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THE PSYCHOLOGY OF PERSONALITY DISORDERS
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Author Topic: DIFFERENCES|COMORBIDITY: Borderline PD and PTSD  (Read 38591 times)
sandpiper
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« Reply #20 on: January 13, 2009, 04:00:29 AM »

I have complex ptsd which is kind of a notch up on the ptsd severity spectrum, lots of my old friends here also had it when I was here years ago.

I was diagnosed with ptsd when I was 21, I had amnesia at around the age of six and there were big chunks of my childhood that I simply couldn't remember.

Over 20 years later I had another nasty flare up where I got triggered by running into someone from my past (a relative, I didn't recognize him at the time, just freaked out) and big chunks of my memory started to return. It was pretty overwhelming.  Like a bad dream, really.  I went back to therapy and my diagnosis was upgraded to c-ptsd, which they didn't know about in the 80's when I started treatment.

PTSD is classed as an anxiety disorder and it is often characterized by control or avoidance - the sufferer either tries to control situations to alleviate feelings of anxiety, or else you avoid situations and people that remind you of the trauma so that you can continue to block it out.

Generally its caused by severe trauma - usually by being in a life threatening situation or by witnessing someone else in that situation.

Soldiers have suffered from it for as long as we have records - they write about it in the Greek classics.

During WW2 they tried to screen for susceptibility to it and it failed.  Trauma is trauma.  You can't predict who will go on to develop ptsd after trauma, although there are a lot of factors that affect resilience during recovery (i.e. a sane healthy supportive family, but I'm here to tell you that you manage and recover without that!)

Rape victims, people who've been imprisoned and tortured, or exposed to extreme violence and danger also get it.

Complex ptsd is something that therapists see in children who've been raised in violent or abusive situations, concentration camps or by abusive/mentally ill/addict/PD parents, for example.

It can be a lot more extreme.

Having said that, everyone brings their own unique personality and circumstances to a situation and in no way do I wish to diminish anyone's experience here.  My father was a war veteran so I've done a lot of group stuff with vets and their families and I've seen how profoundly it affects not only the veteran but the family. I think sometimes men and women deal with things differently, too, I suspect that women are more inclined to seek help and we are better at building support networks.  Isolating yourself isn't good if you have ptsd, although it's often what you instinctively want to do.

Ask your therapist for more info, or if she can suggest some good reading material.

I found a great book by Aphrodite Matsakis called 'Post Traumatic Stress Disorder'.  It was in the Uni library (I'm studying health science so I found it in the Psych section).  I believe it was a textbook, went out of print and I heard a rumour at the med school bookstore that its being revised for a new edition.

I found a lot in there that made sense for me.

Someone here also put me onto a site, I think it was petewalker.com - that I found very useful.

It talks about the effect of 'The Inner Critic'.  That voice in your head that tells you you're no good, you can't do that, you're bad...all the yucky stuff - and it offers suggestions how to deal with it.  People with ptsd can become very negative, about themselves and about others, and it takes work to get past that.

There's probably a lot of crossover between BPD and ptsd, because borderlines have generally suffered so much trauma.

They are different, though.

In the case of the BPD its affected their brain chemistry so that they have a mood regulation disorder.  Last time I checked the psychiatrists were all debating about what to say about BPD and c-ptsd in the next edition of the DSM.  Psychiatry, I've been told, is a developing field of medicine and they really don't know everything they can, yet.  There's a lot to discover.

A big thing about ptsd is that it can make you edgy, jumpy, irritable, paranoid (I don't really like that term so I say 'Unrealistic threat assessment) and it tends to really screw with your sleep and your libido.  (fun times, hey?)

the good thing is that its treatable and it settles down.  I found that working with the trauma counselor and doing Group did a lot to restore my sense that the world was a safe place to walk around in.

I hope I haven't overloaded you with information.

I count myself very blessed that I was diagnosed and got help so young.

Its made a huge difference in that I've been able to build a good life for myself. 

I hope you put yourself in good hands and have a therapist who can guide you through this.  It isn't easy, in fact some parts of it are just downright hellish, but lots of us here have made that journey and we're here to help.


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Randi Kreger
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« Reply #21 on: October 29, 2009, 02:57:28 PM »

Lol, sorry Shay.  The amygdala is the part of the brain that regulates fight, flight, and freeze responses.  The hippocampus affects things like memory; it's why traumatic memories are often so darn different than regular ones, so intense and emotional, sometimes fragmented so you get the smells, sounds, body sensations, as a war veteran you probably already know.  Anyway, there's a bunch of research being done by Drs like van der Kolk and Herman, and they can actually see major differences in the way those parts of the brain function after trauma like combat, rape, torture, that sorta thing.

Great explanation. I think that people with a borderline parent are subject to PTSD-like symptoms and end up being emotionally traumatised in ways that can lead to various physical illnesses as adults. Randi Kreger Author, "The Essential Family Guide to Borderline Personality Disorder "
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Chazz
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« Reply #22 on: August 06, 2010, 10:44:52 PM »

I think there may, in many cases, be a relationship between Complex-PTSD and BPD, but not necessarily PTSD .

Based on my readings, I think that BPD relational dynamics are a form of trauma reenactment.

Their serial reenactments, with successive partners, may be failed attempts at mastering the original trauma.

BPD disappearing acts, and NC episodes, may be escape scenarios.

"Many researchers believe that BPD is a dissociative disorder lying somewhere on a spectrum between PTSD and Dissociative Identity Disorder. For a clear overview of this perspective on dissociation and BPD, see: What is the difference between BPD and the spectrum of dissociative disorders?" - Dr. Richard Moskovitz, author of Lost in the Mirror, an introduction to the disorder.

"BPD is a subtype of trauma associated disorders. The criteria of BPD, of complex post-traumatic stress disorders (C-PTSD), and of disorders of extreme stress not otherwise specified (DESNOS) substantially overlap. Neuropsychological deficits in BPD and PTSD as well as psychoendocrinological and neuroimaging studies in BPD und PTSD also revealed common features." - AAPEL -- www.aapel.org/BPD/BLptsdUS.html

"Regarding the high prevalence of traumatic experiences in patients with borderline personality disorders (BPD), we review the available literature focusing on the hypothesis that BPD is a subtype of trauma associated disorders. The criteria of BPD, of complex post-traumatic stress disorders (PTSD), and of disorders of extreme stress not otherwise specified (DESNOS) substantially overlap. Neuropsychological deficits in BPD and PTSD as well as psychoendocrinological and neuroimaging studies in BPD and PTSD also revealed common features.  Further research will have to prove BPD as a complex and early-onset post-traumatic stress disorder after multiple and/or chronic (type II) traumatic experiences during childhood and/or youth. Definitive conclusions require further research efforts." --  Driessen M, Beblo T, Reddemann L,... - Medizinische Universitat zu Lubeck, Germany

"We postulate that posttraumatic stress disorder is maintained by learnt cortical and subcortical plastic changes. Specifically, we assume that classical conditioning leads to an intense emotional memory of the trauma that is mainly implicit and related to plastic changes in subcortical structures such as the amygdala. At the same time an insufficient explicit trauma memory is formed that manifests itself in insufficient cortical processing of trauma content. This dissociation of implicit and explicit memory prevents the extinction of the emotional response to the trauma and perpetuates the disorder. First empirical results based on this model confirm the main hypotheses." -- Posttraumatic Stress Disorder and trauma memory - a psychobiological perspective by Wessa M, Flor H., 2002        

      

"During a dissociative episode, the brain is thought to switch into a biochemically-induced "high defense mode", during which the storage of new memories is effectively blocked. Yet not all memory is erased, which is quite confusing to those interacting with the individual during these times. Researchers propose that "these early encoding deficits [...] have a deleterious effect on the short-term memory system; they manifest as deficits in the ability to take in new information but not in the ability to conceptualize and manipulate previously encoded information".  -- Memory, Trauma & BPD --  www.bpdresources.net/memory.html

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Wanna Move On
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« Reply #23 on: September 01, 2013, 08:20:36 PM »

I've done some reading about Complex-PTSD and BPD, and it seems like there is an ENORMOUS amount of overlap between the two. I've even read that some BPD theorists, researchers and clinicians think BPD would be better served by being renamed "Complex-PTSD".

Does anyone know anything about this subject and/or it those are, in fact, two different labels describing the same set of diagnostic symptoms?
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heartandwhole
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« Reply #24 on: September 02, 2013, 09:03:25 AM »

I've done some reading about Complex-PTSD and BPD, and it seems like there is an ENORMOUS amount of overlap between the two.

My pwBPD, who was diagnosed and studied psychotherapy as well, said something similar to what you are saying, Wanna Move On: that Complex PTSD has been discussed as an alternative name for Borderline Personality Disorder.  Apparently because of the stigma of the "borderline" diagnosis, and the similarity in symptoms/patterns.  Judith Herman, a well known psychiatrist specializing traumatic stress, may have advocated this as well, if memory serves.

The problem is that studies indicate that a history of childhood trauma, as seen in C-PTSD, is not always present in people diagnosed with BPD.  Nevertheless, the comparisons continue.

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  When the pain of love increases your joy, roses and lilies fill the garden of your soul ~ Rumi
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« Reply #25 on: September 02, 2013, 08:41:44 PM »

I have done a lot of reading on BPD, as a diagnostic entity, and about COMPLEX-PTSD. Not standard, classic PTSD, but specifically "Complex-PTSD." The overlap between the two seems stunning.

I have recently spent some time in AA. (Yes, I had a little bit of a drinking problem post a BPD breakup.) And the one thing that SHOCKED me as I listen[ed] to qualification after qualification, floor share after floor share, is that it seems 90-plus% of the people in AA suffer from either some version of BPD or some version of C-PTSD.

I've also read where Marsha Linehan said, in reference to her realization (prior to her development of DBT) that it seemed the population of suicidal females she initially worked with AND those who were classified as "BPD" in inpatient hospitals where she worked, seemed to be one and the same overlapping crowd.

Similarly, it seems that virtually all the people in AA present with diagnostic symptoms that match with what is labeled as "BPD" and/or "Complex-PTSD."  

Is it possible that BPDer's, C-PTSDer's and alcohol/drug abusers are all one big overlapping crowd, conceptually made to seem distinctive and separate merely by virtue of the fact they are assigned different diagnostic labels?

I'd appreciate any conceptual feedback on this intriguing subject.
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Skip
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« Reply #26 on: September 03, 2013, 05:25:20 AM »

Is it possible that BPDer's, C-PTSDer's and alcohol/drug abusers are all one big overlapping crowd, conceptually made to seem distinctive and separate merely by virtue of the fact they are assigned different diagnostic labels?


Comorbidity of personality disorders was seen as the flaw in the DSM-IV that inspired a new nomenclature system proposal for the DSM 5.0  Just prior to publication, it was determined that the new nomenclature needed more clinical study so it was moved to the appendix to provide a framework for future studies.

C-PTSD is subcategory of PTSD which not recognized by the American Psychiatric Association as a mental disorder. It was not included in DSM-IV or in DSM-5, published in 2013. To our knowledge, except for a few bloggers, there is no movement to change the name BPD to PTSD.  The direction of the new nomenclature is to have a general personality disorder category for people with overlapping PDs.  This would actually lower the number of people in the category of BPD.  

While there is co-morbidity, BPD and alcohol abuse are not the same thing. And half of the people with BPD do not have PTSD - even fewer have C-PTSD.

There are a lot of comorbidities with BPD.

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Wanna Move On
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« Reply #27 on: September 03, 2013, 02:14:29 PM »

Skip, I appreciate your response and I do understand that BPD and alcohol/drug abuse are not the same thing. Maybe the failure was in my communication; maybe it was inexact.

What I was referring to is the statistical reality that the vast majority of people who diagnostically present with BPD and/or C-PTSD are alcohol and drug abusers, to varying extents. And that I recognized from a degree of time involved with AA, that it seems virtually everyone in those rooms present with some degree of BPD and/or C-PTSD symptomology.

I was just wondering, out loud, if the BPD, C-PTSD and alcohol/drug abusing crowd are, in fact, the SAME overlapping crowd, but seen as conceptually distinct due to semantics and/or inexact constructs such as diagnostic labeling.

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Skip
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« Reply #28 on: September 03, 2013, 02:21:31 PM »

And now that you have seen the data, what do you think?
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Wanna Move On
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« Reply #29 on: September 03, 2013, 02:26:03 PM »

What do I think? I guess there is an enormous degree of overlap between those three diagnostic categories. I guess there is a tremendous degree of comorbidity, as you suggest.
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