SSRIs

[DogMan75]

My uBPDgf saw her new PCP for the first time today who promptly put her on Prozac.

While I can't be sure exactly what was disclosed to her doctor, she did tell me that she didn't tell her about her:

1).  Suspected BPD (strongly by me, intermittently by her)

2).  Suicidal ideation (as recently as yesterday)

3).  History of cutting

4).  Frequent low libido

My GF is eager to start right away, and I am terrified. 

Apart from the rare worst case scenarios of increasing suicidal impulses, I am actually more afraid of the frequently reported "falling out of love" side effect. 

When she is upset, that moment that she's in, that feeling she's feeling, is all she ever remembers.  Though we have a wonderful, almost magical relationship 90% of the time, in a moment of anger, she legitimately thinks that is the way our relationship is all the time.

I can so easily imagine her feeling passionless from the drug, deciding she just feels nothing for me and up and ending the relationship.

We talked about it tonight and I voiced my concern and I was called unsupportive and controlling (though she could not cite a single other way in which I am unsupportive or controlling, but nevertheless assured me that I am "all the time".

I would like her to at least wait until she starts seeing someone who specializes in BPD.  She's tentatively agreed, but we're having the damnedest time finding one who accepts insurance, has a compatible schedule, etc. 

Any experience with this?  Advice?

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[sadeyes]

My pwBPD takes Paxil (another ssri). While I do not see great results, I don't see negative effects. Maybe it helps a bit. It does seem that SSRIs are a common treatment for symptoms of BPD. While they don't solve the problem (as it is not really chemical based), there are chemical aspects to it.

[Love Is Not Enough]

I have dealt with a similar situation, but luckily my uBPDgf never took them. I really do not think they would have helped her much.

Her sister is on a medley of 4 medications I believe. At least one being an SSRI. She was diagnosed bipolar when she was young, but I believe she is actually BPD. She may be dealing with both. She says the meds help her, but I do not see her life moving in a very positive direction.

I can also add insight because I myself have been on Prozac and Effexor for depression after divorcing my wife. Who I now realize had some BPD issues of her own. I have always dealt with depression and I realize now that medication is not, or ever was, the answer. I was a mess during my divorce and was desperately looking for relief anyway that I could get it. To put it mildly, taking those drugs was a complete nightmare. I only took them for a few months and the side affects were horrendous. I could not sleep, and I believe I have permanent issues with insomnia caused by the drugs. I was a complete and total zombie. I had no feelings, either physical or emotional. I felt like I had a low amount of electrical current running through my head all the time. You could have put a baby in front of me and I could have dissected it alive and not reacted to it at all. My behavior was out of control and I became a completely different person. I stayed on it for as long as I did hoping it would all subside and actually help me. It never did and I had to stop taking it.

It does not surprise me at all that it may cause some people commit suicide while on them. If I had actually had the motivation, which the drug completely takes away, I could have easily killed myself without giving it a second thought. For me it was bad stuff and I have read countless stories about people having similar issues. Hopefully you can keep her off of it and she can find a therapist. That is a whole other issue. There is no one here locally and my gf is seeing someone almost an hour away. Of course her insurance won't cover it. So I am helping her with it. Some T's will give you a better rate if they know you are paying for it yourself. Just ask.

Good luck and I hope your situation improves. Just be sure to educate yourself on the drugs. Pass it along to her. She needs to know what to expect if she decides to take it.

[Soldier Of Sorrow]

DogMan75,

I personally think it is too early to tell whether the newly-prescribed SSRI will relieve the mood issues of your uBPDgf.

As a start, she will have to rough it out with the initial side effects. And then the dosages may need to be adjusted to achieve the optimum effect.

Drugs like Prozac, Zoloft or Lexipro are less likely to cause sleep problems.

But drugs (SNRIs) that alter the norepinephrine level, like Effexor, WILL give people a hard time with having a good night's sleep. (Imagine an adrenaline overload NOT due to any real-life threats or excitements, BUT due to a little pill instead).

Was you uBPDgf prone to anxiety?

As for the "falling out of love" side effect, wouldn't you prefer that since she is in a calmer/ more rational mood now that she is on the drug, she is more able to acknowledge your gestures of love towards her (instead of flying off the handle)?

My humble opinion is that while SSRI's/ SNRI's may be useful (in the short run) in controlling the acting out/ emotional mood swings of BPDs, long term therapy is still required to help them cope with their mental processing of events cognitively.

So do not place too much hope on psych. meds. ALONE in the long run.

But for now, it is a fool proof approach to begin with.

Hang in there and best of luck.




 

[Nonamouse]

Dogman,

My dBPDw has been on several SSRIs as well as SNRIs. None of them helped. Most had zero impact on her moods, and a couple had negative impact in that they were "activating." She was more prone to rages when on these. I'm not qualified to offer any medical advice, just saying I would be watchful of anti-depressants that are known for this if anger/rages are an issue.

I am not an SSRI basher. I've been on several and am on one now, and it helps. They just didn't do much for my wife's moods and helped not at all when it came to BPD symptoms. (I don't know anything about "falling out of love" - I've gotten a general level of apathy on some but that was better than debilitating depression, hands down.) Again, I am loathe to extrapolate any of this to anyone else's situation... .the brain is a complex thing. Just offering what happened with us.

I think you are right about finding someone who understands BPD. We had to go out of network to find one and it's a financial burden but it's worth it. We got lots of advice from generalist therapists/psychiatrists and none of them would diagnose her with BPD despite agreeing that she had 6 out the 7 criteria. The one who prescribed the SSRI's said, "She can't have that, those people are just mean." DBT skills therapy has helped. Good luck.

[Hydroman]

Dogman75

Good luck finding a psychiatrist/therapist who specialize in BPD.  You are correct in that you need providers who specialize in BPD.  Others will try and treated the BPD but not specializing in it, they won't get the patient where they need to be.   It took us 2.5 yrs to find a good psychiatrist and therapist.   Only the the therapist is on the insurance as a preferred provider.  The psychiatrist we pay out of pocket and insurance gives us less than half back.  For psychiatrist, they find they can make more money not being preferred providers so few are.  If you find psychiatrist on your plan, they probably don't have the qualifications/specialization you need. 

Be prepared to pay out of pocket.  It really kills you financially-I am in so much debt from this, but necessary to get the help the BPD needs.