Q. I have seen 2 psychiatrists over the last year, one of whom was very helpful and agreed along with myself and a psychologist from the Eating Disorder Clinic that I was suffering with BPD. My most recent psychiatrist however, is unwilling to accept this and will only treat me under the diagnosis of 'severe depression' and SI behaviours. I am currently prescribed 40mg Paroxetine daily which is the maximum dose my Dr is allowed to prescribe in the UK. I self-prescribed to 60mg and have finally experienced some minor improvement in my mood after reading your comments that 60mg is the smallest dose you have found to be effective. What can I do to get the right medication short of emigrating? Are there other similar meds which may help in smaller doses? I would really appreciate your perspective on this. Is there no hope of receiving the correct meds in the UK as a person with BPD?

  A. I have not lived in the UK for 14 years, and am not as aware of policy on prescribing as I should be. Honestly, I do not know what to tell you about getting the correct medication, or increased amounts of paroxetine (if it is the right one for you).

Do not mess around with your medications on your own. It really upsets physicians when you do this. I know you are ill, and are only looking for help, but it will alienate you clinician. All I can tell you is to get some of the papers that are published on treating BPD with medications, and try to have your doctor do what is written in the papers.

Finally, whatever your doctor calls your illness is irrelevant, as long as you get better. You probably do have severe depression, so it is not worth arguing semantics unless it hampers treatment.