Personality Disorders Community

Am I A Borderline Or A Narcissist?

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QUESTION:

Dear Dr. Heller,

I am hoping you can help me and at least give me some sort of insight. I am a 29 year old female and have been in psychiatric treatment since I was 14, initially for panic disorder. I come from a very dysfunctional family where I was put down continually and left alone to care for my brother alone during a messy divorce. My mother was either hopelessly in love with someone or cut them off at the slightest, or they were evil.

I seemed to make it to my early 20's when finally I was diagnosed with depression and put on Prozac for 2 years. It put me over the edge and I became an insomniac, shaking and feeling like I was gonna fly through the roof! I went off the medication and ended up charging up credit cards, having an affair, and running off to another state with another man leaving my husband with my daughter. I was eventually put on Effexor and Xanax and lasted 4 years on this. I seemed to be O.K. again, so I thought. Since I was 5 months pregnant with my son, I haven't been the same. He is now 18 months old. I have been on Prozac twice again (no depression help), Lithium (edema), Depakote, (Edema, lethargic), Paxil (no change), Wellbutrin SR (made me extremely anxious), Topamax (numbing sensations), Zyprexa (extremely drowsy), Serzone (no change in depression), Zoloft (no change in depression), BuSpar (I woke up crying and my mind racing with anxiety and agitation) I think you get the idea!

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My symptoms are: obsessive thinking, mood swings every few days, excessive washing, can't concentrate on anything, scary death images in my mind of hurting myself or hurting my kids, poor self image, overeating, reactive to outside circumstances, socially isolated due to self consciousness about weight, periods of agitation and impatience, snappiness, cannot make a decision, need to be moving around, and feeling detached sometimes! I am currently on 200 mg. of Luvox for OCD, 2400 mg. of Neurontin a day, and Klonopin as needed. I was hospitalized for suicidal ideation because the Effexor made me feel like I was going nuts and I was so anxious I thought I was going to fly through the roof again.

The hospital docs said I had "borderline traits" with superimposed major depression. My regular doctors think I am narcissistic with OCD and cyclothymia. What do I do to get some clear cut answers and get help here? I am so confused it's not funny! HELP ME PLEASE!

DR. HELLER'S ANSWER:

It does appear you have the BPD with OCD. You likely also have the generalized anxiety disorder and most likely have post traumatic stress disorder as well.

What I generally do with patients like you is start on Prozac and a week later begin Tegretol. This combination works miracles for the BPD and can work for cyclothymia if present. If the GAD is present, BuSpar can be added - although you'll likely need to take Remeron with it to prevent those side effects. High Prozac doses will likely be necessary for your BPD and OCD (and likely OCPD) symptoms.

You don't sound like a narcissist, although it may be possible. Treating your medically treatable problems combined with intense counseling and massive brain retraining (reading lots of books and studying Ziglar's tapes) can make a huge impact.

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