Borderline Personality Disorder? Depression?

[Searching for relief.]

I am in my mid 20's and I have been treated for major depression for about 4 years. I have been through many drugs that eventually stop working and recently was admitted to the hospital. While in the hospital I received ECT and although I feel better than I did prior to my hospitalization, I know that there is room for improvement. I am often scared at the first feeling of saddness thinking that once again it will lead to another bout of depression. I don't always know if I will be strong enough to survive the next time around. Now, it was suggested that I may have Borderline Personality Disorder. How would I determine the difference? Would fit best into a depressive category or into the BPD category?  Would labeling it as Depression or BPD have any major consequential effect on my treatment or drug prescription? (I am currently taking Prozac.)

Background info: depressed since early teens, suicidal throughout the years, accused of having paranoid thoughts, problems with maintaining an appropriate weight, and abuse of alcohol. Thank you for your time.

[HFHS.MD-AJ]

I can understand your frustration about suffering from chronic depression, as well as your concerns of uncertainty about your diagnosis. Depression and Borderline Personality Disorder (BPD) have some similarities, as well as differences. It is not uncommon for both disorders to go hand in hand. These disorders have been discussed on numerous occasions in our forum, and you may find it helpful to search through our archives for more information. I am glad that you felt better after your recent treatment with ECT. It is not uncommon for depression to respond better to antidepressant medications and psychotherapy after ECT. Alcohol abuse is often co-morbid with depression and BPD. It is important to address issues of alcohol abuse with your treating clinicians, whom I will urge you to discuss your concerns further with.

[PamD]

Are you seeing a therapist regularly to help you cope with the persistent, recurring depression and your fear of it?  I have found that has significantly helped me face life.

My therapist said that depression is like the well-traveled path in my life.  It is clear and familiar, and I tend to travel toward it first, like on automatic pilot.  Creating the pathway toward peace and happiness will take practice and conscious effort.  It is not as comfortable for me as the depressive pathway, and I am in the process of clearing it.

It's hard work at times, but seeing a therapist has really helped me deal with the **** that life throws at us and learn that depression, though it's usually my first response, is not necessarily the accurate one.

In addition, my therapist (a PhD in Psychology) and my psychiatrist (an MD in Psychiatry) consult one another regarding my medications and treatment, which helps ensure consistent care.

I'm sorry you are having such a hard time.  I hope that you can find some relief.

[chris r]

who has suggested BPD and what was their reasoning? you dont seem too upset with the fact this possibility was raised, or am i wrong? the reason i mention this is that it is EXTREMELY rare for someone who DOES have a character problem to entertain the idea, let alone at the onset and without therapy.  thats the nature of the beast! everyone exhibits varying degrees of traits that could be considered "pathological" if these were/are very florid and problematic to the functioning of the individual.  these traits often tend to become exacerbated during times of stress and may appear more florid (theyre inherently defensive in nature).  generally, medication is not used to directly treat personality disorders. if medication is used, it is employed to treat various symptoms/behaviors associated with or arising out of the impact of the PD on the individuals functioning/mood/etc.  people with BPD do often become depressed, not directly because  the disorder causes depression, but rather because of the havoc this style of functioning has on interpersonal relationships. it is a very good idea to discuss your concerns with a therapist, not only to alieviate your depression, but also to address any parts of your self you feel may be contributing to your difficulties.