What support do you currently have? Are you having any therapeutic treatment for BPD?
I remember you from a while ago - were you going to go to the CRU or somewhere similar? Did you go? (sorry for all the questions!)
I have BPD, have been diagnosed since around about 18 though my diagnosis isn't 100% clear. I've been treated mainly for my symptoms rather than diagnosis, and overall, since the age of 17 my treatment has been very good.
I had psychoanalytic therapy with CAMHS for two years, then I went to a residential therapeutic community for a year at the age of 20. I've been "out" for two years, and although I did make definite progress there, I've had repeated crises and hospital admissions since. We (me, my family and team) don't want this to continue so I am being considered for another therapeutic community. Depending upon funding, I could either go to a day therapeutic community which runs 3 1/2 days a week or go to an inpatient one where I could have DBT.
In the two years since I left my TC I've been given lots of support from my psychiatrist, psychologist, day unit, ward, supported housing and care co-ordinator. Sometimes it might be too much support, because their opinions sometimes contradict and that makes things more complicated. In some ways, I might be better tapering off some of these supports.
I'm also on antidepressant and antipsychotic medications.
What would you ideally like in treatment? Does your psychiatrist say why she's reluctant to try other antidepressants? If it's because of an overdose risk, I can understand that and part of the "deal" might need to be that you would keep yourself safe and have them on a weekly dispense. But I agree that she needs to tell you why she's worried.
They might be concerned about offering therapy at the time-being with your risks being so high and the difficulties you have managing them. Sometimes they worry about making things worse (in the shorter term) with therapy.
Therapeutic communities are a good option because they can offer lots of support and treatment at the same time, especially in an in-patient TC (but those often have to be funded) but there's still a fair amout of risk involved in that they often don't have observations or searches of belongings or locked doors like an acute ward, so you'd need to seek help when you're feeling at risk, as far as you can.
And finally (after I, too, waffled!) congratulations on putting in so much hard work to reduce your self harming. I think that's a good step forward to receiving more treatment, and must be really hard. So you've done really well :)
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