New diagnosis: Borderline PD (SLS, your thoughts?), posted by zonked on December 17, 2016, at 13:01:10

> Hi, all:
>
> I have mixed feelings about this. I am male, I don't cut, I am not malicious and do not intentionally manipulate people - however, a lot of this (fragmented sense of self, fear of abandonment, low distress tolerance, black and white thinking, substance abuse) seems to fit. I also tend to be a people pleaser, because fundamentally I want people to like me, so I (unconsciously, until recently) adapt myself to get a favorable response. The unconscious part was until diagnosis. And what people on the Internet say about borderlines is very hurtful, extreme, and terrible!
>
> I've uncovered roots of the trauma that caused me to be this way, but the good news is that borderline PD is (1). just a label and (2). is highly treatable with CBT/DBT/psychoanaysis.
>
> BTW, I have (believe it or not) done a lot of psychoanalysis on myself which, if I dig too deep, I have found a little bit dangerous - I don't want to relive traumatic memories without the aid of a therapist.
>
> Any thoughts, anyone?
> -z

Have you ever heard of Developmental PTSD or Complex Trauma? My treatment has been complicated by this. For what it is worth, I find high dosages (30 mg/day) of prazosin extremely helpful. For me, it acts as a very clean antidepressant when used as an augmenter. In PTSD, prazosin improves anxiety.

Historically, BPD has been maligned as being difficult for others to live with and all but untreatable. This isn't true. I have seen an antipsychotic combined with a mood stabilizer (Tegretol or Trileptal) work wonders when combined with CBT. DBT would probably help even more.

BPD looks different in males versus females. You really need to tease-out BPD in males.

http://namimc.org/male-borderline-personality-disorder-know/

Can you make one list of your symptoms and another list of your treatments with results?

- Scott

 

Re: New diagnosis: Borderline PD (SLS, your thoughts?) SLS

Posted by zonked on December 24, 2016, at 15:21:35

In reply to Re: New diagnosis: Borderline PD (SLS, your thoughts?), posted by SLS on December 18, 2016, at 15:16:52

>
> Have you ever heard of Developmental PTSD or Complex Trauma? My treatment has been complicated by this. For what it is worth, I find high dosages (30 mg/day) of prazosin extremely helpful. For me, it acts as a very clean antidepressant when used as an augmenter. In PTSD, prazosin improves anxiety.

I know, I take it 2mg at night. Personally I believe some people labeled with BPD might have C-PTSD instead (with me, it depends on who's doing the labeling, the symptoms are the same.)

Anyway. regarding high-dose prazosin--is there any literature to support this? I doubt my doctor will support such a high off label dose without supporting literature.

-z

 

Re: New diagnosis: Borderline PD (SLS, your thoughts?) zonked

Posted by SLS on December 24, 2016, at 21:03:34

In reply to Re: New diagnosis: Borderline PD (SLS, your thoughts?) SLS, posted by zonked on December 24, 2016, at 15:21:35

> >
> > Have you ever heard of Developmental PTSD or Complex Trauma? My treatment has been complicated by this. For what it is worth, I find high dosages (30 mg/day) of prazosin extremely helpful. For me, it acts as a very clean antidepressant when used as an augmenter. In PTSD, prazosin improves anxiety.
>
> I know, I take it 2mg at night. Personally I believe some people labeled with BPD might have C-PTSD instead (with me, it depends on who's doing the labeling, the symptoms are the same.)
>
> Anyway. regarding high-dose prazosin--is there any literature to support this? I doubt my doctor will support such a high off label dose without supporting literature.

First of all, the manufacturer suggests that 40 mg/day is the maximum dosage as per the package label.

I'll see what I can come up with. I think I saved an abstract on my computer.


- Scott

 

Re: New diagnosis: Borderline PD (SLS, your thoughts?)

Posted by SLS on December 24, 2016, at 21:12:39

In reply to Re: New diagnosis: Borderline PD (SLS, your thoughts?) zonked, posted by SLS on December 24, 2016, at 21:03:34


_____________________________________________________________


Therapeutic Advances in Psychopharmacology February 2014 4: 43-47, first published on August 16, 2013

High-dose prazosin for the treatment of posttraumatic stress disorder

1. Maju Mathew Koola
1. Clinical Research Program, Sheppard Pratt Health System and Department of
Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
2. Sajoy P. Varghese
1. Department of Mental Health, Captain James A. Lovell, Federal Health Care
Center, Department of Psychiatry and Behavioral Sciences, Rosalind Franklin
University of Medicine and Science, 3333 Green Bay Road, North Chicago, IL
60064, USA
3. Jan A. Fawcett
1. Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque,
NM, USA
1. sajoy.varghese{at}va.gov

Abstract
Patients with post-traumatic stress disorder (PTSD) are frequently symptomatic despite being on
medications currently approved by the US Food and Drug Administration for PTSD. There is
evidence to support the notion that prazosin is effective for PTSD nightmares. However, PTSD related nightmares often do not resolve completely on a low dose of prazosin. The capacity of
prazosin to treat daytime symptoms of PTSD which are distressing to patients has not been well
studied. Clinicians are reluctant to increase the dose of prazosin due to side effect concerns. To
date, the highest reported dose of prazosin used for PTSD is 16 mg daily. We illustrate two case
reports using high-dose (up to 30 and 45 mg) prazosin for PTSD with comorbid treatment resistant mood disorders. We report that high-dose prazosin was safe, tolerable and effective for
PTSD in adults. To our knowledge, this is the first case series to highlight the importance of
using high-dose prazosin for the treatment of PTSD. In patients with partial response to currently
available medications for PTSD, greater utilization of high-dose prazosin for the management of
PTSD may lead to better outcomes.

______________________________________________________________

 

I no longer (!) meet the criteria for BPD zonked

Posted by zonked on December 25, 2016, at 22:42:26

In reply to New diagnosis: Borderline PD (SLS, your thoughts?), posted by zonked on December 17, 2016, at 13:01:10

Um, weird. I was told recently that my treatment team advocated "Borderline PD" be removed from my chart, because I no longer meet the criteria for it.

Apparently, Borderline personality disorder is overdiagnosed with people with a history of substance abuse.

SLS--thanks for the information, I might take that with me to my next appointment.

Some of what's happening I can attribute to benzodiazepine withdrawal, the addiction psychiatrist has taken me down to 0.25mg of Klonopin twice a day, which is causing me to feel dissociated, anxious, and ruminate a hell of a lot. Because I've been on one benzo or another for 15 years I'm beginning to wonder if going off of them at all is wise. I've heard it can take years. I can't endure years of this... and I still haven't gotten it out of my system completely!

-z

 

Re:I no longer (!) meet the criteria for BPD zon

Posted by Horse on December 26, 2016, at 5:48:16

In reply to Re: New diagnosis: Borderline PD (SLS, your thoughts?) zonked, posted by SLS on December 24, 2016, at 21:03:34

That didn't seem like an accurate dx to me. Clarifying dx for optimal treatment is, or should be, primary, so good! How fast are you being tapered? I needed to go back up a step because I was too wiggy. Take heart and don't think worst case scenarios are yours. I'm off and relatively (haha) ok. Don't let anyone lay some sh*tty attitude on you. Your smart and kind and a good guy. Best of the New Year to you.

 

Re: I no longer (!) meet the criteria for BPD zonked

Posted by SLS on December 26, 2016, at 7:51:54

In reply to I no longer (!) meet the criteria for BPD zonked, posted by zonked on December 25, 2016, at 22:42:26

> Um, weird. I was told recently that my treatment team advocated "Borderline PD" be removed from my chart, because I no longer meet the criteria for it.
>
> Apparently, Borderline personality disorder is overdiagnosed with people with a history of substance abuse.
>
> SLS--thanks for the information, I might take that with me to my next appointment.
>
> Some of what's happening I can attribute to benzodiazepine withdrawal, the addiction psychiatrist has taken me down to 0.25mg of Klonopin twice a day, which is causing me to feel dissociated, anxious, and ruminate a hell of a lot. Because I've been on one benzo or another for 15 years I'm beginning to wonder if going off of them at all is wise. I've heard it can take years. I can't endure years of this... and I still haven't gotten it out of my system completely!

Trileptal (oxcarbazepine) to ease the withdrawal from benzodiazepines?

https://www.ncbi.nlm.nih.gov/pubmed/18821451

There is also a lot of evidence that Trileptal can ease alcohol withdrawal.


- Scott

 

Re: OK I am borderline after all (embarassing) SLS

Posted by zonked on January 1, 2017, at 16:24:13

In reply to Re: I no longer (!) meet the criteria for BPD zonked, posted by SLS on December 26, 2016, at 7:51:54

Okay, this is really embarrassing -

I actually am borderline after all... I think my therapist here in rehab helped me by getting me unstuck from DSM labels at the time I needed it.

I've a lot of trouble accepting it.. I got stuck on the "people with personality disorders don't change" thing, and it put me in a very dark space. I'm getting a lot of therapy now which has helped tremendously... I realize this is a medication forum, so I'll keep my personal issues out of here, but I looked at my childhood and realized a lot of my issues stem from there.

I'm going to stay on my meds, which I still need.

 

Re: OK I am borderline after all (embarassing) zonked

Posted by SLS on January 1, 2017, at 18:28:46

In reply to Re: OK I am borderline after all (embarassing) SLS, posted by zonked on January 1, 2017, at 16:24:13

> Okay, this is really embarrassing -

What is embarrassing?


- Scott

 

Re: OK I am borderline after all (embarassing) SLS

Posted by zonked on January 13, 2017, at 17:50:53

In reply to Re: OK I am borderline after all (embarassing) zonked, posted by SLS on January 1, 2017, at 18:28:46

> > Okay, this is really embarrassing -
>
> What is embarrassing?
>
>
> - Scott

Well, I have a highly stigmatized condition...

So, yeah. I'm not extreme and I don't know
where I lie on the severity index, maybe I should ask? I'm also a gay male, so it's a little stranger for me... and there are no
support groups near me, only for family members.


-z

 

Re: I no longer (!) meet the criteria for BPD

Posted by phidippus on October 1, 2017, at 12:00:30

In reply to I no longer (!) meet the criteria for BPD zonked, posted by zonked on December 25, 2016, at 22:42:26

The best way to get off Benzos is to stop them completely and endure the months it takes to detox from them. Most of the addiction to Benzos is psychological and not physical, so there's that...You probably don't want to hear this, but REHAB is great for benzo withdrawal.

Eric

 

Re: New diagnosis: Borderline PD (SLS, your thoughts?)

Posted by phidippus on October 1, 2017, at 12:03:31

In reply to New diagnosis: Borderline PD (SLS, your thoughts?), posted by zonked on December 17, 2016, at 13:01:10

Doing psychoanalysis on yourself is akin to giving yourself a haircut. You just don't know how its going to turn out.

Eric

 

Re: I no longer (!) meet the criteria for BPD

Posted by Lamdage22 on November 6, 2017, at 6:03:41

In reply to Re: I no longer (!) meet the criteria for BPD, posted by phidippus on October 1, 2017, at 12:00:30

Why do you take it so seriously? Diagnosis is pretty random sometimes. Has God given you that diagnosis? I think not.

 

Re: I no longer (!) meet the criteria for BPD

Posted by Lamdage22 on November 6, 2017, at 6:08:35

In reply to Re: I no longer (!) meet the criteria for BPD, posted by Lamdage22 on November 6, 2017, at 6:03:41

They like to label people, period.

 

Re: I no longer (!) meet the criteria for BPD

Posted by Lamdage22 on November 6, 2017, at 6:14:27

In reply to Re: I no longer (!) meet the criteria for BPD, posted by Lamdage22 on November 6, 2017, at 6:08:35

and they are getting a boner because you take it so seriously.

 

Re: I no longer (!) meet the criteria for BPD

Posted by Lamdage22 on November 6, 2017, at 11:34:58

In reply to Re: I no longer (!) meet the criteria for BPD, posted by Lamdage22 on November 6, 2017, at 6:14:27

ok the last one didnt come out like i planned.

 

Re: I no longer (!) meet the criteria for BPD

Posted by Lamdage22 on November 10, 2017, at 12:06:58

In reply to Re: I no longer (!) meet the criteria for BPD, posted by Lamdage22 on November 6, 2017, at 6:14:27

Its just one Psychiatrists opinion. You dont have to go like oh my gosh i have borderline. You are still the same person like before that diagnosis. Dont take so seriously. Lighten up :)

 

Re: I no longer (!) meet the criteria for BPD

Posted by SLS on November 10, 2017, at 13:35:45

In reply to Re: I no longer (!) meet the criteria for BPD, posted by Lamdage22 on November 10, 2017, at 12:06:58

> You dont have to go like oh my gosh i have borderline. You are still the same person like before that diagnosis.

Your comment is helpful, important, and well-taken. However, I think the goal is to make someone better than like before that diagnoses. An accurate diagnosis is often the only way that medicine can choose effective treatments. We are getting closer to being able to diagnose certain mental illnesses using objective physiological tests. I guess some purely psychological conditions will rely upon more subjective clinical observations, although psychological tests like the MMPI remain valuable. Phidippus should be able to name some others. I believe that functional PET scans and other physiological tests will end up being helpful for diagnosing predominantly psychological disorders. I recently read some things in Scientific American suggesting how this might be possible.


- Scott


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