QUESTION:

Dear Dr. Heller,

Thanks for offering this service on the Internet. My question might be of interest to other people, too. I am diagnosed with depression. However, I'm showing some BPD symptoms - especially dysphoria when under stress with strong feelings of anger and fear. It seems to me that those attacks are triggered at times by working long hours on the computer. Since you claim that the BPD is a form of epilepsy - and epilepsy attacks can be triggered through optical stimulation like flashing lights and fast cut-overs in TV films - I'm wondering if spending long hours in front of a computer monitor might have a similar affect? (I am currently taking 60 mg Prozac and 600 mg valproic acid.)

Thanks again for your time.

DR. HELLER'S ANSWER:

Absolutely. I have a few BPD patients who have their dysphoria triggered by light stimulation or visual stimuli in front of their eyes. The odds of this happening to someone without the BPD is highly remote.

Another possibility is simple fatigue from long hours at the computer. Fatigue causes irritability, which often leads to dysphoria.

I have had much greater success with Tegretol than with Depakene (valproic acid).  Dr. Heller's Dysphoria Instruction Sheet explains what I have my BPD patients do under stress. I would generally prescribe Tegretol for the phenomenon you described (combined with Prozac).

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