Q. In 1995 I experienced my second major depression at the age of 20. At this point, I had all ready had 7 years of cognitive therapy.

When I started seeing a clinical psychologist, he diagnosed me with Borderline Personality Disorder and I started taking Manerix 300 mg a day for about 18 months.

At that time, I didn't registered that I had been diagnosed with an illness. I thought I was just being treated for the depression.

From the time I went off the meds, things went a little crazy but I didn't feel depressed. I was in a long-term relationship and as my X put it "you are crazy."

It has been this way ever since. I can be fine for a couple of months. Happy, content and calm and then off the wall for another couple months. Angry, irritable, emotional and extremely moody. I can hardly stand to live with myself let alone hope someone else will.

In late 1998 and early 1999, I started having dizzy spells all the time. It took doctors two years to figure it out. After an EEG, they claimed I was having seizure activity in my brain and put me on Epival 700 mg a day. I took that for 7 months before stopping because I felt it has triggered a depression and the side affects were not worth the cure. I was only dizzy for land sakes!

I have returned the therapy but doctors and psychiatrists are reluctant to prescribe any medication now that I have this "seizure" thing on my medical records. I have never loss consciousness or had convulsions. I just get a little dizzy from time to time.

I am not sure what to think. I have recently started looking back into BPD and whether that diagnosis warrants closer attention. Should I have never gone off the Manerix? Is that what has set off this 3 year roller coaster? Could the dizzy spells be someone linked to this? What are your thoughts on this?

As well, do you know whether Manerix has been linked to increased seizures? I found they worked really well the last time and would like to try them again. However, everyone is reluctant to prescribe me anything. Is there any research you know that I could use to help my cause? Should discussing taking Manerix long-term with my psychiatrist?

I feel like nobody understands what is going on in my head? I am starting to really hate living in my body. I just can't seem to get my mind to work the way I want it to. I can't seem to make myself feel the way I want or think the way I know I need to. Therefore, I just keep slipping deeper and deeper into this dark hole....what can you suggest?

  A. There are a lot of questions raised in your email, and many of them I cannot answer because I do not know all about you. A few general points can be addressed.

First, Manerix should not contribute much to your seizures, if at all. If it is a concern amongst your treating doctors, than you can add an anticonvulsant to your meds. In BPD, I like using either Topamax or Gabatril. The former causes weight loss and has a bit of sedation. The former needs to be titrated slowly, and seems to have antidepressant properties. I am not aware of any data, however, that discuses the interaction of either one with Manerix.

You will need to follow your doctor's advice, and let them know about your condition. No one knows how you feel except you. As a doctor, I try to understand how people feel, but ultimately it really does not matter. What does matter is getting a medication that fits. What I need to do is find a way to get folks better fast, so they do not need me anymore (or just for med checks). Review your concerns with your doctor, and see what they suggest.