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Author Topic: How do you tell the difference between these two disorders (BPD vs OCD)  (Read 1054 times)
DrA

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« on: June 02, 2015, 11:02:04 AM »

How can I tell the difference between an ocd personality disorder (pretty much a control freak perfectionist with some anger thrown in) and a more mild case of BPD? Anyone have any insight out there? I would guess it has a lot to do with the motivation of the anger.  With ocdpd it is about losing control, but with BPD it is about fear of not being loved (abandoned).
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« Reply #1 on: June 02, 2015, 12:54:34 PM »

How can I tell the difference between an ocd personality disorder (pretty much a control freak perfectionist with some anger thrown in) and a more mild case of BPD? Anyone have any insight out there? I would guess it has a lot to do with the motivation of the anger.  With ocdpd it is about losing control, but with BPD it is about fear of not being loved (abandoned).

OCpd is more about rigid rules and not expressing emotions to maintain control. BPD can express perfectionisn as a result of anxiety that they project onto others and consists of fairly more intense extremes of emotion with a lot of dysregulation. Ocpd is more about control and productivity preferred to creating relationships while BPDs can be controlling and focused on productivity as a coping mechanism with anxiety and fear of loneliness. They need relationships with people, no matter how dysfunctional.


So your insight is pretty nail on the head
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« Reply #2 on: June 02, 2015, 04:46:17 PM »

The problem with BPD is that the symptoms that can be observed are all over the place. OCD like behavior is one of many possible symptoms that can be observed. The underlying drivers are somewhat different and especially with BPD there are additional factors in play like impulsivity and disassociation etc... .

For us here we can guess but it is very difficult to do a diagnosis. We are not professionals and even if we were we are really too close.

The LESSONS and the board are structured around DBT skills which are beneficial in a wide range of relationship conflict situations.
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« Reply #3 on: June 02, 2015, 05:06:30 PM »

 

DR A,

Welcome... .this is a great place to discuss differences in disorders and how to deal with them.

Also is a great place to learn how to properly respond to certain behaviors that disordered people (and others) display.

For us (non professionals... .)... .it is usually best to focus less on the diagnosis and more on the behavior that we can see (even if we don't understand it)

So... .

Partner expresses intense emotions... .making communication difficult... .validate or use SET to try to communicate (no need to worry about which PD is at work.  (I'm not aware of a PD where validation of emotions is an incorrect response to a behavior... .if there is... .someone please speak up... .)

Partner accuses  you of all sort of silliness... .possibly including not loving them... .(avoid jading... .if you can identify an emotion... .validate... .etc etc.)

Thoughts? 

FF
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« Reply #4 on: June 03, 2015, 07:04:51 AM »

what i found is anger is misplaced with me, anger was used to ignore other emotions by starting a fight with me, this was the pattern for 20 years of marriage.

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« Reply #5 on: June 03, 2015, 07:25:59 AM »

My partner was misdiagnosed as OCD for many years before finally BPD.

OCD is typically specific issue or phobia based and is quite consistant. There is a need for routine and maintaining a status quo

BPD is more feeling/reaction based and the source and triggers can vary enormously changing constantly.

Both can have anger as defense mechanisms
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« Reply #6 on: June 03, 2015, 07:33:47 AM »

 

I've taken tests that show my OCD tendencies are very high.

I think most pilots are this way... .checklists get done EXACTLY the same way... .there is a reason for doing things a certain way... .etc etc

I'm much more comfortable with an exact routine.

Likelihood that I would feel comfortable "winging it"... .based on my feelings or a change in feelings... .is about zero... .

What I see in pwBPD traits is that some days they are way over here... .some days... .way over there... .and each time... .they feel like they have been that way... .their entire life.  

The rest of the world remembers that yesterday was totally different that the way a pwBPD remembers it... .and this sets up a perfect storm for conflict... .

FF

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« Reply #7 on: June 03, 2015, 06:40:46 PM »



What I see in pwBPD traits is that some days they are way over here... .some days... .way over there... .and each time... .they feel like they have been that way... .their entire life.  


FF

This is an important point and I think it is why sometimes pwBPD think of themselves as OCD, and of course is their version of reality they will sell to medicos. ie In therapy they will say I have always done this or thought that. When in fact last week they would have a completely different story They will sell the consistency and they play down their own flakiness, as that is what they believe. This leads down the path towards false diagnosis.
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« Reply #8 on: June 04, 2015, 12:28:12 AM »

Person with BPD in my life has also diagnoses of OCD, DID, EDNOS.

His OCD has no longer that many compulsory gestures, but his mind is still filled with anxiety and obsessive thinking (intrusive thoughts) that make the anxiety worse. He managed to break out from the extreme routines as they became really difficult (taking half an hour to complete something like getting out the house "in the right way", if successfull with it, or doing to over again). He still has a need for order, but it is enough for him that his own working desk is clean and tools in the tool shed are in their right places.

I think it is the BPD side of him otoh creates a need for big lines in his life to as chaotic and unpredictable as possible (like ending r/s's and ending up jobless and homeless). He hates routines and life that is "too stale"... .

I think of the contradiction in his mind – he has a OCD need for order and predictability and the other side of him makes most effort to brake even the nice and beneficial routines he might have. 
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« Reply #9 on: June 04, 2015, 02:10:32 AM »

The is one aspect where we as partner benefit from being clear of OCD vs. BPD and that is how we support our loved one.

With OCD the behavior - whatever caused it - is causing pain now. The ultimate goal is to overcome the behavior. Overcoming the behavior provides relief.

==> We support overcoming the behavior

With BPD the behavior - driven by inner pain - is relieving pain. The ultimate goal is to overcome inner pain. Overcoming the OCD behavior would simply cause shifting to other relieving behavior.

==> We support managing the behavior and relieving inner pain.

OCD behavior covers a spectrum from a pilot being diligently going through checklists without fail to scrubbing hands until the blood drips. To us as partners OCD tends to go on our nerves - often as the behavior is situationally inappropriate and thus invalidating our view of the world. Watching causes alarm signals in ourselves. But before getting too upset and trying to intervene we have to take a step back and look at the trade-offs. Excessive cleaning may be a pain to watch, might cause unnecessary wear and costs but still is easier to deal with than e.g. drinking or rage. It is less damaging than self-cutting, overeating, excessive shopping or excessive home renovation.

OCD on the BPD side is tough to deal with as it is often invalidating us. Being aware of what is happening (self validation) and stepping away where possible are strategies that allow us to cope.

When looking at the OCD behavior of our partner the question to ponder is not how bizarre and upsetting it is but how damaging it is. OCD behavior for a pwBPD is in some sense functional as it helps them to regulate their core emotional problems. It is a crutch but interfere with a crutch and the person might topple.

But then there is OCD behavior that is truly damaging. Cleaning may be so intensive that it is e.g. damaging household goods at a rate that is financially not sustainable. We need boundaries. At that point we got to draw a line and protect what is important based on our values. In the example it would be finances and we might choose not to replace what has been destroyed and thus a lower standard of living. That strategy would protect our values (sound family finances), would not be controlling and would create tangible consequences to the excessive behavior.
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« Reply #10 on: June 04, 2015, 07:50:53 AM »

Sorry, I was actually trying to find the difference between BPD and Obsessive Compulsive Personality disorder which is quite different than regular OCD.  After becoming more educated from this site about BPD and reading through the ocpd below explanations again, it is plain to me the differences now.  I think I am coming to the conclusion that my wife is a higher functioning BPD with some ocpd traits.  Here is the definition and explanation of ocpd according to Wikipedia:

Obsessive–compulsive personality disorder (OCPD), also called anankastic personality disorder, is a personality disorder characterized by a general pattern of concern with orderliness, perfectionism, excessive attention to details, mental and interpersonal control, and a need for control over one's environment, at the expense of flexibility, openness, and efficiency. Workaholism and miserliness are also seen often in those afflicted with this personality disorder. Rituals are performed to the point of excluding leisure activities and friendships. Persons affected with this disorder may find it hard to relax, always feeling that time is running out for their activities and that more effort is needed to achieve their goals. They may plan their activities down to the minute—a manifestation of the compulsive tendency to keep control over their environment and to dislike unpredictable things as things they cannot control.[1]OCPD occurs in about 2–8% of the general population and 8–9% of psychiatric outpatients.[2] The disorder most often occurs in men.[3]This is a distinct disorder from obsessive–compulsive disorder (OCD), which is an anxiety, rather than a personality disorder, and the relation between the two is contentious. Some, but not all, studies have found high comorbidity rates between the two disorders, and both may share outside similarities – rigid and ritual-like behaviors, for example. Hoarding, orderliness, and a need for symmetry and organization are often seen in people with either disorder. However, attitudes toward these behaviors differ between people affected with either of the disorders: for people with OCD, these behaviors are unwanted and seen as unhealthy, being the product of anxiety-inducing and involuntary thoughts, while for people with OCPD they are experienced as rational and desirable, being the result of, for example, a strong adherence to routines, a natural inclination towards cautiousness, or a desire to achieve perfection.

DSM[edit]

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a widely used manual for diagnosing mental disorders, defines obsessive–compulsive personality disorder (in Axis II Cluster C) as an extensive pattern of preoccupation with perfectionism, orderliness, and interpersonal and mental control, at the cost of efficiency, flexibility and openness. Symptoms must appear by early adulthood and in multiple contexts. At least four of the following should be present:[12]1.Is preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost.

2.Shows perfectionism that interferes with task completion (e.g., is unable to complete a project because his or her own overly strict standards are not met).

3.Is excessively devoted to work and productivity to the exclusion of leisure activities and friendships (not accounted for by obvious economic necessity).

4.Is overconscientious, scrupulous, and inflexible about matters of morality, ethics, or values (not accounted for by cultural or religious identification).

5.Is unable to discard worn-out or worthless objects even when they have no sentimental value.

6.Is reluctant to delegate tasks or to work with others unless they submit to exactly his or her way of doing things.

7.Adopts a miserly spending style toward both self and others; money is viewed as something to be hoarded for future catastrophes.

8.Shows rigidity and stubbornness.

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« Reply #11 on: June 04, 2015, 01:27:46 PM »

Thanks for posting that DrA, I think that definition pretty much nails my partners mother, a perfect recipe for developing BPD kids by placing them well below personal achievement and perfection.

Wasn't actually aware of that as a separate obsessive compulsive category



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« Reply #12 on: June 04, 2015, 02:00:43 PM »



What I see in pwBPD traits is that some days they are way over here... .some days... .way over there... .and each time... .they feel like they have been that way... .their entire life.  


FF

This is an important point and I think it is why sometimes pwBPD think of themselves as OCD, and of course is their version of reality they will sell to medicos. ie In therapy they will say I have always done this or thought that. When in fact last week they would have a completely different story They will sell the consistency and they play down their own flakiness, as that is what they believe. This leads down the path towards false diagnosis.

Yes, yes and yes.

I am diagnosed OCD (but not personality- i have to look into that now- thanks to my ocd... .haha)

In my experience, OCD is about being consistent. OCD is about being predictable. OCD is dependable and ethical. OCD may interfere with what normal people call normal, but to a person with OCD, the perfectionism is totally normal.  I always wash in the same order in the shower. I always read an email 3 times after I have sent it.  Some of it is fear based, some of it is comfort based, but all of it is our "normal".  I do not have times that I cannot remember (disassociation). I do not feel that i have separate personalities. I do not flip flop on how I feel about issues or people. I do not see everyone as black or white. I try hard not to lie. I think of myself as highly ethical and completely faithful. I want my life to be the same way- PREDICTABLE.

I feel like my dBPDbf is completely the same, yet completely the opposite. He may want to be predictable... .he may want to be consistent, but he just isn't. His world is black and white.

My particular kind of OCD is relationship OCD (ROCD). In addition to the insignificant physical ticks like reading an email 3 times or ruminating over something insignificant... .I fear that I am in the wrong relationship with the wrong person or that I don't actually love that person.  I am a runner... .the OCD thoughts tell me to run. It is a significant reason as to why i am divorced. It is why I have always dumped every guy I have been with.  Not only am I fighting the BPD on his end, I have to fight my own OCD.  Yes, I have OCD making me worry that I am BPD, but I know on paper I am not BPD.

I can see how BPD can appear to be OCD... .but I think they are very very very very different. BPD is impulsive and not-predictable, not-dependable. I find I always have to expect the unexpected with my BPD. The only thing it seems I can count on is holidays to be dramatic and ruined without fail. haha.

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« Reply #13 on: June 05, 2015, 06:25:09 AM »

pwOCD fear making mistakes and will check over and over to ensure they dont, and feel overly responsible for any mistakes, real or perceived. Concerns are usually fixed around certain consistent issues. Issues drive the emotion

pwBPD fear being found out making mistakes, and will deny, cover up and pass on responsibility for any mistakes, real or percieved. Concerns are fixed around emotions that can be attached to any number of fleeting issues. Emotion drives the issues

As far as i can tell pwOCPD fearing not being seen to be right or in control. The pursuit of being successful defines who they are
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« Reply #14 on: June 05, 2015, 12:38:41 PM »

Sorry, I was actually trying to find the difference between BPD and Obsessive Compulsive Personality disorder which is quite different than regular OCD.  After becoming more educated from this site about BPD and reading through the ocpd below explanations again, it is plain to me the differences now.  I think I am coming to the conclusion that my wife is a higher functioning BPD with some ocpd traits. 

Haha. This got me confused. I replied to you about OCPD, and everyone is just going for the anxiety disorder and I thought that maybe I had replied about the wrong issue.

I think that in a BPD, OCPD traits might be a way to make sense of the world. If there is lots of logic and productivity, then there is less room of thinking, ruminating, re-experiencing horrible memories, experiencing guilt and generally feeling abandoned and alone in the world.

At least that's how my pwBPD experienced it. His relief from relationships was organizing, fixing, polishing off his life.
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« Reply #15 on: June 05, 2015, 05:52:57 PM »

Sorry, I was actually trying to find the difference between BPD and Obsessive Compulsive Personality disorder which is quite different than regular OCD.  After becoming more educated from this site about BPD and reading through the ocpd below explanations again, it is plain to me the differences now.  I think I am coming to the conclusion that my wife is a higher functioning BPD with some ocpd traits. 

I think that in a BPD, OCPD traits might be a way to make sense of the world. If there is lots of logic and productivity, then there is less room of thinking, ruminating, re-experiencing horrible memories, experiencing guilt and generally feeling abandoned and alone in the world.

I guess its all part of the maintaining the high functioning facade for a pwBPD. Where as with pwOCPD it is part of their core drive, pwBPD would struggle to keep it up. So I guess there would be common behaviors but one is adapted coping behavior, the other is essentially the way they are wired
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