Diagnosed with BPD and psychotic depression

[scrabble]

I currently take 400mg of wellbutrin, 1000mg of depakote, 1mg of Risperdal and 50 mg of trazodone.  I have finally gotten relief from many symptoms because of this combination approach in medicines.  However, I have persistent and constant feelings of detachment, unreality and perceiving things in a way that I am almost sure are incorrect.  I say "almost" because part of the time I don't know if it's real or in my head.  When I look at things everything looks distorted to me, like it is lit all wrong or like I see shadows around everything I look at and I amnot sure if this is what everyone sees.  I have a very hard time conveying this feeling and what I see to the psychiatrist, so I am not certain it is being taken seriously or not.  The feelings I feel seeing eveything so distorted, sometimes the objects seem to shake, itslike I just want to getout of my body for a break from it.  I am not so depressed or out of control as I was in my teens and twenties, I'm 30 now, so I don't think suicide will become an option again, but I get these urges to do drastic things to take my mind of what everything looks like. I get very nervous and agitated, which only makes the sensation worse.  Add to this that I often hear voices arguing or calling my name and it is very noisy, weird and confusing.  The more upset and anxious I get about it, the worse these symptoms get, but they never go away, even when I amin a situation that is totally happy... My question is, what is wrong with me and is this normal and what can I do about it?

[amptech]

I have just read something on this site that has got to me. Someone has written in saying that they a distorted vision of life, seeing shadows, things seem to move. i am in a way relieved that there is someone else out there that suffers with much the same thing as me, I also have a major problem describing this feeling, and destorted vision of my world.
  I seem to experience a feeling of being seperated from my body, my head and body seem to feel somehow not in touch with each other, I have visual illusions all of the time, the only reprieve that I have from them is when I sleep, if I can sleep.
These visional illusions that I have range from seeing faces in carpets to a whole room starting to shift, the ceiling may start to appear to rotate upward, dark things, dark patterns ,shadows, become three dimensionally produced. I have a near constant feeling of floating that with all these other mind effects leave me feeling very unstable, frightend, insecure, paraniod, suicidal, and most of all, very lost and unsure in this world.
  I have taken several antidepressants and have had alsorts of therapy but nothing seems to help. The doctors here in the uk can't seem to help, and no ,atter how positive I try to be this stays with me my every waking hour.

[amptech]

I have just read something on this site that has got to me. Someone has written in saying that they a distorted vision of life, seeing shadows, things seem to move. i am in a way relieved that there is someone else out there that suffers with much the same thing as me, I also have a major problem describing this feeling, and destorted vision of my world.
  I seem to experience a feeling of being seperated from my body, my head and body seem to feel somehow not in touch with each other, I have visual illusions all of the time, the only reprieve that I have from them is when I sleep, if I can sleep.
These visional illusions that I have range from seeing faces in carpets to a whole room starting to shift, the ceiling may start to appear to rotate upward, dark things, dark patterns ,shadows, become three dimensionally produced. I have a near constant feeling of floating that with all these other mind effects leave me feeling very unstable, frightend, insecure, paraniod, suicidal, and most of all, very lost and unsure in this world.
  I have taken several antidepressants and have had alsorts of therapy but nothing seems to help. The doctors here in the uk can't seem to help, and no ,atter how positive I try to be this stays with me my every waking hour.

[kim]

I have a brother-in-law who was diagnosed with bi-polar disorder last year.  It came about rather suddenly and was complicated with voices, dissasociation and other phycotic symptoms. He is in his early thirties.  The only medication he has taken is depokote and an anti-depressant, (I can't remember the name, but it is not welbutrin).  He experiences the same things you do and this leads me to beleive that it is not your medications.  His phyciatrist said that unfortuneatly the phycotic episodes and dissasociation are part of this heart-breaking illness and that the best thing would be for him to go "in-patient" so that an aggressive, consistant trial of different medications can be conducted.  I research constantly and am hearing many promising things about the war with bi-polar illness and have heard many promising things about people coping with bi-polar once they get their meds regulated.  My bro-in-law has learned the hard way that he MUST stay on his meds and that ANYTIME he doesn't take them he WILL have phycotic edisodes. I tell him that it is just like a diabetic going off their meds and their insulin levels going crazy. I am so sorry that you are going through this, I will put you on my prayer list.

[scrabble]

Just to clarify. You said that even though this is an existing problem, the problem could possibly be exacerbated by the medications, so the answer could "possibly" be less, not more? Just to make sure I understood your response. I willbring this up at my next appt with him in 2 weeks. Thank you.

[Roger Gould, M.D.]

It is critically important that you have good communication with your psychiatrist because together you two have to make a very important decision.

The dilemma is the following; The medications you are taking may be exactly what you need, and if so, you and your doctor have to experiment with the doses to get rid of some of these side effects.

Its also possible that the medications are causing some of the problem. That is,the medications may have been necessary at one time, but are no longer as necessary at these dosages because you have continued to develop and have more experiences in life and can cope better, and therefore diminish your stress and anxiety load.

I would encourage you to bring this dilemma to your psychiatrist and together work out a medication reduction or alteration trial to find out whether you will be better  with less mediation or have more trouble with less medication.