Question:

I'm a 22 year old diagnosed BPD patient. I have been in therapy with a nice lady for about 2 months. Symptoms: paranoia, anxiety attracts, fear of people (I don't smile or look people in the eye), self mutilation: On a daily basis, I pick (and have picked for years at acne throughout my body in an agitated state (I know I shouldn't do it, want to stop, but can't), chronic depression ("lasting a couple of hours, but not longer than a couple of days" I have all the symptoms of BPD), I feel like I'm watching television instead of living, I go through "spacey states" many times a day, mood swings, fear of rejection or failure (to the point where I don't do anything but go to work) I've been smoking marijuana as a self medication for years (it's the only time I feel like I can be me) 

But, I go to work sober (I feel I got into therapy in time enough to save my job). I'm kind of up in arms. I just want to be "normal". I am very intelligent, but I'm afraid to go back to school because of these spacey states. My psychiatrist does not seem to want to medicate me. As a matter of fact, my best (and only) friend (whom is also a psyche major) thinks she is trying to go drug free as far as therapy, he says it's some kind of cutting edge techniques by my descriptions of our sessions (she tells me: to smile more, what is socially acceptable, to get out more, tells me to analyze my feelings, try to see how other people see me, lots of positive stuff, but she tells me it will take years of therapy and I only get to see her every two weeks, I don't feel like this is enough. For about a couple of days I feel ok, then Its back to my "normal" state.)

My friend feels that I am schizophrenic (due to my paranoia), and recommends that I take Ritalin and has mentioned he knew someone with BPD who took MBH for medication and is living a happy life now. I don't think I am schizophrenic. He's also saying I'm overanalyzing our sessions and I should just go with the flow for the therapy to work. Sometimes I'm not sure if he really likes me as a friend or just sticks around because he's my only portal to the outside and is afraid I'll lose it if he chooses to not associate with me (I realize this could be real or imagined, to this day, I'm not sure.) 

I don't even know what I look like, every time I look in the mirror I see a different person: sometimes I'm beautiful, other times, too horrid to look at (my psyche calls this a distorted body image). Is there a way without medication? If not, how do I convince my psych that I need medication without her thinking that just because I smoke marijuana that I need a new fix. I feel that if I did have the right meds, I wouldn't smoke pot anymore. WWJD (she says I need to go to church, laugh out loud, like all I need is a guilt trip right now) is what a coworker (that I am close to) says at work. What should I do?

I feel stuck. No friends, no intimate relationships. I have suicidal thoughts, but my psychiatrist said if I try to kill myself, she is no long my psychiatrist. But it works (for some reason I feel that she is the only person who can help me) I've seen other psychiatrist but they didn't talk to me much and just prescribed me with Prozac or Wellbutrin (I don't remember if they helped, Wellbutrin just gave me the shakes.)

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Answer:

One medication alone is not going to do it for you. For the BPD alone, those with those spacey spells virtually always need Prozac combined with Tegretol. You're describing symptoms highly suggestive of temporal and/or limbic lobe seizures. I highly encourage you to learn as much as possible, learn all your diagnoses and take charge of your care.

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