- Is there ever a case where psychotherapy is better than medications?
QUESTION:
Dear Dr. Heller,
Isn’t it true that some of these medications like antidepressants, antipsychotics, etc. can actually make BPD worse? In my case it did. Psychotherapy worked best for me these medications, most of them, caused addictions and adverse side effects and very hostile and psychotic behavior I have never experienced before. Is there ever a case where therapy is better than meds?
ANSWER:
Side effects of medications usually reveal additional diagnoses – particularly the generalized anxiety disorder which is usually aggravated by SSRI medications.
I’m a huge believer in counseling, and it can make a huge difference – particularly with the ability to change the way stressors are perceived. Lowering the perception of stress markedly lowers the need for medication and can make for a much better life.
There are two medical symptom complexes that medications treat:
Unprovoked mood swings, chronic low level anger, emptiness, boredom and emotional pain are usually resolved by Prozac, although other SSRI’s help some patients.
Dysphoria (anxiety, rage, depression and despair) and dissociation need medical treatment, as these symptoms appear to be a seizure-like phenomenon (nerve cells firing inappropriately and out of control). Neuroleptics like Haldol and epilepsy medications like Tegretol can make a huge difference here.
I believe the BPD is due to damage to the brain’s “trapped, cornered animal response.” Anything that makes this response kick in interferes with accurate reality perception. The individual with BPD may believe he/she is interpreting reality correctly, but they’re not. This problem destroys many areas of a borderline’s life – and is part of why I so strongly believe in medication.
