Q. I have bpd and for the last year and a half I have been peeling the skin off of my feet . I do this daily every chance I get. I don't stop until they start to bleed and it's painful to walk. Is this OCD or a reaction to my meds? I'm currently taking Effexor, Risperdal, and trazodone. I really want to stop this. Could it be a form of self mutilation?

A. This is likely part of your BPD. You may want to discuss increasing the Effexor dosage with your doctor. If Effexor is the right medication, and if it has helped, you likely just need more. Average dose of Effexor in BPD is about 400 mg of the old immediate release form and 300 to 450 mg of the extended release (XR).