Q. I have just been released from a five week stay at Cottonwood. I am convinced that I have BPD. I meet all the criteria and I am lost in the wind now that I am no longer in a structured therapy setting. I am not sure what I should do as I do not want to fall back into the same feelings as I used to. I am now on Effexor, Neurontin, Remeron (for sleep), Dilantin (for seizures). I have been officially diagnosed with Bipolar Disorder, but after researching and going through my childhood traumas, sexual abuse, abandonment, ACOA, CODA, substance abuse, suicidal attempts and more and more, the only thing I can pinpoint is BPD. I still have suicidal ideation, but I know it is not the right thing to do. I want to have a life, but I am not sure where to go or what my life really is. I am a mother of three boys and I just recently divorced my husband, of which I am living with now. He wants to work on our relationship, but I just can't do it right now. Over the last year I had three affairs, drug use and many suicide attempts. This is not what I thought I was all about. I am lost and in the fog. Can you suggest anything or what I should do?
A. First, you need to make sure you have Borderline Personality Disorder. If you do, you need to find someone to help treat it. Your medications sound okay, but you need to be on enough to work. Our paper showed a need for about 300-400 mg of Effexor per day, with lower dosages not working as well. Why folks need this much is unclear, but it is what works. Have your doctor get a copy of my paper through their Effexor representative if dosing is a problem. This will justify the use of more for your BPD. If you are already on this dosage, you need to change medications. Talk it over with your doctor ASAP. Make no changes without consulting with your physician.
