Q. While I have never been diagnosed, I believe that I have BPD. I am being treated by me regular doctor for depression and am on 100mg of Trazadone (to sleep) and 100mg of Zoloft each night.

The good news is, by coincidence this is seeming to help my "oddness" I indulge in self mutilation and have anxiety attacks. I at times also experience strange "out of body" feelings, and when on the meds, these decrease.

I recently turned 40, and for whatever reason am coming to terms with my oddness. I have been trying very hard to keep myself from feeling aggressive/sad/doomed and am making small strides. I must say I feel strangely relieved that I think I know what is wrong now, the BPD. Does therapy help in addition to the medication? I have a strong support person in my mom and talking openly with her has been very good for me.

My goal is to one day be able to form a healthy relationship with a man. I have some wonderful friendships with women and men, but have difficulties in an intimate relationship. I would greatly appreciate your thoughts.

  A. Very good questions. Whether you have BPD or not (based on data you give, it is a likely diagnosis), you need to get treated. The anxiety attacks and depersonalization and BPD all have the same chemical basis in your brain, and all should clear up if treatment succeeds. I would highly recommend seeing a psychiatrist for a full diagnostic work up, and treatment.

Zoloft is a fine treatment, but if you have BPD, you may need a higher dosage to resolve the panic, depersonalization, and BPD. Do not make any medication changes without consulting your doctor first. The archives of this site discuss Zoloft use in BPD and serum levels necessary to optimize treatment.