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Question
Posted by: Non-BP | 2003/12/03

Any news on specialists on BPD in SA

Hi there Cybershrink,

I have been here before and you didn't know anybody specialising in BPD at that time. I was wondering if now you have any more info. My girlfriend has been recommended Dialectic Conditioning treatment or something of that nature, which I believe helps change their reactions to stressful situations instead of their usual destructive coping mechanisms. Anyway, she has also changed to Cipramil from Nuzak, on her own insistence. She has been on Nuzak, varying doses, for at least 4 years. It wasn't working and especially affected her libido. We are both hoping Cipramil will change that as we have a friend who recommended Cipramil. Anyway, she is about 6 weeks into Cipramil so it will start kicking in properly now. We shall see. I also read a very interesting article on the net about BPD's being emotional children. HAving the emotional/psychological status of a distressed child. All the hundreds of symptoms presented by BPD's can, according to the article, be extrapolated to that of a distressed child. It was very interesting and made me think that drugs were not the answer to curing BPD. ALthough they do help even out the peaks and troughs. This therapist suggested strongly restructuring/reprogramming of the emotional psyche. Is this the same as the dialectical or whatever it's called? Also where is the best place to get this therapy. Shoo! Thanks.

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Our expert says:
Expert ImageCyberShrink

Dear Non-BP,
I read and check out a lot, but have never heard of "Dialectic Conditioning", nor seen any shred of evidence that it works. I'm concerned when a terapist has a new fad "therapy" and offers it to all comers, without proof that it works well.
Impact of antidepressants on libido is an odd thing, in that all of them can do it in at least some people, none of them do it in most of those taking it ; and a planned shift to a different AD can make a real difference. I agree that while there's some evidence that some of these drugs may help with some episodes in a BPD's life, there is definitively no drug that cures it ; and as it lies within the structure of the personality itself rather than being an illness superimpoised on top of it, it does require proper psychological treatment to try to change these habits and automatic responses. Again, I've seen some evidence of CBT / Cognitive Therapy helping to do this reprogramming. Generally, on's best bet for finding responsible advice about which modern therapies are worthwhile, ought to be obne's local medical school Dept of Psychiatry, as some private practitioners use the opportunity to get a tax-deductable trip abroad to get trained in some flavour-of-the-month therapies, and then offer them eagerly on their return, well before there's evidence of safety and efficacy, and before academic scrutiny of the claims for such therapies has satisfied us that they really are worthwhile.
As I've never heard of the Dialectical Whatsis, can hardly advise where to get it ! ; }

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Our users say:
Posted by: Mariner | 2003/12/07

Hi Non-BP

Careful with that Cypramil. The treatment of BMD with ADs alone can result in the patient becoming hypomanic and ultimately manic. (Bipoler IV - antidepressant induced hypomania). This happened to my ex-gf. I have read of similar cases on a German forum that deals exclusively with BMD. If you are able to understand German, e-mail me and I will send you the URL. I have also read that the best way to treat BMD is a combination of medication and psychotherapy, but it cannot ever be cured.

Reply to Mariner
Posted by: Mariner | 2003/12/07

Hi Non-BP

Careful with that Cypramil. The treament of BMD with ADs anlone can result in the patient becoming hypomanic and ultimately manic. This happened to my ex-gf. I have read of similar cases on a German forum that deals exclusively with BMD. (e-mail me if you are able to understand German and I will send you the URL). I have also read that the best way to treat BMD seems to be a combination of medication and psychotherapy.

Reply to Mariner

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