QUESTION:

I am a 26 year old female from Texas. I have had bouts of depression and anxiety throughout my teenage years and into my 20's. I have a family history of manic depressives. My father was diagnosed with manic depression when I was 13 years old. We now believe that my grandmother was also manic depressive. When I was about 15 years old my whole world seemed to fall apart. My parents divorced, my dad remarried, and my first love broke my heart. All of this happened in a matter of months.

I think I actually had a nervous break down. My mother took me to a psychologist for counseling. Within the first couple of weeks of therapy, a disturbing topic came up. Well, it was disturbing to my therapist. I have always had a fear of sleeping alone. I have never been able to pin point why I'm afraid. It started at a young age and I have never really grown out of it. Well, the psychologist said that this type of sleeping disorder was not something he was equip to deal with. He recommended me to a psychiatrist, who eventually diagnosed me with manic depression. I was put on Lithium and stayed on it for about 8 months. Things improved in my life and my parents assumed that I was cured. I had a few similar incidents during high school put nothing really serious until college.

During exams my junior year in college, devastated over a failed relationship, I called home crying and told my mom that I had to come home right that minute. I dropped everything and took a flight back to Houston. I cried the entire flight and for another 2 days. My mom sent me to a doctor to get on an anti-depressant and it seemed to work. I went back to school a couple days later and that next week I began therapy. My first day of therapy I was diagnose Borderline Personality. I had never heard of it before. I told the Doctor that I thought I was manic depressive and he so no. I was really confused. So the Doctor put me on Effexor. That really seemed to help. But then I stopped taking it.

In college I had a string of bad relationships with guys and tended to jump from one bad relationship to another. I usually already had someone lined up before I broke off the relationship that I was in. I even married a guy that I thought I was in love with. I look back now and see that I just liked that he gave me so much attention. He was a total loser, and I had the marriage annulled soon after.

I have never gone more than a few months alone. I want my boyfriends to give me there undivided attention and to always be with me. I don't even like it when they want to spend time with their friends. I have to know what my boyfriend is doing at all times or I go crazy. The thoughts that run through my head at those times of distress are unbearable. I get very anxious and feel so out of control. I am a very needy person. I want people to need me as much as I need them, but most people can't give me the attention that I need. I fall in love really easily. I really don't have to be attracted to a person, as long as they want to spend time with me I settle for that. I know it's kind of sick. I have always been short tempered and angry. I don't know why. I can not stand to be alone, and if I am alone all I can think to do is sleep (nap). I love to take naps during the day, but don't want to go to sleep at night. I know I have some major issues that need to be worked out. I am fairly aware of my downfalls and personality defects, I just don't know what to do about them. Sorry I'm so long winded, but I wanted to give some sort of background.

I'm in a great relationship right now. I actually feel pretty secure. He gives me plenty of attention and really seems to love me. I have blown up with him a few times and he did not react well. I am scared that he will see the real me though and think I am some kind of psycho. But for now I feel happy. I just know that I am not normal. I don't react the same way to things as others do. I get upset and hurt a lot more than others seem to. You may not even read this, but it actually feel good just getting it out. Please give me some advice.

QUESTION:

1. Do you think that I am borderline?2. Do manic depression and borderline personality overlap?
2. Is this a common misdiagnosis?
3. Do you have any idea why I am so afraid to sleep alone?
4. What medication would you prescribe for me?
5. Am I a product of growing up with a manic depressive father?
6. Should I tell my boyfriend ?

DR. HELLER'S ANSWER:

1. Your description is consistent with the BPD.
2. They do not overlap, although one can have both conditions. Many individuals with bipolar (f.k.a. manic depression) are incorrectly diagnosed as having bipolar because the BPD mood swings can be so impressive.
3. Yes, as mentioned in #2 above
4. I can't say for sure, but likely some anxiety disorder is present, the most common being the generalized anxiety disorder and chronic dysphoria from the BPD.
5. The medication totally depends on the diagnoses. I'm a firm believer that Prozac is the drug of choice to begin BPD treatment, and if it causes side effects it's almost always due to the generalized anxiety disorder being present in which case Buspar is an extremely effective addition. Tegretol may be necessary as well, and you'll need "as needed" medications for stressful experiences.
6. Having psychiatric problems in the family causes confusion about how to be happy and successful, can cause trauma leading to the BPD, and indicates a genetic risk for psychiatric problems.
7. Yes. If he really cares for you, and you're committed to recovery, he will likely be supportive. If he isn't he's most likely going to leave eventually anyway.

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