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THE PSYCHOLOGY OF PERSONALITY DISORDERS
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Author Topic: DIFFERENCES|COMORBIDITY: Borderline PD and BiPolar Disorder  (Read 26532 times)
purpleavocado
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« Reply #50 on: September 07, 2013, 02:31:49 PM »

Hi all, I'm wondering what your thoughts are on this.

My ex was dxed with rapid cycling bipolar. However I think she was truly BPD. She has lupiterally every symptom except self injurt. Meds would seem to help for a short time but never really had lasting or noticable effects. I've read that rc bipolar and BPD are often misdiagnosed for one another, and I've also read that some psychiatrics won't reveal the "real" BPD diagnosis to the patient. Does anyone have a sense of how common this is and how it's recognized to be a misdiagnosis? Or how ommon it is to not know the dx?

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Want2know
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« Reply #51 on: September 07, 2013, 04:49:16 PM »

It is possible there is a misdiagnosis involved with your ex.

This is a general statement from the NIH site: Unfortunately, borderline personality disorder is often underdiagnosed or misdiagnosed.*

I also found this one particular study posted on their site, regarding misdiagnosis and bipolar disorder:

Recent reports suggest bipolar disorder is not only under-diagnosed but may at times be over-diagnosed. Little is known about factors that increase the odds of such mistakes. The present work explores whether symptoms of borderline personality disorder increase the odds of a bipolar misdiagnosis. Psychiatric outpatients (n=610) presenting for treatment were administered the Structured Clinical Interview for DSM-IV (SCID) and the Structured Interview for DSM-IV Personality for DSM-IV axis II disorders (SIDP-IV), as well as a questionnaire asking if they had ever been diagnosed with bipolar disorder by a mental health care professional. Eighty-two patients who reported having been previously diagnosed with bipolar disorder but who did not have it according to the SCID were compared to 528 patients who had never been diagnosed with bipolar disorder. Patients with borderline personality disorder had significantly greater odds of a previous bipolar misdiagnosis, but no specific borderline criterion was unique in predicting this outcome. Patients with borderline personality disorder, regardless of how they meet criteria, may be at increased risk of being misdiagnosed with bipolar disorder.**

*www.nimh.nih.gov/health/publications/borderline-personality-disorder/index.shtmlwww.nimh.nih.gov/health/publications/borderline-personality-disorder/index.shtml

**www.ncbi.nlm.nih.gov/pubmed/19889426
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hergestridge
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« Reply #52 on: November 15, 2013, 04:42:48 AM »

A few months before my wife was diagnosed with BPD she received a bipolar diagnosis. This was based on the fact that she had a history of depressions and wild mood swings. However, after medicatiton had been tried out and her mood swings had been discussed in detail (the doctor intially didn't know that her "down"/suicidal phases were triggered by criticism or interpersonal conflict) the diagnosis was revised and her medication was changed earlier this summer.

The doctor was not very straight ahead with the new diagnosis, and she was rather discrete about the bipolarity being out of the picture. She told my wife (in my presence) "What you describe to me is not bipolarity, this is personailty-related". And that was it. My wife was sent to see a DBT therapist and has been going since.

But after the above mentioned meeting with doctor my wife has been very reluctant to discuss her illness with me. I have tried to talk about her situation but she doesn't want to talk about it. She continues to read her "bipolar mom" websites and doesn't care much for the DBT (she thinks the therapist is too demanding). I have also told my wife that the doctor meant to tell her that he's borderline (I think it just needs to be said) and that's why she's in DBT. My wife knows enough about psychiatry to know what it means. She says she knows this very well but doesn't want to talk about it because it makes her feel worthless.

Earlier this week - just as her menstruation was about to end - she got into the usual deep anxiety.   Apparently it was worse than usual. She was suicidal and she sought care and was hospitalized for a few days. What she was also very anxious about was a doctor's appointment - an appointment with the doctor that says she's not bipolar - whom she now hates.

When my wife came back from the hospital (yesterday) she told me that she had met a doctor there (at psych ER) how had talked to her and "heard her story", who had told her that she was a "classic case" of Bipolar type II. Said doctor took away all her medication, put her on Lithium + a new antidepressant + Immovane.

I asked my wife if she had told this doctor that her moodswings are usually triggered by criticism, quarrels or her menstrual cycle. The answer was no. She had described this "My mood's all over the place and there's there's no discernible pattern"-persona that she likes to paint up when she wants to be taken care of.

What people don't get it that the doctor can't "find" a diagnosis. All about how you describe yourself. A doctor that observers you over time can see and learn things, but a guy who reads a few journals and meets you once or twice only reflects what you tell him.

My wife can't take the idea of being "an incurable b*tch" (i e BPD) and therefore prefers to lie to herself about her own mental condition. She's even prepared to go on a heavy medication that I'm not sure if she will benefit from. But then again it's that BPD personality. It's not about the truth, it's about the feelings.

There's another thread on the subject "is a BPD diagnos important?" and I really think it is. Not changing doctors is very important. Everyone around a BPD person will become the enemy/the devil, including the doctor. A BPD has a fair chance of being misunderstod because they manipulate and they don't know it.
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an0ught
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« Reply #53 on: January 24, 2014, 11:47:07 AM »

This is a fairly recent meta-study specifically focused on BPD-Bipolar co-morbidity. The numbers are not so far off from the previous shared numbers. For people interested in measuring the mind with numbers and the significant challenges to it may want to study the full text.

The relationship between borderline personality disorder and bipolar disorder

Mark Zimmerman, MD, Theresa A. Morgan, PhD

Dialogues Clin Neurosci. 2013 June; 15(2): 155–169.

Abstract:

It is clinically important to recognize both bipolar disorder and borderline personality disorder (BPD) in patients seeking treatment for depression, and it is important to distinguish between the two. Research considering whether BPD should be considered part of a bipolar spectrum reaches differing conclusions. We reviewed the most studied question on the relationship between BPD and bipolar disorder: their diagnostic concordance. Across studies, approximately 10% of patients with BPD had bipolar I disorder and another 10% had bipolar II disorder. Likewise, approximately 20% of bipolar II patients were diagnosed with BPD, though only 10% of bipolar I patients were diagnosed with BPD. While the comorbidity rates are substantial, each disorder is nontheless diagnosed in the absence of the other in the vast majority of cases (80% to 90%). In studies examining personality disorders broadly, other personality disorders were more commonly diagnosed in bipolar patients than was BPD. Likewise, the converse is also true: other axis I disorders such as major depression, substance abuse, and post-traumatic stress disorder are also more commonly diagnosed in patients with BPD than is bipolar disorder. These findings challenge the notion that BPD is part of the bipolar spectrum.

Link to full text: www.ncbi.nlm.nih.gov/pmc/articles/PMC3811087/
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lemon flower
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« Reply #54 on: February 03, 2014, 05:23:43 AM »

I used to think my ex was undiagnosed BPD. Now I found out that he had all kind of psychiatric tests e few years ago and that there exists a file of him. He sais that the psychiatrists doesn't want to tell their diagnose to their patients. So maybe they know that he's BPD but keep it to theirselves ?

I don't get this, so they just let him struggle on his own, causin' problems everywhere he goes ? 

recently my ex got himself together again: he's in a hospital right now to detox from his alcoholaddiction. He's in an introspective phase and he is diagnosing himself now as bipolar. From his point of view I get that, still I would say it's BPD: that makes much more sense.

but allready I'm glad that he made a new step in self awareness, maybe it doesn't matter how he is diagnosed, as long as he tries to do something about it...  

It's probably less painful to think you're bipolar than you' re BPD, which is more stigmatising in my eyes.

but suppose he will get some medication fror Bipolar?

he wants to ask his doctor for lithium, and allready he takes seroquel,

can't that be harmful: taking inappropriate medication ?  and I know him: he's always trying to increase the dose, or combining stuff, not to mention drinking on it...  

and what about therapy? IF he might consider that...  

what a mess...   
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You called me strong, you called me weak
You took for granted all the times I never let you down
You stumbled in and bumped your head, if not for me then you'd be dead
I picked you up and put you back on solid ground,
and watched the world float to the dark side of the moon...
- 3 Doors Down -
hergestridge
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« Reply #55 on: March 08, 2014, 02:30:36 AM »

Triss: Lithium is also used to used for treatment of BPD. I asked this question elsewhere on this forum and got a reply with a link and all. My wife has a combination of seroquel + lithium.

There has been some debate over wether my wife is bipolar or has BPD, but the meds she's one should be doing effect regardless of which.
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lemon flower
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triss


« Reply #56 on: March 08, 2014, 03:22:37 AM »

thx hergestridge. currently my ex takes seroquel but to get lithium he needs to see a psychiatrist which he refuses at the moment.

also he was told by someone that taking lithium makes everything you eat taste different and smell strange   

can someone confirm this ?
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You called me strong, you called me weak
You took for granted all the times I never let you down
You stumbled in and bumped your head, if not for me then you'd be dead
I picked you up and put you back on solid ground,
and watched the world float to the dark side of the moon...
- 3 Doors Down -
hergestridge
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« Reply #57 on: March 08, 2014, 04:40:03 AM »

thx hergestridge. currently my ex takes seroquel but to get lithium he needs to see a psychiatrist which he refuses at the moment.

also he was told by someone that taking lithium makes everything you eat taste different and smell strange   

can someone confirm this ?

My wife hasn't had that experience. The only thing she's had (and I've under that's common) is thirst and craving for sweet drinks.

Thing with mood stabilizers is that is makes you kind of dumb I think. Lithium has been effective in some ways but she's been even more prone to ignore her behavioral problems now.
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spemat


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« Reply #58 on: March 31, 2014, 05:27:12 PM »

I can speak from my experience.  I am diagnosed with bipolar I disorder and ADHD and sort of PTSD (it's agreed that it is there between my psych nurse).  My manias last several months and are followed by long periods of apathy.  I am consistent in my moods though.  I tend to feel like my body is running on adrenaline and some points and almost dead (yet still hyperactive out of sheer antsy urge, ADHD).  I can't wind down during some episodes.

I deal with delusions and hallucinations.  My whole system literally changes...  I can smell better, taste better, want to take on everything and love everyone, sometimes paranoia, like schizophrenia paranoia but they're consistent with me.

My mom and brother both have BPD, my brother is also addicted to a few things and not sober so his is different than hers.  With them, just based on my gut feeling, it was set off or emotive in nature.  It is like being possessed with me but it is almost like they are overburdened with emotion and want others to feel the way they do.  When I am manic and people try to tell me to calm down, I don't understand their problem and think they are jealous of me or they they are manic or something.  I find that I get argumentative but often with people that are more apt to feed into it not knowing that I won't stop and my mom and brother can seem to defuse and whatnot for some period.  One seems emotional.  If I take meds for bipolar I disorder (Lamictal and sometimes Klonopin) and ADHD (Dexedrine).  I stay stable for years as long as I stop myself at times and eat healthy and take meds but even then, I go off, sometimes due to conflict or a death or something or just because I need meds raised.
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EaglesJuju
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« Reply #59 on: October 10, 2014, 07:05:35 AM »

BPD and BiPD seem somewhat similar.  

The difference is there is a baseline of stable normative behavior in BiPD.  There are manic, depressive, mixed, and hypomanic episodes that last up to a week or a few days.  One of the episodes tend to follow another, for example a major depressive episode followed by a manic episode.  

Certain diagnoses of BiPD will be based on their latest episode. The periods of the cycling of the mood can be consistent, for example someone with BiPD can have seasonal manic episodes.  Essentially, it is a temporary spike in their mood and they will eventually go back to their baseline mood.  

On the other hand, with BPD there is no baseline. PwBPD have a persistent pattern of behavior.  A person with BPD can reflect instability with their mood but it tends to last a few hours and rarely less then a few days.  

There is an association between antidepressants and rapid cycling.  To my understanding, there has to be 4 periods of either manic, hypomanic, depression, or mixed episode within 12 months to be have a rapid-cycling specifier.
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