[Mikasa]

I have been diagnosed with bipolar disorder and recently discovered I exhibit traits of borderline personality disorder. Lithium worked well the first two days I took it (was rational and calm), but afterwards the effects were waning off. Then I was prescribed saphris, depakote, and abilify, but none of the anti-psychotics worked after a period of time. They all wore off eventually.

I just want to get to a point where I'm not up and down, irrational, and easily angered. It's affecting my relationship and hurting the person I love, I just want to get better.

Next week I'm doing blood work to determine my lithium therapeutic level, health of my liver, thyroid, and am also checking my blood levels. Depending on the results, my doctor may prescribe carbamazepine so I'm hoping this will finally work.

What has your experience been with these disorders and the medication for treatment? Were they all effective long term?

[Unrigged64072835]

I take meds and have therapy for the BP. I took DBT (dialectical behavioral therapy) a while back and it helps with the BPD. I still use the coping skills.

Yes, the primary treatment for BPD is DBT. Meds are secondary (if used at all) and often don't help as much as one might wish, because the issues BPD causes are reactionary in nature. Meds can't change how one perceives and reacts to the world around them. They can't change interpersonal dynamics. What you describe sounds like the lingering issues of BPD that you are experiencing.

In others words, therapy, taken diligently is going to be your best bet for real change. Good luck!

Oops, forgot the personal experience question... meds have worked well for me, with adjustments time to time. But I'm fortunate to only (yeah, "only", right?!) have to deal with BP, because I don't have BPD. I've been on meds for about 10 years now.

Welcome to Psych Central!

Seroquel and Risperdal are effective for me for slowing down my bipolar racing thoughts and impulsiveness and promoting good sleep. I have gotten breakthrough hypomania on them tho. I've been on them for a while and they still work about as well as they ever did but i haven't had the experience of meds wearing off like you get.

My only relationship is with my dog so my borderline traits don't bother me too much. I quit one DBT Day Hospital after a few weeks and got kicked out of another after a few weeks. A member here, BoogieSmash, is taking DBT online with an outfit called 'DBT Path.' I considered it but since i'm not interested in working on relationships i decided against it.

Hope you enjoy yourself here! It sounds like you're being really thorough and methodical and pro-active so hopefully something will work out.

[bizi]

I react like a person with borderline tendancies when I am manic.
I also exhibit ADD qualities when I am hypomanic...like now.
bizi

[HALLIEBETH87]

Have you looked in doing some DBT? It's a great tool for those with Bpd like us. It's helped me. I'm no longer in frequent crisis!

[Wander]

In 2011 I was diagnosed with BPD and I have been in therapy ever since. The only med that helped the BPD symptoms was Lithium. It reduced my impulsivity and suicide attempts. Later I was diagnosed with Bipolar. The BPD symptoms slowly disappeared and now I no longer have that diagnosis. Either the PTSD and Bipolar gave the impression I had BPD or the therapy helped me recover from it.

The Bipolar has been difficult to manage. I have tried many medications and slowly seem to be experiencing more stable time. Recently I went through weeks of hypomania and now seem to be crashing. Lithium does seem to help a bit but I still cycle. Abilify is good for agitation and mania but of course I didn't take it when hypomanic as I was having too much fun. I have just started seeing a new pdoc and he is going to have a look at changing my meds. The worst state is mixed episodes or psychotic mania. In those states I am generally hospitalised and have many meds thrown at me until the episode subsides. So my levels and types of meds I am on depends on where I am at.

Welcome! I wish you all the best.

[neverending]

I have been going through a lot of situations lately which has destabilized me slightly on my bipolar meds but still doing better than last year bipolar wise. The recommendation for dbt group has been made for me for the bpd part n I m waiting for information on when it will start and if I am in it. I m hoping the dbt will help me get a handle on the borderline reactions, at least to be able to tone them down somewhat. I don't know. Will just have to see. But getting the bipolar part fairly stabilized now gives me the ability, hopefully, to begin dealing with the borderline stuff.

[Sad Mermaid]

It may be that you do not have bipolar and that you instant but waning reactions to meds are so because the meds are placebos for you - you believe they would help and that makes your body and your mind react positively at first, but they do not get at the root of the problem, so you perceive the meds as losing their potency. In general, Lithium is not the kind of a medication that would be felt instantly. Lithium needs to accumulate in the blood and reach a therapeutic level.

Depakote is not an antipsychotic - it is an anticonvulsant, as is carbamazepine.

carbamazepine gave me a serene mood, but I developed a rash that made treatment with it impossible. I take a combination of Lithium and Geodon (a lot of Geodon and a little of Lithium) and together with a very regular schedule (everything is on schedule in my life) they work, but I definitely do have Bipolar I, so it would be expected that I would react positively to the right meds combo. In your case, it sounds more like BPD, for which as noted above, DBT is an evidence-based approach.

I have also heard of several cases where an old antipsychotic HALDOL was used successfully in BPD as a PRN (=a drug you take as needed and not on a maintenance basis). It is a tried and true drug, and if you develop neurological side effects to it, there is a drug called Cogentin which may help counteract them. Plus, PRN use probably would not yield significant side effects anyway. I would obtain a prescription for HALDOL and take it when you feel the first approaching signs of anger, and see how it goes.

Another idea for you is to fill a HALDOL prescription and take it when you feel relatively calm, just to figure out if you have side effects to occasional use. If you do not, then hopefully it would be in your medicine cabinet for you feel out of the control.