Q.  I currently take Effexor and Wellbutrin. When my period comes, I am not able to function. The medicines combined with my hormones make me crazy. Any suggestions for relief?

2. What positive feedback can you give me for hope of living a somewhat normal existence or can you please supply a list of positive reading material... that you recommend? So far, I have heard nothing but the worst!

A. Dosage of medication is important. Effexor is a very good medication, but most patients require 300-450 of the XR for symptomatic reduction. Take enough to get rid of the carbohydrate craving, and stay at this dosage. I have not found Wellbutrin to do much on its own. For some people it helps with energy as an augmenting agent. There are also reports of it eliminating sexual dysfunction in folks on SRRI's. Make sure you are taking enough medication.

As far as hope, I see many individuals once or twice per year now since their BPD is under good control. Like any medical illness you need to rehabilitate after the medications kick in. This takes anywhere from 1-3 years depending on how ill you were, where you need to get socially, and where you need to get educationally. Like tearing an anterior cruciate the surgery (medication for BPD) is the start. How well the knee is rehabilitated is a function of physical therapy (psychotherapy in our analogy), and how good you want the knee to be. A pro football player needs more diligent rehab than someone who just walks a few hundred yards everyday. You can get as far as you want once the disease is under good pharmacological control.