My Case Is Complicated, Could I Also Have The BPD?

QUESTION:

Dear Dr. Heller,

I am writing from England and after reading many of the FAQ’s on your site I felt compelled to write to you.  I feel that I am at my wit’s end and don’t know where to turn next with regard to my numerous medical problems.  It is hard to know where to begin really.  I had a lot of problems as a child being labeled ‘difficult’ and ‘rebellious’ by my parents.  I have never felt properly understood or part of society.  I often feel paranoid that I don’t fit in or that people don’t like me.  I have suffered with depression on and off since I was about 10 years old after being bullied at primary school.  I was fairly healthy until I reached the age of seventeen and got Shingles which I believe was caused by severe anxiety.  I then got Shingles again a year later and almost exactly 12 months after I got Shingles for the 3rd time.  I became bulimic at 16 which continued until I was 23.

I have in the past, hit my head against walls, thumped my arms and legs causing severe bruising and even to this day if I get any sores or spots in areas of my body, which would not be visible to others when clothed, I cannot stop myself from constantly picking them until they bleed leaving unsightly scars which I feel terribly ashamed about.  To most people I appear confident and outgoing but inside I feel terrible anxiety and when I argue with my partner I often accuse him of not loving or liking me anymore.  I think this is partly because one time when I was about 13 years old after upsetting my (very domineering) father I was crying and I said, ‘You don’t love me anymore do you?’ and he replied, ‘Of course I love you.  I have to love you – you’re my daughter, but I don’t like you anymore’.

I sometimes feel it is more important to be liked than loved.  I feel so confused and I cry everyday.  I have cut myself off from many of my friends and family and have an intense fear of picking up the phone to speak to them, and the longer I leave it the more worried I become.  I feel like I need some sort of crisis in my life all the time and I also feel I need something ugly about my body.  If I give up biting my nails I make a sore and pick it all the time.  If I allow that to heal, I make my feet sore and so it goes on.  I would love to be free of having to do something destructive to myself.  I am overweight and am the only person in my family to be this way.

I feel like I am plagued with ill health.  I gained 35 pounds in six months after I got married in 1989 at age 19 and everyone put it down as being content, but I have since found out that I have an underactive thyroid.  Over the years I have gained a further 40 pounds!  I eat very healthily but when people look at me I feel convinced that they imagine I sit at home eating cream cakes all day long!  Four years ago when my thyroid problem was finally diagnosed it was also discovered that I suffer from polycystic ovaries syndrome.  I found it very hard to cope with the shock of finding out I had two awful health problems.  It took nearly two years to find the correct dosage of thyroxine to help my symptoms and I was told the weight would ‘drop off’ but it never did.

Then in September 1999 I was diagnosed with having epilepsy!  I suffer grand mal and absent seizures and so far after trying five different medications I still cannot find a drug to satisfactorily control my condition.  I take nearly 6000 tablets a year for my illnesses and am so thankful that with our British National Health Service all of my medications are free to me – I could never afford it otherwise.  My current treatments are as follows:- 150mcg Throxine, daily (Hypothyroidism) 120mg Telfast, daily (Allergies) Singulair, daily (Asthma) 100mg Spironolactone (Polycystic Ovaries Syndrome) 300mg Neurontin, 3 times daily (Epilepsy) Becloforte, 2 puffs, 2 times daily (Asthma) Ventolin, 2 puffs, 2 times daily (Asthma) Serevent, 2 puffs, 2 times daily (Asthma) Nasonex, 2 puffs, 2 times daily (Allergic Rhinitis).

I find I suffer bad side effects from many of the drugs I take, or have taken and I feel sure that my body is very sensitive to some of the chemicals.  One doctor said he thought it was more to do with psychological response!  This makes me mad as how can I fake things like hair loss?  I also had a very bad reaction to Valium administered intravenously a couple of months ago (for vomiting) when I stopped breathing and went out ‘cold’  a couple of seconds after it hit my bloodstream.

I feel tired and weepy most of the time and totally isolated and full of despair.  What can I do?  I have tried Lamotrigine, Tegretol, Phenytoin, Neurontin and Topamax (in that order).  Lamotrigine made me have terrible mood swings and depression.  I was severely allergic to Tegretol causing me to be hospitalized for 10 days – I nearly died.  Phenytoin caused facial palsy and such terrible aggression that I felt I wanted to leave my partner of 6 years.  Then I tried Neurontin, but after feeling unhappy about the awful debilitating lack of energy I asked to try Topamax.  I have to admit that when this made me so ill after only 4 days I was completely gutted, as if I am totally honest with myself I had read that it sometimes causes Anorexia and I prayed that this would finally be the answer to my weight problem.  I know this was stupid but I felt so desperate.  After 4 days of being on it I could not speak properly, everything came out all jumbled up like as if I was dyslexic.  I couldn’t remember my name and spent all my time just crying hysterically in a corner of my bedroom completely terrified of the whole big bad world around me.  So I had to return to Neurontin for the time being and I have gained about 14 pounds in 7 months, precisely what I was terrified of in the first place.

I feel like everything is out of my control.  I am told that my excess weight makes my PCOS worse and yet my hypothyroidism, PCOS itself and the Neurontin all seem to ‘conspire’ against me.  I just want to be slim, healthy and happy and wonder if I could ever achieve even just one of these things in my lifetime.  I feel like I have wasted half of my life so far.  I turned 30 this year but inside I feel like a baby and yet physically I feel like an old woman.  Do you think it is possible that I have BPD?  What could I do if I have it?  I don’t think my doctors over here know about it.  I see you often recommend Tegretol but with my allergy to it, is there any alternative?  I really would love to come off all my medications but know this is just too risky, but I dream of the day when I can live a drug-free life.

Please help me.

 

ANSWER:

You could easily have the BPD, and the picking at the skin could be a form of self-mutilation.  There’s lots of information in the BPD sectionthat could be of help to you and your physicians.  Prozac is a very important medication.  If you can’t take Tegretol, the most commonly used alternatives I use are Depakote and Neurontin.  http://pks.947.myftpupload.com/AskDoc/First-Do.htm should be of help.