Posted by Fivefires on June 5, 2008, at 16:06:06
In reply to Re: Borderline so no AD will help so pdoc/T give u » Fivefires, posted by Racer on June 2, 2008, at 20:42:34
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> > I was told I'm not being given an AD because it won't work because I'm borderline.
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> Hm... That's quite interesting, since many of the articles I've read say that ADs are helpful for BPD... Other medications are, too, of course, but various SSRIs are usually mentioned when discussing medications appropriate and helpful in treating some of the symptoms of BPD.
>R: Yep. Heard same. And, it almost seems like a cop out to say nothing will work so we're doing nothing.
> > They've pinned me down to borderline and I'm suffering more than ever before, and they're just chocking(can't find proper spelling in dictionary) it up to borderline!
>
> First of all, the word is "chalking," just in case you ever need it again. ;-)
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> And yes -- there's a problem, because there's a huge difference between saying, "Oh, well -- this is nothing more than BPD," and "the suffering you're experiencing is caused by BPD, so you'll work on that -- and this medication will help with your pain while you do so." Guess which one I think is more appropriate?
>R: Can't guess; cognition suffering. Bedridden a week. EMTs said if took to hosp. and I was this lucid they'd toss me out. Lost another 2lbs., now just 108. Tell me pls, what I should be able 'to guess'?
P: Don't know what splitting is? Also, did have some attempts, one just to get into hospital, others due to the black hole w/ some SSRIs (I think it was SSRIs.) when could not think clearly tomorrow another day ya' know. Hasn't been an intention of mine for a long time.
I wonder tho' if it is a subconscious intention at the way I am withering away here? Put food in, comes right out. Walk like 95-yr-old. Feels like body is 'shutting down'.
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> > I hate this and believe diagnoses like this are often way, way incorrect.
>After seeing pdocs for 10yrs or so, w/ never a mention of borderline, it was 'a caseworker' who said to me once out of the blue, 'have you ever been diagnosed borderline?'.
> They can be helpful, as a roadmap to your treatment. And they can be used punitively, as well.
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> I realize this isn't what you want to hear, but can you open yourself to the possibility that this dx is correct, and that the problem isn't with the dx, but with your current treatment team's response to it?>I suppose. Team: had one of those in other county. Here don't. Can't get out of county. Could afford pdoc on other ins. but NOT MEDS. Benzos are not even on the formulary of other ins..(?)
>I'm not saying that it fits you, only asking if you can separate the two -- if it does fit, being open to it may help you find more appropriate treatment options.>
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> > To me, it doesn't explain why I can switch from a low mood to a 'good/higher mood' when something good occurs, small or large, or when someone shows me an act of kindness or love. I told this to my T and T said still symptom of borderline.
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> Actually, she's right -- that sort of emotional reactivity is often a symptom of BPD. It can be associated with Atypical Depression, but it can also be associated very strongly with BPD.>T said BPD is same as Atypical Depression.
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> > It's clear now why I've been left to wither away w/o an AD. They won't consider anything because they are 100% sure I'm borderline!
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> Which is part of the problem -- the bottom line of this is, you are suffering. It is not humane to allow you to continue suffering in this manner.>Do feel like they're treating me like a total nobody, or an animal would receive better treatment! I'm scared to death. I wish to keep living and walking and smiling and 'being' again.
>There are options out there for you -- and even if you are borderline, this sort of attitude doesn't seem as though it would be particularly helpful for your treatment.>
When she said that, I immediately thought need new T! She had never been sort curt, shallow, uncaring, and then to say would be out of office for a while! This 'you're already sunk so you might as well give up attitute doesn't work for me'. Made me very fearful and sad.
>I can't imagine that the therapeutic alliance you've got going with either pdoc or T would be all that effective.>
Yes, if T is saying this to pdoc, pdoc might be following suit.
> > I read your weight should be taken into account when beginning Nardil? T said this is not true.
>It's in a post here on meds called Nardil Best AD Ever, something like this.
>According to RxList, weight isn't taken into account in starting Nardil.>
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> > Anyway, also read somewhere an MAOI, whether effective or not, can be an indicator of whether or not one has TRD.
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> I'm not sure what you mean by this?This was also in the above post.
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> Do you mean that response or lack of response to an MAOI would indicate whether or not your depression is treatment resistant? If so, I don't know that I'd believe that. I do respond to various ADs to one degree or another -- but I responded badly to the one MAOI I tried. If you mean that MAOIs indicate whether or not your depression is the Atypical variety, that might be backwards -- Atypical Depression often responds well to MAOIs, according to the various studies, but Atypical depression also responds to other ADs. Mileage varies.
>And the Nardil was working cognitively, but side effects intolerable; why thought 45mg a day to begin might have been too high. And, have taken other ADs in past w/ success. But, like I said, NEVER ON COMBO, except for an AD and a benzo.
> I tend to agree that combination therapy would probably be helpful for you. From what you're writing, I'm guessing that your current state is as much about anxiety as depression -- and probably also about the anxiety surrounding the treatment you're currently receiving. I don't know your situation -- can you change doctors?
Yes, but this pdoc is supposed to be best in county per casewkr who fled w/o notice. There is an older one who prob' be retiring soon and then it seems not much to pick from. I think I've mentioned spoke w/ county next to me who said, get out of that county as fast as you can.
>If so, I think that would be my first recommendation. If you can't, that's harder. If you're receiving treatment at an agency, perhaps appealing to the administration would help?>
Think have tried and been re-routing back to pdoc.
>Or, if it's a county agency, contacting the department responsible for them might help.
>Have so couple times; now being re-routed back to pdoc from them.
> If you do have to contact an administrator or county department, please let me help you. I had to do that, and learned some things about it...
Can you pls babble me. Maybe my approach wrong.
If I've not yet, can't stay online long or may miss the way too long-awaited call from pdoc. But, I know what will say, 'what do you want me to do for you?' Isn't this backwards?
Isn't this backwards?
Tks ... better sign off.
5f
poster:Fivefires
thread:832552
URL: http://www.dr-bob.org/babble/20080528/msgs/833162.html