I started going to therapy again and was recently hospitalized for depression and suicidal ideation, and that was my diagnosis. However, I have learned about borderline personality disorder recently. My relationships with my friends and significant others become intense from time to time and I always worry about being abandoned, even when they show no signs that they are going to leave me. If someone happens to leave, I feel as if it’s my fault and I have suicidal thoughts or want to self-harm. I have bouts of time where I’m really happy, then it’ll turn into sadness. There’s no in between for me. I am now on Zoloft and atarax and have been for a few weeks now, but over the last week, I have been experiencing sad moods. Nothing extreme, but it’s still there. Is all of this something I should bring up at my medication management appointment? I want to be on the road to recovery. Also, I believe I have PTSD from something that happened when I was 14. I was bullied severely and every time I see one of those people, my heart starts racing and I can’t breathe. Is this something I should tell the clinician as well?
A. Yes, you should report your observations and concerns to the mental health professionals involved in your care. That’s the only way they will know what is happening in your life. Try journaling to record your thoughts and moods. Sometimes it is easy to forget about what happens between appointments. It might also clarify whether borderline personality disorder would be an appropriate diagnosis.
You may only see your treatment providers two to four times a month. The more detailed information you can provide them about your fluctuations in mood, things that are bothering you, and so forth, the easier it will be for them to help you.
Finally, you mentioned having both medication management and a clinician. I’m taking that to mean that you are seeing two different mental health professionals: one for medication and the other for counseling. If so, that is good. Medication can assist with mood stability and counseling is good for developing coping and problem-solving skills. Counseling is a particularly effective treatment for PTSD symptoms, suicidal thoughts and self-harm tendencies. From what you have written in this letter, it seems as if you are on the right track. Good luck with your continued efforts.
Dr. Kristina Randle
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