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1618236 tn?1408072214

Borderline Personality Disorder

I have written to you earlier on my Borderline Personality disorder and you wrote back but am not following you on what you said :
One formulation of borderline personality disorder is that it involves a deficit in the "self soothing" function - the ability to make oneself feel OK/safe. Hence the symptoms of heightened sensitivity, anxiety, and irritability. The most effective treatments focus on teaching people how ways of making up for this deficit - hence the focus in dialectical behavior therapy on "distress tolerance" skills.
Can you explain this in more detail---?
I have been having problems with communicating with others, uncomfortable when people touch me, highly-sensitive to criticism and rejection with extreme anxiety along with angry outbursts with my family having these symptoms continously everyday.  I do see a psychologist weekly and he does Cognitive Behavior Therapy but am unclear on the dialectical behavior therapy that you talked about, what is the difference?  In the last 4 years, I have broken down on 3 jobs where I cry uncontrollably and severe anxiety and could not handle the pressure of working as a medical biller.  Currently, I did find a part-time job entering demos for a medical billing co. PHONES are the thing that I feel very uncomfortable doing, dealing with public brings on my severe anxiety and phobias, and am anti-social in the office.  I currently take Doxepin 100 mg and Trazodone 100 mg for depression and anxiety at bedtime.
  In the past I was on benzies but it did not really help so that is why my dr put me on these other meds.  Can you please tell me if these meds will help me and give me more details on my Borderline Personality.  Thank-you.
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1308134 tn?1295187619
MEDICAL PROFESSIONAL
Dear Connie,

Let me try to answer at least some of your questions.

Not sure that I know what your questions are about my earlier post. What I was saying was that borderline personality disorder (BPD) is felt by some people to be an expression of the fact that your brain doesn't have as much of an ability to make you feel OK and/or safe when you are facing a difficult or challenging situation as other people's brains. In other words, faced with the same kind of challenge (especially a situation where there is tension in a relationship) you will feel much more upset than someone without BPD.

So, the focus of DBT is on teaching you ways of dealing with those situations so that you don't feel overwhelmed or desperate and do something that is ultimately destructive to your relationships.

The difference between DBT and CBT is that DBT is a therapy that is specifically designed to help you with the symptoms of BPD. CBT is a general term for a kind of therapy that helps people with problems with depression and anxiety by focusing on thoughts and behaviors.

Doxepin is a tricyclic antidepressant. Trazodone is a pretty sedating medication which at a higher dose can be used as an antidepressant and at the dose that you are taking is mostly used to help people get to sleep.

There isn't any particular medication that is specific for BPD so I could not say without having done an in person assessment whether these medications are going to help you or not. Medication treatment for BPD is mostly based on the specific symptoms that are most distressing to that particular person. Benzodiazepines generally don't help, as you have noted. Antidepressants may be helpful for some people. Mood stabilizers and atypical antipsychotics may also be helpful to some people. Again it depends on the specific symptoms that are being treated.
Helpful - 1
Avatar universal
dear connie i also suffer with BPD along with depression.. it has taken me awhile to find the correct meds. its a difficult process but the easiest way that i felt comfortable was when i felt like the meds wasnt working i would check myself in to the psych ward. not the smartest finacially but it works. im on three different meds one for depression one for anxiety and an anti-psychotic.as for therapy i to need DBT. i havent started yet due to trust issues but soon will be. hope this helps you some.... take care and dont be afraid!
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