How to get diagnosis for unBPD sister?

[Our abuse recovery guide]

My sister has been hospitalised after months and months of anxiety so severe that it has been dx as hypomania. This all started with a physical illness that she believes has to be fatal despite what the doctors are saying. She was brought to hospital after running in the street.

She is now in hospital, and has been diagnosed with hypomania and I think delusional disorder. The meds are calming her; however I feel this is the one chance we have for her to be diagnosed.

Last time she was in hospital she lied to the doctors so never got the dx of BPD. She knows all about the stigma and symptoms of BPD, so doesn't want to be diagnosed with it. She lies a lot anyway.

So my question is since dx is by clinical interview, how do you diagnose a person who lies? I have a medical background, so really do think she has either BPD or complex PTSD. Either way, without a diagnosis, how can she get treatment?

[Cailin2019]

My sister has been hospitalised after months and months of anxiety so severe that it has been dx as hypomania. This all started with a physical illness that she believes has to be fatal despite what the doctors are saying. She was brought to hospital after running in the street.

She is now in hospital, and has been diagnosed with hypomania and I think delusional disorder. The meds are calming her; however I feel this is the one chance we have for her to be diagnosed.

Last time she was in hospital she lied to the doctors so never got the dx of BPD. She knows all about the stigma and symptoms of BPD, so doesn't want to be diagnosed with it. She lies a lot anyway.

So my question is since dx is by clinical interview, how do you diagnose a person who lies? I have a medical background, so really do think she has either BPD or complex PTSD. Either way, without a diagnosis, how can she get treatment?

[Harri]

Hi and welcome.

I am not sure how to answer your question to be honest.     Do you communicate with her doctors?  Would you be able to contact one and explain your concerns?  They may not be able to share with you but you can with them.

It is not uncommon to hear that some pwBPD will not be honest about their symptoms, though i don't think that is specific to BPD.   

You mentioned c-PTSD.  Is there a history that would account for this?

I hope to ehar more from you.   am sorry I have more questions than answers or suggestions for you.  let's see what we can figure out.

[Mata]

I second Harri's suggestion to try and communicate information to her doctors.  Even if they cannot share information with you, they can accept information/observations you have.  I've literally had a conversation with my mom's Dr. that went along the lines "I know you can't talk to me, but I can talk to you.  You don't need to respond, but here are some things I believe you need to know about my mother."   I try to keep it concise and to the point, usually highlighting 2-3 things only. 

With that said, my mom's BPD diagnosis only came after she had established a long-term relationship with a psychiatrist who really got to know her, and could see through a lot of her lies.  I don't think she would have been diagnosed from an acute episode, like she was with bi-polar.
 
Good luck to you, I know it is really tough to have a family member in a psychiatric hospital.   
 

[Cailin2019]

I will be communicating with her doctors, yes.

She always had a temper, but her personality abruptly changed after our father died, and that is when her issues all started. She has many BPD traits, but does not have the addictions/self harm. IMO, most psychiatrists mostly come into contact with people with BPD who self harm or have addictions, so miss it in those who do not have these issues. It's like they ignore the rest of the criteria, which frustrates me no end.