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Ask the Experts

Question:

My daughter is 23 years old and has been diagnosed with borderline personality disorder. Another psychiatrist has diagnosed her with bipolar.

Regardless, she has had two suicide attempts, been on every medication and combination known to her doctor, and is now going through ECT for the second time. Nothing seems to help.

Are there any other treatments or facilities that can help her with the depression, anxiety, weight gain, severe head aches, etc?

Answered by: John Markowitz

I'm sorry to hear what you, your daughter, and doubtless the rest of your family are going through. This sounds like a complicated situation. It's a good sign that you are pursuing information: an individual in such distress needs an advocate.

It can be hard to tell in a late adolescent or young adult which of several diagnoses is responsible for particular symptoms: it may take a while for an illness to fully "declare" itself. Borderline personality disorder and bipolar disorder overlap in symptoms as well as initials: people with either can have mood swings, impulsive behavior, and make suicide attempts. It is also possible to have both diagnoses simultaneously.

Without having seen your daughter and without know what therapies have already been tried, I can hardly make a specific recommendation. I can tell you, though, that many effective treatments exist for either BPD. The treatments may overlap (some medications) but also differ. ECT is beneficial for severe mood disorders but not for borderline personality disorder. Different kinds of psychotherapy have been shown to benefit bipolar disorder (in conjunction with medication) and borderline personality disorder (with or without medication). If your daughter's doctor feels that he or she is running out of options, it might be worth getting a second opinion. Sometimes a fresh set of eyes sees additional alternatives, and numerous treatment alternatives exist for both diagnoses.

Don't give up hope! Although these can be disruptive, debilitating, and even potentially deadly illness, many patients do very well once they find the right treatment and start to feel in control of their symptoms, rather than feeling at the mercy of them.