Tag: Childhood

QUESTION:

Dear Dr. Heller,

I am new to the idea that I have BPD.  But thanks to writings from you and many others on sites like Mental Health Sanctuary and other places I now have hope that I’m not just a crazy loser.  Other people share my struggle.  Other people have felt the same wild impulses and loopy ideas that have destroyed my life over and over.  The fact that others have recovered gave me hope I had forgotten I had lost.

Recently, after a year of functioning, holding a job and paying bills, I crashed.  I lost it on a customer at work and got fired.  I then saw an HBO special on depression with Mike Wallace, which made me realize I was putting out symptoms all over the place.  I only have the local county (Brevard–only about 90 minutes from Okeechobee!) facility called Circles of Care.  As far as free goes, it is excellent.  I made an outpatient appointment (they still remembered me) and by the time it came I had visited several sites online and found I fit the criteria for BPD.  People on Mixed Nuts (www.mixednuts.net) and The Healing Path (www.geocities.com/ubester) gave me encouragement and information that led me to believe I didn’t have to keep repeating the same cycle of striving and disappointment over and over again.  It was like I had a new way of looking at life.

The therapist I met was very disappointing.  She was competent and friendly, but reacted badly when I brought up BPD.  Prepared for this, I had a floppy disk with links and text on it but she shied away from it.  I probably came on too strong.  We discussed it for a few minutes, she was like “Why do you want to be THAT?” and I explained that it wasn’t that I wanted to be like this, but that it was reality and if I had this it would explain why I had failed at treatment so many times.  She seemed interested in having me bring printouts of the info, but chose to retain the old diagnosis of bipolar with schizoaffective tendencies that the last therapist had tagged me with (funny, I have never had a mania or a hallucination, and I know when my feelings and perceptions are out of whack–but I have several characteristic BPD traits).  She did prescribe the Neurontin and Prozac I had read work well for BPD.  I feel much better now.

Question.  How can I persuade her to spend the time and effort to learn what you research pioneers have found out about BPD and effective ways to treat it?  I realize it will be hard to break through the stigma and misconceptions surrounding BPD and harder still for others (bureaucrats) to become educated and devote scarce resources to it.

I almost feel like if the medication works and I can keep getting it there, I’ll be fortunate.  I gather the dialectical behavior therapy is long, involved, and time consuming.  I can’t see it happening on a fifteen minute appointment every two weeks basis, even though I’ll try.  I have missing years, and have long suspected some traumatic events in early childhood, like other BPD’s report, and don’t think dialectical behavior therapy the proper forum for deep digging.

Suggestions?

ANSWER:

I wish I knew!  I’ve been fighting this battle for 12 years.

The problem is old beliefs, and the incredible slowness of the medical profession – including therapists – to respond to the information.  Most medical information on the BPD is 7-14 years old.

You’re on target questioning the bipolar diagnosis if you’ve never been manic or hypomanic.

You might want to print up a few key studies to show her, or you might need to ask for another therapist.

QUESTION:

Dear Dr. Heller,

My mum is a massive hoarder and has been all my 31 yrs of living.  She has gradually gotten worse over the years.  I’m wondering is this OCD?  Or emotional trauma from childhood perhaps?  I don’t think there is any changing her now; she is nearly 70 yrs old , her house is a fire hazard and I’m worried for her.  But at this stage I’m just wondering if Hoarders are OCD or something else?  I’m trying to come to grips with it myself.

Thank you for your time Kind Regards

ANSWER:

There are many reasons some people hoard.  The most common would be OCD, OCPD and especially anorexia nervosa.  I’d highly recommend you look at anorexia nervosa.  The criteria are available in the DSM IV, and there’s lots of information on line.  My screening test will be of use for other diagnoses as well.

QUESTION:

Dear Dr. Heller,

HELLO!  IN THE LAST WEEK I HAVE NOTICED MY SON BANG HIS HEAD ON THE GROUND.  AT FIRST IT WAS ONLY WHEN HE WAS UPSET OR TIRED, BUT TODAY HE SEEMED TO DO IT FOR NO REASON AT ALL.  I’M NOT SURE IF ITS BECA– USE HE KNOWS HE GETS THE ATTENTION WHEN HE DOES IT, BECA– USE WE AUTOMATICALLY SAY NO OR PICK HIM UP SO HE WON’T HURT HIS HEAD, BUT IT IS A CONCERN TO ME.

IF YOU HAVE ANY INFORMATION ON THIS KIND OF BEHAVIOR I WOULD REALLY APPRECIATE IT! HE IS A VERY HAPPY ONE YEAR OLD AND I DON’T UNDERSTAND WHAT COULD HAVE BROUGHT THIS ON!?  I WAS TOLD THIS COULD BE A SIGN OF SOME DISEASE, IS THIS TRUE?

THANK YOU FOR YOUR TIME AND I LOOK FORWARD TO YOUR RESPONSE!

ANSWER:

The most likely diagnoses are childhood onset bipolar disorder or depression – which may be psychotic.  http://pks.947.myftpupload.com/BiPlrKid.htm can give you information on bipolar. I take this problem very, very seriously.  Risperdal is a great first medication while other possibilities are being worked on like depression or bipolar.  Depression is far more common in children than was previously known.

QUESTION:

Dr. Heller, I am 37, and I think that I have suffered from anxiety and depression since childhood.  At about the age of 30, I was diagnosed by my doctor with GAD and depression.  According to my experience and your screening criteria, I think that “fractured happiness” and the inattentive type of ADD are also parts of my overall condition.  I have tried almost all of the SSRI’s, and generally they let me see what non-depressed, non-anxious thinking was like.  What a revelation! However, side effects have been a big problem.  Prozac made me hyper.  Paxil made me feel the best, but it also caused a rapid weight gain.  Zoloft made me feel wired.  Adding Trazodone caused a quick addition of 10 pounds despite a lot of exercise.  I tried Wellbutrin with Paxil and Celexa respectively but this did not lessen my side effects.  This includes memory glitches that were very disturbing.  Currently, I am on Serzone by itself, and it seems to have made my anxiety worse. Many family members, from both sides, have ADD, depression and anxiety.  Are these conditions related to one another?  Considering the fact that I have multiple issues, which medications would you suggest for me? (I have had my thyroid checked on several occasions.  It has always been normal.)

ANSWER:

The problem is the GAD and an overactive serotonin 1-A receptor.  This is the gene involved in the cognitive generalized anxiety disorder.  SSRI’s increase most serotonins, including this one.  BuSpar lowers that receptor so that SSRI’s and stimulants can be taken.

QUESTION:

Dear Dr. Heller,

I am a 24 year old mother of three. When I was a child I was diagnosed with epilepsy and suffered from two grand mal seizures when I was five. I was placed on Phenobarbital and then to Tegretol when I got older. I was weaned off the medication when I was twelve, however, I still had unexplained symptoms such as twitches in the face and eyes. And periods where I would black out for a few seconds at a time. Since I have been married I have not had these symptoms as much. All my life I have had mood swings, ranging from severely happy to extremely angry. It seems lately I have been so angry that I can’t get anything done that I need to get done. Is there a chance that the epilepsy I had as a child could have manifested itself in a form of BPD? I know this may seem like a strange question but I just want to figure out what is wrong with me. thank you for any information you can give me on this subject.

ANSWER:

I’ve seen many patients with a similar story, and to me it’s clear that a predisposition towards seizure problems can cause or worsen BPD dysphoria. Since epilepsy medications work well for bipolar, the same thing may be true as well. Stress can easily trigger seizures, and lowering that stress can clearly make a difference. Since I believe the BPD is a seizure disorder in the brain’s “trapped” or “cornered” animal response, your conclusion makes sense. The BPD has been caused by head trauma, emotional trauma, and brain infections.

There are many diagnoses you should look into, including the BPD, generalized anxiety disorder, panic disorder, and bipolar. I highly recommend looking at the screening test. Making all the diagnoses and treating them comprehensively is crucial.