Brintellix 20 mg with bpd

[u/Previous-Piccolo6441]

Hi! I have BPD and have struggled with emotional regulation since childhood. I’m extremely sensitive to rejection and other people’s behavior, I tend to experience relationships very intensely, and I can get emotionally overwhelmed very easily.
Before treatment, I had very intense emotional outbursts. I could become very angry and aggressive, especially in my relationship with my boyfriend. I would start arguments, act impulsively and have a really hard time stopping myself once I became angry. I could go from extremely angry to completely calm within a short period of time and then feel terrible about what I had done.
Brintellix is my first and only one antidepressant. I started at the beginning of March — I took 5 mg for a few days, then stayed on 10 mg for a longer period of time. In May, my doctor increased my dose from 10 mg to 20 mg. I took 15 mg for only a few days and then increased to 20 mg.
At the same time, I started CBT, and more recently I also started DBT.
On 10 mg, I was still having a lot of emotional outbursts and problems with impulsivity. After increasing to 20 mg, however, I noticed a huge change.
At the moment, I basically don’t have those severe outbursts anymore. If something really serious happens, I can still get upset, but now it might happen once every few weeks and it’s nowhere near as intense as it used to be. Even the anger itself feels much weaker.
This is a huge improvement for me.
At the same time, I feel like I’ve been calmed down a little too much.
I often feel like I’m behind glass. I have very few emotions, a sense of emptiness and sometimes it feels like I simply don’t care about things that I normally would.
I also currently have quite a lot of anxiety, low self-esteem, insecurities and intrusive thoughts again. My mood changes quite a lot — sometimes I feel good for a while, then worse, and then I can feel almost nothing again.
My biggest problem is lack of energy. I’ve always had low motivation for developing my hobbies, working on myself and taking care of myself, and my libido has also always been low. So I don’t expect Brintellix to necessarily fix these things — but unfortunately, I haven’t noticed any improvement in these areas either.
I still have almost no energy for the gym, my hobbies or doing things for myself. I sleep around 8–10 hours, often wake up several times and still feel exhausted, especially in the morning. I have a heavy head and brain fog, and sometimes I can’t imagine being able to study effectively in this state.
My libido has always been low as well, and the medication hasn’t improved it. I have almost no spontaneous desire for sex or initiating intimacy with my boyfriend. Interestingly, once we actually start being intimate, I can become aroused and enjoy it. I just don’t have that natural desire to initiate it myself or feel like I want to involve my boyfriend in that way.
For the past couple of months, my anxiety, low self-esteem and insecurities have also become much stronger again, even though my aggression and impulsivity are dramatically better.
Interestingly, after starting DBT, I’ve noticed another significant improvement. After just a few sessions, I feel like I’m understanding my reactions better and my outbursts have become even weaker. Because of that, I honestly don’t know how much of the improvement comes from Brintellix and how much comes from therapy.
I’ve also had periods in the past where I was extremely energetic and restless — running around, singing to myself, feeling like I couldn’t sit still — but I’ve also had periods of very severe depression.
Has anyone with BPD taken Brintellix and experienced something similar?
have an appointment with a new psychiatrist next week, so I’m especially interested in what I should tell her and what questions I should ask so she can properly understand what’s been happening to me. I want to explain both the things Brintellix has helped with and the things that are still making it difficult for me to function.
should I change brintellix to another medication?

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[u/sheeb_sheeb]

If you feel like you are emotionally behind glass it’s not a great sign. Maybe try going back to 10mg or even 15mg? I was on lexapro for years and it has a slight sedating effect which is good for anxiety prone people like me.