Help determining if my child has BPD

[My Dear Girl]

Hi everyone,

This is my first post to this group and I am hoping to learn more about BPD and figure out if it should be my teenage daughter's diagnosis.  She has been diagnosed by her primary therapist in a hospital day program as having Major Depression and Anxiety.  The Psychiatrist there said she has Major Depression.  Her current outpatient therapist (for 3 months) thinks she may have bi-polar disorder.  I have done a lot of research on different mental health disorders and I am starting to think that she actually has BPD.  Does BPD often occur with other diagnoses, like depression and/or anxiety or does it usually occur on it's own?  Is there one or 2 particular symptoms or behaviors that best differentiate bipolar disorder?  I want to make sure that we are treating my daughter for the right disorder.  Thanks so much!

Our objective is to better understand the struggles our child faces and to learn the skills to improve our relationship and provide a supportive environment and also improve on our own emotional responses, attitudes and effectiveness as a family leaders

[Modesty68]

Hello!
As I have understood, a main difference between BPD and bipolar is that the BPDs are changing their moods in seconds, while the bipolars can stay in their up or down for weeks. The reactions/outbursts by BPDs seem to be triggered by typical interpersonal stuff, - while that is not the case with bipolar.
I have heard of people having both BPD and bipolar, and both of them is quite often added by other diagnosis.
The path of finding out could be long. I think you should see to that your daughter in any case, and still while waiting months/years for diagnosis, get good therapy. The most important, whatever diagnosis you have, is to meet with kind and understanding people and therapists. I had confidence in the health system, and belived in them when they said they just had to work more on the diagnosis. Now it's been six years, my d is worse than ever, and still they are not conclusive about the diagnosis. So many hours diagnosing, so few hours of treatment...

[20yearsHRS]

The person has to meet 5 of the 9 BPD criteria (below).  You will need a Psychologist to make this call.  Takes about 3 hours in their office with test, surveys that you need to fill out and the child's favorite teacher.  They will hesitate to make this diagnosis if child is not in their upper teens.  My daughter got this diagnosis at age 17th. 

The Criteria for a Diagnosis 

BPD is a pervasive pattern of instability in interpersonal relationships, self-image, and emotion, as well as marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

Chronic feelings of emptiness
Emotional instability in reaction to day-to-day events (e.g., intense episodic sadness, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)

Frantic efforts to avoid real or imagined abandonment

Identity disturbance with markedly or persistently unstable self-image or sense of self

Impulsive behavior in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating)

Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)

Pattern of unstable and intense interpersonal relationships characterized by extremes between idealization and devaluation (also known as "splitting")

Recurrent suicidal behavior, gestures, or threats, or self-harming behavior
Transient, stress-related paranoid ideation or severe dissociative symptoms.[1






]

[Football2000]

I think it depends how old your daughter is. At one time there was a reluctance to diagnose people in their teens with BPD but now it is more common. For younger children I am not sure, as there is still a lot of development going on in their minds. The good news about that is they might have a better chance of avoiding BPD as adults if they are treated.

As for the general question, BPD does occur often with other diagnoses like depression and bipolar. Some research research has shown that certain traits of BPD are more stable throughout life (like intense anger) and others (like identity disturbance) are less stable. BPDs can be high functioning and perhaps not show all the symptoms, and people with BPD can also present themselves with certain symptoms that on cursory examination would just be diagnosed as depression.

Although that sounds confusing, the good thing is that therapies that target emotion regulation like CBT or DBT can help with depression and with BPD...so at least even if some accuracy is missing from the diagnosis, the methods of treatment can still help.