QUESTION:

Dear Dr. Heller,

I've taken Paxil, Klonopin, Ativan, Zoloft, Prozac, Imipramine, Valium, Wellbutrin, BuSpar, Risperdal, Xanax, Lithium, Serzone, Trazodone - all in different combinations and dosages - more than I can remember. Despite the fact that I have a higher than average I.Q., am a brilliant artist and writer, I cannot seem to make my life work. I am in the process of filing for SSI disability. If I am lucky I may receive a fourth of what I was making at the factory across the street doing manual labor as a college dropout.

Not a day goes by that I don't have thoughts of suicide. I've seen numerous shrinks who just repeated back to me what they had just heard me say. My last significant PHD shrink was a nice guy, but for the year I saw him did not give me a diagnosis. He just reiterated the fact that I suffered from clinical depression and anxiety disorder accompanied by panic attacks. It was only when I saw the doctor that doled out my medication who diagnosed me with BPD! What a revelation after spending close to $1000 to finally find out what was wrong with me - and not even feeling the least bit better than when I started!

I am really at my wits end and am not afraid of dying. I have had enough of this. My boyfriend takes care of me at this point, but I don't think it is fair to him. I have overdosed on heroin 3 times and attempted suicide with 50 Klonopin. I cut myself for some kind of physical evidence of my pain. I don't go out of my apartment. I hate this miserable existence. What makes it worse is that I know I am a brilliant artist but do not have the discipline to work on anything. I've been to BPD groups through the county. I've been to rich shrinks and county shrinks The hor ror of the situation is that I know it ultimately comes down to me - and I am not well! I'm in a catch 22. I've been in psychiatric wards, rehabs, and ECT has even been suggested. I guess if one doesn't remember why one was messed up then it's a success.

DR. HELLER'S ANSWER:

You haven't been on the right combination. Prozac followed by Tegretol a week later would give you dramatic relief.

There are three things necessary to successfully treat the BPD, and they are in order:

1) control all the chronic symptoms - which not only includes BPD symptoms but the other symptoms from all your medically treatable diagnoses found on my screening test.

2) having a medication plan for stress and dysphoria (anxiety, rage, depression and despair), found at: Dr. Heller's Dysphoria Instruction Sheet .

3) Retraining the brain. You'll need to change your self image and learn how to be a successful person at every area of life.

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