"Do not try to diagnose BPD -- only a professional can"

[raisins3142]

I think part of the problem with the categories is that they are too broad.

There are nine criteria for BPD which only five of are required to diagnose it. This means that there are many variations within the BPD spectrum. (Probably over forty variations. Ive not done the maths on this).

If you then add co-morbid traits then it gets even more complicated. BPD/NPD/ASPD etc.

I feel that rather than having this broad brush approach it should be dealt with by having a tick list of criterias giving a more overall picture. Yes at the end you can come to a conclussion that a person has BPD with many traits from other dissorders but it could be a more fine tuned diagnosis.


As to the arghment of only proffessionals diagnosing I have to agree with tim. I probably understand BPD more than most mental health proffessionals as I have been enmeshed with it. My ex wife had a psyc eval during our divorce and the resultwas that she had situational depression. Its obvious that the psychiatrist wasnt informed about the voices in her head, the self harm, the little but constant lies, the thousands of pounds spent on clothes that were never worn and a lot not even in her size. All the little things that build up a picture that an hour with a so called proffessional will never be picked up on.

256 variations if I did the math right.

[raisins3142]

9! / 5!  gives approx 2700 plus possible combinations

of symptoms that could result in a diagnosis

You can have 5 or 6 or 7 or 8 or 9 traits.  Those permutations are additive.

Do the following for x is 9 to 5 and add all results (can't put the right notation in here for a summation).

9!/(9-x)!/x!

You'll notice that for x = 9 that there is only 1 variation from that equation for a person with all 9 traits.

If you add them all, it is 256.  Which is a common number for computer etc, so is kind of interesting.

[raisins3142]

It's probably enough to know they have BPD traits, and even if they don't formally fall in that "diagnosed" category binary thingie, it is still helpful to us in making sense of things and avoiding future hurt.

I'd say this though, if someone is a really solid BPD, then it is easier to diagnose, obviously, than the marginal case.

For instance, if you are dealing with a cutter that is also an alcoholic, had a horrible upbringing, does not remember large swaths of time, cheats/lies all the time, and has been in a billion short and rocky relationships... .and has many of the subtler emotional traits mentioned... .well you might really be on to something with the BPD thing.

[enlighten me]

As to the arghment of only proffessionals diagnosing I have to agree with tim. I probably understand BPD more than most mental health proffessionals as I have been enmeshed with it. My ex wife had a psyc eval during our divorce and the resultwas that she had situational depression. Its obvious that the psychiatrist wasnt informed about the voices in her head, the self harm, the little but constant lies, the thousands of pounds spent on clothes that were never worn and a lot not even in her size. All the little things that build up a picture that an hour with a so called proffessional will never be picked up on.

Based on your language, I'm assuming that you're writing from the UK, where it's more difficult to get a formal evaluation.  (And for the record, the NHS sounds like a crummy system for mental health.  12 therapist appointments unless you're full out seeing Jesus in the walls?  Really man!)  Still, from my American perspective, you should have told your mental health pro the full scoop.  My exBPDw was all lined up for electroshock therapy until she just happened to step out to the bathroom, and I told the psychiatrist the stories about her latest breakdowns, up to an including her father getting out of prison.  Suddenly, she was lined up for another go in the mental hospital.

My point is that you need to be able to speak up as to what's going on as much as possible.

Hi iluminati

Yes I am in the uk. During my divorce and for a few years after I wasnt aware of BPD. I was trying to prevent her from moving away with my sons. She had told me she was diagnosed with ME and bi polar. I raised my concerns and the court ordered a psyc eval. I had no input into this. In all honesty I knew something was wrong but thought her histrionic due to all the illnesses. It was only after splitting with my exgf and looking into her behaviour that I came across BPD. When reading the DSM my exgf ticked seven of the criteria. I then realised my ex wife ticked eight. After speaking with my MIL  I showed her the DSM  and she agreed that it fitted. She also said the one criteria that I wasnt sure of the cronic feelings of emptyness was something my ex wife had said to her on numerous occassions so all nine ticked with great big red ticks and no maybe s.

I agree that the NHS struggles with mental health. I think that the problem is that the UK has a lot of catching up to do. I also blame genetics as we are a nation who's ancestors werent neccessarily the most stable folk on the planet. I say this as we have been invaded and colonised by some of the hardiest warriors of their times. Romans, angles, saxons, norman, vikings. Good warriors but probaly not a gene pool thats without flaw.

while you say you would not diagnose BPD are you meaning you wouldnt inform people of it but would consider it as whats wrong or that you wouldnt even form it as your own opinion.

I personally wouldnt say someone is definately BPD but would form my own opinion that they might be. Like another post said if it looks like a duck and acts like a duck then its probably a duck. I dont think this if used as your own opinion is wrong. It helped me a lot to put a name to the behaviours id dealt with for 16 1/2 years.

[no_more_guilt]

Really interesting topic.  I learned about BPD last summer.  Married 8 years by then, and I had arrived at the conclusion that something was deeply wrong with the relationship.  I was being told by her all number of reasons why things were my fault.  Always, she had done nothing wrong.  Anyway, I had by that point reached the conclusion that - even I was really the problem - we should end the marriage.  I'll be happier on my own, and by her words, she should be also.

Then I learned about BPD, and so many things about her - and our relationship - made sense.

I don't require that she be professionally diagnosed.  The DSM criteria lists 9 specific behavioral traits, any of which would be problematic in a relationship.  My wife did not demonstrate all of them, but enough for me to strongly connect with the disorder.  I read them and thought, yup that's her pretty much.  I've seen most of those things repeatedly.  The more I read, the more I connected.

Having said that, her having (professionally diagnosed) BPD would not even be a deal-breaker for me.  The deal-breaker was her denial that she had any issues at all, and her inability to take an adult responsibility for the things she said and did.

[hurting300]

Let's peal this back a little... .what is your real point here?  What is someone doing that they need to do different?

I could shoot down your argument that Borderline personality disorder is highly unique. The DSM 5 committee wanted to scrap the current criteria in favor one that made more sense. Their reasoning was that 87% of people with "BPD" have it in the comorbidity with something else.  The new criteria is in the appendix of the DSM five pending further study. They'd be happy to just make a personality disorder, with traits based on 4 measures.

Look at the criteria behavior for somebody with ADHD... . 

Also, before anyone diagnoses borderline personality disorder, using the DSM IV multi-axial system, they have to eliminate a large number of other conditions.

That's a lot of technical "stuff" that probably doesn't really matter here. Generally, if we know we're dealing with someone with an impulse disorder, we are going to see a lot of the things that we see on this board. And the tools for borderline personality disorder... .

Tim300, what is someone doing that they need to do different?  

I noticed you were taking some swipes at Marcia Linehan PhD and in another thread, what's up?

spot on Skip, the people we hired to profile my ex clearly told me most people with this disorder have disorders as well. There is no clean cut BPD case. Some BPD's like my ex show no anger because they are more psychopathic meaning cool and collected. That's why you need to be a professional.

[hergestridge]

In my case I was the one to suggest a BPD diagnosis for my wife. I took a lot of ___ for it too, but in the end it turned out I was right. She was formally diagnosed.

But I would not go as far as saying that the "non" knows better than the therapists or doctor. There are several reasons for this. To begin with we are so "up close" with our partners it can be difficult to tell our problems from their problems. I see this every day when I read this site. An awful lot of projection going on in the "other" direction. I am sure I have been guilty of this too. Therefore I think it is important to have an outside person evaluate the situation.

My wife met a therapist (well trained in treating BPD) and told her HER story (the usual bull___ I suppose), and even without hearing my part of the story the therapist saw the BPD traits; the tendency to blame, to confront, to idealize/paint black, to stay but to hate etc.

We must never forget that as long as someone is "upwBPD", it is just us suspecting the person has BPD. Nothing else. I mean, for a PD ot be diagnosed there has to be a significant impairment in the life of that person in their work or in their social life - that is one of the basic criteria. Basically this means that when *their* life comes crumbling down then it becomes a big enough issue to start looking into a diagnosis.

For the people around the trouble person it would be better just being a pain in the ass could be enough for a PD, but it's not.

For my wife it was when she suddenly was too unstable to work and take care of her child, something that in itself left her in enourmous distress. This brought to the the surface her inability to self soothe and regulate her emotions.

Also, sometimes when I read stories and posts here I am baffled by how certain people seem to be surrounded by people with various undiagnosed personality disorders - or "traits" thereof. I think it can easily become a "way of thinking", you start you classify the people around you and their problems into various categories from the things you have read about and learnt. But I think sometimes people forget that these catagories/labels are for really ill people. Not for us others

[hurting300]

I honestly never knew what mental illnesses were when I first got with my ex... I classified people as crazy or not crazy . But I noticed some disturbing things from her and believed her victim story... one night she came out and ask me if I was a sociopath! I had NO clue what that was. I said well yeah I am a sociopath because I'm a social guy. So I think and know for a fact mine is off.

[raisins3142]

I honestly never knew what mental illnesses were when I first got with my ex... I classified people as crazy or not crazy . But I noticed some disturbing things from her and believed her victim story... one night she came out and ask me if I was a sociopath! I had NO clue what that was. I said well yeah I am a sociopath because I'm a social guy. So I think and know for a fact mine is off.

I knew about the common ones of depression, anxiety, and substance abuse and that some people just had crappy personalities and complexes.

I never expected to meet someone with her level of irrationality and emotional issues.  So, I didn't believe my eyes or what she even told me.  She told me bad stuff and predicted what she might do to our relationship, but I just thought it was her low self esteem talking.

[hurting300]

I honestly never knew what mental illnesses were when I first got with my ex... I classified people as crazy or not crazy . But I noticed some disturbing things from her and believed her victim story... one night she came out and ask me if I was a sociopath! I had NO clue what that was. I said well yeah I am a sociopath because I'm a social guy. So I think and know for a fact mine is off.

I knew about the common ones of depression, anxiety, and substance abuse and that some people just had crappy personalities and complexes.

I never expected to meet someone with her level of irrationality and emotional issues.  So, I didn't believe my eyes or what she even told me.  She told me bad stuff and predicted what she might do to our relationship, but I just thought it was her low self esteem talking.

I knew about the simple disorders but nothing like what she has. It's really sad how they are. I know she is always miserable and never happy. She might smile but it's a fake one at best.

[Tim300]

I knew about the simple disorders but nothing like what she has. It's really sad how they are. I know she is always miserable and never happy. She might smile but it's a fake one at best.

Yeah, mine rarely seemed happy.  Maybe in the first year or so of the relationship she seemed happy at times.  Then when she had everything she wanted I would ask how that made her feel, she would just say something like "It's too good to be true, I don't believe it" in an anxious/fearful way but not in a happy way.

[Madison66]

You know, I used to get caught up in feeling the need to diagnose or figure out my uBPD/NPD ex gf of 3+ years.  Some of that may have been because I just couldn't understand her actions and words.  I also was trying to figure why we couldn't have a healthy r/s.  Additionally, I had a great of guilt built up from FOO that caused me to constantly take on her issues and feel like they were my fault.  Lastly, I had a value based internal battle going on with myself because I stayed in a r/s that didn't fit my own values.  

I can tell you that my ex gf had so many BPD and NPD traits concerning abandonment, emotional immaturity, emotional disregulation, entitlement, lack of empathy, projection, extreme defensiveness, reckless driving, past eating disorder, addiction to chaos, splitting, push/pull, passive aggressive behavior, etc.  I can tell you that she didn't rage that often, but I saw some things that scared me and was met with physical abuse at the end of the r/s.  I also didn't see the suicidal tendencies I've read about with BPD.  

The bottom line of it all was that I couldn't live with the things I witnessed and endured.  Thankfully, I was able to get out when I did and focus the attention inward.  I'm in a healthy r/s with a fabulous non PD lady and the roller coaster of emotions that I dealt with in my previous r/s are not there.  I'm truly thankful I found resources like this site and a fantastic T who helped me in my recovery and detachment.  BPD or not, I now fully understand what I want in a r/s and how I will live my life moving forward.