Q.. I have a couple of questions. I am diagnosed BPD, Have been for about 3 years. Using DBT or dialectical behavior therapy and intensive therapy I have made a lot of progress. I am on Effexor 2 75 mg tabs 2 X a day for depression and BPD symptoms. Seroquel 50 mg at bed time and 25 mg 2 x a day for anxiety and I just recently went on Neurontin 600 mg at bed time and 300 mg in morning.
1. Will I ever come off my meds?
2. Can I get well and stay well? Can I ever become symptom free?
3. How likely is it that my children will have BPD? As they now show symptoms at ages 8 and 5. they are also in therapy or am I just seeing myself in them?
4. Can I raise my children and not pass this to them? 5. How much of BPD is a chemical problem? will my brain ever get better?
6. Can I heal from childhood trauma and be a borderline? and last but not least my Dr. and I are looking for a med. that will help with chronic fatigue that will work with the Effexor. (should explain I have to take the Seroquel to sleep otherwise I can't yet I stay tiered no matter what I do not have a lack of interest just no energy.)A. Many good questions, with some easier to answer than others.
1. No. Until they come up with a biological cure for your illness, coming off medications will make you worse (assuming the medications are helping). It would be like a diabetic stopping insulin.
2. Yes you can get a lot better, and stay better, but only if you stay on the medications and continue in therapy for a while. As with any medical illness we treat, some folks get tremendously better, and others not at all, and everywhere in between. It is a bell shaped curve. I have no doubt BPD is a biological disorder, and requires a biological treatment along with therapy for best results. As new treatments become available, whatever symptoms left to treat will hopefully be amenable to the new treatments, and you will get better and better.
3. Chances of your kids having BPD are higher than if you did not have the illness, but not all that much higher. I would follow your clinicians advice as far as treatment. If they do have it, the sooner it is treated, the better.
4. Yes. There is no clear evidence to show BPD is learned, otherwise all kids with a BPD parent could "catch it or learn it." Likewise, kids without BPD parents would not somehow become BPD, which we often see clinically.
5. At some level, I think data is strong that it is mostly a chemical problem. I am not aware of people getting better or cured with time.
6. Childhood trauma is not the cause of BPD. Even if you heal, you will still be borderline. Whether it is or is not really is irrelevant. Either way, you have to get better. Work on whatever suits you, but stay on medications.
7. I have had very good luck with Provigil (modafinil) for the lethargy/fatigue. It is a wakefulness agent that is not addictive or habituating. All it does is keep you awake and alert if it works. I have used 100 in the AM for a few days, and then I usually go to 200 in the AM for a week or so. If things are going better or improving, I stay at that dosage. If not, I go to 200 mg at breakfast and lunch.