Psychosis - do people with BPD have it?

[Lifewriter16]

Hi All,

I read somewhere that people with BPD have psychosis. My BPDxbf has psychosis but he also had an earlier diagnosis of schizophrenia, so I put his psychosis down to schizophrenia not BPD.

Is psychosis part of BPD? And what does having psychosis actually mean?

Lifewriter

x

[FannyB]

Hi Lifewriter

Psychosis is when an individual loses touch with reality and their thinking becomes delusional. Weren't borderlines originally so described because they existed on the border between neurosis and psychosis?

If they do 'crossover' then does the BPD then become a secondary diagnosis rather than the primary one? 

A very confused Fanny

[sweetheart]

Hi Lifewriter16,

My h has a diagnosis of Paranoid Schizophrenia with co morbid BPD.  There is some debate as to whether the two diagnoses can coexist by some P's.

The rule of thumb for diagnosis is the transient nature of the psychotic symptoms. Psychotic meaning a loss of contact with reality.

Usually the dissociative psychotic states associated with BPD are fleeting and transient. Whilst with PS they are longer lasting with fixed delusional beliefs and hallucinations. (There will always be exceptions.)

My h most definitely fulfills all criteria for BPD and PS; when dysregulated he has all the classic symptoms of clinical BPD, and when actively psychotic has a primary fixed delusion that he is telepathic, experiences auditory hallucinations and demonstrates no insight whatsoever. When he is well, which he is at the moment, his belief that he is telepathic recedes in to the background and his psychosis abates.

So yes pwBPD can become psychotic but it tends to be short lived, but no less distressing for all involved. 

[sweetheart]

Hello FannyB,

Yes that is what the term borderline means, straddling those two states. It was created by a psychoanalyst in the 1930s Adolph Stern.

And no, when dissociation takes place it is a symptom of the primary diagnosis of BPD, unless the dissociative state persists after emotional dysregulation has returned to baseline.

[FannyB]

Thanks for the clarification Sweetheart. 

My ex has recently been diagnosed with GAD. Does that mean she's an anxious person with (undiagnosed) co-morbid BPD or the other way around?

So many of these disorders have similar symptoms it can be quite confusing for the uninitiated!


Fanny

[sweetheart]

If the BPD is not diagnosed then it's not technically comorbid. That said people can present with a whole array of symptoms and behaviours that may be attributable to BPD, but for many reasons never receive a diagnosis. And of course they might not actually meet the clinical criteria for a diagnosis of BPD either.

What we know though from bpdfamily is that diagnosis or not, the impact of the behaviours and symptoms that bring us to these boards can and do have a devastating impact on all involved. 

[rotiroti]

I think the 9th criteria from the DSM-IV explains it:

(9) transient, stress-related paranoid ideation or severe dissociative symptoms.

So it's just one of the criteria and you'll see that some BPD will have this symptom while some won't. While mine didn't have complete psychotic symptoms, she did display lots of dissociative ones.

If the BPD is not diagnosed then it's not technically comorbid. That said people can present with a whole array of symptoms and behaviours that may be attributable to BPD, but for many reasons never receive a diagnosis. And of course they might not actually meet the clinical criteria for a diagnosis of BPD either.

What we know though from bpdfamily is that diagnosis or not, the impact of the behaviours and symptoms that bring us to these boards can and do have a devastating impact on all involved.  

Absolutely! The diagnosis is irrelevant when it comes to being incompatible partner material for us.

Also SH, your avatar is Howl!