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Kate McCoy, M.Ed, NBCC, LPC
Kate McCoy, M.Ed, NBCC, LPC, Therapist
Category: Mental Health
Satisfied Customers: 5402
Experience:  Over 20 years experience specializing in anxiety, depression, drug and alcohol, and relationship issues.
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"Kate" you kindly answered a question about bipolar and borderline

Customer Question

"Kate" you kindly answered a question about bipolar and borderline for me yesterday.

Having re-read your answers I see that you have stated that self harm usually is indicative of borderline as opposed to bipolar. The other reason that they seem to think it's borderline seems to be around my childhood experiences, as they say that a large percentage of people with borderline were abused as children. Is this true?

Sorry, I keep asking more questions!

I have looked at both links you sent me yesterday and I feel I fit more into the bipolar description. One doctor at the end of last year suggested Lithium, but then I saw a different doctor the next time who said he didn't think that was necessary! I have been on the Olanzapine for 12 months now ... they tried reducing the dosage but I hit another hyper phase.

Are the Olanzapine and the Lithium similar (do they do the same job), because another doctor told me that Olanzapine was better?

One final question (sorry, this must be about the 6th final question I've asked you!) ... they want me to join group psychotherapy. I am petrified of this as I naturally clam up if I have to speak in front of others. I have had 1:1 therapy before and I find that hard enough, but wondered what the benefits of group work is? They seem to be ignoring my concerns and just say that they think I would benefit from this.

Sue
Submitted: 2 years ago.
Category: Mental Health
Expert:  Kate McCoy, M.Ed, NBCC, LPC replied 2 years ago.

Sue,

I am glad to answer your questions anytime. I want to be here for you and if I can help in anyway, I am happy to do so. So ask away!

There have been studies done that indicate that up to 76 percent of people with Borderline disorder have a history of abuse. The most common type of abuse associated with Borderline in adulthood is emotional abuse and neglect. This makes sense because the nature of Borderline disorder deals with the way a person relates to others and the battle between attachment to others and fear of abandonment. This is very close to what someone would experience as a child who is neglected emotionally and did not have their bonding needs met.

Olanzapine and Lithium were part of a study published in the American Journal of Psychiatry in 2005. The study was done to see which medication was more effective in treating Bipolar disorder. The results showed that Olanzapine was more effective in helping to prevent manic and mixed episodes. It was noted that Lithium was known for helping to prevent mania, but the study showed that Olanzapine ended up to be more effective. Finding the right medication is a bit more complicated than that though. Since each person's body chemistry is different, one medication may work great for someone, but cause another person to feel worse. So if Olanzapine is working for you, then it is the better medication. But if you have side effects and do not feel better, Lithium would be the better choice.

If you feel that group therapy is not a good choice for you, then do not go. You need to feel some level of comfort when you seek help. If individual therapy is already stressful and difficult, then group therapy is going to be worse. You may want to consider it later after you work in individual for a while. It could provide extra support and an opportunity to feel less alone, but it may not be for you right now. As an alternative, you may want to consider on line groups. They give you a certain amount of anonymity and at the same time provide support. There are links to support groups on the Helpguide link I gave you last time. If you need help finding more support groups on line, I am happy to help you.

Let me know if you have more questions,

Kate

Customer: replied 2 years ago.

Ok, thanks.

 

One of the main symptoms of Borderline does seem to be the fear of abandonment and also the inability to maintain relationships.

 

The psychotherapist I saw for the assessment asked if that was a problem for me and I said I didn't think so, as I have been with my husband for 22 years, 19 of which we have been married for. I have a few friends but they are all good friends that I have had for a minimum of about 10 years and I am still friends with a girl I started school with some 40+ years ago.

 

I did have a fear of being discharged from the mental health team when they mentioned it at the beginning of this year, but I think that was more about knowing that I wasn't feeling well. I have had no problems when I have been discharged from them before and I left a therapist after several years with no problems either.

 

I don't know if the Olanzapine is working as it should or not. I am better on this dosage than I was on the lower dosage. Should it completely stop the mood swings from high to low. The psychiatrist I saw back in May also thought it was more likely to be Borderline because I don't feel as though I have any 'normal' periods between the highs and the lows; I always seem to be one or the other, but the depression lasts longer.

 

Is it normal though to have a mix of the high and the low, as this is how I've felt for the last couple of weeks. I have had the unending energy, with thoughts buzzing through my head at 100mph, but my mood has crashed and I am well and truly in a depression. It's not one thing or another! I have had this before, but probably only once in the last 12 months.

 

Am I going mad, because that's how I feel at times?

 

Sue

 

 

Expert:  Kate McCoy, M.Ed, NBCC, LPC replied 2 years ago.

Sue,

 

I think you fear of being discharged from the mental health team is a normal fear that many people experience when they end therapy. Most people are hesitant to sever that connection since it is a huge support in their lives. Even if you had no trouble before, each time is different. And if you weren't feeling well, then you still needed the support they were discharging you from. So you were reacting normally.

 

The Olanzapine may help stop the mood swings but if it does not, you can ask for another mood stablilzer medication such as Abilify. At a low dose, it could supplement the Olanzapine and help stabilize your moods. Or you could increase the dosage of the Olanzapine, though in the UK and some other countries, 20 mg. is the maximum dose they may allow. Check with your doctor about the limits.

 

From your description of your moods, it sounds like you have the mixed form of Bipolar or the rapid cycling type. This is where you experience both moods, high and low, at the same time. It does not mean you are not going mad. It may feel like it, but you are not. Feeling that you cannot control your own emotions is scary and it can make you feel crazy. I have worked with many people with Bipolar and they were not crazy no matter how bad their symptoms got. Once you are diagnosed correctly and can get the right balance of medication and treatment, this feeling should go away. You just need answers right now to help you find the right path.

 

I found a link that describes Bipolar Mixed Type. See if it fits what you feel and let me know: http://www.webmd.com/bipolar-disorder/guide/mixed-bipolar-disorder.


Kate

Customer: replied 2 years ago.

Okay Kate, I have looked at that. I felt a huge sense of relief when I read that, so thank you.

 

I certainly have the irritability, racing thought, anxiety and agitation, together with the low mood, guilt, worthlessness and suicidal thoughts. I don't have the low energy as this still seems to be higher than I can cope with.

 

Something I did read there that caught my eye was the fact that I am at higher risk if I have a family member with Bipolar. Have I read this right? My mum was never diagnosed with it but I have my suspicions (she was a generation that coped whatever the problem). She used to have severe depression at times but then at other times she would have days/weeks which she spent 12-14 hours a day working in her garden! The immense swing in her moods was really hard to live with.

 

Reading all of this felt like someone was writing a desciption of me!

 

I really don't want to feel like this anymore ...

 

Sue

Customer: replied 2 years ago.
I meant to say that the maximum dose of Olanzapine is 20mg here!
Expert:  Kate McCoy, M.Ed, NBCC, LPC replied 2 years ago.

Sue,

 

The occurrence of family related Bipolar with one parent affected is up to 30%. If both parents have it, it goes up to 70%. But because Bipolar is a brain chemistry based disorder and therefore genetic, it is possible your mother did have Bipolar as well and it affected you. It certainly sounds like she might have had it.

 

I am glad you found the information helpful. If you feel that Bipolar, mixed is what you may have, you will be able to focus in on the right treatment. It is so discouraging when you don't know what is wrong.

 

Kate

Kate McCoy, M.Ed, NBCC, LPC, Therapist
Category: Mental Health
Satisfied Customers: 5402
Experience: Over 20 years experience specializing in anxiety, depression, drug and alcohol, and relationship issues.
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