BPDRecovery.com: Forums

Hi, just last week my boyfriend was diagnosed with BPD after nearly 4 years of suffering without both of us knowing what the problem was. We had seen different doctors and had been told it was depression, social phobia and was advised to try anti-depressants(Mirtazepine). These only help with getting to sleep at night.
I have to say that as well as BPD he also has a serious social phobia which inhibits us both from going anywhere and if anything has to be sorted out where it involves contact with other people then I have to sort it out.
The question I'm asking is what is the best medication for leveling out the mood changes that he experiences and the aggression and his unreasonable behaviour.
What upsets me and depresses me is that doctors are really reluctant to give him a mood stabilizer. It could be so simple if they would just understand the destructiveness that all this is causing.
We have split up so many times through this and I love him so much and feel relieved that he has finally been correctly diagnosed, I would just like to know from people in a similar situation as to what medication has helped them or their loved ones and if there are any good self-help books out there.
we have already read 'walking on eggshells' which was really helpful..
Thanks in advance.

Hi NIckyBilly --

The bottom line is that there are no drug treatments for BPD. Yes, we have mood swings, but the mood stabilizing drugs have minimal effectiveness. I'm not a mental-health professional, so you have to take my opinion with a grain of salt, I guess, but I've been dealing with depression/mood swings/BPD for a long time now and I've taken a LOT of different drugs. The problem, from my point of view, is that BPD is largely the result of learned, dysfunctional coping mechanisms -- perhaps co-existing with a more biological, chemically based problem -- and the fix for it is not drugs but unlearning the crap that doesn't work (the reactivity as opposed to thoughtful responsiveness, the jealousy and push/pull relationships, the black/white splitting) and relearning more effective ways of dealing with insecurity and hurt and the other situations that send us off the deep end.

Frankly, I'm all for a doctor who prescribes based on what he/she thinks is in the person's best interest, and not based just on what the patient thinks he wants or needs. If your bf is depressed, the first-line is anti-depressants. Mirtazapine is only one of dozens, and sometimes it takes several tries, sometimes different combinations or playing with dosages, to find the right one/ones for the individual. Usually only after those drugs have failed to bring some regulation are other drugs considered. And ongoing, usually fairly long-term, therapy is commonly required -- this is hard to figure out on your own, though our Tools (in the box on the left) can be quite helpful. If your bf is really committed to solve these issues -- it takes work, a lot of work -- he can do it. But nobody can expect to fill a prescription for a mood-stabiliizer and get better without the work.

BTW, "mood stabilizer" is another name for "anti-psychotic" -- and there are major side-effects. They are NOT a panacea, and should be kind of a "last resort" option.

Hi Nicky,

First, it's great to see you standing by your boyfriend through all of this and coming here to learn more about how to help him. The first line treatment is non-medicinal therapy. Some people do need a mood stablizer to reach the point where they're stable enough to learn and use the tools. Like Sari said, they come with plenty of side effects.

I should probably recuse myself from the conversation because I'm diagnosed with clinical major depression with "some" mild BPD traits and anxiety. I once was diagnosed with BPD, then it was Bipolar and now it's depression and anxiety. I too don't like leaving the house or engaging in anything social.

I've been on all the mood stablizers but what has finally worked for me is combination of Epival and Seroquel. Until the Seroquel was added just over three over three months ago, I was a serious mess. Keep in mind, I'm not diagnosed BPD.

I hope you can direct him to this forum so he can take advantage of all the support and knowledge that the Admin's and fellow BPD sufferers can give. This site carries a wealth of information and practical tools for BPD sufferers.

All my best to you, Luna

Thank you both for your kind help.
It is difficult sometimes because everyone with BPD have individual things that make them unhappy. I really think therapy is important too but my boyfriend won't go anywhere or talk to anyone so i feel he needs something to give him the feeling of being able to cope with going somewhere.
It took me weeks to get him to go to the doctor and it was really traumatic for him to go there.
We are both reading up on lots of info regarding his illness and the effects it has on others and that in itself is quite therapeutic, thanks again

I've been treated for bipolar for the past 10 years and have some significant dementia from a mood stabilizer I had been on that whole time (and I'm only 37), and the truth is, even 10 years of being on a mood stabilizer, the only time my mood was stable was when I was not in a relationship...I don't know that I was ever bipolar, but even then, I found that no amount of medication will fix sick thinking...you have to be willing to do the work and that would give any medication you may take a chance to work. I just caution on the side effects since I have experience with that. good luck
Alicia

As you've already discovered, Borderline is a tricky one to treat with medication because it's so often co-morbid (seen) with other disorders. Much of BPD thinking can be restructured with Cognitive Behavior Therapy so it can sometimes be as "simple" as stabilizing the mood swings and controlling the impulsivity that generally pre-empt the healthy thought patterns. For me, the answer has been Wellbutrin XL 300 mg, every day for the last ten years or so. I treat it like a diabetic might - the medication is a necessity to healthy living. It just has to be there or else things go to shit.