Q. Help. Recently I’ve been expieriencing extreme highs, I’m used to mood swings and am usually able to keep a lid on them, but I’m getting more and more out of control. This weekend has been one of the most hectic in my life. Friday I started out good, happy, bouncy chirpy and just plain ecstatic, then stuff happened, I overreacted (as I tend to do) and I spiralled into the irritated, pissed off wreck. I got mad, threw some stuff around, had a drink to calm me down before my friends arrived. We went to a gig, I was ok again, happy, bouncy, fine. Saturday I took off, stayed at a family friend’s place. I just had to get out of the house, I had to move. I was going crazy. I’ve done it before, but I’ve always come home the same day – normally I take a run and come back later, but I’m not allowed to run anymore because my doctor said so.(I have kidney problems – walking and swimming are about all I can do) I’m losing control of it. What do I do? I keep feeling myself drifting back to self injury, nothing else works. I need to centre, an ground myself, but I don’t want to cut again. I mean, its nice after that long depression to finally be able to smile without feeling my face is gonna crack, but it’s driving me crazy. I don’t feel my current Therapist can help, lately I keep thinking she’s useless. She knows about my moods and the cutting and everything, but I don’t think she realises how serious it is. Maybe I don’t trust her because my dad chose her and I often feel he’s an idiot and doesn’t understand me at all, but it’s not working. I’ve got noone else to talk to. I can’t tell my best friend because I a) don’t want to burden her and b) what’s she gonna be able to do, I dunno what to do. I’ve been like this as long as I can remember (even though nowadays that isn’t very much) but it’s never been this bad, I’ve always been able to tackle it or hide it, sometimes I’ve had to resort to self injury but I was still ok. Now I’m losing it. My high’s are too high, my low’s are too low, and if I’m not one of those I’m usually completely emotionally detached. I need help but I don’t know where to get it. I need to know what’s wrong with me so I can deal with it. Is it BPD? I seem to have most, if not all of the symptoms, and it sounds right, but I doubt my own judgement. I refuse to commit to any relationships because if I don’t attach I won’t hurt when they leave. All my relationships are messed up, be they friends, family, partners… whatever, I love someone one minute, the next I hate them, the simplest little thing can cause me to think that someone who I used to percieve as wonderful and nice as the most horrid treacherous person on the planet. I can never make up my mind, I used to be decisive, and firmly so but now I decide one thing and 2 minutes later I’ve chaned my mind. One moment I’ll love myself, the next I’m disgusting, I’ll change my opinion faster than anything. I’ll do extremely rash things on a whim without a second thought, I’ll spend money when I’m meant to be saving, I’ll drink when I know I’m underage and ill, I’ll eat tons of junk food when I’m supposed to be eating healthy… it never ends. I’ve self harmed since the age of 4, and have never actively quit, i’ve stopped, but I’ve never quit. I’ve planned out suicides, and although I’ve never carried through I’ve both desperately wanted to and intended to. I’ll be happy one minute, then something snaps and I’ll suddenly be irritated, something else and I’ll be ready to kill someone, two minutes later I’ll want to curl up and die. My emotional state has only one rule, its unpredictability. I often feel like there’s this great big void inside me and it’s going to swallow me up, sometimes I just wish it would, and others I’ terrified it will. The smallest things can set me off, something someone said, the way someone looks at me, stuff I don’t even consciously notice will make me really angry, sometimes I get so mad I lock myself in my room because I’m afraid if I go outside I’m gonna kill someone. If I’m not in an extreme mood I’ usually freaking out or completely disconnected, I lose all my emotions, it’s almost scarier than when I’m desperately high or low, or whatever. It terrifies me that one day I might slip into that state and do something terrible, and feel nothing. Am I Borderline? Where can I get help? How can I get help? Do I need help? What about my current therapist? Please, I really need some guidance.

A. I am sorry that you are going through such a difficult time. I cannot give you a diagnosis online but I can say that your emotional state is very irregular. You are definitely in need of help. I am worried that without help, you will hurt yourself or someone else. If you feel you are too out of control and that you may hurt yourself or someone else, then you should go to the hospital for immediate help. I am not sure how the mental health services work where you live, but do what you can to find someone that can help you. I understand that you have trouble trusting people, so finding someone you like may be somewhat challenging. If you feel your therapist is not helpful at all, try another one.

You might also want to see a psychiatrist about the possible introduction of medication. I am not sure how you feel about taking medication but people with some of the symptoms you are describing have found that medication helps to balance their extreme moods. You may not need medication for very long but in the short run, it could be helpful to you while you undergo more counseling to learn how to deal with your mood and dramatic ups and downs. Perhaps medication is the missing ingredient in your therapy process. My advice is to get emergency help if you feel you might hurt yourself or someone else, try another therapist if you feel you are not being helped, and consider seeing a psychiatrist for medication. I hope I was at least a little helpful. Please write again if you have any more questions and to let me know how you are doing. I wish you the best of luck.