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Is medication effective for Borderline Personality Disorder?

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I suffer from BPD and have been on over 25 medication including thorazine and haldol. None of them helped. Right now Im on Lamictal which i feel like works but Im also DXd with bipolar II rapid cycling so maybe thats why. they also put me on suboxone because it was shown in a study or two that it has helped with medication resistant patients. it does seem to help my panic disorder/mood swings but i think the only thing that actually helps bpd is therapy and only if the therapist is actually qualified to treat someone with bpd. ive ended up coming out much worse than before due to ignorant therapists who straight up cut me off as a patient because i was "too difficult" or "not seeing any progress therefore i must not be trying and am wasting their time" its called a personality disorder for a reason... its not going to just go away with meds or with just therapy. it will be with you forever and therapists/doctors never seem to take that into account when it comes to my past experience with treatment anyway. sorry if this deviated from the topic at all but in all honestly i do not think that medication alone can help bpd. it can lessen my symptoms, if i didnt have my 6mg of klonipin a day i def would not be alive right now. so yea, benzos work for me, but i also suffer from an extreme panic disorder, ptsd, anorexia, bdd, bipolar II (rapid cycling), adhd, and trhicotillomania

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It is possible to make a full recovery in therapy, it is not lifelong or incurable.

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I have found that Risperdal really worked for me (I felt awesome) BUT I gained 20 lbs in a month sooooo that was out. I want to try another antipsychotic like Geodon but my crappy doctor is set on Lithium, which I hate. It makes me sick if I don't eat before I take it and I have some pretty bad tremors. It was nice because Risperdal really took care of bipolar disorder and borderline symptoms. I have tried a lot of meds though, it's always hit or miss :(

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I have found medication to be effective enough for my BPD. I was off and on medications for a long time... I have been on every medication I can think of... tried them all.

I went off for two years and my borderline got worse again ( mostly due to a lapse in depression) so I went on prozac and seroquel to help me sleep at night. I find the seroquel makes me feel so tired all day I don't feel like " lashing out" at anyone, and I haven't felt depressed at all on Prozac so far.

I find that the side effects of some of them scare me and add to my BPD. For instance, since i have been on Seroquel in the last year I have gained 10 pounds. I find that that not only triggers past ED problems for me, but my BPD shifts by how " fat " I feel that day. When I feel " fat" I think others are looking at me, treating me worse, my identity feels unstable. As a catch 22- Seroquel also eliminates some of the feeling that people are judging me based on how I feel about myself--- it might make me gain some weight, and I might feel uncomfortable about it, but I am so " zombied" out I don't care as much.

I think that ( speaking from my own experience) with BPD the meds do about 30% of the work and it's up to me to do the rest.

Note on this: I think doctors should stop overmedicating BPD. At one point I was on two APS, two ADs and a MS. This is was too much. No wonder I got off of everyone for a couple of years.

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I have found that medications work to help somewhat curb symptoms, but not the disorder itself. Since BPD is not biological, medications cannot effectively treat the disorder, and as such treatment is primarily therapeutic.

Topamax has done wonders in curbing my impulsivity. Vistaril does all right on anxiety, but not much. Unfortunately I'm not allowed benzo's. All in all, in the past not many meds have helped the borderline symptoms. Only therapy has helped.

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So far, no. If anything, I think it's getting worse.

In week 7, up to 150 mg. of lamotrigine. More depressed. Still obsessed with a traumatic event from last spring. More anger, more frequent emotional breakdowns, increasing thoughts of suicide. Trying to decide whether to call my therapist and annoy him once more, call my psychiatrist for suggestions on other drugs I don't want to try, or go to the emergency room for god knows what sort of experience.

Every option I can think of leads toward me losing what little control I have over what's happening.

So, no. At least in my experience, meds don't work.

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Lamictal is the only thing that's really helped me and to lift my horrible depression. It is my miracle drug. It took a long time to find out this was the med for me. It worked overnight practically. When I miss more than a few doses I cannot function well. The difference in my mood, energy, and focus is extremely noticeable.

Edited by Teacup

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I'm making myself crazy with this...I'll share and see if anybody has an idea. I have no idea what to do at this point.

I quit the lamotrigine. Shortly after my last post in the thread, I went to 200 mg. Lasted not quite a week...I was a complete basket case emotionally. I'd begun developing pretty severe mood swings while on lower doses, and they hit with a vengeance at 200. I'm talking about complete breakdowns; uncontrollable sobbing coupled with bouts of absolute rage, three or four times a day for 20-30 minutes at a time. I was taking 2-3 mg of Ativan during the day to try and maintain (5-6 .5 mg tabs over 8-12 hours). So evenings where when I just fell apart. I'd go sit in the car to hide from my family. One night, I spent most of a session with my therapist sobbing on his couch. Left the office, and spent another half an hour sobbing in the car.

Next day I met with my pdoc and after listening to me complain she said to just quit, then gave me a quick discontinuation schedule. Other problems I was experiencing included balance problems (stumbling, walking into walls, etc.) which have improved, hair loss which seems to have slowed but not stopped, and an increase in tinnitus (first developed while on Lexapro and Wellbutrin) which seems about the same.

Since I've been off, the mood swings have abated -- so it's a good thing, right?

Wrong. I now seem to have fallen into a deep depression. Consumed by hopelessness. Still suicidal, except it would take too much effort. I'm able to work, but it's a huge struggle and takes almost all the energy I have.

The pdoc gave me a script for Abilify at the time. I've considered it for several weeks, and basically there's no way I'm going to take it. I will not risk the weight gain -- I've lost 90 pounds, am still obese, and I'm just not willing to take the risk.

I'm wondering if I should try going back on the lamotrigine. When I wasn't consumed by the mood swings, it actually seemed to be helping my outlook. There was a sense of calm and confidence -- it's what I imagine normal people feel like. I'm wondering (hoping?) if I titrated faster I could see if I could get past the side effects.

I honestly have no idea what to do. I quite literally feel like I'm damned if I do, and damned if I don't. I have an existential dread of meds. They've never worked particularly well -- the lamotrigine was the closest thing I've experienced in over 15 years of trying. But I feel like I can't go on like this either.

I'm open to ideas. Pretty desperate actually.

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I take SSRI's and A-typical neuroleptics with BPD. They are intended to treat the axis 1 diagnoses but with the MDD and panic disorder in check it's easier to deal with the borderline. I totally advocate medication. 

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Hi...I'm new to the forum and have not seen a psychiatrist yet (I am going to see my GP soon, I have an appointment) - but it's pretty obvious to me that I have BPD. I've known it for some time. I have known for a long time that there are things 'wrong' with me but I have just thought it's eating disorders, impulsive behaviour, depression, anxiety, suicidal tendencies, severe lack of identity, uncontrollable anger, fear (terror) of abandonment...But now I have found a name for it.

 

Anyway. My question is...and it's shallow, I know. I am shallow. Is weight gain inevitable with antipsychotic medication and mood stabilisers? I don't suffer from eating disorders anymore, but I'm very conscious of my image and I worry that if I'm prescribed medication that makes me fat I am just going to stop it, and lose all the benefits. I also have this weird inability to see my body realistically, I cannot seem to tell if I am fat or skinny or average, so I probably wouldn't even be able to tell if I was putting on weight.

 

I feel really sad that I'm writing a post like this. I always just blamed my chaotic past for all my problems...Now I sort of have to take responsibility for getting better. And I feel incredibly sad that I am nearly forty and I have wasted all this time, feeling unwell.

 

Thanks in advance for any replies :)

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Hi Marcie, I don't think you are being shallow at all regarding weight! I have gained weight on antidepressants, mood stabilisers, etc and I am with you on not wanting a medication that does that to my body! I cannot say definitively if there is anything that won't make you gain weight as everybody is different and what might work for you might not work for me for example.  So, all you can do is be healthy - eat healthy, get some exercise and keep checking in with your doctors/ therapists.  These are all a good start.  Sometimes we can still gain weight regardless but there are ways of doing something about that, main thing is to be patient with yourself and your situation.  I can relate to you as I have BPD and maybe some BDD plus some others!

 

Welcome to the forum, btw! :)

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Thanks for the reassurance kirstenk. I have been on fluoxetine before, not for this but it sort of helped with my jealousy and insecurity a bit, but I also felt knackered all the time, I'd just sleep for hours. It also made me feel everything was unreal.

 

I am perfectly happy to live with some side-effects if I can get medication that helps to make me feel a little bit more normal. Currently, I am in a relationship with a man who loves me but I am not sure if I love him, and if I don't love him, if it is because of all these problems I have, or if we really just aren't compatible. Every few days, I get so furious about everything, I had the same problem with my previous partner but he was (and is) a sex addict, so all that stuff also affected me, and I guess some of my reactions to the stuff he used to do could have been considered as perfectly normal...It's just unfortunate that his sexual obsessions and hiding and lying took away what little trust I had in people, and now it continues to affect me in my current relationship, together of course with this 'madness' I have, going around in my head. It seems to me also that I am unable to end a relationship when it has gone bad - I hang onto it, get depressed and suicidal and shout at them...But I won't leave. And then, eventually, they go because I have made their life with me impossible.

 

So I am really really really hoping some medines will help me to feel a bit more normal and then I can started to get my life sorted out, and find myself, somewhere. From what I have read so far, it seems medication does make a positive difference in the treatment of BPD, but, as you say, finding the right medication can take some time.

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I am not a doctor or a therapist or anything really, lately I am pretty much just a lump of coal, but here is my opinion which is based on personal experience, some studying, and the observation of people I know's experiences.

 

I don't think that meds are ever the answer to everything, but I also think they are most often helpful. Thats is what I think when it comes to most disorders. This is because, in my opinion, almost nothing is solely physical or solely psychological, with the exception of a small handful of things. So if someone has schizophrenia, I tend to believe that is a largely physical biological disorder and meds are needed but they still in my opinion will need psychological counseling too because it takes a psychological tool. They will likely benefit from help in learning to accept and cope with having the disorder. Personality disorders are mostly psychological in my personal opinion and largely caused by psycho-social factors and parenting. Therefore therapy is needed, but I think one must have a brain-based physical predispositon to develop a PD, otherwise everyone who had a troubled childhood would have one and that is not the case. I think that without both the predisposition and the upbringing in concert the PD would not occur. So, I think meds and therapy together are both equally needed for the PD. But, even in almost completely psychologically based disorders like PTSD which is directly linked to experiences, meds can still help because they have a direct effect on the chemicals that control the brain. So no matter the reason for feeling anxious a tranquilizer will cause a calming effect. Yeah I talk too much, but point is, why argue meds vs therapy when almost always both are necessary for the best help possible?

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May I please hear reviews from folks who use (or have used) Lamictal for BPD? thank you.

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I am diagnosed BPD and am currently on 10 mg abilify and I find it helps curb my anger

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Medication has been very effective for my BPD. My symptoms were completely out of control untilI started SSRIs. (Prozac, then Zoloft, now Lexapro) Even with an SSRI and talk therapy, they were still uncontrollable. When I started a mood stabliser (Lamictal, started at 100, now at 300), things were a lot easier for me to deal with. No longer having total breakdowns because a friend didn't text me back or because not being able to find the cheese was obviously a sign that I was unlovable. Seroquel (now 50mg) helped me with my more severe Borderline symptoms (dissociation and specific hallucinations).

But I will always advocate for therapy first. Talk therapy is definitely an important part of treatment, especially with illnesses like BPD. DBT, taught correctly, is incredibly effective for Borderlines. (It was actually developed for us!)

Wishing you all strength <3

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The only medication I ever felt was helpful for my BPD symptoms (well, technically I have/had complex PTSD which is like PTSD with borderline traits) was Lamictal...  SSRIs haven't been helpful, AAPs weren't helpful, benzos were helpful until I built up a tolerance and refuse to keep going up, etc.  (This is why we are in the process of tapering me off my meds... because medications have either made matters worse, had nil effect, or some combo thereof.  The ones I stuck with for so long were basically because they had the least side effects not because they were effective.

 

Lamictal helped in weird ways that's hard to describe.... it helped me to feel less triggered by "abandonment threats" and PTSD triggers, it helped me to feel less of sense of pervasive shame, it helped me to dissociate less, I think it helped with some chronic pain stuff that isn't exactly borderline but I feel is trauma-related/psychosomatic.  The only problem is when I stay on it too long, it really starts to fuck with my hormones and makes my PMS worse.  (None of what I'm describing is what is "normal" for the medication... but then again med treatment for BPD/trauma-disorders tends to be just symptom focused, not targeting the whole disorder)

 

Anyhoo, the only things that have truly helped my borderline symptoms/complex trauma issues are therapeutic: DBT, some insight-oriented psychotherapy, mindfulness practice.

Edited by Lady Krazy Kat

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