Annual Updates - Annual Updates of BPD

Written by Dr. Leland Heller

Major Depression and Prozac:

Prozac (fluoxetine) is an amazing medication for the genetic depression I described as "Fractured Enjoyment" in Biological Unhappiness. It's also phenomenal for the BPD. Other than those two diagnoses, I am prescribing more Remeron, Effexor and Wellbutrin (buproprion) for depression due to the sexual dysfunction SSRI's can cause.

Antidepressant induced sexual dysfunction:

The major treatments for difficulty getting erections I prescribe are ginkgo in high doses (180-240mg daily) and Wellbutrin. In males, if there is a lack of sexual interest or inability to get or maintain erections, the total or free testosterone should be measured and treated if low.

Panic Disorder:

It turns out that Prozac and the other SSRI antidepressants work about as well as Paxil does for panic disorder.

Insomnia:

1) The new medications Sonata and Ambien have a much lower risk of addiction and dependence than the older benzodiazepine medications like Xanax (alprazolam) or Ativan (lorazepam). The sedation is usually completely gone by the next morning.

2) Remeron (mirtazapine) can be very helpful for sleep, especially with those who have been traumatized and are having trouble sleeping due to "Hypervigilance."

3) The antipsychotic Seroquel (quetiapine) has been extremely useful for difficult to treat cases of insomnia.

4) Insomnia causes many, many problems including work and auto accidents and impairment of the immune system. It's not a minor problem and for most insomniacs it's not a short term problem either.

5) The FDA has expressed concern regarding melatonin.

Lack of zest for life:

This can occur with all SSRI antidepressants, including Prozac. The development of the persistent blah's or lack of interest in life can be due to an imbalance of serotonin with low dopamine and noradrenaline. The addition of Wellbutrin, usually temporary, can solve this problem.

Spiritual Healing:

I believe strongly that we have to heal mind, body and spirit. While some have a strong and successful spiritual base, most don't - particularly with the BPD. Spirituality is about how you see yourself, God, the Universe and your role in it. No one, including me, has the right to tell you that you are wrong and they are right. It's a journey you have to make for yourself. I'm sharing with you some of my teachers:

The book "The Other Side and Back" by Sylvia Browne has been very helpful to many individuals, especially in determining their purpose for coming to Earth. She is the psychic the FBI uses. I usually recommend avoiding the predictions at the end. While psychics may be right about their prediction, the time is usually wrong. Individuals may lose sight of her message by focusing on what predictions came true, etc.

Also in "Where God Lives," Dr. Morse describes a 20 year reunion of children who had a near death experience. They were not involved with drugs, not pregnant, had no problems with authority figures, and had a purpose in life.

In "The Dancing Wu Li Masters," Gary Zukov describes quantum physics, which can be very useful in understanding the universe and your spirituality.

"Soul Stories," also by Gary Zukov, describes a happy and spiritual life, including a clear and loving description of a true spiritual partnership.

"Journey of Souls" by Michael Newton describes "life between lives" - based on reports of individuals who have undergone hypnosis.

"The Dragon Doesn't Live Here Anymore" by Alan Cohen describes the beautiful journey he has taken towards enlightenment and is extremely helpful towards an understanding of spirituality and healthy thinking.

Dr. Wayne Dyer has a number of terrific spiritual books and tapes out in the past few years, especially "The Wisdom of the Ages," "There's a Spiritual Solution to Every Problem," and "Manifesting Your Destiny." The tape "101 Ways to Transform Your life" has been extremely helpful to me and many of my patients and friends.

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