QUESTION:

Doctor Heller-

I have been disabled with being diagnosed as a agoraphobic with severe anxiety and panic attacks. In my Drs. notes I found something disturbing. They said I had mix personality Disorder. What does this mean.. I have been like this for 20 yrs now and want to much to be "normal". I was housebound for 4 yrs due to this. Also had ECT treatments which didn`t work. I have no idea what to do at this point. I noticed you used Prozac on some patients. I took 1 tablet and all I did was think of knifes. I`m on meds. now. Zoloft, BuSpar, Clonazepam and Xanax when needed. Please give me some answers. Thank you.

DR. HELLER'S ANSWER:

What he probably meant was that you had symptoms from many of these disorders, which is common. 82% of borderlines have at least a second personality disorder. Having the OCPD (obsessive compulsive personality disorder) is usually a plus when treating the BPD. I believe firmly in making all the diagnoses and treating them comprehensively. So far the BPD, OCPD, and schizotypal disorders are the only ones that are treatable with medications, but most of the others improve significantly when the treatable disorders are also managed. In my experience, the borderlines who worsen on Prozac always have the generalized anxiety disorder. Once BuSpar has been in the system at a therapeutic dose (usually 15mg twice daily), that individual can take Prozac without seeing a worsening of symptoms. Sequencing of medications is often as important as the actual medications.

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