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Dr John B
Dr John B, Psychologist
Category: Mental Health
Satisfied Customers: 557
Experience:  PhD in Clinical Psychology, registered clinical psychologist.
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Could you possibly tell me what I need to work on first I

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Could you possibly tell me what I need to work on first? I have been diagnosed with BPD with all the other things that usually go with it. Depression,PTSD,GAD,Dysthymia,and a few more that was more speculation than put on paper. I am using Celexa and it seems to work for the intense feelings. But I have another problem that has not really been addressed. I have days of feeling "normal" and physically well. Then days of mental and physical decline. These come in regular cyclesof 10 days each. I am 55 years old and this has been a problem as long as I can remember. I would love to know what it is.
Submitted: 3 years ago.
Category: Mental Health
Expert:  Dr John B replied 3 years ago.

Hi,

By BPD do you mean Borderline Personality Disorder or Bipolar Disorder? People often use BPD for both.

Customer: replied 3 years ago.
Borderline Personality Disorder
Expert:  Dr John B replied 3 years ago.

With regards XXXXX XXXXX cycling mood you have noticed, has Bipolar mood instability been considered/ruled out?

Customer: replied 3 years ago.
It has been considered. When I did a psyhc evaluation, my therapist at the time went with me. She said the test showed bi-polar but the person doing the test did not consider it to be right.(What ever that meant). THe cycles are predictable and the same thing happens during each 10 days. Meaning 10 days of this and 10 days of that and 10 days of this and that and then it starts over again. I think that is why it was ruled out.
Expert:  Dr John B replied 3 years ago.
Ok, thanks for the extra information. Well if we assume that Bipolar isn't an issue and assuming you have been cleared medically (e.g. hormone dysfunction) then in my opinion addressing any trauma or PTSD should be the main focus of therapy. People often develop a whole range of co-morbid difficulties secondary to trauma....that is they develop after the trauma has occurred. For example, we often see the development of BPD after a traumatic event. Trauma has a nasty way of driving complex anxiety problems and driving mood down. Have you ever received any specific trauma therapy?
Customer: replied 3 years ago.
No. And truthfully,therapy of any kind has not worked for me because I find it very hard to be truthful. I don't know what I am afraid of, but usually face to face,it is hard to convince anyone there is anything wrong unless they see it happening. ANd I would rather die than have someone think badly of me or think I might let someone down. Go figure.
Expert:  Dr John B replied 3 years ago.

It's actually quite common for people who suffer from BPD to have great difficulty trusting a therapist and forming a good therapeutic relationship. As the most effective treatments for BPD, and PTSD are both psychotherapeutic (not medication) finding a therapist that you can work with should be the main focus. A skilled Dialectical Behavior Therapist (DBT - the therapy that is specially designed for BPD) should be able to help you settle into therapy. DBT therapists have deal work with this problem all the time....it's their job and their responsibility to make it work for you.

Would you consider trying to locate a good DBT therapist?

Customer: replied 3 years ago.
Of course I would. If nothing else, to help me accept me the way I am. I didn't choose this, but here it is. Thank you Sir. I wish this was something I could do on line, but it is probably a good idea to deal with this differently. But as far as my meds.,I have tried to go off them, but that other personality comes back full force and I can't deal with such intense emotions. I know Celexa probably isn't what would work for most, but it has for me. So I bid you good night and thank you again for your help.
Expert:  Dr John B replied 3 years ago.

If you do wish to locate a DBT therapist then I suggest you contact the American Psychology Association (APA) for assistance with locating a Psychologist trained in DBT; take a look at the APA locator service here. You can use this to find Psychologists in your area and there is a phone number you can contact if you want a referral arranged for you. Also, take a look at an article published by the APA here. It's an interview with a senior Psychologist and covers some of the things you should consider when you looking for a Psychologist.

I hope this has been of some help, best of luck!

Dr John B, Psychologist
Category: Mental Health
Satisfied Customers: 557
Experience: PhD in Clinical Psychology, registered clinical psychologist.
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Dr John B
Dr John B
Clinical Psychologist
557 Satisfied Customers
PhD in Clinical Psychology, registered clinical psychologist.