Q. I have been diagnosed with cyclothymia/bipolar II by four different psychiatrists. Only one said I had bpd tendencies after administering an MMPI test. I've extensively studied manic-depression through the writings of Jamison/Goodwin, Jamison, Whybrow and it's like they wrote their books about me. (a little narcissism goes a long way :)

The DSMIV clearly states that these conditions are not exclusive of one another. I only have a DSMIII, which is a bit outdated, but seems fairly consistent in the area of mood disorders, both bipolar and unipolar.

Scientific research is being done to determine the cause of manic depression through disruptions of the double helix, indicating strong genetic factors. Can you provide medical, physical evidence for the cause of bpd, or is this merely a socially/environmentally affected disorder? Please understand that it is not my intent to diminish what I've read on your pages, simply a means of understanding its foundation. It seems to me that bpd includes symptoms of just about every mental illness that's been defined: psychotic disorders, OCD, Mood and Anxiety disorders and it's labeled under an umbrella title of borderline personality disorder. Your thoughts would be greatly appreciated.

A. There is no such thing as a psychiatric disease. I know that sounds unusual, but its true. Everything we diagnose is a syndrome. Frequently, certain syndromes occur together. Thus, 90% of the people who have depression also have at least one anxiety disorder. Over 90% of women with BPD have one or more of headaches, migraines, irritable bowel, TMJ, PMS, neurodermatitis, or fibromyalgia. They all have the same biological cause when they co-occur. If a person has four or five of the syndromes mentioned in your letter, they likely all arise from the same biological cause. If this is addressed, they should get good improvement in functioning. One medicine does this for many people.