I need some advice!

[Elisabeth]

I am in my early 20s and have recently started seeing a therapist to expore why I have been having signs of depression since I was a child. About two months ago I started to develop (once again...) feelings of emptiness, tons of guilt, fatigue, loss of consentration, a complete lack of interest/motivation in hobbies, and a recent weight loss of a bit more than 10 lbs. In the past I have been reluctant to get therapy because I also tend to cut myself (superficial)bruise myself and once or twice burn my arm with cigarettes. I do not want to kill myself and I think the resson I self injure is to validate my feelings of depression. Although my childhod was not perfect I have great parents, all my needs were met, and even had almost everyhthing I could want. There are plenty of people out there who have had painful lives and have reason to be miserable. I have no reason to be depressed and frankly feel self-centered and selfish that I am. I am worried that if I talk about injuring myself and how depressed I feel my therapist will either over-react and want to put me in a hospital or that she'll think I'm being ridiculous and just seeking attention. I think I would feel somewhat reassured if you could explain how you would deal with one of your patients who self-injures. I also have a second questions about medication. When do you think it is necessary to prescribe medication to people who are depressed? Thank-you for your help.

[KEV78]

Hi EVERYONE...I'm new to the forum.  Ive got tons on my mind and many questions to ask.  Seems as if my probs started one day when i used cocaine.  Just that morning I suddenly freaked out and was afradi my heart was going to explode cause of how it was beating etc.  Had used the stuff for two months on weekedns with no probs.  EMT's told me everything seemed fine and that it was prolly a panic attack.  But deep inside i thought for sure i may have screwed up my heart or something.  Few weeks later i tried it again and a few times after that and each time i freaked out swore I was gonna die.  Anyhow i stayed clean and didnt mess with the stuff anymore. However then i starteed to get thesee weird episodes like I had trouble breathing like a smothering feeling and concentrated alot on my breathing cause thought if i didnt i would stop also a slight abnormal feeling or i guess sense of sight was weird or seomthing not sure how to explain it.  Suddenly one day i had a panic attack i guess again and that was the end of that afterwards i think i fell into depression.  Then started to get these weird heart skips..alot everyday for about a month and a half all day long really scarey.  Bad thing is i was afradi i messed up my heart and now it was doing all that weird stuff.  got my heart checked out and doc said everything came back normal maybe just stress.  Ive got alot of symptoms including sleep disturbances like i wake up suddenly in a panic i guess doesnt last too long and i go right back to bed easily but very scarey.  I still worry about my health alot..just wondering if something is being overlooked etc.  get tons of muscle twitches all over my body..in the mornings when i wake up i feel shaky inside and out..i also kinda feel off balance like i feel like i sway alot when standing straight up or light my head or body rocks back and forth when i am at rest kinda goes along with my heavy pulse rate.  I am taking paxil 37.5mg CR.  I am alot better than I was but still have tons of doubts.  Can somebody help me with my questions or have any responses..please email me at ***@****  THANKS SO MUCH!!!!!!!

P.S.  also a little more depth about my history..previous to this all the only thing I can think of that has some importance is i ised to take alot of Ephedra dieting pills also drank lots of coffe and smoke cigarettes...and did have a bit of a stressfull realtionship too...dont know i was thinking maybe all that had to do with it too...who knows?

[STARLA GRRRL]

I also just wanted to quickly mention that it could be that there is nothing seriously wrong with you. Why does everyone feel the need to have stringent labels to put on themselves, does it make things feel better? I too am guilty of doing this and I don't think it's done me much good at all.
It could be borderline...but it also could be a whole sleugh of other things that are fixable with therapy, and the like. I am not undermining you here, nor am I trying to tell you how you should be feeling. But I think it's important that you seek the help of a therapist before calling yourself "borderline" or going on meds.
I believe in you, and I have faith in you.

[STARLA GRRRL]

Could it be that a big part of your problem is the fact that you always critique yourself and cause yourself stress by continually saying to yourself "Oh, I'm being selfish" or "Oh, I'm so stupid, I have no reason to be depressed, so what is my problem?" Honey, read your post to see what I'm talking about. A lot of these things can turn into vicious cycles. First you feel down, then you berate yourself for feeling this way, and then that makes you depressed, then the combination of feeling depressed and wondering why makes you self injure. Can you see the pattern here?
I'm no doctor, but it sounds to me like you have some kind of periodical depression, and you probably have low self esteem. Does that merit medication? According to psychiatrists it might, and this is why I want you to see a THERAPIST. They are different in that medication is not their first solution, and they seem more willing to actually deal with the CAUSES of your feelings. Really, how much good is medication going to do in the long run if all it does is offer a temporary solution? You need to talk to someone about WHY you feel this way. And once you have done that, maybe then consider medication.
But if you do choose the medication route, then I urge you to RESEARCH the meds yourself. Far too many doctors fail to tell their patients the WHOLE story about these meds. I'm sorry if I sound too judgeing or whatever, but this is just my experience, and the experiences of many people I have spoken to. So, if a medication is recomended, then do the research yourself. Other than that, I still think the first big step should be TALKING about yourself and your life with a professional.
I really hope everything works out for you.
God bless.

[Kelp]

Elisabeth
I can really relate to you story. I suffer from major depression and anxiety as well as some OCD type symptoms. Ther have been time too when I have injured myself and been diagnose wit BPD. It is very frustrating and often a good way for a doctor to just get rid of a patient because Bpd is so difficult treat. What I found hepfull were shot term sedatives until an anti- depressant had full affect. If your anxiety is extreme don't worry about addiction. This is a far less problem than harming yourself. A psychologist I think would also be helpful in getting to the cause of you harming yoursef. I know with me, I didn't want to do it at all but the anxiety was so strong.
all the best

Kelp

[maybehelpful]

Elisabeth,

I am soooo glad you seeked and found help!!  I just have 2 comments for you.  ALWAYS remember...

1) You (probably) have a chemical imbalance - which is a disease.  Think of it like diabetes... it's physical, it's real, it doesn't make you a "bad" person and you didn't do anything to make it happen.  (So don't feel "taboo" about telling people.)  You also need to realize there is no cure... and it will NEVER go away. But just like diabetes, you will learn to adjust your life to live with it (which is so much easier now since you know what is wrong.  It's just a chemical imbalance!  That's all!!)

2) DO NOT... DO NOT... get frustrated.  It may take some time.  There is the right "solution" for you.  Everyone is different - one size DOES NOT fit all.  You WILL find what works for you and live happily ever after.  Even if it's trying different meds, or talking to people, or just screaming in your pillow.

Good Luck!!

[Elisabeth]

Thank-you for your advice. I found out today that cutting and depression are often seen in borderline personality disorder. Is there a set critereia for this? How can a personality type be considered an illness?  -Elisabeth

[lucylucy]

Hi there,

I was really touched reading your letter.  I am 38 diagnosed with panic disorder.  I have not ever experienced the need to self injur, so i can't give any personal advice, but i have had depressive episodes many times in my life.  Medication definately has helped me, and i take paxil 20 mg's.

Have u tried searching the net/ psychological journals on the topic of self inury? I hear it is quite common, and I do remember seeing/hearing about people doing it at my school when i was young.  I have asked people why they do this, and they say to be rid of pain, to express pain, etc.  Perhaps its worthwhile then, talking to a therapist about your feelings, and why you are depressed and want to cut.  I suspect that self injury is symptomatic of underlying issues, and thefore treatment would be to investigate why u are injuring yourself.  

I'm sure a good and experienced counsellor should be able to help you.  If u don't like the first counsellor u see, seek another till you are happy and feel confortable with the counsellor.  

Talking through your feelings is a good idea.  Its great that you had a happy family life, but maybe there is something else bothering you... self esteem, bad experiences in the past, relationship problems, school, work, life! etc ?  Your feelings are valid.

Sometimes I wonder whether my problem has a biological basis, as I have had my problems all my life.  It is probably the case that I am oversensitive and haven't coped as well as hoped with life's challenges.  Oversensitivity is sometimes a blessing as it can make u smart and intuitive, however othertimes a curse, as the smallest things upset you in the world.  Maybe this is the same for you?  

Counselling and medication have both played their part in helping me cope better with life.

Anyway, I do hope u are feeling better soon and find a path where u will feel more comfortable, best of luck..
love, Peggy

[Roger Gould, M.D.]

I don't think a good therapist would react in either of the ways you fear. He or she would take it seriously, and try to help you understand what it means on an even deeper level than you already understand.

That's what I would do.  I would go further. Depression, and the cutting symptoms you described, are not necessarily the result of mistreatment. IN your case, you seem to see that already. But there are interior forces having to do with separation from parents that can cause depression, and in your early twenties, being more independent, and on your own, and not being sure what the future will bring,how much you deserve,how much you can do, etc.;  these are the questions to explore.

I would pursue the exploration before I considered medication.