Why Is Nothing Working?

[fuzzyfelt]

I have suffered with depression for the longest time, diagnosed with bpd 8 years ago and depression 2 years before that. Been on antidep's, sleepers, antipsych's, am I simply not going to get out of the depression and what is left of me after you take away the symptoms of bpd and depression? Who am I then? Any1 got ideas on what may help? Used Citalopram upto max dose, Melleril on ward and then chlorpromazine for about 6 months after that I took myself off them and changed addresses roughly every 6 months after that so that I wouldn't be prescribed again. Been on Venlafaxine and that didn't work, Lustral ditto, Duloxetine is current prescrip and keep getting really bad can't get out of bed days, so doc gave me 10 mg of Diazepam to take daily and then because I had to re apply every 5 days for a new script he took me off because I wasn't talking to him. Mainly because he had just hit my back to tell if I had sciatica or not? Gave me the Diaz for about 3 weeks and I felt mood lifted although not completely mood stable (bpd I guess) I feel a bit lost now and the urges to harm are back in force and unfightable and I don't know what to do. Please help me, my mask is coming off and I don't want to go to prison for knocking my dox face in because the anger is horrendous at the moment. My sleeping is next to none, I'm getting forgetful, word confusing, can't focus on anything without trying to do other jobs at same time. HELP PLEASE

[Vorpalblade]

meds play only a small part in our recovery. attitude, strength of character, determination all play larger parts.

[Lily-Bee]

I agree with Vorp, meds are not like magic unfortunatly, they can help but it sounds like you need more.

Do you have therapy to learn other copingskills? have you ever considered or asked about CBT or DBT those are both therapies that can really help people with BPD.

Maybe you need to speak to your doc about this.

Its hard work therapy but it goes step by step and its worth it, it has done me a lot of good.

Lilly

[Xanthrax]

Benzos can make it harder to control our emotions, a bit like alcohol can, so maybe be careful about that? Benzos are wonderfully calming at times, but other times they can make you blow your top. I've had many 'incidents' while under the influence, a few involving psychiatrists.

I think low-dose risperidone has shown good results in BPD. There's a psychiatrist in the US, I forget his name, but he has a treatment protocol for BPD that is based on a combination of carbamazepine (mood stabilizer) and Prozac. Docs are probably most likely to feel comfortable with prescribing a low dose of a sedating antipsychotic like Seroquel rather than typical sleepers for insomnia in someone with BPD due to 'abuse issues'. Borderlines are notoriously resistant to conventional meds though, so they're useful mostly to control 'excessive' symptoms that might interfere with therapy, rather than a solution in themselves.

[fuzzyfelt]

Yes you are right, because I have moved sooooo many times I've never had the opportunity to follow up on CBT (the waiting list in Mancs was a year) but I will get my friend to prod the GP because so far at the local mental health services (still waiting for someone to give me an appt they keep saying I'm ok) thanks for taking the time out to respond

[fuzzyfelt]

Thanks lilly, you are right I do need some additional support, that's the hard bit, I am ready and willing but as I said to Bladey, my moving hasn't helped. I can't afford private care I don't think but any ideas on this would be good, because the way I am going I'm not gonna be around for too long

[fuzzyfelt]

Thanks Xanthrax (beautiful picture by the way), what are benzo's? Should I ask to change meds then or are these meds dealing only with the depression?

[stinkyboy]

I have suffered with depression for the longest time, diagnosed with bpd 8 years ago and depression 2 years before that. Been on antidep's, sleepers, antipsych's, am I simply not going to get out of the depression and what is left of me after you take away the symptoms of bpd and depression? Who am I then? Any1 got ideas on what may help? Used Citalopram upto max dose, Melleril on ward and then chlorpromazine for about 6 months after that I took myself off them and changed addresses roughly every 6 months after that so that I wouldn't be prescribed again. Been on Venlafaxine and that didn't work, Lustral ditto, Duloxetine is current prescrip and keep getting really bad can't get out of bed days, so doc gave me 10 mg of Diazepam to take daily and then because I had to re apply every 5 days for a new script he took me off because I wasn't talking to him. Mainly because he had just hit my back to tell if I had sciatica or not? Gave me the Diaz for about 3 weeks and I felt mood lifted although not completely mood stable (bpd I guess) I feel a bit lost now and the urges to harm are back in force and unfightable and I don't know what to do. Please help me, my mask is coming off and I don't want to go to prison for knocking my dox face in because the anger is horrendous at the moment. My sleeping is next to none, I'm getting forgetful, word confusing, can't focus on anything without trying to do other jobs at same time. HELP PLEASE

Man, i really feel for ya. I thought i had it bad until i read your post. I guess i'm blessed cause i've always been high functioning, never locked, no suicide attempts etc. I do understand however the hell your experiencing on one level at least. The horrible depression won't go away either and i've pretty much been on all the meds too. Probably not all the ones you have taken though. I know just saying hang in at this point would be an insult so i won't say it. But what i will say is that i will pray for you. Don't know where your at in that regard and i don't want to offend, but i know the power of prayer has worked in my life. I used to be so much worse than i am now and there can be no other explanation, so please don't give up. steve

[Xanthrax]

Thanks Xanthrax (beautiful picture by the way), what are benzo's? Should I ask to change meds then or are these meds dealing only with the depression?

Hi, thanks Fuzzy. 'Benzos' is just an abbreviation of 'benzodiazepines', the class of drug that diazepam (Valium) belongs to. If your current medication regimen isn't working then obviously you need to discuss it with your doctor, and not all of them take kindly to requests from patients.... but if you have a good relationship with him/her, then would you feel comfortable taking printouts of a few studies along with you to support your case? I've just searched the PubMed archives and some of the data on carbamazepine is conflicting, but there is evidence showing that it can be beneficial in BPD. Parnate (tranylcypromine) is one of the most effective antidepressants in BPD, but it can be very difficult to get a doctor to prescribe it, especially if you have a history of O/D. My doctor once told me that treatment with MAOIs must be initiated only under the supervision of a psychiatrist in the UK, so that could be another sticking point. This is a very old study, just after Prozac first came the market in fact. It would be interesting to see a comparison of Prozac and Parnate, but I guess it would be easier to try the carbamazepine/Prozac combo first?.

1: Arch Gen Psychiatry. 1988 Feb;45(2):111-9.Links

Pharmacotherapy of borderline personality disorder. Alprazolam, carbamazepine, trifluoperazine, and tranylcypromine.

Cowdry RW, Gardner DL.

Intramural Research Program, National Institute of Mental Health, Bethesda, MD 20892.

Sixteen female outpatients with borderline personality disorder and prominent behavioral dyscontrol, but without a current episode of major depression, were studied in a double-blind, crossover trial of placebo and the following four active medications: alprazolam (average dose, 4.7 mg/d); carbamazepine (average dose, 820 mg/d); trifluoperazine hydrochloride (average dose, 7.8 mg/d); and tranylcypromine sulfate (average dose, 40 mg/d). Each trial was designed to last six weeks. Tranylcypromine and carbamazepine trials had the highest completion rates. Physicians rated patients as significantly improved relative to placebo while receiving tranylcypromine and carbamazepine. Patients rated themselves as significantly improved relative to placebo only while receiving tranylcypromine. Patients who tolerated a full trial of trifluoperazine showed improvement, those receiving carbamazepine demonstrated a marked decrease in the severity of behavioral dyscontrol, and those receiving alprazolam had an increase in the severity of the episodes of serious dyscontrol. As an adjunct to psychotherapy, pharmacotherapy can produce modest but clinically important improvement in the mood and behavior of patients with borderline personality disorder. As a research tool, patterns of pharmacological response may provide clues to biological mechanisms underlying dysphoria and behavioral dyscontrol.

PMID: 3276280 [PubMed - indexed for MEDLINE]-------------------------------------------------------------

Carbamazepine is an anticonvulsant and has mood-stabilizing properties, and it can reduce anger and aggressive outbursts too. It usually needs to be combined with an antidepressant, such as Prozac or Parnate, because there are reports of people developing 'melancholia' during long-term treatment. The antidepressant/s seem to work in synergy with carbamazepine to reduce mood swings and aggression.

[fuzzyfelt]

dear Stinkyboy

Thanks for your response but don't belittle your condition it doesn't need comparing to any1's each one of us is here because we feel we need the help. I'm not trying to lecture you but don't think you don't have it bad, cos I don't live in your life and vv. I believe that god exists in your heart, and as this is a very touchy subject here I won't go into further detail but thank you for your kind thoughts and prayers.

[fuzzyfelt]

Thanks Xanthrax, been looking after what you all said previously, and have found some lit to take into my dox (he's the one I wanted to thump last time because he thumped me in the back to see if I have sciatica!?) Unfortunately have had OD trouble but have some1 bring my meds daily (bestest friend) so maybe that might work? Have had trouble with stomach ulcer though so I dont know if the MAOI's are compatible with the Lanzopramole (excuse spelling). Reading some tests on Resp (not even going there) sounds like it might work but I'll take in the meds studies and let punch face decide? Take care and thanks again

[Xanthrax]

Yeah, I think letting the doc decide is a good idea. The Parnate is a long shot, but definitely worth trying for just in case. Yup, lansoprazole can be taken with MAOIs - just had a course of it myself back in July due to an ibuprofen-induced ulcer! I'm just wondering what literature you found on those meds, because I've found a lot of doctors are hostile to non-doctor-based webpages. Results from clinical studies in the PubMed archives tend to be more persuasive. I'm not telling you what to do, just a bit of advice gleaned from years of bitter experience in getting the meds I need from doctors.

This is a link to the PubMed archives, just in case you haven't seen it and would like to do a bit of research yourself: http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed

[fuzzyfelt]

Thanks again Xanthrax, will be looking there to see what I can add to my growing educational support item (lol) for the doctor. Talk soon, and hope you are feeling stable at the moment. Fuzzyfelt xxx