- Could I Have The BPD? (From The Netherlands)
QUESTION:
Dear Dr. Heller,
Before you delete this mail because it is too long and you are a very busy man, please hear me out: It would mean terribly much to me if you would read it, cause I’ve seen your website, which made me believe that you might understand my problems better than anyone else could. I do not know who else to turn to. I am confused about my whole situation and I suspect I have reason to believe I (partly?) am a borderline. My therapist has mentioned the word, but she’s quite vague about it and doesn’t seem to understand my need to know exactly what’s wrong with me. I am a 22-year-old girl from the Netherlands and I have already sent you an e-mail last Thursday, but wrote it in a hurry and was not really satisfied with it. Therefore, I would like to give it another try.
CHILDHOOD: I was brought up in quite a protective environment. I felt I had to please my parents and 5 older brothers and sisters, but didn’t feel I could. We never used to talk about ‘feelings’ at home, but, still, I was a rather sensitive girl and had a great sense of imagination. I was shy, insecure, a dreamer, already felt I didn’t fit in anywhere. Back then, my 3 big wishes were: 1. To learn to swim 2. To learn to whistle 3. To stop wetting my bed at night (did that till the age of 11, of which I was very ashamed).
ADOLESCENCE: Though, as a child, I already felt like an outsider, it has gotten much worse during adolescence. At secondary school, I felt lonely, horribly ugly, ‘less than zero’, shy, scared and I worried over everything. Kids at school sometimes teased me and for about 2 years I did not have any real friends. My ability to concentrate got worse: I usually put my homework off till it was almost too late, so I had no choice but to do it, I was scared to death to stay down a grade (new kids), which helped enormously to set myself in motion. My unhappiness now and then burst out when I got home from school. I think because I felt safer at home. In particular in the presence of my mother (loved and trusted her), I was often thin-skinned, cynical and grieved. I sometimes tried to talk to her about it, which didn’t work out, usually triggering an out-of-control mood – I was desperate, upset, cried, used harsh words (Why the hell did you put me on this planet? – I am awful – everybody hates me, etc.). Than I’d flee up to my room, where I cried, buried my face in a pillow, pulled at my hair and/or banged my head against the wall. After an hour or so I used to calm down and started feeling guilty. What got me through secondary school was, I think, my intelligence, the fact that I was very hard on myself, and my sense of imagination – I fled into fantastic fantasies starring a fantastic me and fantastic others who found me fantastic.
AFTER ADOLESCENCE ; At 19, I went to a new school, far away from home, which forced me to find a place to stay in a city unknown to me, amongst strangers. I was very, very scared but did not realize nor accept it. In the 2 1/2 years to follow, I had a few ups and many downs but never dared to give myself a break. When I had the prospect of a work placement of 5 months in England, however, I felt so horrible about that and the rest of my life that I sought professional psychological help. I did not go to England. They found my case ‘complex’, thought that I did not have enough basis (was too confused/weak) for therapy and thus sent me to a therapist who gave me supportive therapy; she had the task to make things clear for me (with my help), make me stronger first. After a lot of waiting, talking and some tests, this was the diagnosis: Social phobia, agoraphobia, avoidant personality disorder, dependent personality disorder, depression, identity problem (underdeveloped identity), problems of adaptation.
Supportive therapy hasn’t improved much (after almost 1 year), which is why I will most likely start intensive day therapy soon (activity program). What isn’t helping me at all, is that I could not and still cannot accept that there’s something wrong, and that I am not just lazy and undeservedly drawing attention. It is also hard for me to discuss it with my parents. After my therapist had repeatedly requested medications for me, the psychiatrist finally prescribed Seroxat (paroxetine) to me. 20 mg did reduce my fears and made me more indifferent, but not yet more active and I still felt very guilty. The dose was heightened to 40 mg, which has taken away a bit of the guilt feelings and has made me more active. I also feel more indifferent since the 40 mg, though ’empty’ describes the feeling better, I think. Sometimes I seem to feel happy, but it is more like a kind of hollow happiness, one that does not touch my soul.
I often desperately want to get attention from other people, ALL people, and get very lonely, sad, miserable when I do not get any. (For example, I sat by the river twice, waiting for someone to come and sit next to me, talk to me, love me, which never happened). I also very quickly feel abandoned by people I should actually trust. In moments of despair, I carve myself with a knife (about 1 time per 1 1/2 weeks), the last time was last Tuesday. I do that because I have no other choice.
A few times, I drink a lot of alcohol at once, but not often. Lately I sometimes cannot stop myself from eating loads of cookies and/or candies. I tried to throw up twice, in which I didn’t succeed. Before I sought professional help, I also had a lot of those feelings and I had also cut myself once, because my boyfriend was being selfish, which made me lose it. At the age 15-19, I also used to drink a lot (liquor mixed with other liquor) before I went out, in order to lose my insecurity.
I do not know if the following is important: When I was 3 I fell real hard on my forehead, causing a very big bump that almost burst. I have also had one (bad!) experience of vertigo (recognized it at your site!) at the age of 17.
I sure hope you have read this. My therapist has mentioned ‘borderline’ once or twice when I had told her how I felt and what I had done, but I still just don’t feel like I know anything much. Do you think there is a chance that I am a borderline? Could you please tell me what you think about the diagnosis (given before I started taking Seroxat), and the fact that I am taking Seroxat?
I don’t think you can imagine just how grateful I would be if you would answer my questions.
ANSWER:
The cutting and other symptoms imply that you could easily have the BPD. The official criteria can be found at: http://pks.947.myftpupload.com/DSM.htm This FAQ can give you lots of information about what to do next:http://pks.947.myftpupload.com/AskDoc/First-Do.htm You need to get all your diagnoses made and comprehensively treated. I have not been that impressed with Seroxat (called “Paxil” in the US), although it works for some patients with the BPD. An explanation of the medications I use and why is available at: http://pks.947.myftpupload.com/20a.htm
