Q. I am currently 19 years old. I was diagnosed with Borderline Personality Disorder in January of 98 when I was 17 years old. I had therapists BAFFLED. the doctors told me what I had, but never explained it...they just WOULDN'T. I would beg, but get no info. I was in an institution 3 times in one month, and then sent off to live in a residential environment called Kidspeace. I was on Depakote, Mellaril, and at one point risperdal. I always felt I was never treated right. My medications were always being shifted, I never got a fair amount of attention etc. I was released in April from Kidspeace. When I got home I stopped taking all of my medications. I finished my senior year of high school, took it upon myself to get rid of my old friends (including the one I had the intense horribly sickening relationship with) and find better friends who weren't so intense. I wound up getting close to my best friend from elementary school. I graduated (to everyone's surprise) and it took a lot of work, which I endured. I got accepted to college (to everyone's shock) but came home within the first month. it was far away and not the right time. I spent a year just working, hanging out, taking it easy (I had felt like I lost a year). but in the time I had returned from the residential, and stopped the meds, I developed a strong motivation to fix myself, and rid myself of my disorder, but I never really understood what it was...just knew the small details they had told me. but I worked hard to rid myself of the self destructive behavior. The last occasion was in spring of 99. I worked hard to stop all manipulation, and needs of control. I held down a job. (I don't have the job now because the store went out of business). I began college again this past fall. I started college again this past fall... I made even MORE friends. I felt accomplished and alive. happy, but not high, my lows were not threatening. I had a job, good school, good friends, good family, my first relationship, (we broke up after a month...my idea because he was obsessive) and no medication or therapy since spring of 98. Then all in the moth of November, I get expelled from school for slapping my ex boyfriend (which I argued, and eventually a hearing got me back in, but not without me losing the semester). My grandfather develops cancer in his brain, a handful of my friends turn on me and threaten my life because they believed I started a rumor (which I didn't and they have NOW apologized) and everything began to go wrong. My mom wanted me to go to therapy, but I refused. I KNEW IN MY HEART nothing was a problem.... and miraculously I handled everything without a shred of mutilation, or devaluing, or any real horrible mood swings. I just saw the movie "girl interrupted" which is about a girl with BPD. It inspired me to learn more about it which I began tonight, completely SHOCKED by something. I would like for you to respond to me including the following things:
1) any comments about the story I told
2)Whether or not most BPD VICTIMS (I feel like a victim...a disorder I didn't cause but must deal with? that sucks) spend a lot of time in denial (I was for a long time...just recently I actually admitted to myself what my problem really was)
3) comments about the medications I was on. (I had read about them just after I was released and found one of them is a horse tranquilizer?!?!?!)
4) in my personal experience and in the movie I watched I noticed that doctors tend to not explain borderline, but seem to want patients to figure it out for themselves......is this true, and if so WHY?
5) I like having my own personal treatment of no meds, thinking, quiet reflection, and self improvement.....I know you think medication is best.......can you put that aside and give me other non-therapy, non-meds advice?

Thank you and I'm sorry this is so extensive, but I feel like I'm just waking up. I always felt constantly lied to by my doctors, and I need honest answers. If you have some doubts about me having BPD please DON'T TELL ME.......they've been trying to pound it in my heard for a lo-o-ong time and I JUST let them win.

A. Here goes. First off, I do not think medications work in everyone. If they do, however, it would be a fool that would not try them. What we mean by "working" is of critical importance. I try to get people to function as best they can do. Some folks do better than others. Some get no benefit from medications. About 75% get a lot better. BPD is unequivocally a biological disorder. It does not fit a learning model, because everything else a borderline does is logical. They wear coats in winter, shoes on hikes, etc. Things that hurt, are stopped. Unless you are a borderline, and the same learning curve does not apply. The same "mistakes" are continuously made. It would not take most people even one try to find that cutting or burning themselves hurts. No one would be suicidal if they could think another way. It is chemical.
1. Your story is consistent with BPD, but you could have something else. The details are sketchy. Based on the chaos you describe, however, a diagnosis of BPD is high on the list.
2. Anyone in the world will deny they have a mental illness if the illness is not dysphoric. When it becomes uncomfortable, painful, compromising, they try and change it. As soon as they feel a bit better, they do not change. That is why my patients stop their medications and therapy. Denial is a primitive but logical defense mechanism. Particularly at 19, the last thing you want to do is think you are flawed.
3. I cannot comment on your past medications because I do not know the circumstances that led to their use. The bottom line is they did not work for you, so changing to something else makes sense. Stopping them on your own is not in your best interest. Your inability to handle your first semester of school suggests some kind of active problem.
4. Most people do not like being told they have a personality disorder. I hate the term personality disorder, and just refer to any personality disorder as defined in DSM-IV as a personality style. The doctors tried to fix it as best they knew how, and were not able to help you as much as they or you would like. There are many other treatment options. The more you try, be they psychotherapy, pharmacotherapy, meditation, etc., the more chances you have to be well and function better in society.
5. No. Not using medications when they have been shown to work in what would otherwise be a progressive and treatment refractory illness is malpractice. You should be on medications.