Q. I have Borderline Personality Disorder and depression and mild ADD. I have been going to DBT and Counseling for about two and a half years now.
My big problem is that since I can remember I have violent and strange thoughts in my head. I constantly, from just about Sec to sec have these urges to jump up on tables and spit and puke or run around outside naked, swear, moon myself or others, laugh for no reason swing arms shake all over, jump and crawl all over furniture. My mind wants to do these things all the time. I have these urges like I said moment by moment, so I have acted on some of these very strong urges to see what would happen if I did them ( if my mind would calm down). I have allowed myself to fall on the floor and start spitting up and to jerk my body around and scream and eat grass. Even when I do it and I am so tired from doing all of what my mind wants me to do. The very next sec it is just the same as before, I want to jump up and down stand in the toilet swear and kick. I am not angry like I want to kill or kick others but my mind wants me to. I don't want to but apart of my mind does. Of course I try hard to restrain myself from doing these things because I could go to jail for streaking and some of these things are not socially acceptable. I also have a very very hard time trying to talk to people it is like I try to talk and I am distract by something and I forget what I was saying it is hard for me to concentrate.
I can't hold jobs because when I get anxious it gets even worse I try to Radically Accept and let the thoughts go threw me like a waterfall but it doesn't work . So I lose jobs all the time.
My therapist thinks it might be tourette's syndrome or obsessive compulsive. She is checking with my Doctor who gives me medication.
If you could please help me figure out what it is and what I can do and what medication might help I would REALLY APPRECIATE IT.
I take Paxil 40mg and my Doctor has just but me on Risperdal 1mg.
A. I am not sure if it is a form of OCD, Tourettes, or part of your BPD. It really does not matter, since it needs to be treated. I have had horrible luck with Paxil in cases like yours, so it is low on my list of things to use. More importantly, it has not worked for you yet to get rid of these thoughts. If your doctor insists on Paxil, it may take 80 to 100 mg to work. Better would be to use Effexor XR (450-600 mg) or Zoloft (serum level of 180 ng/ml, which usually is a dosage of 400-600 mg/day depending on whether you smoke or not). Serzone is useless in your case because you have some form of obsessionality. Risperdal will not do much other than slow your thinking down.