I remember reading somewhere that 4 of the 9 criteria for BPD can be said to overlap with a bipolar dx.
It cannot be easy diagnosing BPD given the blunt instruments psychiatrists have at their disposal, but it seems like many psychiatrists will err on the side of a dx that can be medicated.
That seems to make bipolar more common than BPD, altho perhaps bipolar meds can help with some of the emotion regulation, idk. One of the things I also remember reading about BPD symptoms is that they must be extraordinary and persistent. I'm curious how a psychiatrist would evaluate that, or how a pwBPD would declare whether something was persistent.
Plus, there is also still so much stigma about BPD. The woman with BPD who wrote the memoir Buddha and the Borderline requested psychiatric records from when she was a teen and discovered more than a decade after her hospitalization that she had been diagnosed with BPD.
Imagine being diagnosed with what some people consider a fatal disease (given the high rate of suicidal ideation and self-harm among pwBPD) and not being told.
It's one of the reasons Gunderson's work was interesting -- he believed BPD should have levels like autism now has. The DSM-V criteria for BPD as listed are not helpful for communicating severity. I imagine that more acute cases are more diagnosed, and only the more specialized psychiatrists diagnose cases that would otherwise slip by as bipolar.
When SD25 was dx'd bipolar, everyone was like, Ok. But bringing up the possibility she was BPD? Omg no. Too awful to think she might have the same thing her mom has
There is also probably so much stigma, which is too bad. The same doesn't seem to apply to other mental illnesses, but for some reason "walking on eggshells" seems to apply even to diagnoses.
