Category: Ask the Doctor

Is it Genetic?

QUESTION:

Dear Dr. Heller:

I am a 20 year old college student. I have known, for quite some time now, that something must be wrong with me. I know this because I experience unusually frequent mood swings and on a daily basis, I am very confused and angry. I answered “yes” to every question on the screening test describing ADD and BPD. I never knew that there was actually a medical reason for why I experience these things.

My mother has a history of moderate mental illness. I wondered sometimes if maybe it was genetic. I just wanted to tell you how helpful and reassuring your web site has been for me. I know it is just the beginning, but I am so glad to know that there are other people who go through the same things I do.

Again, thank you.

ANSWER:

Thank you for your kind words. You have no idea how common – or how genetic – these problems are. The US Surgeon General recently reported that 20% of our population fits the criteria for a “mental illness” annually, and 50% in their lifetime. I see the combination of ADD and BPD every day. Three individuals with this profile work for me. I’m great at remembering details and what happened today, but those with ADD are better at the big picture and remembering things from the past. It works out as a great team.

I love helping borderlines, and treating ADD is simply exciting. Those with ADD are remarkably bright and creative, and adding the ability to focus, to stay on task, to consider before acting, and having mental energy is phenomenal. These people are so much fun when treated. I encourage you to get treated. The information in my books and this Website can be of enormous help to you.

Is There Hope For Me?

QUESTION:

Dear Dr. Heller,

I am thoroughly depressed and see that there is no hope and unfortunately I answered yes to most of your screening test questions.  Is there hope for me?  I used to enjoy life although that was a long time ago, I’m tired all the time and people perceive me as weird.  I have a very short attention span but a high code of moral values which seem to be deteriorating ever day as I am afraid of talking about my beliefs and experiences.  I have tried drugs and alcohol in the past and they have only worked to make things worse and given me a terrible sense of paranoia.  I hang around in packs although I have little time or too much time for these ‘friends’.  Relationships are a no-no although I want to have a girlfriend but am afraid of letting them down or showing them up, i.e.  I feel worthless.  Can you help?

ANSWER:

Yes, there is hope.  The screening test is designed to find which medically TREATABLE disorders are present.  Treating them all is crucial, and the sequence of medications is as important as the diagnoses.  The What should I do first answer will hopefully get you started.

Is There A Connection Between BPD And Abusive Partners?

    Is There A Connection Between BPD And Abusive Partners?

    QUESTION:

    Dear Dr. Heller,

    Hi, I wanted to know if there is a connection with those who have BPD and are married to abusive partners.  I have BPD and seem to have the pattern of marrying men who are abusive.  Currently, I am married to a very abusive man and cannot seem to break free.  I do not trust myself with decisions, and I don’t know if it is because of my BPD or just a factor of the abuse I have suffered.  Let me know if you have found this to be true.

     

    ANSWER:

    It is indeed common.  There are many reasons such as tolerating the level of anger, feeling profoundly relieved when a spell is over (which can stop a dysphoric spell), self-hate, etc.

Separator (Biological Unhappiness)

 

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Is Zoloft Also Used For A Pain Management Treatment?

QUESTION:

Dear Dr. Heller,

Is Zoloft also used for a pain management treatment?

ANSWER:

Not really.  The entire SSRI class of medications has been disappointing in treating pain unless underlying psychiatric diagnoses are also present that would be successfully treated with the medication. The antidepressant Effexor (venlafaxine) can be very helpful for pain.  The epilepsy medication Neurontin (gabapentin) has also been very useful.

Is There Hope For Vestibular Migraines?

QUESTION:

Dear Dr. Heller,

I believe I am suffering from vestibular migraines.  I searched your index and found nothing!  I really need this information.  It seems the site is mostly about BPD, which is fine, but the add I followed lead me to believe you had lots of information about vestibular migraines.  I have been suffering for a year now with dizziness and pressure in my ears looking for answers.  HELP!

ANSWER:

I’ve never heard of that term before.  I’m assuming you have a problem with your balance, probably in association with headache.  It’s starting to look as if migraines have a neurological rather than blood vessel or “vascular” basis.  Many individuals respond to novocaine injections in the top of the neck, or to medications like Vioxx and some epilepsy medications (particularly Neurontin and Depakote).  The best headache specialist I know of is Dr. Steve Wheeler in Miami, FL.  In my “interesting tidbits” section you’ll find information about headaches, and Dr. Wheeler’s site can be found from there.  Many patients have a mental health cause to their headaches – particularly due to the profound muscle tension that develops in the neck and jaw.  Doing the screening test might give you some clues there.  Everything that a person has wrong with them makes everything else they have wrong worse – so making all the diagnoses is crucial.

Is There A 12 Step Program For BPD?

QUESTION:

Dear Dr. Heller,

I have recently come to suspect that my husband may have the BPD and finding you is no less than a miracle!  Your site has helped me gain great insight and I thank you so much.  He displays most of the symptoms you describe (does not self mutilate) and was physically, verbally and emotionally abused as a child.  Unfortunately, he does the same to me.  I have also come to realize that I have codependency traits and feel this is a direct reaction to try and keep “peace.”  We are now separated, (I finally got the courage to do it and he’s not happy) and are both in therapy.  My question is whether there is such a thing as a 12 step program for people with the BPD or people who display these kinds of behavior.  It seems to me that this would be extremely beneficial for people like this.  Thank you so much.

ANSWER:

Thank you for your kind words.  Not that I’m aware of, but it certainly makes sense.  Many of the principles of the 12 step programs are built into my approach.  The 6 week treatment programs we did involved a higher power and I use this concept regularly – we’re a 3 legged stool (mind, body, spirit).  The approach I use has worked very well if the individual really wants to get better.  It involves making all the diagnoses and treating them comprehensively, have a formal plan for stress, and retraining the brain.  Zig Ziglar’s “How to Stay Motivated” tape series will likely be of enormous help to both of you right away.  Without the right medication, it is highly unlikely that an individual with the BPD will get well enough to have a great life.  In the talks I’ve given to AA groups, I was repeatedly told the equivalent of “wow, those are the folks who usually fail.” This is because they so desperately need medication.  The BPD is likely a form of epilepsy that needs medication.