question re. dx & mood stabilisers

Hi, hoping someone can help me. Been diagnosed with BPD, and have bad mood swings (they can change daily from hypomanic to irritable and angry to depressed, or I can be severely depressed for months and months, have been psychotic at times too, but hypomania only lasts a week or two it seems). I don't know if I have true BPD anyway as I do not lie compulsively or abuse people and don't usually put people on a pedestal one minute and then hate them the next. I don't have terrible rages either. Not sure that you have to be like that to have BPD, but have heard others suggest that you do. I do have other traits that are BPD; emptiness, impulsivity, fear of abandonment, self sabotage, suicide attempts....

Anyway, I have been on a downward spiral for a week or so now and much of the time feel I can't go on. I know it's only a matter of time before it gets too much all of the time and I become completely incapacitated. I don't like the idea of mood stabilisers as the side effects are awful, but I am willing to try them seeing as nothing else helps. I have asked my psychiatrist about this but he says it would not be suitable for some reason. I have heard they can help BPD. Bipolar runs in my family and I wonder if it's possible I have bipolar II, in which case they may be more suitable. How can I convince him to just give it a go seeing as it could help? I'm in the UK if that changes anything.

oh my. well, if your doctor is still saying 'no' while you don't feel at ease till you've given SOMETHING a shot....try over the counter $#%^ first. take note of what you're reactions are to them.

on an entire more personal note, uh....don't stuff ANY drug down you're mouth butt period. but keep in mind this is coming from someone who has $#%^ for luck results with meds.

since you're in the uk, i have no clue what their over the counter market is over there so i'm not gona go naming products i've tried (also because i had $#%^ luck with them). best suggestion, go google yourself into research and see what you can find and if its on the market over there. you know your body, i don't. you know what meds you've taken in the past and had reactions to, what foods you can and can't eat, and whatever other medical probs exist you're bod has. just think it through, examine everything you can and make the decision for yourself. discuss it with your doc about the over the counter available stuff. i'll give you one hint. you'll find stuff in the vitamin/mineral/herbal aisle/store.

This is basically what I keep posting about... the difference between the USA's 'slap a label on and hand out pills' brand of psychiatry and the UK version... where psychiatry is much less happy about handing out pills or labelling people.

It's also much harder to get hold of stuff 'over the counter' here.

Mood stabililsers are not anti-psychotics. Typical mood stabilisers used here include Tegretol, Lamotrigine and Gabapentin (all three are also used as anti-epilepsy drugs, and Gabapentin in the treatment of severe and chronic pain), Lithium (old favourite - needs regular blood testing to ensure you are within therapeutic levels but is still an effective drug), and Valproic acid. Most require regular monitoring of blood. There are others... not all approved for use in treating Bipolar.

Anti-psychotics (which work in a different way) can also have mood-stablising effects; so are sometimes used to treat mood swings even when psychosis is not present. But they are not mood stabilisers, and are not usually the first choice when treating mood disorders.

If your psychiatrist doesn't feel drug therapy is appropriate, ask him why - and ask if you can be referred for therapy. There is a big emphasis in the UK on talking treatments, CBT, that kind of thing - which can be really helpful. I see a psychologist who specialises in CBT for psychosis... more and more psychiatrists here are recognising the value of non-medical treatments in mental illness.

ah, ok, i think i see what you mean now by the differences between the us and the uk. i think for me personally, since i've only left the country once and that was to vancouver british columbia - and i don't think that really counts as leaving the country too - all i've known is the us's approach to medical issues. so if i understand you correctly, then yes. pharmaceutics are not monitored very well with regards to who gets them, when, how and why. added to the decision of the drug is perscription only, or over the counter. i know a lot of drugs on the counter now, several years ago, you needed a perscription. other drugs went reverse. and then the backdoor route existing where something that should be by perscription only, is recombined chemically to form a new drug which is basically equivalent to the 2ndary byproduct that 'completes' the bio-chem process but was able to skip a first few important steps.

heh, i'd list a couple otc's that exist here and ask if they exist there, but i don't wana give any ideas.

tergretol, lamictol, and depakote, i cannot take. lithium is in a certain family of chemicals i cannot take. i havn't been put on the gabapentin. aed's i can't take anymore, i either throw it right back up rather violently, or get a rash that will not go away for a while...even after i'm taken off the drugs, the rash is still there and existant and hell to deal with.


i agree. personally i feel that treating a mental condition physically, doesn't improve the siuation. if broke my arm and the bone was protruding the skin, all the mental 'positive thoughts' wont heal or reset that bone now will it? no, you have to physically reset the bone and apply a cast around the arm. same goes in reverse. you saw your loved one get murdered before your eyes by terrorists. you make it out physically 'ok'. but all the drugs, anti-depressants/psychotics won't make you get over your loved ones death with a snap of a finger. nope. it'll make you all drugged up and drunk looking and loose touch with reality...once that drug wears off, are you over the death yet? nope. you have to go through 'mental therapy'. talking $#%^ over thats in your head. coming to acknowledgement and agreeance on issues and coping with the pain. so i woud say yeah. what would happen to the world if a global new approach was taken upon 'mental disorders'. ie, talk first, drug later.....hmmm, i wonder.

cursed, you need to come live with me and meet my Psych!

I have never lived in the US... but knowing how psychiatry works here, and reading what happens in the US with regard to diagnosis and handing out pills, I think we're very lucky here.

From what I can gather, anyone presenting with auditory hallucinations in the US is more or less guaranteed a diagnosis of schizophrenia or BPD within a few visits (so, maybe a couple of months on average) and neuroleptic meds in the first two or three visits.

Guidelines in the UK state that symptoms must have been in place, proven not a result of drug or alcohol use, for six months or more before you get a diagnosis like that.

And ok, while once a diagnosis is in place you are often medicated here, it's not usually a case of 'medicated for life' neccessarily and there is a big emphasis on altrenative treatments like CBT. That's particularly true of personality disorders like BPD - but is also proving really useful in the treatment of so-called serious mental disorders like schizophrenia.

Hence the hesitation in prescribing... much better to treat without drugs if it can be done.

I'd actually be glad I had a psych who felt less inclined to hand out pills - but I would be pushing for CBT etc. It is available...

hi again, thanks for all your responses. Yes I am in the middle of CBT (also know of a DBT group that runs so might try that too at a later date if need be). I don't know if I agree about the UK and mh services as in my experience it was quite how you describe the U.S. I was given a dx of paranoid schizophrenia after a few months (yes guidelines state symptoms should be present for at least 6 months but....!) and even before that when first presenting with psychotic symptoms was dosed up to the eyeballs! NOT PLEASANT! Olanzapine; slept for three days after taking just one tablet once so was even worse when taking it every day. Just got up to eat then straight back to sleep again. Risperidal; pretty much the same but felt really sick and grimy too. Had another one (abilify, thats the one) that just made me really agitated, then finally put on chlorpromazine which suited me much better. Am still in the process of trying to come off it as do not sleep a wink when I try not to take it at all. However cos of how things r at the moment have to stay at dose I'm on. I'm not saying meds r the only answer, but I do think they can play a part depending. I've just been finding it so hard to deal with the rollercoaster ride that is my emotions and moods atm that I feel I need something (ANYTHING GODAMMIT!) to help. I know my psychiatrist is only thinking of my welfare as there are risks involved, well I don't know I know I should go by what he says really.......... ????

Sounds like you got unlucky with your psychiatrist... sorry to hear that.

Am a bit confused though - have they changed their minds about the original diagnosis? If so, why?And why, if they were so happy to medicate you to begin with have they now changed their minds? Is this all the same psych or have you changed doctors?

yes, over the last couple of years have had 3 different doctors (and then other ones when in hospital).