Please respond! So confused! Physical and Mental, PTSD,BPD,Bulumia etc

[Susan__0__0]

  I have so many problems, and questions, I truly hope somebody will give me some answers.  I am a 41 year old female.  I have been treated for 9 years for Severe depression, PTSD, Bulumia and BPD.  In the last few years I have had elevated liver enzymes.  I may have Autoimmune hepatitis or NASH.  Nobody is truly sure.  I have had a serious suicide attempt 3 years ago.  I overdosed on 1month supply of Depakote and high 1mos of Xanax-at 8mg per day.  Had some serious problems-open wounds for laying so long before found.  Severe infection, venilator etc.  Now for all the questions.  Now that I have tested positive for some Autoimmune diseases-mainly positive ANA, could autoimmune disease also cause severe depression.  My psychiatrist thinks the liver disease could be-since I have been real resistant to anti-depressants-just don't work well.  I have had a liver biopsy which shows fibrosis/cirrhosis.  Could the depakote caused my liver problems-when I was hospitalized they said I had no liver damage-I'm so confused.  I saw a hepatologist at IU and because of my mental health history I was treated very poorly.  I am a nurse-worked for 20 years off and on with depression and then just couldn't maintain anymore.  I'm currently on SSDI-did not have to appeal-I was that severe.  With my health problems I am finding it difficult to find a doctor that will listen to all the problems without judging me.  Could you also provide a referral to a doctor-for liver diseases that would treat me like a real person.  I live in Indiana and would be willing to travel to OH,MI.  I'm divorced with 2 children and want to live to finish raising them.  The hepatologist said eventually my liver would fail-transplant probably slim because of psych history.  I haven't been hospitalized for 3 years now-he said that was good.  He said I needed to improve my psychosocial status before I would get a liver transplant. Thanks for listening.  I would appreciate any information.

[HFHS.MD-AJ]

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Susan,
It is obvious that you are struggling with many medical and psychiatric problems. However I sense that you are determined to get through all this.
Some of your questions can be best addressed with the help of your primary care physician and hepatologist. Autoimmune and liver disorders are rare causes of depression, and you describe a history of depression predating the onset of your recent medical problems.
Depakote can cause persistently elevated liver enzymes, but this effect is usually asymptomatic, and resolves after discontinuation of the medication. Depakote-related hepatotoxicity is rare, and is usually seen in people younger than 10 years. This would suggest that your liver disease is unlikely to be due to Depakote.
A good psychiatrist will not minimize your psychiatric and medical concerns, but wil want to give you all the help at his or her disposal. It seems important for you to have a psychiatrist whom you will feel comfortable working with. It may be helpful to consider some form of psychotherapy in addition to medications for treating your depression.
This response is for general information only. Always contact your physician for any health concerns. Henry Ford Behavioral Services is available for consultation at [phone]. You may also check the Henry Ford Liver Disease Forum at www.medhelp.org/perl6/gastro/index.htm ;  for further information, or call [phone], for referral to a Henry Ford Hospital hepatologist.
keyword: autoimmune, Depakote, depression, liver disease