Bi-Polar II... misdiagnosis?

[Think About It...]

OK. I have a feeling I'm being spied upon as some people have little better to do than snoop around on the internet all day spewing lies. Lots I'd like to get off my chest but I'll keep it for now.

Anyway, can anyone give me info on Bi-PolarII? How does it present and what's the treatment? Has anyone any experience of the condition? Does the treatment for it go any way towards treating Borderline Personality Disorder?

From what I understand it is very difficult to get any treatment for BPD here in the UK on the NHS. Not only that, but it seems private clinics often misdiagnose BPD with Bi-Polar. There seems to be a strong reluctance to diagnose it here. And I've seen it said on here that they will often deliberately misdiagnose it with Bi-Polar for some reason. So I have read anyway.

Am I right in thinking that Bi-Polar disorder just isn't anything like the same thing. I know it's characterised by severe mood swings. Thing is, I remember an interview with Stephen Fry who suffers with the condition. He remarked that he's always been reluctant to go for treatment as even the the lows are very depressing and severe, the pay off with the absolute ecstatic highs is completely worth it. I'm sure he was somewhat tongue in cheek in what he said but when I weigh that up with my ex...well I just don't see the highs. I see her running away and being impulsive to alleviate the pain but that always just led to her being miserable with something or someone else. Never any "high" to speak of. Bi-Polar, as far as I understand doesn't present with a complete lack of empathy for others or highly impulsive, continuous destructive behavior.

Anyone else had experience of a misdiagnosis?

[the_way_back]

OK. I have a feeling I'm being spied upon as some people have little better to do than snoop around on the internet all day spewing lies. Lots I'd like to get off my chest but I'll keep it for now.

Anyway, can anyone give me info on Bi-PolarII? How does it present and what's the treatment? Has anyone any experience of the condition? Does the treatment for it go any way towards treating Borderline Personality Disorder?

From what I understand it is very difficult to get any treatment for BPD here in the UK on the NHS. Not only that, but it seems private clinics often misdiagnose BPD with Bi-Polar. There seems to be a strong reluctance to diagnose it here. And I've seen it said on here that they will often deliberately misdiagnose it with Bi-Polar for some reason. So I have read anyway.

Am I right in thinking that Bi-Polar disorder just isn't anything like the same thing. I know it's characterised by severe mood swings. Thing is, I remember an interview with Stephen Fry who suffers with the condition. He remarked that he's always been reluctant to go for treatment as even the the lows are very depressing and severe, the pay off with the absolute ecstatic highs is completely worth it. I'm sure he was somewhat tongue in cheek in what he said but when I weigh that up with my ex...well I just don't see the highs. I see her running away and being impulsive to alleviate the pain but that always just led to her being miserable with something or someone else. Never any "high" to speak of. Bi-Polar, as far as I understand doesn't present with a complete lack of empathy for others or highly impulsive, continuous destructive behavior.

Anyone else had experience of a misdiagnosis?

[ConfusedMichael]

Yes the_way_back,

My own ex was given a tentative diagnosis of bipolar disorder when she was in her mid-teens.  This was before I knew her so I am simply going by her own account of it.  She was treated for that for a year or two, but although the medication helped regulate her moods, she hated the way it made her feel, saying she felt like it robbed her of having any emotions at all.  Eventually she cut off all contact with her doctor, threw out her meds and moved to another city.

When we began our relationship some five or six years later she told me about this, and admitted that although she abandoned treatment she was sure that the doctor was correct.  Eventually I persuaded her to find a new doctor and see if there was a less extreme course of treatment she could follow.  Instead her new doctor diagnosed her with BPD, and she began treatment for that instead.  She was unsure about it at first, but she soon came to terms with the diagnosis and, from her own account, I got the impression that she found the medication to be much more effective.

And you are certainly correct in your belief that they are two very different illnesses, even if there is some overlap in the symptoms.

[SWLSR]

Bi Polar and BPD have many of the same symptoms and they are often confused with each other.  Bi Polar II is something that means the highs are not as high but the lows are still the same.  There has been some study that Bi Polar II is BPD but I am not sure what has become of it.  Anyway, the DSM IV has them as two distict diseases Bi-polar being a chemical imbalance BPD being an emotional disease.  However I have been told that DSM 5.0.0.0 coming out next year is going to blur the differences between bi-polar and BPD which at this time I do not have many details on itm

[the_way_back]

Interesting

However, I was under the impression the Bi-Polar can be treated with medication alone. BPD needs serious counselling.

Very confused.

Medication is hardly going to introduce someone to themselves and challenge them to accept responsibility for their behaviour.

[GENERAL ANNOUNCEMENT: Are you on the right board?]

GENERAL ANNOUNCEMENT: Are you on the right board? This board is for members with failed or failing relationships that want to detach from their relationship and relationship wounds. If you are still analyzing the decision to stay, please post on Undecided: Staying or Leaving All members living with a pwBPD should learn to use the Stop the Bleeding tools - boundaries, timeouts and other basic tools - to better manage the day to day interactions with your partner. If you have questions on any of the tools, feel free to go over to Staying: Improving a Relationship with a Borderline Partner and ask for help. :-)

[MaybeSo]

Bi polar II as mentioned is an up and down mood swing but if it's bpII they aren't frantically manic...a person could be on an upswing but they aren't crazy manic like BP I is (up for 6 nites in a row cleaning, booking trips to Spain with no money, feels like God) but does have the bouts of depression.

Bi polar if not comorbid with another issues, has cycles that can be somewhat predicitable, and the ups/downs aren't triggered by situational stuff, rather they cycle through the ups and downs regardless of what's happening socially or situationally...whereas Borderline is all over the board and triggered all the time by relationships and the environement etc.

So, BPD can look likes the ups/downs of bi polar but there's usually situational stuff triggering all the ups/downs and no realy clear cycle.

Some do wonder if BiPolar and BPD are related in some way...I wonder that too, but at this point they are considered separate, BiBolar is Axis I, BPD is Axis II.

Insurance will cover BiPolar cause it's Axis I and is considered more treatable as a disease process (biologically based, responds to meds) than all the symtoms of BPD (developmental) so that's one reason why a clinic might put that down as  a diagnosis.

Medication doens't cure BPD but it can help combat and soften some of the symptoms such as impulsivity, anxiety and depression, irritability. My ex takes Lexapro and it helps. Medication IS considered a part of treatment for serious BPD these days, along with therapy like DBT, Schema, Mentalization Based therapy  (which I'm pretty sure was developed in the UK), CBT etc.   These therapies would not be adverse or inappropriate for the treatment of BiPolar, but it would be even more important if it's bipolar that a psychiatrist is perscribing meds to control Bi Polar symptoms because the more manic episodes a person has the worse they can get,  so meds are very important with BiPolar.
  
If you're not still totally confused...

Bipolar I or II can be comorbid with BPD.   My ex is dx cycloythmic (biopolar lite) but he certainly has the social/realtionship problems seen with BPD.

 

[the_way_back]

Ok thats useful. Thatnks maybeso

Obviously it's not going to have her develop any sorrow for the things she's done.

But moving forward, will the medication enable her to stop splitting, be a bit more rational?

[MaybeSo]

Obviously it's not going to have her develop any sorrow for the things she's done.

I wouldn't hold my breath on that one unless you think you look especially good in shades of blue.  Besides, my ex felt bad about a lot of things, but he still had BPD, anyway.   It is what it is.

But moving forward, will the medication enable her to stop splitting, be a bit more rational?

No. The meds wont' cure cognitive distortions. They can cut down on impulsivity, anxiety, depression, irritability, but there is no med that helps you think healtheir thoughts. The meds can set them up to be calm enough to start thinking about their thoughts in therapy.  They need a cognitive therapist to work with them on that for a long time.  My ex has been working in therapy for over 7 years and he still struggles with the cognitive stuff.

[the_way_back]

Ok thanks for the insight everyone. Gives me a clearer idea of what to expect. Basically, not much different ha!

[Knivesxx1]

I would like to add that the meds might help with anxiety, the impulses and depression if they take them. Mine took them for a month tops before he decided they didn't work or he didn't need them anymore.

[the_way_back]

Well, are they basically just anti depressants?

She has been on them during the course of our relationship ( I use that word in that loosest sense). It doesnt take much effort to recall that they just made things worse.

She basically became a fulltime emotionless zombie which made it easier for her to detach from her devious behaviour.

[ConfusedMichael]

Sorry the_way_back, I didn't make my reply as clear as I should have.

When my ex was diagnosed with BPD, it was a combination of medications AND regular counselling that was her treatment, not meds alone.  As to her treatment for bipolar, which came before I knew her, the only treatment she ever mentioned was the meds she was given for that.  That's why I made the comparison between the two sets of medication.  You are right however, the counselling is a vital part of it too, and if she wasn't receiving it when it was thought she was bipolar, then that would certainly help explain why she never felt comfortable with that treatment plan.

[the_way_back]

hey Michael

I got the gist of what you were saying. Basically the meds wont be enough on their own. I can see why its rarely diagnosed. Funnelling money into counselling for a condition with little guarantee of successful remission probably goes someway to explaining that when you consider the NHS is over stretched as it is.

Plus her NPD fella will be overjoyed as he won't be paying for fruitless counselling sessions. Which will probably make it easier for her to justify cheating on him (again) in the future!

All the fun of the fair