COMPARISON: ADHD vs BPD

[BPDFamily.com]

Wondering how similar these are? Anyone have any insight? Does anyone know of a really good informative site for info on ADHD?

Thanks,

htl

[htl67]

Wondering how similar these are? Anyone have any insight? Does anyone know of a really good informative site for info on ADHD?

Thanks,

htl

[BPDFamily]

DIFFERENCES|COMORBIDITY: Overview of Comorbidity

Additional discussions... .

Personality Disorders

Borderline and Paranoid Personality Disorder

Borderline and Schzoid/Schizotypal Personality Disorder

Borderline and Antisocial Personality Disorder

Borderline and Histrionic Personality Disorder

Borderline and Narcissistic Personality Disorder

Borderline and Avoidant Personality Disorder

Borderline and Dependent Personality Disorder

Borderline and Obsessive Compulsive Personality Disorder

Borderline and Depressive Personality Disorder

Borderline and Passive Aggressive Personality Disorder

Borderline and Sadistic Personality Disorder

Borderline and Self Defeating Personality Disorder

Other

Borderline PD and Alcohol Dependence

Borderline PD and Aspergers

Borderline PD and Attention Deficit Hyperactivity Disorder

Borderline PD and BiPolar Disorder

Borderline PD and Dissociative Identity Disorder

Borderline PD and P.T.S.D.

Borderline PD and Reactive Attachment Disorder (RAD)

[Abigail]

One site I would recommend for info on ADHD is www.chadd.org

Both ADHD and BPD can involve impulsivity but for somewhat different reasons.  ADHD impulsiveness is linked more to acting before thinking and some impulsive behaviors are a form of stimulation for a bored ADDer. 

Those with BPD become involved in self-destructive impulsive behaviors such as drug use, gambling, reckless driving, compulsive shopping, etc. to deal with the pain and dysphoria so they will feel better.

Approximately 50% of those with BPD have comorbid ADHD as well.  And a substantial percentage of adults with ADHD have BPD (there have only been a few studies but the percentages were 29% to 38%). 

[Aboutme2011]

I am reading "Understanding the mind of your BiPolar Child"  My husband is BPD and Bip.  It has a great section about ADD and how it differs from Bip and is often confused.  You might find that helpful.

The book it says "Although they share some common properties - inattention, hyperactivity, impulsivity, and an abundance of speech - ADD/ADHD and Bipolar disorder arise from different problems in different areas of the brain."  It is my understanding that BPD is conditioning of the mind or damage to the personalitly whereas ADD and Bipolar are physical problems in the brain.   Although Bipolar is not BPD this book compares ADD and Bip which is similar in some ways (the outward manifestation of symptoms)  and gives a lot of insight into how to tell the difference.

[tiff]

My bf has previously been diagnosed with severe ADHD, PTSD from childhood and anxiety issues, but not BPD officially.  To me - one issue that stands out (beyond meeting so many of the general BPD criteria) is that when he feels pain he does something impulsively self-destructive to his life.  I don't know why no one has noticed this before about him. He's been labeled an impulsive person for years - but it's not random - his planned out actions are good ones and the impulsive choices are often not in his own best interest.  The more pain he feels, the more he'll quickly wreck his life. 

[truthbeknown]

my girlfriend is very scattered, loses things easily, and can't seem to stay "present" sometimes.  She is disorganized, impulsive and hyper focuses on emotions.  All of these traits have been listed on sites that talk about Adult ADHD.  I did find one site that said there is some cross-over between Adhd and BPD.   So i'm confused because from what i have read on this site, while she has ups/downs, shifts gears, locks on negative feelings in an instant- she does not swear or yell at me. She apologizes profusely if i confront her on her hyperfocus and change of emotional status etc. and she hasn't shown any signs of being the "leaving type". Instead she is clingy and very "needy" emotionally.  Just yesterday we spent all day talking about "us" and trying to work things out.  I felt like she was really getting some of what i was saying and really understanding.  Then, it came time for me to take her home and she went back to an emotion that was upsetting her about me not wanting to let her see my kids.  She went into overfocus mode as if she never remembered or comprehended anything we talked about all day.  I told her how upset i was that i spent all day talking to her only to hear her say things like, "there's more going on here than just you not wanting me to see your kids".  then she confessed that she had gone back on the date site a few weeks ago after an email exchange between us to see if i was actively dating again!  i was flabbergasted!

I told her i was going to take her home. She asked me if i was going to stay over? i said "no".  She cried and begged me to please reconsider.  She gets so focused on what she needs that she can't see the big picture. 

So, is there anybody that knows enough about both disorders that can shed some light on this?  Either way its a handful but maybe if its ADHD related than it can be treated easier than BPD. 

[lbjnltx]

dear scattered

i can't claim to know enough about adhd to diagnose anyone... .especially since i am only a lay person... however, i read a book by dr. daniel amen last year about all the different types of add/adhd there are.  if a person has several types of add/adhd then they could present as a BPD.  the name of the book is "healing add the breakthrough program that allows you to see and heal the 6 types of add".  this is the same dr. amen that founded the amen clinics and has been featured on various tv programs.

the 6 types are:  classic

                         inattentive

                         overfocused

                         temporal lobe

                         limbic

                         ring of fire

dr. amen states that a person can have several of the types at the same time.  to be diagnosed w/a specific type of add they must first meet the basic criteria for classic add as well various criteria for the other type(s).

temporal lobe, limbic, and ring of fire symptoms mimic many of the criteria of a pwBPD.

since this book was written, a few more types of add have been identified.

many of the skills taught here at ftf as well as recommended therapy models can help persons with severe types of add as well as pwBPD.

lbjnltx

[desperate dutchman]

Hi I can only speak for myself I have been diagnosed with ADHD and i married 20 yrs w uBPDso and there seems to be some striking differences ie I do not have trust issues or intimacy issues I still have healthy respect for family and friends. My wife has disconnected herself from anyone other than me that gets past the stage of casual friend. I get angry she can rage .  We both can get distracted and manytimes will talk over / past each other . (I am working on that one)

[modafinilguy]

Any information anyone has on this specialized topic I would be very interested in.

ADHD kids are KNOWN to be difficult. When they have a traumatic childhood, one direction they go in is BPD.

I personally know various ADHD diagnosed youth later diagnosed with BPD.

They are still ADHD, but the psychiatrist often drop the ADHD perspective.

From what I understand, this is AGAINST best practice guidelines.

Most people with BPD, but also ADHD, are NOT properly dual diagnosed.

I will find link later, but i have read the incidence of ADHD in BPD people is 25%. It is very high.

The best prognosis for a BPD person with ADHD, is treatment of BOTH disorders, ADHD does require medication.

Any info, experiences, insight, with this I am thirsty for.

I cannot believe there are not a fair few people around with say teenage/ later BPD diagnosis, with EARLIER ADHD diagnosis.

I have a lot to learn in this area.

Very interested in person stories, (or any info), of people that have had both diagnosis in the same lifetime (if you know of such people).

I strongly suspect BPD people with ADHD are likely poor responders to normal BPD therapies. This is my personal belief, don't have scientific data to back it up, just accumulation of personal experiences and observations.

Interested in any insights into either BPD or ADHD, including standalone without the other diagnosis.

Any conclusions people have drawn, to a degree I like to measure experienced "folk wisdom" up against what I read up as "scientific data".

[lexialpha]

My mom is uBPD and definitely uADHD!  I think that the traits/symptoms of each seem to overlap a bit, which may make it hard to diagnose. She skips from project to project without completing much because she becomes bored easily. Frankly, she becomes bored mid-sentence in a conversation if you aren't entertaining enough. She can't leave her brain idle, always needing to be doing... .but is not successful at a job. She craves contact with people, yet doesn't invest any time in relationships. She is always looking for art shows or music festivals to attend, scouring the newspaper and flyers every day, but is usually disappointed somehow that it wasn't good enough in some way or another.

My sister is ADHD and finds that meds help. Before, she recognizes that she was treating herself with what society deems "normal" - caffeine. I am uADD, but I'm not sure if that is tangled up with the PTSD from the abusive childhood. These could be learned responses instead of an actual chemical imbalance. My sisters ADHD is definitely chemical, as she has displayed symptoms since she was a toddler. Even in the late 60s the doctors suggested meds, but my mother declined. My sister has always been more physically active than most, and a leg bouncer.

I think that it is interesting that you find a connection. I hope that you are able to learn more.

[EdR]

Hi!

I already told you in your intro post that I've learned years ago of the link between ADHD and BPD.  

What I've 'learned' though is not the same as what my own analysis would be.

I remember from literature that people with BPD are often -initially- misdiagnosed with ADHD. Especially in their teens. BPD is a 'destructive' diagnosis and teen behaviour could be extreme and BPD-like by nature, so ADHD is often the 'safer' diagnosis for psychiatrists.

Also, some parents are extremely career minded, and don't accept a BPD diagnosis. An ADHD diagnosis feels a lot more comfortable to them, as it wouldn't give they're children such a huge stigma and possible further difficulties in their future career. I have even seen parents who were still even desperately trying to hide this ADHD-diagnosis (which was kind of hard for me).

I also remember the data suggesting the strong correlation between those two. So this would include misdiagnosed BPD/ADHD people and people who do actually have both.

What I don't know:

* Could ADHD be a pre-stage of BPD for the ones who would eventually develop BPD ?

* In how many cases is the presumed ADHD just a 'symptom' of Borderline (so misdiagnosed) and in how many cases do they co-exist (not misdiagnosed)? Remember that, just like BPD in a sense, the diagnosis is made by using something very similar to a checklist. Some of those check-boxes overlap with BPD ones.

* Is someone with ADHD more likely to develop Borderline? (I seem to vaguely remember to have read something, but I don't know for sure what :-P )

Those are actually important questions, because someone with ADHD benefits greatly from the right treatment (med's and specific nutrional advice/diets).

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[GreenMango]

Here is more information from Dr. Robert Friedel's website www.BPDdemystified.com

The Symptoms and Treatment of Attention Deficit Hyperactivity Disorder in Patients with Borderline Disorder

Background

Attention deficit hyperactivity disorder (ADHD) occurs in at least 25% of people with borderline disorder; 5 times more often than it does in the general population. The symptoms of ADHD include decreased attention and concentration, easy distractibility, difficulty in the completion of tasks, and poor management of time and the space area that you use. These symptoms of ADHD result in significantly impaired school, work and social performance, and are described in detail below.

ADHD is estimated to occur in about 5% of school age children. It is more common in boys than in girls. There are subtypes associated with hyperactivity and normal activity levels. The hyperactive subtype is more common in boys, and is associated with impulsivity, while the inattentive subtype (the subtype with normal activity levels) is somewhat more evenly distributed among boys and girls. The symptoms of ADHD are now known to persist into adulthood in many people, and to require continued treatment. There is often a strong family history of ADHD.

Identifying the symptoms of ADHD in patients with Borderline Disorder is critical for their treatment plan.

Symptoms of ADHD*

Inattention

fails to give close attention to details or makes careless mistakes in school work, work, or other activities

has difficulty sustaining attention in tasks or play activities

does not follow through on instructions and fails to finish school work, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions)

has difficulty organizing tasks and activities

avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework)

loses things necessary for tasks or activities (e.g., toys, school assignment, pencils, books, or tools)

is easily distracted by extraneous stimuli

is often forgetful in daily activities

Hyperactivity

fidgets with hands or feet or squirms in seat

leaves seat in classroom or in other situations in which remaining seated is expected

runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness)

has difficulty playing or engaging in leisure activities quietly

is often “on the go” or often acts as if “driven by a motor”

talks excessively

Impulsivity

blurts out answers before questions have been completed

has difficulty awaiting turn

interrupts or intrudes on others (e.g., butts into conversations or games)

Treatment of ADHD in Patients with Borderline Disorder

It is not uncommon for children, teenagers and adults with borderline disorder who have some symptoms of ADHD to be misdiagnosed with only ADHD, and then receive customary treatment with stimulants such as methylphenidate or an amphetamine derivative.

If borderline disorder and ADHD co-occur, patients often do worse when treated for ADHD if they first receive a medication for the symptoms of ADHD. Under these circumstances, they may then demonstrate an increase in emotionality, aggressive impulsivity and even paranoid thinking. Fortunately, clinical experience and anecdotal reports in the scientific literature suggest that this problem can be effectively managed in one of two ways.

When the symptoms of ADHD are mild, behavioral treatments alone may be effective, thereby avoiding the risk of increasing the symptoms of borderline disorder with a stimulant.

However, if medications are required to bring the symptoms of ADHD under optimal control, it appears to be helpful to initiate treatment with a low dose of an antipsychotic agent for the symptoms of borderline disorder [Medications]. Doing so permits the use of a stimulant to produce a beneficial effect on the symptoms of ADHD with a minimal risk of worsening the core symptoms of borderline disorder.

*Adapted from DSM-IV-TR. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC, American Psychiatric Association, 2000.

[hergestridge]

My wife is diagnosed with ADHD but has not yet been put on medication (don't know if she will). Her doctor say she's got a "problem related to her personality" which has lead to treatment with neuroleptics (Seroquel) and Zyprexa. We've been to therapy sessions together with a T whose specialty is mentally ill parents and their relations to their children (this is one of my wife's one bigger problems) and the T in question says (to her and me) that my wife most likely has "emotional instability" which BTW has a suicide rate of 10% ( a k a borderline). The T is used to treating borderline patients and has DBT competence. However, she's not as experienced with ADHD (her own words).

I have been present at a few therapy sessions and it's been propblematic. You just can't get her attention. She always has her an agenda of her own. I try to talk about her after the session about what the T said, and usually she just remembers the parts she liked (a few favorite phrases that she found uncontroversial and sympathethic) and a few things the thought was wrong (provocative stuff that rubbed her the wrong way). She can't connect the things she just heard into some kind of coherent whole or narrative. Or she doesn't try to? After I explain my impression to her she seems to get it. But I have to do it in 30 seconds - that's about her attention span. And she mustn't be tired.

It's the same thing when I explain things to her. She loses interest immediately and pretends to listen. She only remembers unrelated details here and there.

Don't tell me this doesn't get in the way of DBT.

[GreenMango]

hergestridge

It may help to look into Dr Friedels website a little more and specifically for the treatment of the two issues.  He also has a section on finding appropriate therapists and clinicians.

If you do end of looking into this please post what you found.  It could help other members finding the right resources.

GM