bipolar disorder, Dr. Paul Markovitz  Q. Based upon reading about and discussions regarding Bipolar Disorder, I'm beginning to wonder if I may be suffering from it. I have been diagnosed as eating disorder NOS (similar to anorexia), depressive disorder NOS (similar to dysthemic depression), and ADD. I am currently on 20mg of Prozac and 10-30mg of Dexedrine each day. I'm wondering about bipolar because of the drastic mood changes I have had for a while now, periods of self-injury (cutting my arms and legs with either a razor blade or, if I'm really desperate, a key), recurring insomnia, and agreement with the characteristics of a hypomanic episode such as: more talkative than usual, flight of ideas, distractibility, decreased need for sleep, increase in goal-directed work, and barely restrained shopping sprees. I'm a 20 year old female, and a college junior working towards a double major in English and Business communications. Any thoughts or advice you could give me would be appreciated.

  A. It sounds like a pretty clear case of borderline personality, but a psychiatrist would be good to ask about this diagnosis after a good work up. If this is the diagnosis, increasing the Prozac to 80 mg daily would be the way to go. The paper on this is by me and was in the American Journal of Psychiatry in August 1991.