Hi....

[cute_1974]

Hi, obviously I'm new here...i came across this site while looking up info...I was diagnosed with depression about 8 or 9 years ago, tried many different meds, none of which helped. About 2 years ago, my doc also diagnosed me with anxiety...yesterday for the first time I saw a psychiatrist for a consultation/evaluation...I had finally asked my doc to refer me cuz i need help....after over an hour with the psychiatrist...he diagnosed me with borderline personality disorder. He also told me that he couldnt help me there at the psychiatric hospital, even on an out patient basis, that I should call CMHA (Canadian Mental Health Association) and they could try and teach me some "coping skills". I cant begin to describe how I felt when he said all of that...almost like I was just given a death sentence...

I guess I am just looking for some sort of support...I don't know what to do or think right now...I've been crying since the psychiatrist told me i had BPD...

I had applied for ODSP for my depression/anxiety, and have a hearing in August with the tribunal to plead my case...I don't know what to do... I will copy and paste this in the forums in hopes that someone may read it and be able to help/advise me....

Teressa

 

[David Baxter PhD]

Re: hi....

Hi, cute, and welcome to Psychlinks.

yesterday for the first time I saw a psychiatrist for a consultation/evaluation...I had finally asked my doc to refer me cuz i need help....after over an hour with the psychiatrist...he diagnosed me with borderline personality disorder. He also told me that he couldnt help me there at the psychiatric hospital, even on an out patient basis, that I should call CMHA (Canadian Mental Health Association) and they could try and teach me some "coping skills". I cant begin to describe how I felt when he said all of that...almost like I was just given a death sentence...

Perhaps there are some other ways of looking at this. First, assuming that the diagnosis is correct - and note that it may not be - it is certainly not a "death sentence". There are effective treatments for borderline personality disorder, some of which are described in various threads in this forum. It may be that this particular psychiatrist does not treat BPD and that the hospital does not offer treatment programs for BPD, but that doesn't mean they don't exist. Additionally, the CMHA and similar organizations often are helpful in teaching coping skills, which are important with or without medication and psychotherapy. And finally, whether or not the diagnosis of BPD is correct doesn't mean that you cannot make substantial progress in managing your depression and anxiety.

You indicate that medications have not been helpful. I would like you to add "so far" to that thought/sentence. There are new medications and new combinations of medications introduced every year, so there is always hope. Can you tell us what medications have been tried so far?

 

[cute_1974]

Re: hi....

Hi, cute, and welcome to Psychlinks.



Perhaps there are some other ways of looking at this. First, assuming that the diagnosis is correct - and note that it may not be - it is certainly not a "death sentence". There are effective treatments for borderline personality disorder, some of which are described in various threads in this forum. It may be that this particular psychiatrist does not treat BPD and that the hospital does not offer treatment programs for BPD, but that doesn't mean they don't exist. Additionally, the CMHA and similar organizations often are helpful in teaching coping skills, which are important with or without medication and psychotherapy. And finally, whether or not the diagnosis of BPD is correct doesn't mean that you cannot make substantial progress in managing your depression and anxiety.

You indicate that medications have not been helpful. I would like you to add "so far" to that thought/sentence. There are new medications and new combinations of medications introduced every year, so there is always hope. Can you tell us what medications have been tried so far?

Hi David, So far I have been on Paxil, Prozac, effexor XR, Zoloft, I cant remember all of them... just a couple of weeks ago my family doc started me on a new one Celexa (?) it too isnt helping...I have been on several different dosages for all of them. When you say that his diagnosis may not be correct...how can I go about finding out? I mean he is a psychiatrist...i thought that since he deals with mental health issues on a daily basis that he would definately know for sure...is there any kind of test to find out for sure? either blood work or whatever?

 

[David Baxter PhD]

Re: hi....

No, there are no blood tests, or none that are likely to be especially helpful. My comment about diagnosis was referring to the fact that differential diagnosis is an art rather than an exact science. The first starting place might be to request a referral to a second psychiatrist for another opinion. It might also be helpful to ask your family doctor if there is anyone in your area who specializes in psychopharmacology.

One thing that is helpful for many patients who don't respond to SSRIs is to look at a combination of medications. There are several options here: One is to add in a mood stabilizer; a second is to add in a low dose of one of the medications in the family with the scary name of "atypical antipsychotics" - at low doses, these help to boost the effects of the SSRI antidepressants; and a third option is to use something like Wellbutrin in combination with an SSRI such as Celexa.

One other question: When you say that the medications don't work, do you mean they don't help at all? Or that they help for a while and then stop working?

 

[cute_1974]

Re: hi....

No, there are no blood tests, or none that are likely to be especially helpful. My comment about diagnosis was referring to the fact that differential diagnosis is an art rather than an exact science. The first starting place might be to request a referral to a second psychiatrist for another opinion. It might also be helpful to ask your family doctor if there is anyone in your area who specializes in psychopharmacology.

One thing that is helpful for many patients who don't respond to SSRIs is to look at a combination of medications. There are several options here: One is to add in a mood stabilizer; a second is to add in a low dose of one of the medications in the family with the scary name of "atypical antipsychotics" - at low doses, these help to boost the effects of the SSRI antidepressants; and a third option is to use something like Wellbutrin in combination with an SSRI such as Celexa.

One other question: When you say that the medications don't work, do you mean they don't help at all? Or that they help for a while and then stop working?

There was one...prozac, that helped for a little bit at a high dosage, I dont remember what the dose was (it was several years ago), then it too stopped working...my doctor tried it again about 2 months ago and it didn't help at all...the side effects were too much for me to handle. At one point, my doctor had taken me totally off all medications and said that there was no point prescribing me anything since nothing was working...then when I went in for his help to apply for ODSP, he decided to put me back on the meds. I should also tell you that I don't like my doctor, i feel that he thinks I am lying about how I am feeling, like he thinks its all in my head. I went to him a few times because of pain in my back that goes into my left hip and progresses down into my left knee...he didnt even bother checking it out, just said that maybe if we can control the depression then the pain will go away as pain is usually caused by depression. I don't feel comfortable with him at all...I want a new doctor, someone who wants to help me, but no one around here is accepting new patients...I check the doctor search site almost daily.

 

[David Baxter PhD]

Re: hi....

The shortage of doctors and psychiatrists has become chronic in this country....

If you can get a referral to another psychiatrist, that might be the starting point. I do think you should contact your local office of the CMHA if you can find one - they may have information about other resources in your area and they often run support groups.