Antidepressant had no effect on BPDex

[Frank88]

Has anyone else noticed that an antidepressant had no effect whatsoever on their pwBPD? Mine tried three different ones over the course of many months and they had no effect at all.  She even commented that she felt no change.  I've never known anyone who took an antidepressant that did not see some improvement in their symptoms.  This is one of the big reasons for me realizing that this was way more than just a mood disorder, or a series of bad days.

[cosmonaut]

As far as I know, antidepressants are not effective in treating BPD.  They may be effective at comorbid conditions like depression, however, but not with BPD itself.  I don't know of any drugs that are actually.  Therapy like DBT and Schema Therapy seem to produce the best results.  It there is PTSD involved, and that's not uncommon in pwBPD, then EMDR can also be effective.

[blackbirdsong]

Drugs treat symptoms, they don't 'cure' the disorder.

I assume she used them just for depression. It is possible that she needs to find the right dosage/type of AD to work.

[Lonely_Astro]

Mood stabilizers and antipsychotics don't 'treat' and they certainly don't 'cure' BPD.  While it can help treat other issues, it doesn't do anything for BPD (or other disorder, for that matter).

The only known treatment for persons with BPD is an intense therapy known as DBT.  It has shown promising results in helping a BPD cope.  It is intensive and takes years before a tangible result is achieved.  This is if the suffer takes it seriously and does the work needed.  Roughly only 50% of those enter it, stay.  Out of those 50%, 20% backslide and don't recover.  The other 80% show improvements that last long term, some not even being classified BPD under DSM criteria, but can still be "triggered" under certain stressors. Oh and studies suggest the higher functioning the BPD, the less likely DBT will have any success/result. 

Real world results suggest that BPD isn't curable, it's manageable.  But, medications alone don't do it (and only work if there are other issues with the person).

Btw, my ex is diagnosed, on meds, and started DBT (mid- Sept 2015).  She discarded me around October, dated another guy in December while we were in limbo, and also started seeing another different guy at the same time.  They have been inseparable since that time, from what I now understand (so ~2mo into a r/s).  They're "head over heels" in love and she's supposedly confessed all her sins to him, has no secrets, gives him access to her phone whenever he wants it, etc.  it's the honeymoon phase, that'll change.  We were the same way when we started our affair. 

My point is that even under the best set of circumstances, unless they've COMPLETED DBT, they are more likely than not a hot mess.

[Frank88]

Good points. My ex is undiagnosed, so I assumed the antidepressants would work on her issues, not knowing about BPD at the time. If antidepressants don't work, then it's just another red flag that there is something bigger than just depression or anxiety.

[cosmonaut]

Good points. My ex is undiagnosed, so I assumed the antidepressants would work on her issues, not knowing about BPD at the time. If antidepressants don't work, then it's just another red flag that there is something bigger than just depression or anxiety.

It could, but it's hardly a confirmation either.  Ultimately, only a professional can make a genuine diagnosis of BPD, and it's not an easy diagnosis to make since it shares considerable overlap in other symptoms with other disorders.  There are sadly no known biomarkers for BPD, so diagnosis comes down to symptoms.

One of the problems with antidepressants is that they don't work sometimes even in people suffering from clinical major depression - people who will eventually respond to a different antidepressant.  This is why there are a whole range of antidepressant classes and drugs.  Often a good deal of trial and error is needed before a suitable drug is found for a patient.  There are also some patients who never respond to pharmaceutical treatment.  So, it's hard to draw many conclusions from a patient not responding to one drug.

[Lonely_Astro]

Good points. My ex is undiagnosed, so I assumed the antidepressants would work on her issues, not knowing about BPD at the time. If antidepressants don't work, then it's just another red flag that there is something bigger than just depression or anxiety.

It could, but it's hardly a confirmation either.  Ultimately, only a professional can make a genuine diagnosis of BPD, and it's not an easy diagnosis to make since it shares considerable overlap in other symptoms with other disorders.  There are sadly no known biomarkers for BPD, so diagnosis comes down to symptoms.

One of the problems with antidepressants is that they don't work sometimes even in people suffering from clinical major depression - people who will eventually respond to a different antidepressant.  This is why there are a whole range of antidepressant classes and drugs.  Often a good deal of trial and error is needed before a suitable drug is found for a patient.  There are also some patients who never respond to pharmaceutical treatment.  So, it's hard to draw many conclusions from a patient not responding to one drug.

I agree.  For instance, J went no less than 3 times that I know of the past year for 'adjustments' of her medications.  She told me each time that they put her on a new one and also increased the dosage.  She told me to leave her after each visit because she was "obviously crazy if they had to keep upping her meds" (her words).  She also hinted at one point she had stopped taking them (or wasn't taking them as prescribed) because they made her "not feel anything".  Of course, when I asked if she had stopped taking them later, she got mad at me because I asked.