Q. I have a question about BPD and how a psychiatrist can diagnose BPD in a person just based on the self injury because it is the only one in their book that has this symptom as part of this disease? Are there tests that can tell if this is the real diagnosis?
I have been diagnosed having this mental disease as well as being Bipolar II. All I know is that I am just out of the hospital from a suicide attempt that almost let me win over this ugly diseases. I have no memory except the police reports given to me...I downed 2 whole bottles of my meds and under that influence I cut my arms pretty bad. I woke up in the ICU two days later and spent 2 weeks in mental health ward.
I also do seem to suffer greatly from Severe Major Depression, recurrent, which is all where I still am and the pain is excruciating for me. I am in therapy but he doesn't seem to believe that I can do something about all this and keeps telling me I don't want to get better; but I do. I just don't know how to be different and not do the things I do that have been happening since I was young child (self injury). My parents did not believe in mental illness just called me very spoiled and lazy and seeking attention which always came in the form of physical and emotional abuse. I was beaten by my father when I was 6wks old and abused by not only them but teachers in early childhood and molested at 8 years old, raped twice in late teens that nearly killed me and wished he had to go through all this stuff alone.
Even the psychiatrists couldn't believe how severe my mental illness' are inside me...like it is all my fault. Is it?? Right now self injury has become like an addiction in me that I just have to do to deal with the pain and the guilt and the whole thing!! The depressions are the very worst and suicide is always on my mind. I don't know what to do anymore to help myself because I feel so hopeless, my therapist, wants me to come up with 3 things of what I'm willing to do to change my life. Dr. Heller, I am SO LOW right now it is a struggle to just keep going, I want to change how this all has taken over my life but it is ME and I don't know how to not be depressed or not be BPD or not be Bipolar.
My psychiatrist is treating me with Effexor and Prozac plus to sleeping aides Temasapam & Trazadone which are not helping me sleep very much at all so I am dragged out, tired and still very depressed....which makes me feel unable to resist self injuring myself. My tears are genuine and my feelings of worthlessness, hopelessness and why can't I just leave this life...I can not stand being this way anymore but I don't know what to do to help myself change and my therapist really gets angry at me for all of this which is causing great anxiety in me because of it. I thought my therapist and psychiatrist would be the two people in my life I could count on but I am finding out it isn't so....why??
A. There is not a test for BPD. It is a clinical diagnosis. The Diagnostic and Statistics Manual, Fourth edition (DSM-IV) is the book all psychiatrists and psychologists use to make any mental health diagnosis. There are specific criteria for BPD, and if you fulfill them, you carry that diagnosis. Based on your history, it sounds like you would fulfill the criteria for BPD.
Hopefully, you are on enough of the medications you mentioned (Effexor and Prozac) to work. We have published on each of these medications. The former in Psychopharmacology Bulletin 1996 and the latter in the American Journal of Psychiatry, August 1991. The former usually requires 450 mg per day, the latter medication 80 mg/day. The illness is treatable, and most of the time, most of the illness can be reduced or eliminated. Keep the faith. It is a biological illness.
