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Date of last update: 8/24/2017.

Forum Name: Psychiatric Topics

Question: Borderline Personality Disorder

 Conrad - Thu Nov 12, 2009 12:34 pm

Ok so after being diagnosed add/hd as a child, and then thinking I may be bi-polar,

I have done a bit of internet research and came across a test for BPD found here:
http://www.borderlinepersonalitysupport ... order.html

I answered yes to nearly every question on here.

So I guess I need to seek the help of a professional.
Should i go to a psychiatrist for a diagnosis or therapist?
Get a referral from my general physician?

What is the best course of treatment for this if in fact this is whats wrong with me?

My General MD put me on prozac 20 mg recently (2 weeks ago) and I can see some benefit from it, but not sure its right for me, as I am developing huge anxiety in the form of actually feeling it in my stomach most of the time.

I believe I have suffered from this for many years now (20+), but at least have some hope that I can be helped.
 Debbie Miller, RN - Sat Dec 19, 2009 5:31 pm

User avatar Hello,
Congratulations on your research to find help for something that is probably causing you much grief. It is not uncommon for it to take quite a while to come up with a diagnosis for BPD and it is not unusual to have been diagnosed with other disorders along the way.

Psychotherapy is the primary treatment for this disorder along with pharmacotherapy (medications) targeting symptoms. This can make it easier to deal with the problems associated with BPD. Prozac might help for this and it is possible you could have coexisting conditions besides. Sometimes it takes trial and error to find the right medication treatment for you so don't get discouraged if you need to try a couple. It can take several weeks to find the right medication because each one can take a couple weeks to show the benefit and if you need to try another, you start all over again.

I have had psychiatrists tell me that psychotherapy itself can work but if you can calm down some of the symptoms with antidepressants, the talk therapy will actually go smoother. This is a real illness and it should not be assumed that you can just convince yourself that you are well. If medication can help the process along you will have a greater chance at success.

I would suggest beginning with a mental health therapist who is familiar with BPD. They tend to kind of specialize in areas of interest, so ask to speak to the therapist by phone to inquire about this prior to your first appointment, if possible. Whether or not you need a referral depends mostly on your insurance plan. Some require that for any specialist. Some plans just have preferred providers and you need only select from that list. A psychiatrist is sometimes needed for a diagnosis but psychologists and other professionals can do this too. If medication is indicated you do need an MD (family practice or psychiatrist) to prescribe.

Two approaches to treatment are psychoanalytic/psychodynamic therapy and dialectical behavior therapy. You might check with mental health facilities in your area to see what is available. is another resource for finding help.

You can get better and you can learn to function within the restrictions of this disorder. Accepting the idea that there might be a behavioral disorder is a critical first step that you have already accomplished. There is hope and there is healing.

Best wishes.

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