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THE PSYCHOLOGY OF PERSONALITY DISORDERS
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Author Topic: DIFFERENCES|COMORBIDITY: Borderline PD and BiPolar Disorder  (Read 24597 times)
PotentiallyKevin
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« Reply #10 on: October 07, 2008, 04:51:33 PM »

Thanks for this topic. My BPD gf has been misdiagnosed with Bipolar disorder three times now. I myself have bipolar affective disorder(BP II) and i know the illness inside out. They are very very different. If you have any questions about bipolar disorder, feel free to ask me. I love discussing my illness.
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1. Capable of being but not yet in existence; latent: a potential greatness.
2. Having possibility, capability, or power.
3. The inherent ability or capacity for growth, development, or coming into being.
4. Something possessing the capacity for growth or development.


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« Reply #11 on: October 17, 2008, 04:28:41 PM »

Thanks for this topic. My BPD gf has been misdiagnosed with Bipolar disorder three times now. I myself have bipolar affective disorder(BP II) and i know the illness inside out. They are very very different. If you have any questions about bipolar disorder, feel free to ask me. I love discussing my illness.

i agree with you, they are very different. i was diagnosed bipolar over ten years ago, and have been working on maintaining balance since. it's been an interesting ride, and i haven't always been someone that's easy to be around (i usually recognize it and pull back in attempt not to affect others), but never have entered into some of the behaviors that i'm learning are typical of a BP. i have felt a growing fear-based stigma toward bipolar individuals over the last several years, and i was wondering if perhaps you've noticed anything, pop-culturally or even in the psychiatric arena, that would reflect what i consider to be a gross misunderstanding of what a bipolar individual really deals with? if so, do you think the stigma is exasperated by this trend to diagnose BP's as bipolar?
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« Reply #12 on: January 24, 2009, 01:15:32 PM »

Hi

I thought that this was an interesting article comparing and contrastin bipolar and BPD

www.mentalhelp.net/poc/view_doc.php?type=doc&id=4185
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« Reply #13 on: March 14, 2010, 09:17:53 PM »

It's been awhile since anyone posted, but for closure I wanted to add this. This is from my new book, the Essential Family Guide to Borderline Personality Disorder, out in November 2008:

Both people with BPD and those with bipolar disorder experience dramatic mood swings. But there are three crucial differences:

1. People with BPD cycle much more quickly, often several times a day.

2. The mood swings with BPD are more specific: all emotions are affected (fear, anger, sadness) while people with bipolar either have mania (intensely high) or major depression.

3. The moods in people with BPD are more dependent, either positively or negatively, on what’s going on in their life at the moment.



Randi Kreger

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Stop Walking on Eggshells and the SWOE Workbook

The Essential Family Guide to BPD

Hi

Since this came back up again, I wanted to adress your points.  I respectfully disagree on a few.

1. People with BPD cycle much more quickly, often several times a day. - People with ultra radian rapid cycling bipolar can go through multiple mood dwings in a single day.

2. The mood swings with BPD are more specific: all emotions are affected (fear, anger, sadness) while people with bipolar either have mania (intensely high) or major depression. - People can present with a variety of moods when in mania or depression.  Mania is also much more than an intense high.  In bipolar type 2 it can be a mild high.  Or, a person with any form of bipolar disorder can suffer from what is known as dysphoric mania, which is a very nasty, irritable, angry high that is also referred to as a mixed epsiode.  In terms of depression, the sadness associated with a bipolar depression is brutal.  Lastly, a person with symptoms of the schizoaffective end can most certainly suffer from feelings of fear and paranoia during an episode.  

3. The moods in people with BPD are more dependent, either positively or negatively, on what’s going on in their life at the moment. - I am 50-50 on this one.  I agree that people with bipolar do not experience the intense and transient symptoms that can come on like lightning for people with borderline, but life circumstances and stress have an affect on all mental health conditions.

The difference to me is level of insight and the way people with bipolar treat others.  Most people with bipolar diisorder know that they are sick.  They might have a hard time with med compliance, but they know that they hv a problem.  They also generally do no manipulate and treat other people like crap the way that borderlines do.  Also, I have noticed that if something does go on during an episode that damages a relationship, they are generally sincerely remorseful.

Just my observations.

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« Reply #14 on: June 17, 2010, 09:11:42 PM »

These 3 links are summarizing the same recent study info, but each includes a few details that the other doesn't.  Says that "nearly 40 percent (20 of 52) of patients diagnosed with DSM-IV borderline personality disorder had been over-diagnosed with bipolar disorder."

Personality Disorders Misdiagnosed As Bipolar | Psych Central News    www.psychcentral.com/news/2009/07/30/personality-disorders-misdiagnosed-as-bipolar/7439.html

Some conditions misdiagnosed as bipolar disorder | Reuters      www.reuters.com/article/idUSTRE57C4SZ20090813

Bipolar over-diagnosis associated with personality disorder       www.masspsy.com/leading/11.09_bipolar.html


In case you're interested, a few links I read over when I was researching the difference between bipolar and BPD:

What's the difference between BPD and bipolar?-(this is full of info, I found it very interesting)     www.psycheducation.org/depression/borderline.htm

Difference Between Bipolar and Borderline Personality Disorder - Bipolar Disorder Center - Everyday Health-    www.everydayhealth.com/bipolar/specialists/difference-between-bipolar-and-borderline-personality-disorder.aspx

Three Easy Ways to Differentiate Bipolar and Borderline Disorders | Psychology Today-   

www.psychologytoday.com/blog/stop-walking-eggshells/201003/three-easy-ways-differentiate-bipolar-and-borderline-disorders


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PotentiallyKevin
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« Reply #15 on: June 18, 2010, 05:44:16 PM »

Almost every borderline that I have known or have heard about by others, has been diagnosed AT LEAST ONCE as being bipolar. It is hugely misdiagnosed. Somewhere in my archives of posts I have ranted about this and the reasons why, I will have to dig it up...

This is actually one of my goals to "blow the lid off" when I finish my psychology degree. Last spring semester I was working on a project comparing the two illnesses and seeing how many of the general population of the school knew about bipolar disorder and how many knew about borderline personality disorder. The results didn't surprise me. Almost everyone has heard of bipolar disorder, and only a select few have heard of borderline - or any PD for that matter. When I asked some of the people to describe bipolar disorder, a lot of them did give me an accurate description... of borderline personality disorder... -sigh.
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2. Having possibility, capability, or power.
3. The inherent ability or capacity for growth, development, or coming into being.
4. Something possessing the capacity for growth or development.
Randi Kreger
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« Reply #16 on: June 24, 2010, 12:30:21 PM »

There are no stats on this.Randi KregerThe Essential Family Guide to BPD
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« Reply #17 on: June 27, 2010, 11:36:28 PM »

My wife is currently diagnosed with Bipolar.  She has tried most bipolar medications: Paxil, Prozac, Zoloft, etc.  They help some, irritate other parts of her life, and generally fail to work in the long term.

She clearly exhibits black/white thinking and crazy-making behaviors.  She also cycles incredibly quickly... too quickly for bipolar in my (non-professional opinion).  I can be a god one moment, garbage the next, and back to wonderful later that evening.

I think that having a non-BPD learn how to deal with some of the behaviors is the most helpful with dealing with the BPD behaviors.  This is essentially behavioral therapy for the BPD partner.

However, I think some mood stabilizers can have some helpful effects in making some of the BPD behaviors less accute and perhaps more manageable by the couple.  My wife is currently taking a low dose of Seroquil.  I've notice that during this time we've been much more successful in working with the behaviors.  The behaviors are still there, they just tend to be less intense.  So instead of fearing for my physical safety, many times it's just my feelings that get hurt.  It also seems the frequency of the behaviors is reduced.

I'm still struggling with how to broach the subject with her about the possibility of her being BPD instead of Bipolar... but for now, I'm finding it helpful that at least this mood stabilizer seems to help somewhat for dealing with the behaviors.
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« Reply #18 on: June 28, 2010, 01:43:29 AM »

My wife is currently diagnosed with Bipolar.  She has tried most bipolar medications: Paxil, Prozac, Zoloft, etc. 

I think the Seroquel is the med for the bipolar diagnosis.  The others -- Paxil, Prozac and Zoloft -- are antidepressants and I don't believe they're meds commonly prescribed for bipolar.


I'm still struggling with how to broach the subject with her about the possibility of her being BPD instead of Bipolar...

You'll find reference material on this site that suggests it's not entirely a good idea to share that idea with someone you suspect has BPD.  You should read that before considering sharing your thoughts with her about this particular diagnosis.  It could help you out tremendously.
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PotentiallyKevin
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« Reply #19 on: June 28, 2010, 06:47:36 PM »

My wife is currently diagnosed with Bipolar.  She has tried most bipolar medications: Paxil, Prozac, Zoloft, etc.  They help some, irritate other parts of her life, and generally fail to work in the long term.

She clearly exhibits black/white thinking and crazy-making behaviors.  She also cycles incredibly quickly... too quickly for bipolar in my (non-professional opinion).  I can be a god one moment, garbage the next, and back to wonderful later that evening.

A good indication that her psychiatrist doesn't actually believe she is bipolar, is by prescribing Prozac. Prozac is the preferred staple drug for Borderline Personality Disorder. Prozac is also the worst nightmare for pwBipolar Disorder - if prescribed alone (without a mood stabilizer) it will induce mania faster than an alcoholic binge...

Bipolar disorder is usually treated with mood stabilizers such as Lithium, Depakote or a combination drugs such as Zyprexa, along with an anti-psychotic or tranquilizer such as Xanax.

From what I have read, Borderlines seem to do OK on mood stabilizers - but I have read that Zyprexa has poor results - and Xanax seems to be a borderlines Kryptonite...I have read several accounts of Xanax having horrible results with BPD.  My ex was on Xanax and her rages increased 10 fold while she was on it - same with her dissociation...

Psychiatrists prefer to "officially" diagnose a patient as bipolar rather than borderline for three main reasons.

#1 No drama with the insurance company. Bipolar is considered highly treatable - and usually fully supported by insurance companies.

#2 Many psychiatrists feel that if they diagnose as borderline - the patient will be "shunned" by future therapist/psychiatrists. They consider it almost "blacklisting" the patient. I had a therapist admit to me that she almost always diagnoses bipolar rather than borderline - because if she diagnoses borderline, the person won't get the help they need. In her words "Any therapy is better than NO therapy" and "Treatment for the two are basically the same."

This really pissed me off, but I guess if it kinda makes sense. Most people have multiple therapists/psychiatrists before they recover, and having a rapsheet of being borderline, might be the difference between getting help and getting discharged... like I said, most therapists I know either A: Refuse to treat borderlines (saying they aren't qualified) or B: will only accept 2-3 borderlines at a time. My uncle, who specializes in treating sexually abused women and children, says he can only "handle" two borderlines at a time, that they are that taxing and emotionally draining...

#3 Many psychiatrists aren't familiar enough to properly distinguish between Bipolar Disorder and Borderline Personality Disorder. Unfortunately, this seems to be the #1 problem. Bipolar disorder and Borderline Personality Disorder have a lot of the same characteristics (Grandiose/Magical Thinking, Impulsiveness, Hyper-sexuality, Recklessness on the "high" side, Extreme Depression, Anxiety, Panic attacks, Loss of interest/appetite on the Low Side), The root of the problem, however, is very different.

It takes a keen eye, and someone familiar with BPD to see what is exactly triggering the "mood swings." Bipolar disorder is a more Mania/Depression chemical cycle, a lot of the times, with no "triggers" or the triggers are very predictable, like sleep disruption, alcohol abuse, moving to a different time zone, etc etc etc - all of which are mostly "physical changes."

Borderline Personality Disorder - as with all PDs - seems to be triggers associated with interpersonal problems. Also, the "cycles" tend to last minutes/days/hours compared to weeks/months as with Bipolar. With borderline, the pwBPD can literally split a person within seconds, and also go from elated, to horribly depressed in the same time. I watched this happen numerous times.

This subject is near and dear to me. Having successfully managed my Bipolar II disorder , and also witnessing my exBPDgf, I can tell you that the illnesses are very different from one another. My struggles seemed to be more internal than external. Sure I was a royal pain in the ass to those around me - especially my parents. They had to bail me out of some tight spots... Gambling Addictions, Grandiose thinking, months where I would literally sleep for 18 hours a day, etc etc etc... but I never did take it out on them, or "split" them like what is so common for a borderline. My support system was easily accepted by me, and I knew I had a problem (although convincing me in a manic episode was quite the challenge because I felt like GOD). Also. I was never abusive. When I was manic, I would get extremely frustrated at people not "keeping up with me" or telling me to slow down or that I was "acting crazy", but I never ever split them black nor idolized them. In short, Bipolar disorder is like being on speed. During a manic phase, everything was colorful and exciting, I felt like I could run a marathon or take a bullet... I was immortal. When the high ended, a horrible withdrawal like feeling entrapped me. I was sluggish, the most simple tasks FELT like running a marathon, no motivation whatsoever...sleep sleep sleep and sleep some more... I was that drained.

After witnessing my borderline girlfriend for three years. I never once saw a manic phase. Sure she would rotate from being extremely Narcissistic to extremely self-loathing - but this was so different from the endless energy to bed-ridden depression.  Also, EVERY one of her shifts seemed to be related to some interpersonal trigger, like getting fired from a Job or me not living up to her never-ending, unobtainable demands and expectations... I do think that borderline personality disorder has a strong chemical component, but in my experience, it has a lot more to do with relating to people than bipolar disorder does.

Also - the biggest difference between a person with Borderline Personality Disorder and Bipolar disorder is that A LOT of the times, Bipolar disorder is neither on a Manic Phase nor a Depression Phase - and the person is completely normal, can hold a job just fine, and is every bit as functioning as everyone else.

pwBorderlinePD don't seem to have these long durations of calm. Their lives seem to be a never-ending cycle of dysregulation. After a while, Its a horribly predictable pattern observed by those who are close to them.

Hope this helps.
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po·ten·tial  adj.
1. Capable of being but not yet in existence; latent: a potential greatness.
2. Having possibility, capability, or power.
3. The inherent ability or capacity for growth, development, or coming into being.
4. Something possessing the capacity for growth or development.
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