Q. I am 27 years old and I was diagnosed with BPD 3 years ago. I have met all criterion for my illness except cutting; I have never cut in my life but I did hurt myself when I was young before my diagnosis. I am currently taking Luvox and Zyprexa to control my moods. I have tried Depakote and Zoloft as well. I am doing wonderfully, i.e. control my moods, rages, thoughts of suicide, etc. etc. and any other thing that I might be able to control (Although I do have the occasional outburst but I calmly remind myself of my problem and that I, of all people, really need to control my emotions) But the question I have Dr. is that I have been hearing voices for 3 1/2 years, roughly six months before my diagnosis is when they started. Sometimes they are consoling, other times hateful, and yet other times, completely silent. I have never told this to my therapist for fear of being hit yet again with some God awful mental illness stigma or label. I have also kept this silent to my fiancé of three years for fear of losing her because she has stated that if I were to have something worse than BPD she didn't know if she could take it (Which is funny, in a way, because she suffers from bipolar and is the most understanding person I know, but she did say what she said). Also, I have problems with really outrageous, sometimes sadistic and just plain weird thoughts going through my head when I encounter people in public or whenever I'm out in public in general. My fiancé is aware of this problem and refers to them as "racy thoughts"; which she had suffered from before taking Luvox, one of her meds. I noticed these thoughts about the same time I was diagnosed; I had never had a problem with "racy thoughts" before my diagnosis. Even though I have been on Luvox for a couple of years, I still get these weird, racy thoughts all the time. This gives me severe anxiety when outside of the house. Do people with BPD ever hear voices? Do they oftentimes have "racy thoughts" or improper thoughts?

  A. As you are aware, just about any symptom is possible with BPD. I like to think everyone has a single disease, with many symptoms. The BPD, thoughts, anger, etc., are all symptoms of your particular illness, and likely flow from a single chemical cause. If I had to make a guess, and it is only a guess, it sounds like you have a form of obsessive compulsive disorder. The Luvox, if not at 300 or 400 mg, probably needs to be increased. In time, the voices should damp down if the are OCD.