Q. Dear Dr. Heller,
Where are you located? I am seeking help for my friend with BPD. Can you recommend someone within a few hundred miles of the Greater Cincinnati- No. Kentucky area?
My friend has been treated for long standing Graves Disease with radioiodine. We thought many of her symptoms would subside, however, most did not. Is it possible that there is a connection to untreated Graves Disease and BPD? The doctors say it must be something else, since the blood tests now show her in the normal thyroid ranges. I have suggested that she see an endocrinologist. What is your opinion?
I have read literature from the Thyroid Foundation that states that untreated hyperthyroidism can “cause behavior changes such as irritability, nervousness and paranoia, making it appear that the patient has a severe mental disorder.” She has all of the symptoms of BPD. Is it possible that because the thyroid was untreated for so long it may have caused permanent damage, even though the blood test now show in the normal range.
She is 35 years of age. She has had 2 auto accidents in the past 3 years. Since the accidents she complains of chronic migraine headaches and neck pain. She is treated with Midrin and Imitrex.
As a teenager, she was hit in the head over her let eye during a soccer game. It was a serious accident, requiring some surgery. She claims that she has been treated twice for “toxic shock” in the past 10 years.
Her father is critical and verbally abusive towards her. He is sarcastic. He makes humiliating, sexual remarks towards her. Her mother is cold and calculating. She is extremely obsessive- compulsive. Quietly manipulative and demanding. My friend tries to do everything she can to please them. No way. The mother seems to have a lot of influence over my friend. The mother has had 4 thyroid surgeries to remove tumors. She told me one time, that as a child her mother would hit her in the head with her fist, when displeased with her.
I have noticed at times my friend’s left eye jerking. Recently her anger and rage have increased. She said that she “feels detached sometimes” and as if there were “electrical shocks in her head.” I told her to tell the neurologist. She said he ignored her.
She has tried to take Zoloft twice. She became much worse. High anxiety, out of control, and incoherent raving. Constant complaining over and over the same trivial issue. Hysterical.
I have tried to do more than anyone to help and understand. It appears that she has totally devalued me. It is impossible to talk to her. In trying to talk to her or explain something to her. She just says “I am not going to argue.” and she begins the illogical complaining.
She is impulsive, demanding, manipulative, paranoid, constant complaining about everything- no matter how trivial. Never pleased. Refuses to believe what I say, questions everything. Screams but then complains that one’s voice is loud even if whispering. She sees people and things as black or white. Hate or love.
Suddenly she has became verbally abusive and very cruel towards me. She tells everyone that she can about how she is the “victim” in all of her life. To her, everyone has mistreated her. She is also a Chameleon. When she meets someone new , she takes on or imitates their personality. I have seen it many times. She is extremely sensitive and I have “walked on eggshells” for a long time.
She has lived in my house for the past 3 years. She had some stability here. I took her to many doctors, but it was if she slipped away before I could get the right help for her. She decided to live by herself – so she moved out- She found out that she could not stand to be alone so she has moved in with someone else. This person is very cold, cruel, cocky and can be violent. I am very concerned about my friends welfare. My friend seems to be controlled by this new person. My friend came to visit and presented the same cocky, violent personality recently. Very disturbing.
I have let her know that I am her friend. That I will help her when she wants my help. That I care about her. Can you think of anything that I can do? She knows that there is something wrong, but I believe she thinks that it is “mental illness.” She fears being institutionalized. I have told her many times that she is not “crazy” that she has a physical disease that is causing this. Sometimes I see a frightened little child inside, but it is rare.
Any opinions or ideas will be greatly appreciated.
A. I’m located in central/south Florida, and no I don’t know of anyone I can recommend in your area. The best thing you can do is arm yourself with information and get help from a concerned, caring physician who is willing to learn about new information.
There is no connection between Graves Disease (overactive thyroid) and the BPD – and I have no way of knowing if the BPD is present. If the labs are normal, and endocrinologist will be of no further assistance – her physician is correct. Sometimes one hopes for answers in something simple like Graves disease, but this is rarely the case with “mental” problems.
If her behaviors was in no way present prior to the Graves disease, clearly some brain damage occurred from the Graves. My suspicion is that her symptoms started before this, but were worsened by the stressors from her hyperactive thyroid.
Chronic neck pain and headaches are extremely common in the BPD, chronic anger and grinding teeth are major culprits. They are commonly seen in the generalized anxiety disorder as well. The head injuries caused their own problems, and may have exacerbated the BPD.
The family background as you described it is awful, and extremely damaging. It sounds like she’s continuing the pattern into her adulthood as did her parents before her. You described the BPD identity problems pretty well with the idea that she “takes on or imitates their personality.” Many of her symptoms would improve with Prozac, but in my experience only if pretreated with BuSpar first.
Those “electrical shocks” may be temporal lobe epilepsy and/or complex partial seizures, frequently associated with the BPD. Neurologist often want nothing to do with medical problems causing psychiatric problems.
If Zoloft made her worse, I will virtually guarantee that she has the GAD (generalized anxiety disorder) – particularly the “cognitive component.” This will need to be successfully treated, usually with BuSpar, before SSRI medications can work (I don’t have a lot of confidence in Zoloft).
It sounds like she does indeed suffer from the BPD and other problems, particularly dysthymia and the GAD.
The best thing you can do is move on with your life. Your friend clearly doesn’t want your help, and you are strongly exhibiting “rescuer” traits. The best thing you can possibly do for your friend is learn how to be a happy, loving and successful person in every aspect of your life – your friend will then likely ask you how get what you have for herself. Read the books I recommend in this Website, and get Zig Ziglar’s tape series and start listening as often as you can.