Expert: Ivan Goldberg, M.D. - 10/31/2006

Question
Hi, I am a 27 year old female. My mother says she has been diagnosed as a manic depressive with a personality disorder.she has spent months at a time in hospital and has been on lithium not anymore and no hospital for over ten years. I remember mum would loose touch with reality and say silly things that has not happened to me accept once at glastonbury after three nights of no sleep and drugs i heard voices that was 10 years ago and nothing since.My mums mother was really ill but never diagnosed she would flip and had crazy ideas. I feel my problems are taking over my life and although i have been on antidepressants i don't think they helped me at all.My main problem i think is irrational fears and paranoia. I don't think people are plotting against me and i don't hear any voices. my day to day worries are say if im on a bus and a guy gets on i think he may attack me, or if im in a car with a friend i jump and my heart goes allot i feel im highly strung. My anxiety is terrible and i have periods that are worse than others i think its at its worse when i worry about actually being mad, the fear of loosing my mind or the fear of being very ill, i have a kidney desease.The overwhelming waves of fear i would not wish on anyone. I often think it could be the fact that people with fear ultimately fear dying, who knows im no doctor. I am not working at the moment and spend lots of time at home, although i am very successful in social situations and have many friends in all kinds of circles for eg i spend tome in London with media and music luvies! i think this is how i deem my success in life. I live with an ex partner and sometimes get very angry at him infact i treat him very badly, he is an educated man and agrees i have menatal health issues but we are both afraid of what the nhs may do i was once sent to be seen by a physiologist who within 20 minutes said i had a personality disorder and wanted me to go five days a week to group therapy. I have never been a drug addict but have taked e's, coke, weed and speed over the years and still sometimes take an e if i go out for a big night. i dont smoke of take coke anymore as it makes my anxiety worse. I have always been abig binge drinker and in some sets of my friends its quite normal to go out on a three day binge often. my physical health has taken a turn and i cant keep up with that anymore so go out more on a monthly basis.I have also been promiscuous and enjoyed the rock n roll lifestyle again i feel thats sorted, i escape and haven't taken responsibility yet, i am lucky my ex is looking after me but not sure how long that will continue, i eat well but am lazy and dont really exercise. and would say im rather clever although i did not finish school. lots have people say i have been on self distruct for a long time but i truely feel i have that under control as i fear having more pain. sometimes if i am productive symptoms ease. maybe its that im not operating properly at the worst times everything seems surreal and i feel dizzy and have thought of going to a and e and getting admitted. i know you cant make a diagnosis, but i have tried to be honest and just want any kind of guidance. thanks.

Answer
Hi . . .

While your question was quite long and involved, the answer is short. I am not familiar with how the NHS works, but the thing for you to do is to have an evaluation with a PSYCHIATRIST. I have no idea if psychotherapy alone or the combination of psychotherapy plus medication is what you need, but only a psychiatrist can tell.

Best regards . . .

Ivan
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