![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by Deneb on June 10, 2009, at 19:17:49
I read the message you gave me to pdoc. Pdoc gave me a script for 0.25 mg Risperdal to take as needed for meltdowns.
I hope it works and I hope I don't have a meltdown in a long while.
Posted by BirdSong on June 10, 2009, at 20:40:52
In reply to I did what you suggested Dinah, posted by Deneb on June 10, 2009, at 19:17:49
I think it is interesting that you asked for medication to help meltdowns. The meltdowns are caused by behavioral patterns that are characteristic of the rejection/abandonment and punishment cycle of someone with borderline personality disorder or borderline tendencies.
Medication is not going to help this. There are numerous studies regarding these behavior patterns and basically all scientific evidence points to effective therapy specifically using DBT as the way to improve.
Medication may sedate you, but it will not change your behavior patterns and it certainly won't stop the meltdowns.
What will stop the meltdowns, the feelings of wanting to die, the threats of killing yourself, the mood swings, the self-hate, etc is learning to challenge those beliefs and behaviors by becoming aware of what you are doing. That comes from therapy with someone who has expertise in borderline behaviors.
Medication is not going to fix this. Have you thought of starting therapy with a PhD (clinical psychologist) or perhaps even a very-experienced social worker? These are the people that are going to know what to do with your behavioral patterns.
Posted by Dinah on June 10, 2009, at 20:51:23
In reply to Re: I did what you suggested Dinah, posted by BirdSong on June 10, 2009, at 20:40:52
I would have to disagree.
I can think all the proper thoughts in the world, but once that cycle gets activated, it builds on itself.
There is a definite physiological component to it. Risperdal gives me the chance for my brain to use all of what I've learned in therapy.
There's nothing wrong with halting the physiological aspects of meltdown.
IMO.
At any rate, it works for me, and it might work for Deneb. If it does, great, if it doesn't then other methods might work.
Posted by Deneb on June 10, 2009, at 20:51:43
In reply to Re: I did what you suggested Dinah, posted by BirdSong on June 10, 2009, at 20:40:52
I like my pdoc, she does therapy. I'm going to stick with her. I have been trying psychological ways of dealing. I just spiral out of control at times.
I am not sure if the medications help me, but others say they do.
I'm not sure if pdoc does DBT with me. I am aware of what I am doing now. I still feel bad.
Posted by Dinah on June 10, 2009, at 20:52:25
In reply to I did what you suggested Dinah, posted by Deneb on June 10, 2009, at 19:17:49
That's great, Deneb!
I hope it works for you as well as it works for me.
Posted by BirdSong on June 10, 2009, at 21:22:42
In reply to Re: I did what you suggested Dinah » BirdSong, posted by Dinah on June 10, 2009, at 20:51:23
Dinah - I did not say medication was not useful. It is sedating and calming, but what I have seen posted on this forum are posts and responses of behavioral patterns that are clearly indicative of a very-well-known and described cycle in psychology.
That cycle is broken by correct therapy; it is not broken by medication because the cycle is a behavioral pattern. Rejection/abandonment and punishment. Medication may calm and sedate, but once the cycle is started, until the person gets the response that they want, it will not end. That is why people consider borderlines manipulative. The behaviors have a purpose. Sedating a borderline who is starting the cycle may calm them, but they will still threaten suicide, harming themselves, etc, because of the behavioral cycle. The behaviors are used to (a) communicate needs and (b) get what they want.
A personality-disordered individual must become aware of (a) the cycle, (b) their behaviors, (c) the impact of their behaviors, (d) ways to soothe themselves, and (e) learn ways to identify their needs and ask for what they need correctly.Medication does not alter the behavioral patterns. What alters a personality disordered behavioral pattern is therapy...and there are certain therapies that are highly successful in stopping this cycle that is displayed.
That's all I am saying.
Posted by Deneb on June 10, 2009, at 21:35:48
In reply to Re: I did what you suggested Dinah((Dinah, posted by BirdSong on June 10, 2009, at 21:22:42
Does this mean I still have borderline personality disorder? Because last I heard my pdoc said I didn't meet criteria anymore.
I used to be worse, much much worse. I used to actually OD. Now I don't. I don't even really threaten to now either, I just say I am thinking of it but won't do it.
I feel kind of hopeless. Does everyone still think I am borderline? Isn't it good that I recognize these behaviours in myself? I am really trying here and it never seems to be enough.
Some borderlines won't even say they have this illness. They have no insight whatsoever. I think my insight is pretty good. Doesn't that count for anything. Why do I need more therapy? I am already getting therapy, weekly with my pdoc.
I just get the feeling I will never be good enough.
:(
Posted by Deneb on June 10, 2009, at 21:39:08
In reply to Re: I did what you suggested Dinah((Dinah, posted by Deneb on June 10, 2009, at 21:35:48
I am getting upset again. I feel hopeless.
I will never be good enough. I thought I was doing really well, especially compared to the past, but it is not enough.
I am sad.
Posted by Dinah on June 10, 2009, at 21:50:18
In reply to Re: I did what you suggested Dinah((Dinah, posted by BirdSong on June 10, 2009, at 21:22:42
I used to have rather visible meltdowns on board, and now I don't.
I wasn't trying to be manipulative, although perhaps I was asking for what I needed.
Yes, there is a cycle. But some of the cycle is physiological. Long term stress builds up and adrenaline pumps out and I kept thinking what I was supposed to think. But eventually it went on overload and my best intentions went haywire. I hurt myself, I posted in meltdown mode, I called my therapist, I thought about hurting myself.
Part of getting better was recognizing when my body was under too much stress and I needed to take care of myself with medication.
It still happens, but now I can take medication early enough to use my other tools.
I don't think I agree that it's purely psychological. I never have agreed with the great axis I axis II divide. Some people have highly strung nervous systems and that leads to coping mechanisms which may not be overly healthy. If the arousal point gets too high, behaviors result.
Is it possible to use other methods? Yes. Understanding when arousal is rising below the surface is a great idea. Knowing when I'm angry or scared or stressed often allows me to talk about it and keep arousal low. But that doesn't always work.
Things aren't always what they seem on the surface. When my meltdowns happened, I was usually under some sort of stress or in an arousing situation. I find the same is true of Deneb, from what I know of her.
It isn't all psychological.
Posted by BirdSong on June 10, 2009, at 21:53:18
In reply to Re: I did what you suggested Dinah((Dinah, posted by Deneb on June 10, 2009, at 21:39:08
I am making these suggestions to get you thinking about better help, so you feel better, not to be mean. If you look at your posts, you frequently have people here telling you to goto the hospital for safety. You asked recently about ODing and you talk frequently about wanting to die. When I first started here, you were talking about not being able to control yourself from jumping off the bridge in SF.
That can all get better...The reason I used labels is because there are proven treatments that break the behavioral cycle.
And you could feel better and stop having the extreme reactions you have.I don't know your history or how long you have been in therapy, but I know the behavioral pattern and behaviors that you display. I work with people with them and I also know they can get better.
Posted by BirdSong on June 10, 2009, at 22:04:23
In reply to Re: I did what you suggested Dinah((Dinah, posted by Deneb on June 10, 2009, at 21:39:08
Dinah-
Some things are physiological such as the build-up of stress and the release of endorphins when a person self-harms to produce calming, but the behavioral pattern is conditioning. Rejection, self-hate, and punishment (of self or other) as what is being shown here now when the poster feels rejected by my post..I am not really going to go on with this, because it is clear that no change wants to be made and you allow people to threaten suicide frequently.
I will ignore these posts from now on.
Posted by emme on June 10, 2009, at 22:18:36
In reply to Re: I did what you suggested Dinah((Dinah » BirdSong, posted by Dinah on June 10, 2009, at 21:50:18
I have to agree with Dinah here. My illness is recurrent depression with anxiety. When I'm overwrought, medication can help calm me. Once the physiological overload is reduced, rational thought kicks in and other coping mechanisms can be used.
I see no reason why Deneb can't use medication when appropriate and also continue to work on learning new ways of dealing with the world. They're not mutually exclusive.
Posted by Dinah on June 10, 2009, at 22:20:15
In reply to Re: I did what you suggested Dinah((Dinah, posted by BirdSong on June 10, 2009, at 22:04:23
I don't think we're all that far apart in what we're saying.
It's just that I found such incredible help with as needed meds for meltdowns, that I hope Deneb also finds herself helped by it.
If she does, then all to the good. If not, then not.
I finally ended up thinking outside the DSM box for myself. I think my diagnosis is nervous system like an overly inbred cocker spaniel. No offense to cocker spaniels of course, other breeds would do. But you know what I mean?
I take a multipronged approach to it, including as needed meds, and I've got a regimen that works pretty well for me now.
I remember when I didn't, though.
Posted by Deneb on June 10, 2009, at 22:29:06
In reply to Re: I did what you suggested Dinah((Dinah » BirdSong, posted by Dinah on June 10, 2009, at 22:20:15
I know you mean well. I just wanted to say "thanks" for trying to be helpful. Sorry if I took it the wrong way.
I am pretty sensitive these days. Am working on it. :)
Posted by TexasChic on June 10, 2009, at 22:30:32
In reply to Re: I did what you suggested Dinah((Dinah » BirdSong, posted by Dinah on June 10, 2009, at 22:20:15
I'm just grateful you're here and you're you, because your support has helped me more than I can ever express. I just felt the need to say that to you Dinah. You too Deneb - you've always been so supportive!
-T
Posted by Phillipa on June 10, 2009, at 23:45:20
In reply to Re: I did what you suggested Dinah((Dinah » Dinah, posted by TexasChic on June 10, 2009, at 22:30:32
Deneb I've watched you grow and yes go from oding to talking about it and then talking yourself down. So to me your coping skills are skilled now and nothing wrong with meds. Sometimes you or anyone else needs them. Great job!!!!! Love Phillipa
Posted by seldomseen on June 12, 2009, at 7:19:36
In reply to Re: I did what you suggested Dinah, posted by BirdSong on June 10, 2009, at 20:40:52
I believe can not be overestimated. While you are correct that the only cure (or the closest we can get) is targeting the underlying thought patterns which may lead to a crisis, the crisis itself can be quite damaging.
At the bare minimum, it interrupts our lives and can actually set back any progress that is made toward ultimate resolution.
I think they key then is to combine medication and the appropriate theray. The conjunction of the two seem to work best in a host of studies.
Seldom.
This is the end of the thread.
Psycho-Babble Social | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.