Q. *Note* I know that you are experienced in dealing with BPD patients, just disregard the questioning part of the e-mail as I have sent it to about 5 psychiatrists and no one answered or replied. I really hope you can help me as I am losing hope very quickly.
Hi Dr. Heller,
You may or may not be able to give me any of the information that I’m looking for, but I thought maybe you could since you have the appropriate degrees in psychiatry.
A. I don’t. I started treating borderlines because the psychiatrists were refusing to do so and I was having success. It’s too important a problem to ignore.
Q. I’m just curious if you’re familiar with Borderline Depression Disorder and if you’ve had any experience in terms of therapy or diagnosis of people with BPD.
A. Many.
Q. I’m a 21 year old young woman and I have recently seen a psychiatrist who told me that he thinks I suffer from BPD.
What confuses me is that he made this analysis within only an hour of talking with me and without asking me any of the questions required from the DSM-IV criteria for diagnosing people with BPD. I’m somewhat skeptical of his approach to me as well.
A. If he didn’t ask the main questions, review the criteria or address them in other questions, the diagnosis is suspect.
Q. So I guess where I’m coming from is as a young woman who has had a very difficult life filled with trauma and abuse, and I am now in the process of trying to search through all the available resources and look down all the possible avenues for help in recovering from my difficult past. I just want to have a future and I find it very discouraging to think that it might never be possible for me.
I have read a lot about the negative opinions on BPD and the chances of living a “normal” happy life with this condition, but I have also read some positive and hopeful material on it. Basically I have been going all over the net to many mental health and psychological sites regarding BPD and other mental illnesses or conditions. I have even taken a BPD automated diagnosis questionnaire (test) and it came back as a failed diagnosis. I answered the questions honestly and to the best of my knowledge, though I know that a computer based test shouldn’t be taken too seriously as to it’s credibility and effectiveness in diagnosis.
A. That last conclusion is true. There are no good diagnostic tests.
You need to look at the DSM IV criteria and fairly and honestly see what if any of the criteria you fit consistently, in virtually every aspect of your life, and since essentially puberty. If you consistently fit five of these you likely do fit it.
Q. Personally I’m not sure that this is what I have, but I think it could be possible and I’d like to know for sure.
A. You likely have more than that. Don’t be afraid of diagnoses. Find out what’s going on and fit it. You can’t fix something when you don’t know what’s wrong.
Q. So my question to you is whether or not you could offer me any information on this topic or if you know of someone who can. I would like another opinion instead of trusting in the first psychiatrist I’ve seen. I just don’t have the finances to go about looking for a recommendable therapist/ psychiatrist nor am I sure who to look to for this recommendation.
I received a pessimistic, negative attitude from the psychiatrist that I did see. I went into the appointment with some hope in finding out what my problem is and I came out of it with one answer ( which has left me with even more unanswered questions) from a doctor who seemed to be of the opinion that there’s not much of a chance for me. He told me that the good prognosis was that I was intelligent and that I stressed a desire to get better, but the bad prognosis was that I was young and had 21 years of hell, therefore it could take many years to turn that around. He did agree to “take me on” as his patient , but he did this with much hesitation and this left me feeling confused, discouraged, and hopeless. I apologize for carrying on here and I thank you sincerely for your time. I hope to hear back from you maybe with an opinion on this. It would be greatly appreciated.
A. Whether the psychiatrist was a problem, you were the problem, or a combination was a problem isn’t important. What’s important is moving on. You wouldn’t refuse to get your flat tire fixed if the repairman was mean to you, would you? You might choose to find another repairman, which is the wise choice.
I appreciate you are feeling fragile, but your life and your health is in your hands – and you can do it.