Q. I have been carrying the BPD, DID, PTSD, and Bipolar diagnosis for many years now. I have had little luck with medication and outpatient therapy offers just enough to keep me alive. I have been hospitalized 23 times with little help there. Recently, I became brave enough to try ECT for some hope of relief. I was warned that my BPD may interfere with the ECT and may hinder it’s benefits. I went ahead and tried the treatments.
I managed to make it through four treatments but found it too uncomfortable. Also, my borderline behaviors exploded, as I was warned. I also began to dissociate a lot too.
Now that a month has past since my treatments I have noticed improvement in my ability to cope and tolerate life’s little struggles. I have not self-mutilated in a month nor have fallen into a deep depression. I do continue to cycle but not a severely. I did find some relief with the ECT.
My question is, why would my borderline behavior explode to the extreme that it did while undergoing the ECT? I understand and experienced the confusion and memory loss that comes with the treatments, but I don’t understand why I became so erratic and out of control. I was warned that it could happen, but didn’t realize how bad it would have gotten. I’m asking this question because I am considering finishing my ECT treatments with hopes for more improvement.
I am concerned and curious as to why the BPD blows up. Knowing now what I do and having a better idea of what to expect with the treatments, I would like to be better prepared as to how to handle myself. If you can explain BPD in relation to ECT, and have some suggestions for being more prepared I would appreciate it. Thank You.
A. ECT can be a remarkably effective technique for “refractory” depression. “Refractory” means nothing is working for it. I’ve never encountered any literature about why it would worsen the BPD, but I have an easy likely explanation….
ECT stands for “electro” “convulsive” “therapy.” The convulsive part means a seizure. The goal is to have an entire brain seizure and sort of start over again – like shutting the computer down and restarting it when it won’t work well. No one knows how it actually works. The ECT is likely triggering a seizure in your limbic and/or temporal lobes causing BPD dysphoria (anxiety, rage, depression and despair) and dissociation. I’ve had countless patients who drift off into an obvious “fugue stage” (like an unconscious awake state) followed by BPD rage.
I would think that bipolar Rx such as Depakote would be very effective for this. The combination of Depakote with either Tegretol or Neurontin could be of enormous help to you.
The only long term way to get over DID in my experience is to 1) make sure the diagnoses (all of them) are correct, 2) get the meds right, and 3) become safe. The DID appears to be a defense the brain employed when you were a child to deal with terror and powerlessness. Only by feeling totally safe can you start to build a new, stronger personality and have a good life. Generally the “other” personalities are there to protect you from pain. That’s their job. They were built mostly when you were a child, and that child needs to feel safe in order to live life again. Retraining the brain is crucial, old patterns of thought that never worked before won’t work in the future.