QUESTION:

Several of the diagnostic criteria between BPD and chronic depression seem similar to me. I have lived most of my life 37 yr. old male with a feeling of emptiness. Do not connect with many people. I have cyclical (every three to four weeks) depressed states that often lead to minimal functionality, deep pain and suffering that is hard to describe to myself or others. I have been diagnosed with depression and attend therapy and are taking Effexor after trying several different medications. Can't tell if it does anything or not. I seem to go from a major depressed state to my normal state of dysthymia and never really achieve lasting happiness. What is happiness ? How can I tell if this is depression or BPD ?

DR. HELLER'S ANSWER:

Dysthymia with either cyclothymia or the BPD fit your description well. It's extraordinarily unusual to find an individual with the BPD who doesn't have a major depression.

Prozac is particularly helpful for dysthymia, usually working in three days. Cyclothymia usually responds to low doses of Depakote and sometimes Tegretol.

I highly encourage you to research more about these diagnoses.

Happiness should be our normal state, and you deserve the opportunity to be happy. Your problems are primarily biological, which is why I named my new book "Biological Unhappiness."

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