"The majority of our undiagnosed ex's would not be diagnosed by a professional"

[AwakenedOne]

Several members have stated that from time to time. How do we actually know this though? After reading stories on this site, it seems that many if not most members have basically dated the same person or personality. Some milder and others more severe.

What do you rate the percentage chance that your undiagnosed ex has BPD?

My answer is 99%. She meets all 9 of the criteria clearly in my opinion.

[GreenEyedMonster]

I am 100% sure that my ex has a severe psychiatric disorder, and I'm 99.9% sure that it's in Cluster B somewhere.  It would take a professional to tease apart the nuances of BPD, NPD, and paranoid PD that he displays, but right now I think NPD is the frontrunner.  It doesn't take a whole lot of talking to him to figure out that he and reality parted ways a while ago.

[steelwork]

There seems to be an idea that BPD is not diagnosed unless it's preventing someone from functioning, though I don't know why that would be. I have a diagnosis of major depression and c-ptsd, but it's not preventing me from functioning. It just makes it a lot harder to function.

My ex is quite functional out there in the world, generally really well-liked, considered a mensch, but I'm pretty sure he meets the diagnostic criteria when you scratch the surface -- 8 of 9 at least from the DSM IV list. In terms of the updated DSM V criteria: he absolutely has displayed significant impairments in self functioning (chameleon, changes value systems like pants, pronouncements of self-loathing, long-standing history of dissociation under stress). As for interpersonal functioning: intense, unstable relationships, self-proclaimed abandonment fears. Meltdowns when I was late to meet him or had to change plans. Pathological personality traits: pronounced Jekyll and Hyde behavior, anger issues, response to rejection (even ordinary disagreements perceived as rejection or criticism) can be pronouncedly hostility. Panic attacks after intimacy. Classic projection of negative self-evaluation. Reinvents history to the extent that he can convince himself we haven't had months worth of interactions that in fact happened. On and on and on. Disinhibitions: let's just leave it at former heroin addict and alcoholic, reckless driver,  By all accounts dating back to age 14, most of it.

He also probably has C-PTSD, but that doesn't account for all of it.

You could say he is "only" displaying BPD traits and would not be diagnosed as having a personality disorder, but what IS a personality disorder? It means that a significant number of traits of the disorder are present and have been since adolescence, and have affected relationships significantly--right?

I guess what I'm saying is, I can't diagnose him, and in terms of the spectrum people talk about he's what you would call high-functioning, but just because the impact is selective (i.e. he works and has superficial friendships and is a good parent so far, mostly, and can be in a romantic relationship until he can't and then look out), does that mean he would not be diagnosed as having BPD? I don't know. It's enough for me.

-- EDIT --

Oh yeah, how could I have forgotten that he put me on the highest of pedestals. He love-bombed me like the Luftwaffe. And then I was beneath contempt, apparently.

[Ab123]

100 percent sure.  BPD, no comorbidities aside from ADHD. No traces of NPD. I was about 70 percent sure when I found this board, after a sudden discard 4 months into the r/s. The post recycle relationship was textbook, and I was about 90 percent sure by the time we broke up 6-7 weeks ago. Any doubt is gone now, after last a recycle attempt night / this morning.  His background is textbook, and the behavior is exactly what one would expect.  It has been helpful to have the hypothesis and then be able to test it through further observation.

Seriously, his last text to me this morning said he just needed a friend because he is "so f'in lonely."  He triangulated with his adult son immediately before the last break up. Not surprising that his needs aren't met. He is dating, but not anything that could even possibly be serious because he is on an inappropriate dating site for one seeking companionship. Of course he is lonely. Total self sabotage.

[teapay]

Classic BPD is pretty easy to dx.  It's kind of like dx a protruding fracture.  Hard to miss and misdx.  You know it when you see it without too much handwringing.  You just say, "Eeew" because it is so obvious.  So if you're 99% certain your partner has BPD you are very probably right, especially if they are lower functioning.  If someone is unsure about their partner having BPD, then the partner probably doesn't have it.  I knew (100%) my W had BPD very shortly after learning about BPD.  I heard the line about the difficulty of dx BPD from one of her Ts.  Then her P dx her pretty quick with BPD and he was a 1st year resident.  Eventually that T dx her with it too as well as other Ts.  Hundreds of others echo my experience.  The folks referred in that quote would not be dx by professionals simply because they do not have BPD.

[steelwork]

Classic BPD is pretty easy to dx.  It's kind of like dx a protruding fracture.  Hard to miss and misdx. 

... .

The folks referred in that quote would not be dx by professionals simply because they do not have BPD.

And yet almost no men were diagnosed with BPD until pretty recently. So apparently it isn't so hard to miss... .in men?

[teapay]

More men are being treating for psy now.  Historically and currently men have not sought treatment or were not evaluated in jail, so there wasn't or will

be dx.  What was your ex dx, as if not BPD?  If he hasn't been dx have him seek treatment and see if he is dx.

[Lonely_Astro]

My ex is diagnosed BPD, so I know 100% she is.

Classic BPD is pretty easy to dx.  It's kind of like dx a protruding fracture.  Hard to miss and misdx. 

... .

The folks referred in that quote would not be dx by professionals simply because they do not have BPD.

And yet almost no men were diagnosed with BPD until pretty recently. So apparently it isn't so hard to miss... .in men?

There's a gender bias in diagnosing cluster b disorders. More women are diagnosed BPD, men are more likely to be diagnosed aspd or npd.  That is actually shifting, but that can account for why women 'are more likely' to be be BPD than men.

[snowmonkey]

Hey all,

Some professionals have a great reluctance to diagnose BPD, even if it is as clear as day to them and everyone else around what the diagnosis should be.

The story of my GF is this:

She was diagnosed with BPD by her psychiatrist 5 years ago. She refused to go back and see him ever again. She found a new psychiatrist. Her conditioned fluctuated over time although generally went down hill. It was as clear as day that she suffers from BPD and so I (and her daughter) met privately with her new psychiatrist. He told us that he has known for many years that she has BPD but he has not presented that diagnosis to her for a variety of reasons.

Anyway, we all agreed (partner, daughter and psych) that by not confronting her with her illness that we were facilitating her illness. He agreed on their next meeting that he would present her with his diagnosis. Indeed, he told me and her daughter that he would refuse to treat her if she did not accept his diagnosis.

What happened? He was gutless and didn't present her with the illness. I mistakenly believed that he did so and let on that I had visited her psychiatrist and knew that she was BPD. Oh my god, did sh*t hit the fan on that day!

Anyway, the current situation is that she will never accept that she has BPD, her psychiatrist who never gave her a diagnosis in 5 years (but knows she has BPD) has miraculously discovered in a two week period without a single consultation that she has C-PTSD and given her that diagnosis. Basically, to placate her and deal with her threats of lawsuits for breach of confidentiality she has been given a non-BPD diagnosis.

In other words, I agree, the majority of undiagnosed ex's would not be diagnosed by a professional.

[FannyB]

My ex had a psychological evaluation about 30 years ago after a major incident at her job required it. They found nothing wrong with her apparently. More recently she has been diagnosed with an anxiety disorder via a telephone interview.  I'm 99% certain she has BPD as I pieced the evidence together over time and it all adds up perfectly.  For me it's a maladaptive way of thinking rather than a mental illness which drives her behaviour - which would probably explain why professionals could not determine any underlying psychological condition all those years ago.


Fanny

[once removed]

this is one of my favorite articles when it comes to keeping my ex in perspective: www.the-toast.net/2013/12/04/your-ex-might-not-have-a-personality-disorder/

its important to keep in mind that our opinions are generally informed by our experience, a romantic relationship, with one person (as opposed to an unbiased, experienced professional).  not only are we not professionals, but we bring an awful lot of bias to the table. we of course, have not all dated the same person or known or met the people involved in the stories we read, but its a given that when you are dealing with a group of people with a set of personality traits, youre going to have a lot in common (you will also find that the membership here has a lot in common). if you and a friend each dated an introvert, for example, youd each have very similar stories to tell. our stories obviously effected us in much more painful ways than "dating an introvert" and this is bpdfamily after all. it is equally fair to say that the majority of our exes displayed BPD traits. in many cases, traits of other personality disorders. but there can be a risk to putting too much emphasis on a diagnosis and its important to remember we really are not in a position to confirm it.

the percentage chance that my ex would qualify for a diagnosis? hard to say. she has seen a professional - many times, who has been told about the dynamics in her family, who has met an ex of hers and heard his side, who has probably heard that each of us is "the one". he did not diagnose her as BPD. he did diagnose her as bipolar. im a little suspicious because that is a common, often deliberate, misdiagnosis (also a common comorbidity) and theres little to nothing about bipolar disorder that i recognize in her having known her six years and dated her three. i experienced, in my unprofessional opinion, seven out of nine traits, sustained throughout her life and romantic relationships, to the extent i know the truth. she also once told me that she might be "a little BPD". i can form a reasonable conclusion one way or the other, and i have, but the fact remains that she is not diagnosed.

to be frank with you its been a long time, and if someone told me my ex does or doesnt have a personality disorder i couldnt care less, shes history. the knowledge of BPD of course meant the world to me at the time. i was in a relationship that involved common BPD behaviors and x amount of traits and thats what matters to me.

[MapleBob]

There seems to be an idea that BPD is not diagnosed unless it's preventing someone from functioning, though I don't know why that would be.

I think that's basically the case for most of the undiagnosed BPD significant others referred to here. People don't tend to go to a psychiatrist for problems in their intimate relationships, they go to a psychologist for some variation of talk therapy. Unless a person is very unruly and clearly in need of psychiatric assistance, why would a therapist refer their paying client away? And why would someone with BPD go straight to a psychiatrist when the whole disorder is about avoiding feeling like they're "bad" or "broken"?

I've always said: the diagnosis doesn't matter (for us, the nons). What matters is the behavior. Unless your partner is very actively seeking a diagnosis (most of our exes aren't), they won't get one.

[steelwork]

this is one of my favorite articles when it comes to keeping my ex in perspective: www.the-toast.net/2013/12/04/your-ex-might-not-have-a-personality-disorder/

There's something here I don't understand, which kind of gets to the basic thing I feel I'm missing in this thread.

"Extent means a person with a personality disorder will have the same relationship issues with you, as with their mom, as with their boss, as with their best friend, as with grocery store Pete who gives out free samples in the deli section. Pop psychology diagnostic articles rarely mention the importance of consistency across context."

But BPD involves maladaptive behaviors that are brought out in intimate relationships. The fear of abandonment/engulfment is not consistent across context... .right?

[MapleBob]

But BPD involves maladaptive behaviors that are brought out in intimate relationships. The fear of abandonment/engulfment is not consistent across context... .right?

That's generally correct, except in maybe extreme cases? Intimate relationships are inherently more high-risk/high-stakes, so more pressure, so more disordered thinking, so more disordered behavior... .But yeah, I see what you're saying about that quote. Diagnoses require multiple "samples", I assume.

[steelwork]

 iagnoses require multiple "samples", I assume.

I think that's why the diagnostic criteria stipulate traits being present consistently over time--i.e. in intimate relationships over time.

[Turkish]

this is one of my favorite articles when it comes to keeping my ex in perspective: www.the-toast.net/2013/12/04/your-ex-might-not-have-a-personality-disorder/

There's something here I don't understand, which kind of gets to the basic thing I feel I'm missing in this thread.

"Extent means a person with a personality disorder will have the same relationship issues with you, as with their mom, as with their boss, as with their best friend, as with grocery store Pete who gives out free samples in the deli section. Pop psychology diagnostic articles rarely mention the importance of consistency across context."

But BPD involves maladaptive behaviors that are brought out in intimate relationships. The fear of abandonment/engulfment is not consistent across context... .right?

It's a function of maladaptive behaviors as a function of intimacy. Only a couple of times my ex came home and said that she took a roundabout way home because someone in traffic that she flipped off started following here. Is that BPD? Though highly competent in her job,.she sometimes had conflicts with co-workers or her boss (juxtaposed by getting along really well with a select few at work). Was that BPD? Who is closest to being her BFF (not really, but has been friends with her since age 12) told me a year into our r/s, "thanks for giving me My Friend back." Was she aware of BPD? One of her brothers made an off-hand comment during a nice dinner with us (and his then gf, now stbw), "you're mean." Does he know BPD, or just a sometimes mean elder sister? Her mom called her the angry and steadfast child. I saw them get into a few dysregulations, despite their enmeshment, which always confused me.

My point is that only those of us who have been in intimate relationships "see it all," so to speak. Or maybe more correctly, bear the brunt. Most of the people I mentioned above, may only rationalize, "that's a difficult person," and go on with their lives. They neither see, nor experience, what we do or did.

[steelwork]

I think we're in agreement about the confusingness of that quote, Turkisk--can't quite tell.

Then too there are individual characteristics of pwBPD--some more acting-out, some more rigid in their efforts at self-control, etc. So I still believe people can have BPD without it being obvious to everyone.

[GreenEyedMonster]

My ex was in therapy when I was dating him, and had been for some three years.  He is probably still in therapy.

He never shared his own diagnosis with me (other than OCD and SA), but claimed that his other ex girlfriend was diagnosed as Cluster B.  (That is very suspect though -- long story.  She definitely had traits but the way the diagnosis was shared makes me wonder exactly what happened there.)

He initiated therapy after his mother's death because he felt a profound sense of emptiness and purposelessness in his life.  He was near middle age and had never had a relationship with a woman other than his mother for more than 2-3 weeks.  As I've said before, he is not an attractive person and has few traits that would attract a female companion, other than his intelligence.

Bottom line:  I'm guessing there's a diagnosis somewhere, if only hidden somewhere in the deep dark underbelly of a file.  My ex has a very clear pattern of not wanting to submit to anyone else's judgment or authority in his life, and this would likely extent to a psychologist, who would have to tiptoe around his ego problems.  With his many narcissistic traits, giving him an unflattering diagnosis would send him running for the hills and he'd quit therapy.  After all this time in therapy, his therapist is either a master at handling his particular issues or he's an enabler.

The fact that I don't have a label to put on him, endorsed by a professional, does not give me any doubt that this individual has a severe personality disorder. 

One of our mutual friends told me that my ex recently sent him an e-mail about how he hadn't heard from me in three months.  He followed it up a few days later with an e-mail about how I am a "psycho stalker."  I hadn't talked to him in between.  That sort of sums it up, no?

[teapay]

I find that article pretty accurate.  In particular it's emphasis on dx BPD as being pervasive and severe enough to impact individuals functionality across many domains of life, even outside intimate relationships.  Intimate relationship are definitely rich grist and top soil for the expression of BPD traits, but the emotional and identity disorders inherent in BPD continue outside intimate relationships.

It is a given that a partner cant be dx if they don't ever seek or get help/trearment.  That quote isn't addressing those cases.   It also isn't addressing those who seek help where the clinician simply won't dx for ulterior motives.  I dont exactly know why that happens, other than keeping them in the chair and insurance purposes, but it frequently happens.  The quote is addressing that great many who simply, if given (or gotten) an honest appraisal by a professional, don't meet the clinical criteria of a BPD dx.  They have some BPD traits or many traits with transient, possibly acute, expression that in many professional opinions don't rise to the level of BPD to be differential.  This is not uncommon, particularly among partners.

[steelwork]

Okay then, I submit to you my niece. Diagsosed BPD, lovely and popular with people outside the family. This is I'm told quite common.

Also, though it's beside the point sort of, my T pointed out that some practitioners have affinities for or against certain diagnoses.

[Mowgli]

Most regular clinical psychologists or psychiatrists may not use the proper tools. If you suspect someone of having a BPD, I STRONGLY suggest you contact:

The Borderline Personality Disorder Resource Center

www.BPDresourcecenter.org/

The Borderline Personality Disorder Resource Center of NewYork-Presbyterian Hospital/Weill Cornell Medical Center maintains a database of clinicians, agencies, and facilities nationwide with experience in the treatment of BPD and co-existing disorders. If you believe you or a loved one may have BPD, contact the Borderline Personality Disorder Resource Center at 888-694-2273 or at BPDresourcecenter@nyp.org. Only a mental health professional can diagnose BPD after a comprehensive psychiatric evaluation. Our compassionate certified social workers can help you determine the next steps for you or your loved one and connect you and your family members with resources in your area.

They are very helpful in getting a proper diagnosis by a PD trained clinician, using the appropriate interviews and surveys/tests .