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I know this is probably a worn out topic, sorry. :(  I'm just wondering if you guys can give me examples of how you know your current medication is "working."  I'm aware that therapy > medication for people with bpd, but that they are used to treat certain symptoms. I guess I'm specifically asking about depression. I keep asking myself, is this depression or is it bpd? Is there a difference? I haven't felt happy in at least a year. I've been on a rollercoaster of meds. 2 of them made me feel better for about 1-2 weeks, but then it stopped and I was back to feeling depressed. Do I sound treatment resistant? My pdoc told me last time I visited and she put me on a new cocktail that I was "difficult to treat." Is that the same thing? 

 

TLDR; I don't really want to keep taking these stupid pills if they aren't doing anything for me. Thoughts?

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Most people with a mood disorder and BPD as well are going to be difficult to treat - it's pretty hard to untangle what is what, and each will make the other worse.

 

Personally, I was on a bunch of antidepressants (Remeron, Celexa, Zoloft) and I found the same thing as you - they would work for a while, generally a few months, and then I would get depressed again and no amount of raising the dose would do anything.

 

I have found Lamictal to be very helpful for my depression though - I've stayed on it for 2 years now, which is longer than anything else has ever lasted.  I believe (though I am not sure my pdoc agrees) that I can tell the difference between my normal BPD, and a depressive episode superimposed on top.  But it's hard to tell what the Lamictal is really helping with.

 

I liked Seroquel for a long time for anxiety/agitation, but the side effects were crummy, so I'm currently trying to get off of it.

 

Have you spoken to your doctor about this?

 

My doctor suggested to me that it is possible that my depression may be secondary to my BPD and she offered me a medication-free trial on the grounds that "it could go well or you could feel worse than you've ever felt in your life".  I declined to roll those dice :P

 

Have you ever asked for a consult, if you don't feel your pdoc has a handle on your medications?  I saw a psychopharmacologist a few years ago and it was very helpful to have that second opinion on my medications.

 

What are you doing to treat your BPD therapy-wise right now?

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I feel like the combo my doctor has me on is working pretty good. I love Prozac, even at a low dose it makes me feel better, I don't feel depressed hardly ever anymore. I like myself better, so overall my Borderline symptoms are working their way though by using coping skills in situations and working with my therapists. But the low dose of Seroquel is what really hits the nail on the head, The extra sleep and numbness feeling on this medication really calms me down, but the sedation is a little too much some days though, and the weight gain aspect in triggers my low self-esteem which triggers my BPD symptoms. 

 

I'm thinking of switching to Abilify and using something else for my insomnia problem, or trying to just sleep on my own again. 

 

Like Tryp I used Lamictal for a while, while it just gave me a headache and a rash. It also gave me bad joint pain, but a lot of people with BPD ( and bipolar) swear by it, I think I am just sensitive to neuropletics ( spelling off )

 

My Pdoc told me that with people who have a diagnosis of BPD he usually gives them either Lamictal or Abilify as those two have great success in treating the symptoms of BPD, but Seroquel is often used off label by those with BPD and I have read reviews online that it has really helped people with BPD. When I was on Zyprexa I found it numbed me out so much that it really helped, but the overwhelming hunger was too much on it. Seroquel is bad enough. 

 

When I am more depressed my BPD comes back HARD. I prefer to have my Pdocs treat my depression first and foremost and then start laying on on the other drugs to argument the SSRIs. Not being depressed really helps me see things clearer and therefore helps me get better therapy done... If you are feeling depressed I would suggest finding something to treat that first... keep asking for a new SSRI maybe? Or an SSNI? or another kind of antidepressant, sometimes it takes a while to find the right one. 

 

I have been on Prozac for almost two years now and I haven't had to raise the dose, it works fine still.

Edited by sleepy borderline
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Most people with a mood disorder and BPD as well are going to be difficult to treat - it's pretty hard to untangle what is what, and each will make the other worse.

 

Personally, I was on a bunch of antidepressants (Remeron, Celexa, Zoloft) and I found the same thing as you - they would work for a while, generally a few months, and then I would get depressed again and no amount of raising the dose would do anything.

 

I have found Lamictal to be very helpful for my depression though - I've stayed on it for 2 years now, which is longer than anything else has ever lasted.  I believe (though I am not sure my pdoc agrees) that I can tell the difference between my normal BPD, and a depressive episode superimposed on top.  But it's hard to tell what the Lamictal is really helping with.

 

I liked Seroquel for a long time for anxiety/agitation, but the side effects were crummy, so I'm currently trying to get off of it.

 

Have you spoken to your doctor about this?

 

My doctor suggested to me that it is possible that my depression may be secondary to my BPD and she offered me a medication-free trial on the grounds that "it could go well or you could feel worse than you've ever felt in your life".  I declined to roll those dice :P

 

Have you ever asked for a consult, if you don't feel your pdoc has a handle on your medications?  I saw a psychopharmacologist a few years ago and it was very helpful to have that second opinion on my medications.

 

What are you doing to treat your BPD therapy-wise right now?

 

Re: Therapy - I'm seeing a therapist twice a week, but not really seeing improvement. Been in therapy over a year, maybe 2 I can't remember right now. There is no DBT in my area at all. My therapist works with me and believes in some DBT skills, tries to teach reframing and following a routine and schedule but for the most part I don't feel like I'm medicated enough for therapy to work. Basically, too depressed to do any of it.

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I feel like the combo my doctor has me on is working pretty good. I love Prozac, even at a low dose it makes me feel better, I don't feel depressed hardly ever anymore. I like myself better, so overall my Borderline symptoms are working their way though by using coping skills in situations and working with my therapists. But the low dose of Seroquel is what really hits the nail on the head, The extra sleep and numbness feeling on this medication really calms me down, but the sedation is a little too much some days though, and the weight gain aspect in triggers my low self-esteem which triggers my BPD symptoms. 

 

I'm thinking of switching to Abilify and using something else for my insomnia problem, or trying to just sleep on my own again. 

 

Like Tryp I used Lamictal for a while, while it just gave me a headache and a rash. It also gave me bad joint pain, but a lot of people with BPD ( and bipolar) swear by it, I think I am just sensitive to neuropletics ( spelling off )

 

My Pdoc told me that with people who have a diagnosis of BPD he usually gives them either Lamictal or Abilify as those two have great success in treating the symptoms of BPD, but Seroquel is often used off label by those with BPD and I have read reviews online that it has really helped people with BPD. When I was on Zyprexa I found it numbed me out so much that it really helped, but the overwhelming hunger was too much on it. Seroquel is bad enough. 

 

When I am more depressed my BPD comes back HARD. I prefer to have my Pdocs treat my depression first and foremost and then start laying on on the other drugs to argument the SSRIs. Not being depressed really helps me see things clearer and therefore helps me get better therapy done... If you are feeling depressed I would suggest finding something to treat that first... keep asking for a new SSRI maybe? Or an SSNI? or another kind of antidepressant, sometimes it takes a while to find the right one. 

 

I have been on Prozac for almost two years now and I haven't had to raise the dose, it works fine still.

 

I hear you on the weight gain triggering low self-esteem triggering BPD. That's something I've been struggling with a lot lately. There's a mirror in our bathroom, straight across from the shower so you HAVE to look at yourself when you get out and I almost threw something at it the other day. :/And I've felt like punching every reflective surface I see. I just do not want to look at myself.

 

As far as meds go, I was on Lexapro the longest, then Prozac. And I've been on Abilify - got the side effect where you can't sit still and want to crawl out of your skin, but not Lamictal. Changed to pristiq and seroquel last month and I thought I was dealing with things better, but now everything feels like the worst again. 

 

Thank you for your response

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