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Doctor Rao
Doctor Rao, Doctor
Category: Mental Health
Satisfied Customers: 641
Experience:  MBBS,MD,DPM,MRCPsych
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I am in recovery ( BPD) However in the last few weeks I have

Customer Question

I am in recovery ( BPD) However in the last few weeks I have noticed that some of my bad habits are returning, like bingeing, impulse buying, thoughts of self harm, smoking more, dreaming of self harming and not wanting to get on with things. I don't have anyone to talk to about this. I find it difficult to talk to my husband about these things. I am wondering weather I should contact the mental health team? I don't want to make a fuss and waste their time!
Submitted: 2 years ago.
Category: Mental Health
Expert:  Ryan LCSW replied 2 years ago.
Thanks for your question. My name is XXXXX XXXXX I'd like to help you out.

It's good to hear that you have been in recovery but I can certainly understand your concern over the bad habits returning. Considering the fact that you don't have anyone else to talk to about this, it would probably be a good idea to contact the mental health team. I know that you don't want to make a fuss or waste their time, and I completely respect that. However, the reason in contacting them now, is because if you are able to get some help, it may prevent a larger problem from happening, and in that way you may be helping the mental health team in the long run by taking some preventative measures now. It's not uncommon for someone in recovery to have difficulties and even relapse which I am sure they are aware of. If you are able to get a handle on it before it gets worse by calling the mental health team, that seems to be a good way to be proactive about your own recovery.

I'm sorry to hear that you've been having a hard time but I hope that I was able to answer your question. If there's anything else I can do to help just let me know.

Ryan
Expert:  Doctor Rao replied 2 years ago.
Hi,I would like to answer the question in two parts. First part I would like to elaborate some of the symptoms you mentioned and their significance In the second part would comment briefly about my suggested plan of action.I am pleased to read that you are able to identify early some of the warning signs of relapse. As with most of the mental health problems BPD also runs in relapsing and remitting course.The symptoms you mentioned..Binging, it is not an uncommon symptom with BPD as it is somewhat about the control over food. We do know that eating disorder symptoms are co morbidly associated with BPD and their recurrence can be interpreted as the relapse of the illness. It is important to address this problem as sometimes the pattern can deteriorate and moves to restriction of food intake thinking which would effect your physical health in general if left unaddressed. Next symptom , Impulse buying, again a symptom of poor impulse control and relapse of the illness. However, one more important thing is we usually recommend after any burst of excessive spending to be seen by a mental health professional to rule out any co occurrence of major mood disorder.If left unaddressed again this could effect you negatively in the long term in the form of accumulated debts.Thoughts of self harm and dreaming of self harm can be very worrying and difficult to manage by yourself.It is important to seek help to address these issues. So, it is important for you to seek help. By contacting the CMHT they would appreciate your willingness to seek help and identify early warning signs of relapse. Sometimes the medications need to be looked in to, although I mus agree medications are not the first line in the treatment. Your community mental health team might choose to refer you to Crisis resolution and Home treatment team which can provide short term Intensive support at home.This might be helpful especially if you are struggling to communicate these feeling with your husband.Moreover it is important not to put all these as a relapse of the BPD because you have past history. It might be helpful to have contact with Mental health professionals. Please discuss this either with your GP or Your mental health team. All the mental health teams do have a duty worker between 9 to 5.So, you can ask to speak to the duty worker.Due to the bank holiday weekend, if you are struggling to cope it might be helpful to contact OOH GP service.so, that you would be referred to home treatment team by them if they feel necessary/appropriate.I hope you find this answer helpful. I have to say you have been very good in identifying the early symptoms.I wish you all the best. If you find the answer useful ,please leave a positive feedback. Thank you
Customer: replied 2 years ago.
Thank you for your answer, I found it reassuring that I am on the right track and reaffirmed that I need to take action. I have had CBT and CAT therapies in the past and found them useful. I now feel I need someone to talk to help me understand what is happening and how best to put in place all the tools I have learnt and know. I have been wondering if another approach therapeutically would be of use right now. I have done all the past stuff and understand how I became to have BPD or as my psychiatrist has diagnosed it Emotionaly Unstable Personality Disorder sub type Borderline, with recurring Depressive episodes. I feel confused and getting conflicting messages from my mind as to how I am feeling. Things are quite good in my life and I am more confident and able to take on challenges. I do feel that by having these destructive thoughts and feelings I am failing. I am taking my medication on time every day and don't run out. What is going on? I don't have a reason for being like this. I seem to have rambled on a bit, thank you for listening.
Expert:  Doctor Rao replied 2 years ago.
Hi, Thank you for the response.
I want you to know that sometimes interpersonal reasons can effect how the person feels especially when the person has history of BPD. Having said that I have also seen some of my patients have experienced a mild set back with out obvious triggers.

So, I want you to continue believe in your self and seek help as we discussed in my previous answer. I am pleased to hear that you have received CBT and CAT therapies in the past and able to use some of the techniques learnt.
If you want to consider other options there is some evidence that Art therapies do offer some practical help. Another important thing if you feel you need to talk to on regular basis is to discuss with your CMHT about the option of short term input from support worker or Occupational therapist with time limited and specific goal based involvement to support you through this phase. You can also discuss with your CMHT the option of home treatment to help you through this crisis and then involve the options we discussed.

If you find the answer helpful please leave a positive feedback. I wish you all the best. Thank you.
Doctor Rao, Doctor
Category: Mental Health
Satisfied Customers: 641
Experience: MBBS,MD,DPM,MRCPsych
Doctor Rao and other Mental Health Specialists are ready to help you
Customer: replied 2 years ago.
Hi, I would like to say that things are still much the same. I have not yet rung the CMHT but I am going to tomorrow as my motivation levels have dropped and I feel tired most of the time. Mornings are ok but from mid mornings I start to loose energy and motivation. The day starts off great and I make plans as to what needs doing. Then it's gone! But then I am having muscular problems. I am seeing a physio for this, so I guess that could be contributing to how I feel. So I should not moan so much!! I am still functioning and fulfilling my obligations eg voluntary work 3 x a week and taking my dog for a walk and doing the daily shop. Thanks for listening.
Expert:  Doctor Rao replied 2 years ago.
Hi,Sorry to hear that things are more or less the same.However it is reassuring to know that you are motivating yourself to do your best for three times a week voluntary work and taking the do for walk.

It is important to speak to your CMHT to explore the option see discussed previously.
When you ring CMHT tomorrow,please ask to be seen by a duty worker even if they haven't got outpatient slots available straight away.My understanding is the duty worker would usually be able to see you if you request or not feeling well. You can also explore the option of low dose SSRI to improve the motivation,if you already not on any.

I can completely understand the tiredness and motivation issues if you are developing muscle pains by the afternoon. I am pleased to know that you are receiving some help from the physiotherapist which can contribute tot he recovery in a positive way.

I wish you all the best. Please do not hesitate to ask me for more information if required. I wish you good luck and hope you wold be able to sort things out with CMHT tomorrow.

Thank you.

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