Q. I have just learned that I have BPD or at least the physiatrist thinks I have it. Over the years I 
have been diagnosed as having major depression, manic depressant and I really am so lost and confused that I sometimes think I am crazy. I am inclined to go to extremes either I am so happy and friendly (most of the time) then I seem to loose all control - I became oversensitive, easy to anger, irritated, bored and then I start hurting myself to get those people out of my head. In the last six weeks I have really banged my hands with a hammer, cut myself on the hand (needed 6 stitches) and tonight I stuck a screwdriver in my leg. I am gay as well and am in love with a straight married woman at work - but sometimes I am so rude to her I just can't believe myself. As a child I was bright but very much an introvert who would rather sit with a book than sit with a person. When I was about 18 years old I started on drugs in a bad way but somehow I seemed to "calm" down a bit but the self-mutilation carried on - I think I have hurt myself  about 15 times in the past.I have recently changed my shrink again. Now I have two different opinions - what am I Manic Depressant or BPD Please help me I am so confused and I am running out of places to hurt myself and I don't  want to loose the women I am in love with because she is not in love with me she is a great  and true friend and we share a marvelous spiritual love

A. The best thing to do is to find a psychiatrist that you can work with, and follow their medical advice. You have a biological illness, and for many people it can be markedly improved. Yes, it is like high blood pressure, but it can be fixed, like high blood pressure.You are probably both manic depressive and BPD. They frequently overlap. It is like fever and diarrhea occurring together.There are a lot of reasons why both could occur together. It is your doctor's job to figure out how to treat  it. The diagnosis only matters if it aids in treatment. Work with your psychiatrist and try to find a medication that helps.