Q. I WAS DIAGNOSED WITH CLINICAL DEPRESSION AND BPD 9 YEARS AGO. I HAVE BEEN SEEING THE SAME THERAPIST FOR 8 YEARS AND I RECENTLY FOUND OUT THAT HE IS LEAVING THE AREA . MY PSYCHIATRIST IS ALSO MOVING IN JUNE. NEEDLESS TO SAY, THIS SEEM TO BE AN IMPOSSIBLE SITUATION FOR ME. I TAKE EFFEXOR XR 600MG, WELLBUTRIN 450MG, BUSPAR 90MG, TRAZADONE 30MG, TEMAZEPAN 60MG AND PHENTERMINE 60MG. I HAVE BEEN ON THESE MEDS SEVERAL MONTHS WITH ONLY MINOR CHANGES. I HAVE BEEN THROUGH IT ALL: HOSPITALIZATION, ECT DIFFERENT PSYCHIATRIST, SPIRITUAL HEALING AND ACUPUNCTURE BUT TO NO AVAIL. THE FEELINGS OF GUILT, HOPELESSNESS AND ABANDONMENT ARE OVERWHELMING AND NOW WITH MY THERAPIST LEAVING THINGS ARE HOPELESS. LAST YEAR I HAD A RADICAL MASTECTOMY AND UNDERWENT CHEMO, I LOST SOMEONE I WAS CLOSER TO THAN MY MOTHER, MY HUSBAND UNDERWENT OPEN HEART SURGERY AND IN JANUARY THIS YEAR ON MY BIRTHDAY I BROKE MY LEG WHICH REQUIRED SURGERY AND A 2 MONTH STAY IN NEW YORK. THIS TRIP WAS PLANNED TO GET AWAY FROM THE STRESS AT HOME. I REALLY DON'T HAVE MUCH LUCK IF ANY. THE ONLY HOPE I HAVE IS AN ELECTRICAL IMPLANT WHICH WOULD BE INSERTED IN MY BRAIN TO CONTROL MY DEPRESSION. DR GOODNECK AT THE UNIV OF MIAMI IS HEADING UP THE RESEARCH ON THIS PROJECT AND I AM DESPERATE. WITHOUT SOME HELP. I WILL NOT MAKE IT. I FEEL LIKE A BURDEN TO MY FAMILY AND REALLY FEEL LIKE GIVING UP MOST OF THE TIME. PLEASE TELL ME OF YOUR EXPERIENCE WITH PEOPLE WITH MY MEDICAL HISTORY. HOW MANY MAKE IT? HOW DO I START ALL OVER AGAIN WITH A NEW THERAPIST? I CAN'T TRUST ANYONE ELSE? IT IS DIFFICULT TO FIND SOMEONE WILLING TO TAKE ON THE RESPONSIBILITY OF TREATING ME. I WOULD APPRECIATE ANY ADVISE YOU COULD SHARE.
A. It sounds like a bad situation, but there are a few good points. First, I have heard very good things about the electrical implant for depression. It works very well. Second, even though your psychiatrist and therapist did a good job, you are still not where you want to be yet. You can look at the new therapist and psychiatrist as a way of getting a second opinion. I know of a lot of people in your situation. Many of my patients had some of the same feelings you describe when I left my practice of 11 years recently. The abandonment issues are part of BPD, and yet, your ability to handle them is an indication of just how far you have come. Your message actually sounded like you realize the dilemma of your abandonment fear and are just looking for an acknowledgment that it is appropriate. It is. Even if you were a totally normal individual, it is appropriate to feel loss after a relationship as long as the one you have had with your therapist and psychiatrist. Your ability to handle the transition will be a sign of how well the therapist and psychiatrist did to move you further along to normalcy. You will do fine. Keep the faith, and find someone you are able to work with psychiatrically and therapeutically.
