- Do I Have The BPD?
QUESTION:
Dear Dr. Heller,
I have been treated for depression with Paxil for the past year(since I was 23) , and it has literally changed my life, as previously I would have thoughts about dying (either listening to the international news on the radio wire I was about to hear nuclear war announced and imagining what it would feel like when a bomb went off, to attempting suicide myself). I would harm myself (i.e. hitting myself and cutting my face), and I abused drugs (mainly speed and alcohol) from the ages of 16 to 21. I would become very scared of people, even people I knew, and would not trust anyone. If someone became close to me I would push them away as I was scared that they would get to know the “real me”.
I would constantly cry and say that I was worthless and unlovable. In relationships I would become insecure and jealous for no reason. I could not talk to people or eat in public (let alone talk!) without blushing. I would leave all my college work until the very last minute as I was scared of starting it and I got a kind of a rush from the danger of almost failing. This all started when I was 14 and until last year I had seen doctors and been to counseling to no avail. However, now I feel very much better and like a different person since I have been taking Paxil, which I began taking when I went to the doctor as everything had become unreal and I felt that I was seeing the world one step behind from where my eyes should be seeing it from.
Do you think I had BPD? The reason I ask is that both my mother and my uncle have epilepsy which is controlled by Epilim (a UK drug – called “Depakote” in the US). I do not have epilepsy but I noticed that you seemed to mention a connection between epilepsy and BPD on you Website. Is there a connection, and will I pass either epilepsy or BPD on to my children? I feel I ought to mention my mother has also been to counseling and took Valium and beta-blockers since going through her divorce when I was 6 months old, and she used to cry for no reason, so could the link be environmental?
Also, I know I am supposed to avoid alcohol whilst taking Paxil, but I find it hard to avoid social drinking without drawing attention to my treatment. I have cut down on my intake as I have become very aggressive when drunk and my irrational thoughts would return (i.e. I would accuse my best friends of not liking me and talking about me behind my back, and accuse my boyfriend of not loving me and only going out with me for a joke). The weird thing is that when sober I realize this is all rubbish, but when drunk I would truly believe these thoughts, in the same way that before I took the Paxil I believed that my bad thoughts were real and there was no hope, but when I felt temporarily better I could not believe that I had been thinking such things. Is drinking small amounts harmful, and if so, what excuse can I use to decline drinks in social situations (without appearing to be a recovering alcoholic!) I apologize for the long letter but I have never really got everything off my chest before!
ANSWER:
It definitely sounds like the BPD, and Im very happy for you that the Paxil has worked. The SSRI medications (including Paxil and Prozac), have a dramatic effect on those with the BPD – and relatively quickly.
Epilepsy is nerve cells firing inappropriately and out of control. The type of epilepsy depends on what part of the body is having the seizure. Some neurologists believe diabetic neuropathy is a form of epilepsy – which certainly makes sense. I believe the BPD is a form of epilepsy in the brains limbic system – especially in the brains “cornered” or “trapped” animal instinct areas. Epilim (valproic acid or Depakote) can work for this, although I believe carbamazepine (Tegretol) is far superior.
The genetic link is strong. Id also highly recommend you look into the possibility that you have attention deficit disorder along with the BPD.
You need to know that drinking alcohol is extraordinarily dangerous to you, and can easily ruin your life due to these seizures. Your description of what happens to you is strong proof for what I just wrote. Imagine if you got angry while drinking and hurt someone – especially while driving. Knowing that alcohol affects you this way could cause a sense of guilt and shame that would haunt you the rest of your life, plus could put you in a legally dangerous situation. You could easily tell your friends “I dont like how I feel when I drink alcohol” and simply stop drinking with them.
