Q. I’m a 29 y/o male. I’ve had mental problems for as long as I can remember. I’m an Australian currently in Thailand and so cannot contact my usual Doctor (which may just turn out to be the impetus for a breakthrough for me).
For many years my Doctor has been treating me for OCD. Venlafaxine (an SSRI) and CBT. I expressed my concerns at my instability and my lack of “self identity”, as well as all the other symptoms I experience. After reading your web site I think that it is a strong possibility that I have BPD. I relate to so many of the symptoms. However, there are some that I do not.
1. Does the fact that I can control my anger, and am not a self mutilator mean that I’m not a BPD sufferer?
A. No, it doesn’t. The BPD is a medical illness. Not experiencing some of the symptoms has many possible explanations. Self-mutilation is not common. Many borderlines control their anger for a myriad of reasons. Many also believe they control their anger, and others disagree.
Q. I’ve overcome my physical reliance on substance abuse (no booze for 2 years) but the tendency is latent – to any substance.
A. Congratulations, that’s a sensational accomplishment.
Q. 2. Why would my Doctor (who is a reputed, experienced psychiatrist) not tell me of the possibility of BPD? For years I’ve returned to him and expressed my concerns about me being an emotional cripple and explained so many of the symptoms. Is BPD that bad that he would be trying to protect me? Surely he would know of BPD – wouldn’t he?
A. I don’t know, however you brought up many common reasons. Many mental health professionals don’t know that the BPD is a medical problem that can be treated and see no reason to bring it up and/or give you a label.
Q. 3. I work really hard at surviving. Every minute of everyday – I’m not kidding. Whenever my mind wants me to give in – I view this as a symptom and press on. But I feel as though I cannot sustain for the rest of my life – let alone the rest of this week. Are there real cures where BDP sufferers can live a life approaching normality ?
A. I’m reluctant to use the word “cure” – but the symptoms can be brought under control.
Q. Please be honest with me. I’m really sick of the “learn to be optimistic” approach as though this is a cure in itself. This approach has allowed me survive this far – and I know that it has its place; but it is not a cure. I have been intensely retraining my mind.
A. You won’t believe how successful those techniques are once the medications are right! All the diagnoses must be made and a plan to treat them all must be established.
Q. I’ve given up everything to heal myself. The only problem with giving up everything is that there’s no reason to push on. So I feel like I’m caught in an inescapable mind trap,i.e. become non reactive so as to avoid harming myself then finding I’m in an emotional vacuum with no reason to live. Do nothing and I sink – struggle and I sink faster. Is there are cure to this cycle? I know and understand helplessness.
A. You may be experiencing chronic dysphoria (anxiety, rage – even if self directed, depression and despair). Yes this can be treated very successfully.
Q. 4. How do I go about getting tested for BPD? What do I do when the Doctors won’t listen? How can I check the credibility of the assessment?
A. There is no “test” – if you fit 5/9 DSM IV criteria in every aspect of life since puberty you likely have the diagnosis. If you came into a doctors office with a 104 fever and a sore throat and he “won’t listen” what would you do? You’d find a doctor who would listen!
Q. 5. Are there any survival hints you can give me for the short term. I’ve another month in Thailand and whilst I’m in a good environment – I’m really doing it tough (anxiety, sleeplessness, total loss of >identity, depression etc..)
A. The most important survival tool is hope. The way to get hope is to find out the facts!!!!! Things are not what they seem.
I hope I was of some assistance to you.