Fellow Travelers: Borderline Personality Disorder and Depression

For many people with borderline personality disorder (BPD), depression is often a frequent, unwelcome visitor. However, it is not always easy to tell when a depressive episode is beginning. Sometimes it comes out of the blue, other times it sneaks up on the person. All we know is that once things were okay, but now they're not.

Know the symptoms

According to HealthyPlace.com, the symptoms of major depressive disorder are:

• depressed mood most of the day, almost every day
• loss of interest or pleasure in most activities most of the day, almost every day
• significant weight loss or gain when not dieting, and significant change in appetite
• sleeping too much or too little nearly every day
• physical agitation or slowing down nearly every day
• fatigue or energy loss nearly every day
• feelings of worthlessness or false guilt nearly every day
• reduced ability to concentrate or indecisiveness nearly every day
• thoughts of death or suicide

The symptoms must interfere considerably in one's life, and must not be due to a cause such as bereavement.

Five or more of these symptoms may merit a diagnosis of major depressive disorder, which commonly occurs alongside BPD--fellow travelers, if you will. It is important to know these symptoms in order to effectively communicate the problem. Note: Thoughts of death or suicide should be considered an emergency.

Treatment for depression

The good news is that depression is treatable. You don't have to feel bad for the rest of your life. You can feel better with the right kinds of treatment.

Medication is a common treatment for depression. Antidepressants, and anti-psychotics in some severe cases, are often prescribed. However, medication therapy is as much an art as a science. It may take several attempts to get it right. But once the medication is working, the depression is often considerably lessened.

Psychotherapy is another common treatment. Therapy gives you the opportunity to discuss what is going on behind the diagnosis. Therapy allows you to examine how your symptoms are affecting your life, what you can do about those symptoms, and how you can fight back.

The two are often used together. The medication can stabilize the chemical imbalance, while the therapy teaches coping skills for what the medication can't fix. This gives you not only the strength, but also the know-how, to fight back against depression and BPD.

Fighting the darkness

There are many different coping skills that can be used when medication can't solve the problem. One thing that has worked for me is listing reasons to live.

When I was first diagnosed with BPD, I was also diagnosed with major depressive disorder (among other things). I felt I had no reason to live. I was chronically suicidal. As time passed and I learned how to manage my symptoms, I began to find reasons to live. For example, I have two one-year-old nephews and a newborn niece. They are one of my reasons for living.

Another way I deal with my depressive symptoms is my spirituality. I remind myself that some of the great heroes of my religion--Moses, David, Elijah, Jesus, Martin Luther--all had moments where they were depressed. Some even wished they were dead. It helps me to feel less alone.

I also have a church family that looks out for me. We have many psychiatrists, social workers and medical professionals in our congregation, which leads to a great deal of understanding of my diagnosis. When I was in the state hospital system, they wrote me frequently and prayed for me. Again, knowing that I don't have to walk this path alone is a source of tremendous comfort.

You have to find what works for you. Remember, if it's silly but it works, it's not silly.