hi VL

the course of illness varies with each individual.

my worst bouts were in my teens, early-mid twenties and mid thirties. i can't really speak too far after that, but so far i seem to be improving? that would be consistent with statistics indicating that the illness tends to be worse in twenties and/or thirties. however every individual is different, and this does not have predictive value for any particular person.

i feel that therapy has helped me a lot, yes, at the times when i had a therapist i was comfortable with. even just having someone to deal with dealing with regular "issues," or to provide support / or be a sounding board for even more mundane stuff, is helpful when you are emotionally vulnerable. i have had cognitive-type therapy (but not rigorous) and some analysis. but i feel that supportive therapy has helped me the most. i think that dialectical behavioral therapy (DBT) would help me, but i don't have access to that - just thought i'd mention it as that might be something useful for your relative as well - more so that CBT most likely.

meds have helped... at times a lot, at times not at all, at times only kinda-sorta-maybe.

i feel that the benzodiazepines have done me more harm than good in the broad view of things. i think their limited use for anxiety was ok in the beginning but that i should not have been kept on them. they are not supposed to be scripted long term - the same drug companies that sell them warn against it. more recent studies have shown that addiction is not the only issue with prolonged use, but that long term use (many years) leads to cognitive deficits - reversible with suspension of the drugs. however every situation is different - sometimes we must choose what is "the least of two evils" for our own situation - not everyone feels the same way i do about these meds, in spite of the issues with them.

the pros and cons of antipsychotic class drugs are also problematic. again, some situations are grave enough to call for their use, but many people have ended up with massive weight gain / hyperlipidemia / diabetes II from the newer generation ones, or tardive dyskinesia from the older ones (although there is risk with the newer ones as well)... so this is another set of meds i think should be used only for periods necessary.

other classes of meds are not problem free. so in general i think they should be used judiciously in function of actual need, and with as much information as possible. clearly a physician that is willing to do this is needed. (some will stuff you with pills, and/or not be terribly familiar with the issues). a good pdoc is key to good treatment, in any case.

~ waves ~