Depression Relieved by Medication

by Patty Fleener M.S.W.

Depression comes with the borderline personality disorder (BPD). It causes extreme psychic pain and there is a high rate of suicide resulting from this depression for people who have been diagnosed with this disorder.

What is the use of knowing DBT (dialectical behavioral therapy) skills if you in the midst of a deep depression where all you can do is vegetate?

First off, I want you to know that I am a fellow sufferer. There is no basic difference between you and I. Some people believe that because I own a website, that I am all well all the time. This is not true. I will say however that I am a whole lot better in many ways as I have worked through many issues, gotten older (45), etc. HOWEVER, what is to keep me from experiencing a deep depression caused "from my brain" or as professionals call it, endogenous depression.?

Do you see where I am going with this? Some have used DBT, cognitive behavioral therapy and have discovered which behaviors are destructive, and so on. BUT, due to the biological nature of this disorder, what we all have in common is what we experience when our brain "fires out of control."

We can read every book, go to a good therapist, etc., yet our brains remain "broken."

Let us discuss that "broken brain" and how it touches our lives. It touches many areas of our lives - depression, anger, rage, etc. Today I choose the subject of depression.

Depression can kill us. A few years ago, I still hadn't found the right combination of medications to treat this depression and every day was the same. I sat (actually I vegetated) on the couch, and obsessed about what I would write in my suicide note. I didn't want anyone to feel responsible so I was going to say that my disorder was at fault and I simply could no longer bear the immense psychic pain that experienced. Each day I wondered just how long I could go on feeling that way. The outside world ceased to exist for me. The curtains remained drawn, I went days without showering, slept in my clothes and cried constantly. I wondered if I could no longer take it at some point, how I was going to end my life. It was at this point that I became very afraid. I didn't want to die, I just wanted the pain to end. It almost felt like physically my whole body hurt in addition to the emotional pain. I wanted to feel joy again.

The stage of depression I attempting to describe is very close to suicide. If this level of depression would have continued, I honestly don't know how long it would have taken for me to take my life. One thing that helped me during that time was my strong faith in God and feeling that it would not be right for me to commit suicide. I believed that if I was on this earth alive, God must have a reason or He would have already taken me. I also believe that there are reasons that we can't understand for episodes such as this. We all know we grow during crises and perhaps my purpose is to help others through the website. Feeling this way, helps me.

Due to my fears, I asked my husband to lock up my medication. Most of us have quite an array of medicine, is that not right? I had quite a bit medicine that was current and meds that I took before but kept. Tim threw those meds away and locked up my current meds, only allowing me to take what I needed for the day.

I took a few trips to the local Crisis Center where they screen you for the hospital. It did help to talk to the counselors but when they asked if I would be safe that night, I knew I could promise that. I took each and every day as it came, one day at a time.

Ok, now that I have you depressed even more, here comes the good part - the hope. FINALLY I had my appointment with Mental Health and this time I demanded a psychiatrist be present. (By the way, don't be afraid to fight to get well. Many professionals don't believe you can. Be sure you are aware of your patient's rights). I sobbed the whole time I was in the waiting room and during the whole appointment. I couldn't help it. I begged for help and let them know I was in a serious danger zone regarding my life.

Some med changes were made. The next day I was extremely manic, yelled and screamed and threw cups at my husband. (For those of you who are not aware, I have bipolar disorder in addition to the borderline disorder). This was brought on by the small amount of antidepressant they gave me. We called Mental Health and I was given Seroquel. Immediately I calmed down. Here is the strange part. OVERNIGHT my depression lifted considerably. At this time in my life, it is COMPLETELY GONE!

There is no miracle here, at least none that I can see. What happened is what I believe will happen to you if you are experiencing depression right now. My brain needed the right combination of medications to relieve that endogenous depression. As you know, we are like guinea pigs and getting on the right meds is trial and error a lot. In fact, I was considered to have "treatment resistant depression," i.e., I felt like a hopeless case. Every person is different and we don't all respond the same way to all medications. For instance, Prozac is a first line drug for many borderlines for depression and chronic anger. Many swear it has dramatically changed their lives. For me, I tried it three different times and broke out in a horrible rash each time. I am totally allergic to it.

I firmly believe in the use of psychotropic medications for the treatment of both borderline personality disorder and the bipolar disorder and so do the experts. Both are biological. Remember a recent newsletter of mine? The research is almost "for sure" that the BPD is biological. 

"The effect of genes on the development of BPD is likely substantial. The effect of common family environment may be close to zero." 
Torgersen S. Psychiatr Clin North Am 2000 Mar;23(1):1-9

However, my belief is the way to get better is to put your focus on recovery instead of how you got the BPD. As I mention in my article on therapy, stay away from therapy that opens you up to painful experiences in the past. Borderlines are not good with regulating their behaviors. We can go from feeling fine to feeling suicidal very quickly. 

Stay in the present, take meds to assist you with borderline symptoms such as chronic anger, rage, depression, mood swings, etc., talk to other borderlines in person or on the Net and discover you are not alone, and forgive yourself for ALL of your past experiences that your illness has caused. Know that you didn't ask for it, didn't cause it and don't deserve it. 

I wanted to share my recent experience with each and every one of you to remind you that there is hope and that if your state of existence presently is poor, that it can only be temporary. If it can happen to someone like me who was labeled "treatment resistant," you can bet it will happen to you. Some of us are luckier than others. Some find relief right away, some go a long time.

Of course I am still working on many issues, but I can work on them now because I have finally made it out of the depression hole. 

Also I want to mention that our intelligence is in no way affected by our disorder and in fact, it seems to me that most of us are more intelligent than the average person. Not only that, but even though we have developed destructive ways of survival, I believe a large percentage of us are stronger than many people because we have experienced so much turmoil. This is my opinion.