Ask the Therapist
Adderall and Possible BPD
When I was about 14 years old, I was in a bookstore, just browsing, and
I came across the title "I hate you... don't leave me." it seemed to epitomize the way
I was feeling about my boyfriend at the time. I bought it and read it thoroughly, and
I remember thinking that I exhibited many behaviors similar to that of the patients mentioned in the book.
I went to my parents, asked them if I could see a therapist, but they became defensive, telling me there was nothing wrong with me.
I've felt suicidal every time a relationship in my life has ended. I became obsessed with the person, and felt justified in trying to destroy their lives because
I could not have them. yet I still love them at the same time. I've attacked people in sudden bouts of anger, come up with detailed plans of revenge,
I've even had a restraining order filed against me. I am 22 years old now and have been seeing a therapist once a week for the last 2 months.
I chose to go to therapy, and was strongly encouraged by my friends because I was having a very hard time dealing with my last love relationship ending. i find it hard to trust her, although gradually she is getting through to me. when
I am there, i usually feel fine. everything seems normal. when I am alone I sometimes panic and incessantly call my exboyfriend, pleading him to come over.
I think about suicide, but do not want to die because it would hurt my family. I
inflict injury upon myself, but only when I am in a frustrated, frenzied state. this state is usually caused by him arguing with me or refusing to cooperate with my requests of him.
I do not want to be this way. I am currently taking adderall for adhd, which I started at the beginning of my therapy.
I find it useful in concentrating on my school work, and I've lost weight which has improved my self-esteem
(I am still overweight). recently, in my second month on the medication, i find myself more obsessive.
I have always had some obsessive/compulsive behavior, but none in which i strive for perfection. my obsessions usually lie in other people and things like picking at my skin, plucking hair.
I've read over the criteria for BPD and I think mostly all of it applies to me, although
I realize I cannot diagnose myself. my main question is, could the adderall be worsening these symptoms? since
I have been taking it, I have not had an angry outburst. but I have felt like I
have lost control over other aspects of myself... I feel panicked somewhat often now, and i have more trouble eliminating thoughts that bring me down or cause me to act impulsively. is there anything
I should tell my therapist that could help her help me better?
Good call. Were you diagnosed with ADHD? The reason I ask is that an inability to focus as a consequence of what's called collateral anxiety in persons manifesting borderline features is very common. I don't want to second guess your therapist because I don't know you, her or your history, really, but it's a thought.
That said, yes, Adderall, being an amphetamine, can increase anxiety-related behaviors like the ones you describe. Also, because obsessiveness is somewhat related to impulse control the obsessiveness, face picking, hair pulling, etc. are all in the same bucket. The Adderall could be exacerbating all this, as some of the side effects (and this is mentioned in the PDR - your therapist should know what that is) of this particular drug are restlessness and an increase in tics or obsessive tic-like behaviors. I also speak from clinical experience on that one.
You may want to look into changing your meds. I am not prescribing or diagnosing, but it sounds like a mood stabilizer might be a more appropriate than an amphetimine. Even if you are not full-blown BPD (and, again, not a diagnosis), you describe enough symptomatically that I would guess you are walking around in an above-baseline state of anxiety -- and you're taking an amphetamine...doesn't seem to quite jibe, yes?
