There seem to be a lot of different views within the mental health community about the usefulness of medication in the treatment of BPD, and I thought I would add my one experience to the discussion.
Personally, based on my experience, I am in favour of the use of medication to assist in the management of mental illness if it is suitable.
Understandably, some people feel concerned about the idea of being "on meds" or feel there might be a stigma attached. However, I strongly believe that someone considering medication options shouldn't have to be restrained by these social or emotional pressures, and should be able to focus on the facts about what's best for them and their health.
This does not mean I am advocating that:
- Drugs fix everything,
- If you take medication you don't need any other therapy,
- Everyone who feels ill should be on medication, or
- Medication is suitable in the treatment of all mental health issues.
What I am advocating is that I frequently see it stated that "there is not much research on the effect of medication on BPD" or that "there are no medications commonly used to treat BPD" when in fact there are many people using medications to successfully help treat BPD symptoms and that there are a variety of medications that can be used.
So, now for my experience! It has taken a long time and a lot of adjustments, but the current equation of meds that I have worked out my body responds relatively well to is:
- Pristiq (Desvenlafaxine) antidepressant, 200mg daily
- Desvenlafaxine is an SNRI antidepressant which basically works by blocking the reuptake of key neurotransmitters, like serotonin, leaving more available to your brain. I have been taking it for two years, and the most noticable difference was at the 200mg mark, whereas you typically start at 50mg. The only side effects were that it could make it difficult to go to sleep, so I take this in the morning.
- Valpro (Sodium Valproate) mood stabiliser, 800mg daily
- Valpro doubles as an epilepsy medication, in that it combats seizures. For unknown reasons this also assists in managing the parts of the brain that struggle with panic and anxiety type disorders. I haven't experienced any side effects.
- Seroquel (Quetiapine Fumarate) antipsychotic, 200mg daily
- Many people feel uncomfortable when they hear the term "antipsychotic", but aside from treating schizophrenia and bipolar disorder, it is mostly used to augment (or enhance, improve, etc) the effects of an antidepressant. It makes you very sleepy though, so I take this at night. One side effect experienced was hand tremors, which went away after the first three and a half weeks.
- Ativan (Lorazepam) antiaxietant, 1mg PRN
- Lorazepam is an antiaxietant, in that it combats anxiety. "PRN" means the dosage is "as required". This means I can take it to help me fall asleep, or if I am finding my symptoms unmanageable, or if I am expecting a very stressful event or activity. As you can imagine, this is very helpful with the unpredictable nature of BPD. I have found the effects don't last longer than 12 hours and have experienced no other side effects.
- Avanza (Mirtazapine) antidepressant, 30mg daily
- Mirtazapine is a tetracyclic antidepressant, which just refers to its' chemical structure. This is used to augment the effects of my initial antidepressant. However, this one does make you sleepy, so I take it at night. I haven't experienced any other side effects but have only been using it for one week - so I will update this.
So how has medication helped me? All I can go on is a comparison of my moods and behaviours before and after. Before, I used to be able to continue conflicts for hours to the point of screaming and screaming until I threw up - with no regard for neighbours, police attendance or life structure. After beginning medication, I have never done this again.
It's my best guess that it seems medication has "taken the edge" off my symptoms, rather than totally "curing" them. Even though I still have horrible moods, suicidal thoughts and irrational overractions to things, it seems like these just aren't as sudden or destructive as before.
Essentially, it's like the roller coaster has slowed down a little. (I just wished it helped more with the depressive symptoms.)
But overall, given I have no major ongoing side effects, this means medication is worthwhile in treating my BPD symptoms.
I hope this gives any other sufferers out there a better idea of their options.
(This isn't to say that I am cured or that I am never going to relapse in any of these ways. The thing about medication is that your body can and will adjust to it over time. This is why it is so important to consistently take medication as per your doctor's instructions, as well as to review dosage and application along the way. In addition, I am no scientist and I write this only from the basic understanding of a consumer. Obviously, you should confirm all facts and details with your doctor when deciding what is right for you.)