Q. Quick review, Female 33, incest survivor, mental abuse survivor, pregnant at 18 married 10 years two beautiful boys. After the birth of my first son I noticed a change in my personality, my mind always seemed to race not able to concentrate on one specific thing. Now I believe I had ADD in school. After the birth of my second child I had severe depression, three days after my delivery I was so severe I was put on anti-depression and sent for counseling. I seemed to really improve the meds brought me out of the depression almost opposite their was nothing I couldn't do, then I got a divorce my choice, My husband was the only man I had ever been with and wanted to experience someone else, cheating was not for me. I discovered Alcohol and cannot control myself when I do drink. Very uncontrollable behavior and frequent blackouts. I also discovered that other men found me attractive and I loved that bars for a couple of years were my second home. I never would sleep around not that I did not want to I am very sexual but I knew if I went down that road it would ultimately make me feel worse than I already do about myself. I have almost totally stopped going out mainly because every place that I have gone I have made such a fool of myself, and when I get drunk I hate everybody, particularly men and I get very violent. My real dad is an alcoholic and he is not productive at all! I see myself going down that road, not with alcohol but with success. I was accepted into PT school and the pressure of school, work and trying to get my boys to their ball events was too much. Basically here is how I feel. I am afraid of being hurt, so much so that I almost make things up in my head such as being cheated on or being left for someone else. Also I know I am such a kind person and a very healthy Mom but as far as myself I am in a rut. I am attractive at times depending on how I am feeling at the time. I do like to be around people because I can tell men are attracted to me. I am dating a man who is a little verbally abusive he is very ambitious and has a hard time with my not so ambitious personality. I am very loving and easy to get along with I just cant see the light. I am on prozac I switch between 20 mg and 40 mg per day depending on how strong I feel. I am also sick a lot! Nerves I am told.

A. It sounds like you have BPD, and there are a number of treatments available. The best is a combination of correct medication, cognitive therapy, and effort to meld these treatments on your part. Medication options have been listed in other letters. Therapy includes DBT or any of its conjoiners. And finally, you really need to want these things to work and actively participate in your treatment.

As a note, if you do have BPD, you will need 80 mg/day of Prozac to get maximal benefit from this medication. Therapy is imperative to get your self-esteem issues back on track.