Tag: Pregnancy

Is There Hope For This Abusive Mom With BPD?

QUESTION:

Dear Dr. Heller,

First I am giving you only one side the story, knowing that…My wife is a child abuser and undergoing a court mandated Psychological Exam (in 1 of 2 court proceedings that she has been accused of Child abuse in).  She has been abusive to children even under supervised visit situations taking them off away from the supervisors and mentally tormenting them (they are in therapy now, disclosing horrible events from the past, both 6yrs old.)

My wife’s past is atrocious, filled with so much junk that you feel very sorry for her (I mean bad).  But currently we have an infant together and I fear for his safety.  What kind of future may this hold.  She WILL NOT get help, she lies almost compulsively, Dysphoria, gaslight, etc.  She is a 9 of 9 in the DSM-IV with many extreme case examples, and other PD’s also.

I have been coordinating with many professionals and I am looking for as many resources as possible to help the infant now because of my mistake (the other boys are from a previous marriage of hers and a non-marital pregnancy while she was exotic dancing).  What dangers does a 9/9 BPD person pose on an infant?  According to the boys counselor she has deeply damaged the boys psychologically over several years and now they suffer identity disorders, anger mis-management, on and on.  I have copied your cover, and your message to BPD’s because first she needs help, and I haven’t been able to help her, but I also could not watch her attack and beat children.  This has been very difficult.  But it seems so text book, as long as your reading a BPD or addiction text.

 

ANSWER:

Certainly some individuals with the BPD are significantly tougher to manage than others, and hers seems a prime case.  I’ve seen many “severe” borderlines go on to become stellar human beings, and those with “mild” cases become extremely abusive, manipulating, hurtful, and destructive.  It’s very hard to predict, and I’m extremely reluctant to pre-judge. Fitting 9/9 criteria doesn’t suggest to me that someone is a higher abuser risk than others.  There’s no direct correlation with number of criteria.  If she has been abusive in court appointed supervised visits, the courts may choose to step in and stop the visitations for a while.  Your best approach for now is likely to take care of yourself and become happy and serene.  This will do more for your own children than anything a court can do.  Focusing on your wife, her problems, and her behavior will likely make everything worse for all of you.  You’ve probably done all you can at this time.  Therapists and attorneys will likely need to guide you through the maze you and the children are now caught in.

Is Celexa Going To Hurt My Boyfriend?

QUESTION:

Dear Dr. Heller,

Hi, I have a couple questions about the drug Celexa.  My boyfriend is only 15 and he has been taking it since January.  His doctor recently took him off of it.  We watched a special on 20/20 about anti-depressant drugs and the side effects that have very negative effects on people.  He is now worried about any side effects that may show up once he stopped taking the pill.  If you could give me a list of them, that would be very much appreciated.  Also, anymore information you have about this drug and mainly the effects of not taking it anymore.

Thank you

ANSWER:

There may be long term risks for all medications.  No one knows.  This includes birth control pills, Tylenol, antidepressants, antibiotics, etc.  We can only go with what we do know for sure and make value judgements. Most people who take Celexa and other SSRI’s have no long term problems.  Not only is it usually the best, the Prozac has been around the longest in the US and is the most studied medication.  It is now considered safe in pregnancy.  Celexa doesn’t have the long term US safety data yet, and a withdrawal syndrome may develop – which interestingly is treated with Prozac.  The side effects of untreated depression are devastating including premature heart disease, cancer, strokes, and particularly substance abuse.  We know for a fact that alcohol, cigarettes or other forms of nicotine, cocaine, intravenous drugs and marijuana are damaging long term.  Evaluating risks is a lot like choosing to drive a car – there are risks, but do the benefits outweigh the risks.  If the individual will self-medicate with alcohol or the other drugs mentioned above, Celexa clearly is safer. I often tell my patients that if it’s more dangerous to drive to the drug store to get the medicine than it is to take the medicine, that to me the medicine is safe.

Is Breast-Feeding Safe When Taking Zoloft?

QUESTION:

Dear Dr. Heller,

My Sister-in-law is concerned that: 1.  She may have to stop breast feeding her daughter after taking Zoloft.  2.  She can’t take another drug (I don’t know the name but has a similar effect as Valium) which was prescribed in concert with a Prozac or a Zoloft prescription which accelerated her recovery from previous crises events and still breast feed.  (The second drug was Xanax) She appears to me to be at a crisis stage where in her own words “she can’t take anymore”.  As you can imagine, the family reaction is mixed from “Get over it” to “If I could just be there to hold her”.  My Mother-in-law has similar problems and is on medication and I’m sure my wife at times has concerns of her own.  We’ve counseled her to talk to her pediatrician but in any case she should understand that her well being is more important to her daughter than the breast feeding.

ANSWER:

Like all other medical problems, it comes down to risks against the benefits.  There is no significant data regarding breast feeding when taking Zoloft.  Zoloft is used for children 6 and older. Xanax has the high possibility of causing addiction in the baby as well as the mother. The consequences of depression and raging while breast feeding – or not breast feeding at all – also need to be taken into consideration.  Maternal/infant bonding is a very, very important time.  Prozac is considered safe during pregnancy, so it might be a reasonable alternative during breast feeding.  In my experience, Prozac is more effective than Zoloft for most people as well.

Could This Be The BPD?

QUESTION:

Dear Dr. Heller,

My Mother took me by the hand and led me to your site four days ago.  She firmly believes I have suffered from BPD for the past 10 years.  I am now 32 – female, and beginning to discover that maybe I have this disorder.  I have been a functioning professional up until now, appearing confident and content (only my parents knew different).

10 months ago I encountered an unplanned pregnancy with my boyfriend of two years.  I was scared, but not unable to cope with the situation.  I was NOT, however prepared for the complete abandonment that followed from my partner, his words were “I want nothing to do with you or it”.  I believe my stress/anguish led to the miscarriage.  He returned weeks later to assure me he was only frightened, and he was terribly sorry.  I forgave the incident, but never recovered completely.

I started taking Paxil four months later, and three months into my medication I became pregnant again (not planned and clearly the stupidest thing ever)and again my boyfriend ran.  It threw me into a spin that was completely foreign to me: (In the past) I have gone into rages/threatened suicide/paced the room looking for things to throw/stalked/ or banged my head against walls when devastated, but this time was different, I calmly brought out my stash of alcohol and began to celebrate the end of my pain, I knew I was going to commit suicide that night.  I reached out by phone to my boyfriend at the last minute, but he didn’t believe I was capable of hurting myself…but I did.  I thought taking an overdose (90) pills of Paxil was going to kill me.

Unfortunately I simply ended up in the hospital throwing up for days.  I was “counseled” into an abortion, and now two months later I have been prescribed Wellbutrin and I am now wondering if I have BPD?  Or did the trauma of being so devastated trigger a depression?  Or has BPD been underlying all this time?  Will this medication help?  I feel like giving up.  If it wasn’t for my Mom showing me this site I think I would still be considering ending it.  I hate feeling crazy.  Is it possible that I unknowingly tried manipulating my partner that night?  If so, I seriously need some help.

Thanks from Canada.

 

ANSWER:

There are many reasons for attempting suicide.  The most significant one is feeling overwhelming pain, and genuinely believing there is no hope.  Depression, the BPD, overwhelming situational problems, bipolar disorder, and drugs and alcohol can all trigger suicidal behavior.  The BPD may be a cause, however the key is persistence of symptoms since early adulthood (usually beginning at puberty).  The official criteria may be enlightening to you.  It’s important to make all the treatable diagnoses and treat them.  My screening test may be helpful to you in this regard.

What Can I Do For Bipolar And Pregnancy?

    What Can I Do For Bipolar And Pregnancy?

    QUESTION:

    Dear Dr. Heller,

    I was diagnosed with Bipolar depression about 6 months ago.  I was put on Depakote for my depression.  My doctor that I had, told me that I can not take my medicine if I intend to get pregnant.  He said that it could have serious side effects on the baby.  Me and my husband are trying to have another child so I stopped taking my medicine.  My question is what is there to help Bipolar depression when your pregnant, and that is safe? I hope to hear from you soon.

    Thank you for your time.

     

    ANSWER:

    If you really do have bipolar with true mania or hypomania you are caught with a significant problem since most medications carry a risk.  Prozac is now considered acceptable in pregnancy.  Medications like Depakote, Tegretol, Neurontin, or lithium have their potential problems.  I’d recommend getting a number of opinions – particularly from a psychiatric psychopharmacologist (psychiatrists who are experts in the medications).  I’d also make absolutely sure that you have bipolar, and not just depression. It will boil down to risks against the benefits.  Being depressed or manic during pregnancy will likely affect your baby as well.

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What Happens To Bipolars During Pregnancy?

    What Happens To Bipolars During Pregnancy?

    QUESTION:

    Dear Doctor,

    I am 38 years of age and actively trying to get pregnant.  I have suffered with manic-depressive illness most of my life and am very afraid of being completely off of medications (which as of today, I am).  How will this effect the baby, and am I more prone to postpartum problems?  Does Manic-depressive illness affect the baby if I am not on any medications?

    Thank you for your time.

    ANSWER:

    The medications for bipolar can be dangerous during pregnancy, but they are not a contraindication.  If you go manic and do dangerous things during the pregnancy you can seriously injure the baby.  Depression in pregnant moms has been shown to hurt the baby as well, and probably increases the risk of postpartum depression.  It’s a tough call – and requires lots of questions of your practitioners.

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