FAQ: Could it be multiple comorbid personality disorders?

[BPDFamily.com]

I have a question.

I read somewhere that BPD often coexist with other personality disorders like NPD, or ASPD.

Is this true?

[Almost_Nobody]

I have a question.

I read somewhere that BPD often coexist with other personality disorders like NPD, or ASPD.

Is this true?

[GENERAL ANNOUNCEMENT]

GENERAL ANNOUNCEMENT This board is intended for general questions about BPD and other personality disorders, trait definitions, and related therapies and diagnostics. Topics should be formatted as a question. Please do not host topics related to the specific pwBPD in your life - those discussions should be hosted on an appropraite [L1] - [L4] board. You will find indepth information provided by our senior members in our workshop board discussions (click here).

[Skip]

Analyzing comorbidity data is a complex matter that probably exceeds most of our laymen skills    

In medicine, comorbidity describes the effect of all other diseases an individual patient might have other than the primary disease of interest.

In psychiatry it is a bit different.  In psychology and mental health counseling comorbidity refers to the presence of more than one diagnosis occurring in an individual at the same time. However, in psychiatric classification, comorbidity does not necessarily imply the presence of multiple diseases, but instead can reflect our current inability to supply a single diagnosis that accounts for all symptoms. The term comorbidity was first used in psychiatry in 1970's.

The current DSM-IV definitions have so much overlap, just about everyone with a personalty disorder has a co-morbidity with another mental conditions.  The Amercican Psychiatric Association is trying to reduce this up in a revised version of the DSM (DSM-5) due to be published in 2013.

In a study of 34,653 people in the general population by the Laboratory of Epidemiology and Biometry, National Institutes of Health (NIH), Bethesda, MD, USA the incidence of comordibities with BPD were very high.  

Comorbidity with another personality disorder (Axis II) was very high at 74% (77% for men, 72% for women) and as such, the PD are being redefined.

Comorbid w/BPD--------- Paranoid Schizoid Schizotypal Antisocial Histrionic Narcissistic Avoidant Dependent OCD

Men----------- 17% 11% 39% 19% 10% 47% 11% 2% 22%

Women------- 25% 14% 35% 9% 10% 32% 16% 4% 24%

But even with the changes in the DSM-5, co-morbidity is real with Axis I disorders.

In the NIH study comorbidity with mood disorders was very high at 75% as was anxiety disorders 74%.

Comorbid w/BPD--------- Anxiety Disorder (Axis I ) -Posttraumatic stress -Panic with agoraphobia -Panic w/o agoraphobia -Social phobia -Specific phobia -General anxiety Mood Disorder (Axis I ) -Major depressive -Dysthymia -Bipolar I -Bipolar II

Men--------- - 30% 8% 16% 25% 27% 27% - 27% 7% 31% 7%

Women------ - 47% 15% 21% 33% 47% 42% - 37% 12% 33% 9%

Male and female borderline patients were also found to be significantly different comorbidities in the areas of substance use disorders and eating disorders (Axis I).

Comorbid w/BPD--------- Alcohol abuse Drug abuse Anorexia* Bulimia*

Men---- 52% 22% 7% 10%

Women---- 33% 14% 25% 30%

* From a separate study of 515 inpatients at McLean Hospital (Harvard University)

Looking at all this comorbidity, it's easy to see why a therapist might initially focus on the more "treatable" and episodic Axis I disorders (e.g., depression, anxiety disorders, bipolar disorder, ADHD, anorexia nervosa, bulimia nervosa) before diagnosing and tackling the more difficult to treat and stigmatized borderline personality disorder (Axis II).  In many ways, this makes sense.


Please note:  This soon to be published study data is provided to give a general idea of the magnitude of comorbidity. I selected this study because it was comprehensive and the data are easy to understand and because it was a general population study -- a representative sample of the civilian population, 18 years and older, residing in households and group quarters in the United States. There are (and will be) numerous other studies that update and further refine these findings.

[JoannaK]

Some members here reported that they are dealing with loved ones with some NPD or ASPD traits... .these people may be harder to diagnose and treat than someone with "simple" BPD.  

Those with NPD and ASPD tend to refuse to accept that they have any problems.  

They tend to "ride above" the chaos.  Those with BPD are a bit more involved with and cognizant of the chaos.

[Abigail]

Good points, Skip! Sometimes there is a tendency to attribute every undesirable or problematic trait to BPD.  It is important to distinguish what is caused by BPD and what is attributable to another disorder or factor.  Otherwise, we may miss other disorders that need to be treated also.  Each of these separate disorders can influence the other.

 

One fairly common example would be substance abuse/addiction and BPD.  If one treats the substance abuse but neglects to treat the BPD, the chances of relapse are much greater.  :)rug abuse and alcohol can make the BPD worse.  In particular, withdrawal from alcohol (12 to 72 hours after drinking) can bring on dysphoria.  Seeking release from the dysphoria, they are apt to drink again.  

And the cycle continues.

 

Abigail

[Skip]

Keeping it in Perspective

When asking differential questions about multiple personality disorders, it is important to understand why you are asking the question and how you intend to use the information. Without this perspective and focus, the data may be overwhelming, confusing and misleading.  For example... .

~ if your child is not responding to therapy, it makes sense to look more carefully into the possibility that the wrong personality disorder was diagnosed or whether there are comorbid (multiple) personality disorders at play.

~ If you are trying to get along better with your wife, it's not as important to pinpoint the specific disorder or analyze the comorbidity as it is to recognize and fully understand the problem behaviors and how to constructively deal with them.  

~ If you are recovering from a failed relationship, the important thing is often to understand which behaviors were pathologic (mental illness) and which were just the normal run of the mill problems common to failing/failed relationships - there is often a bias to assign too much to the "pathology" and not enough to common relationship problems, or the issues we created by our own behaviors.

Some helpful hints for sorting through this.

• General and Specific There are definitions for "personality disorder" as a category and then there are definitions for the subcategories (i.e., borderline, narcissistic, antisocial, etc.).  Start with the broader definition first.  Keep in mind that to be a personality disorder, symptoms have been present for an extended period of time, are inflexible and pervasive, and are not a result of alcohol or drugs or another psychiatric disorder - - the history of symptoms can be traced back to adolescence or at least early adulthood - - the symptoms have caused and continue to cause significant distress or negative consequences in different aspects of the person's life. Symptoms are seen in at least two of the following areas: thoughts (ways of looking at the world, thinking about self or others, and interacting), emotions (appropriateness, intensity, and range of emotional functioning), interpersonal functioning (relationships and interpersonal skills), or impulse control

• Spectrum Disorders  An extremely important aspect of understanding mental disorders is understanding that there is a spectrum of severity. A spectrum is comprised of relatively "severe" mental disorders as well as relatively "mild and nonclinical deficits".  Some people with BPD traits cannot work, are hospitalized or incarcerated, and even kill themselves.  On the other hand, some fall below the threshold for clinical diagnosis and are simply very immature and self centered and difficult in intimate relationships.

• Comorbidity Borderline patients often present for evaluation or treatment with one or more comorbid axis I disorders (e.g.,depression, anxiety disorders, bipolar disorder, ADHD, autism spectrum disorders, anorexia nervosa, bulimia nervosa). It is not unusual for symptoms of these other disorders to mask the underlying borderline psychopathology, impeding accurate diagnosis and making treatment planning difficult. In some cases, it isn’t until treatment for other disorders fails that BPD is diagnosed.  Complicating this, additional axis I disorders may also develop over time.  Because of the frequency with which these clinically difficult situations occur, a substantial amount of research concerning the axis I comorbidity of borderline personality disorder has been conducted. A lot is based on small sample sizes so the numbers vary.  Be careful to look at the sample in any study -- comorbidity rates can differ significantly depending on whether the study population is treatment seeking individuals or random individuals in the community.  Also be aware that comorbidity rates  are generally lower in less severe cases of borderline personality disorder.

• Multi-axial Diagnosis  In the DSM-IV-TR system, technically, an individual should be diagnosed on all five different domains, or "axes." The clinician looks across a large number of afflictions and tries to find the best fit.  Using a single axis approach, which we often do as laymen, can be misleading -- looking at 1 or 2 metal illness and saying "that's it" -- if you look at 20 of these things, you may find yourself saying "thats it" a lot.     A note in the DSM-IV-TR states that appropriate use of the diagnostic criteria is said to require extensive clinical training, and its contents “cannot simply be applied in a cookbook fashion”.

• Don't become an Amateur Psychologist or Neurosurgeon  While awareness is a very good thing, if one suspects a mental disorder in the family it is best to see a mental health professional for an informed opinion and for some direction - even more so if you are emotionally distressed yourself and not at the top of your game. 

I hope this helps keep it in perspective.  

Skippy



Additional discussions... .

Personality Disorders

Borderline and Paranoid Personality Disorder

Borderline and Schzoid/Schizotypal Personality Disorder

Borderline and Antisocial Personality Disorder

Borderline and Histrionic Personality Disorder

Borderline and Narcissistic Personality Disorder

Borderline and Avoidant Personality Disorder

Borderline and Dependent Personality Disorder

Borderline and Obsessive Compulsive Personality Disorder

Borderline and Depressive Personality Disorder

Borderline and Passive Aggressive Personality Disorder

Borderline and Sadistic Personality Disorder

Borderline and Self Defeating Personality Disorder

Other

Borderline PD and Alcohol Dependence

Borderline PD and Aspergers

Borderline PD and Attention Deficit Hyperactivity Disorder

Borderline PD and BiPolar Disorder

Borderline PD and Dissociative Identity Disorder

Borderline PD and P.T.S.D.

Borderline PD and Reactive Attachment Disorder (RAD)

[jalk]

Something I read online. The most co morbid diagnosis with BPD's is eating disorders. How many of you folks here on this message board know if your ex BPD has an eating disorder. Mine does. In fact she has had it ever since she was in her 20's and she is now 49 yrs old. She was able to keep it from me for 8 years by staying up later than me, binging, then she would go and vomit. Once in awhile I would hear her vomit and she would say that something did not agree with her. I took it at face value, being the naive trusting person that I am.

[FloatOn]

Mine had anorexia and bulimia. She would basically binge for periods and then starve herself to compensate. I knew she had it from the beginning basically, she was in therapy and told me all about it. I thought no biggie, she's getting treated for it and she seems to be doing fine now right? Like a month before we broke up she started to have problems with food again, one time telling me "I just have a really strong desire to starve myself right now". She would wake up in the middle of the night and not be able to sleep because she was so hungry. All this from gaining 15 pounds from the night we met 4 years prior (she was still thin and really hot) and thinking she was fat and ugly.

[Matyr]

My SO is also diagnosed as Bi Polar, & having Major Depressive Syndrome. I'm currently trying to figure out whether or not the Bi Polar diagnosis has any bearing on her mood swings (or phasing as I've come to call it). I'm documenting her moods on a daily basis, so I may look back & see if there is a pattern. Also she is on Sertraline (Brand name: Zoloft), which seems to take the edge off, but certainly does not prevent her mood swings, hostility & occasional dis associative aggression.

Any comments or advice would be greatly appreciated.

PS   I'm also trying to subtly suggest that she may be happier if she returns to DBT (I'll let you know how that one goes )

[artman.1]

My UBPDW for the last 42 years, has been diagnosed as Bi-Polar about 15 years ago when she had a nervous breakdown.  She was assigned Therapy at that time and was given Lithium which was the med of Bi-Polar choice at that time.  

I just recently discovered that her mood swings do not match Bi-Polar behavior, and does match BPD behavior.  

Well, how can we get her to seek treatment?  We cannot do this or control this.  We must only help ourself.  That is what I am doing, and learning the skills to set boundaries and enforce them, which, surprisingly helps with her behavior.  

Read the lessons and read the lessons, and you will begin to see.

[Matyr]

42 Years... .Man oh Man !

I commend you sir. You must have a Masters Degree in dealing with BPD by now !. Thank you for your input regarding mood swings, & naturally you are correct in recommending the lessons. I am finding both the workshops & the forums very helpful & informative. I'm finding that a lot of the material is pretty subjective, & at the moment I'm finding it easier to cope by detaching emotionally, hence my desire to make sense of this all in an empirical manner. I am relatively new to this having only been in my relationship for 5 years, during which time my efforts to help her have basically involved getting her involved with case management & calling them when she gets violent, to leaving for 9 months. Like most people who share their lives with BPD"s, I'm just trying to make sense of it all. I realize the only person I can help is myself, but at least by learning as much about this disorder as I can, perhaps I can circumvent & maybe prevent some of the more extreme symptoms. We have a young child, so I feel obligated to see this through.

 

[Styx]

I'm told my wife had a possible diagnosis of Bi-polar at one point. Honestly I have no idea what that means (the possible part). But as it sits she officially has 3 diagnosis' and one of them I kinda question (I'll get to why below). So far as bearing on mood swings, I'm not nearly qualified to answer that or even give a meaningful opinion.

My wife's diagnosis' are:

1) BPD and at the moment is considered relatively low functioning. In reality she's definitely a mix of high and low functioning.

2) Masosadism to which her Pdoc has told us there's not many studies on and not much he can do about it (paraphrased and summed up). We only found out about this one in January... .made total sense when I heard it. It's one thing to have fantasies and like things on the "rougher side" (IF both parties are ok with it) but some of the stuff she's done to herself and others... .man, outright scary and NOT my cup-o-tea . 

3) Depression. This is the one I'm not sure on... .It was diagnosed YEARS ago and knowing what I do about her past, she's definitely been struggling with BPD for at least as long even if she didn't know it at the time. So it makes me wonder, which came first? the chicken or the egg?  Was her depression brought on by her inablilty to really integrate in society? by the string of "bad" relationships? by her mother being an alcoholic? the abuse she suffered from her ex-step-dad? Or is it a "clean", seperate diagnosis?

The important question in our case though is "does it matter?" It is what it is so carry on . I just find it interesting to consider... .Where did it all start? What was the cause and effect? and so on. I guess it's kinda my way of trying to understand some aspects of it.

[GENERAL ANNOUNCEMENT]

GENERAL ANNOUNCEMENT This board is intended for general questions about BPD and other personality disorders, trait definitions, and related therapies and diagnostics. Topics should be formatted as a question. Please do not host topics related to the specific pwBPD in your life - those discussions should be hosted on an appropraite [L1] - [L4] board. You will find indepth information provided by our senior members in our workshop board discussions (click here).

[Jaybird]

Matyr, I don't have the same issues you are facing. My H has been diagnosed with depression and ADD but not BPD.  However I did see this article in our archives.  See if this is of any benefit to you.  I think we can drive ourselves crazy trying to make sense of our spouses' behavior.  Understanding can lead to more compassion on our part but ultimately our main focus needs to be on our part of the dysfunctional dance.  Is she in any therapy at all right now?


What are the diffences/similarities between BPD & bipolar? Comorbidity?

[Auspicious]

It's possible to have multiple diagnoses.

My wife was initially diagnosed with bipolar II. She later (in hospitalizations) picked up the BPD diagnosis, but kept the bipolar one too.

The bipolar one has changed around - it went to bipolar I, then to major depression and anxiety, then to "mood disorder not otherwise specified".

Whatever they want to call it, I do believe that she has both types of disorder: a "chemical" mood disorder, and also BPD.

She has been on bipolar meds for years, and she has been in DBT for months.

[Matyr]

Yeah I hear you all.  Good information Skip.

It seems like sometimes BPD is used as a "catchphrase", when therapists really can't pin a definitive diagnosis to the symptoms. As I've stated before, it's blatantly obvious that my SO's behavior stems from her childhood trauma, but why are some people affected more than others ?. I too had a "rough" childhood, but in my instance , it just made me stronger & more self reliant. I make friends easily & maintain relationships, & have a generally positive outllook on life, & I am able to deal with "drama" when it arises, without letting emotion cloud the issue.

I'm going to continue documenting her mood swings & her behavior, & try & look for a pattern. In the meantime, I'll continue with the workshops & lessons (thanks for the link Jay Bird). It's all good therapy for me, as well as leading to a greater understanding of BPD, which can certainly aid me in maintaining this relationship.

Thanks guys ! 

[peacebaby]

I too had a "rough" childhood, but in my instance , it just made me stronger & more self reliant.

Me too, but you know what, it also made me think I had this strength to save people, that I would be okay no matter what, and it brought me to a relationship with someone who needed a lot of saving and though I'm still strong and self reliant, I have a bit of PTSD from it.

My partner has been diagnosed with major depressive disorder, PMDD, BPD, and PTSD. She's done a lot of DBT and is doing very well these days, but still has a bit of all these illnesses.

As to why, I'll just give my partner's example. She endured every kind of abuse and neglect while receiving little love and no validation. She was also descended from and surrounded by mentally ill substance abusers as a child. Never mind being poor and black in the south and never knowing her father. Most people don't have all these factors, and even when some do, they don't get BPD.

And remember, all these diagnoses are just combinations of symptoms. If my partner didn't have these symptoms, it wouldn't matter if she had a diagnosis. I personally have emotional regulation issues, but I don't have BPD.

[Matyr]

Hey peacebaby (cool handle !)

Yeah, I'm way over thinking I & now just focus on what I can change (ME), while doing my best to accept what I can't change.

It's very difficult when "what you can't change" impacts your life so much, & the only option to change the situation your left with is to dig out !. I'm hoping that my SO will return to DBT, so that we may both work on our relationship.

At this point I see little hope... .at least while she is in denial, & projecting all the BS onto me, & yes, it is a sad fact that most BP's were "damaged as children.

AnOught has some very helpful things to say about this topic in another thread I'm participating in.  Try check it out !

https://bpdfamily.com/message_board/index.php?topic=140686.0

[irishbear99]

I've seen a lot on co-morbidity for PDs.  Ex, someone having both BPD and NPD.  What I'm wondering is if having BPD increases the chances of other non-PD mental illnesses.

[mommies dearest]

This is a very interesting topic, I've been wondering the same thing.  My uBPDm has the official mental illness diagnosis of "bipolar disorder", which I DO NOT think she has.  In my opinion, she has been "acting" with her psychiatrist (to get on disability) and really doesn't exhibit any of the real traits of bipolar disorder.  She is a classic borderline. But like immadone said, the therapist can only go by what the patient tells them, and my mom is a master manipulator.

[Ann2034]

Fascinating topic. I know that research has linked ADD/ADHD in girls to BPD. I wouldn't be surprised if clinical depression, bipolar and other genetically inherited mental health problems can lead to BPD. It makes sense if you think about it. My mom and I both have ADD, and she has BPD as well. ADD can cause a lot of problems; drifting off when people are talking to you, feeling slow in school, not being able to focus on social interactions and behave appropriately; these make developing healthy relationships that much harder and I believe have contributed to my mom's feelings of inadequacy and self-loathing, and ultimately her BPD. Luckily for me, I was able to get into treatment at a young age and was spared the potential of developing BPD for myself (phew on that one!).

The interesting thing to me is that while ADD and bipolar are genetic and managed with medication and therapy throughout a person's life, BPD is (supposedly) much more curable IF the person wants to get better. The IF is the big question though... .

[BlueCat]

I think it's a spectrum as Skip points out. I think also some things are actually symptoms.

I'm not a doctor so I could be off base, but it seems to me that hoarding is simply a symptom of something else. From my research, I don't think I've ever come across anyone who is "just" a hoarder.  :)epression, PTSD, a personality disorder - something like that always seems to be present. So some people have a PD and end up as hoarders. Some have a PD and end up as neat freaks. Some people have a PD and the state of their house is not affected and it shows itself in other ways instead.

My mom is a hoarder. It runs in my family. Child abuse, child neglect, depression and alcoholism also run in the family. It's definitely related.

[Peridot]

I believe it is possible, but then I am just a lay person, not a pro. It seems there is so much at work with my foo - not just BPD, and even beyond other pd.

Related to this, my rheumatologist once made a comment that stuck with me. He was going over my family medical history to try to grasp where my conditions may have come from. In discussing some things, he said it wasn't uncommon in the old days (or even now I suppose) for people to self medicate to deal with their pain. So he suspects that many alcoholics became alcoholics simply because they couldn't deal with some other pain condition / illness in their life. It makes a person really think. Alcoholism gallops in my family. (I'm a tea totaller.) Since then I have considered what other things might have turned my various past and present relatives to drinking ... .and I've thought a lot about mental and physical pain they were trying to drink away. What I'm getting at is that I don't think it is easy to always identify what all is going on with any one person.

Not sure if that is helpful or not.

Speaking of hoarding, there was a news story about a woman being arrested for neglect of her animals. She was a hoarder.  I bet she's really a mentally ill woman who thought she was saving those animals before it went all kinds of wrong. It wouldn't seem to me that arrest is of any benefit to anyone involved. I mean, what sort of help for mental illness is that? She'd be better off being required to be treated for her issues - and have the animals taken to safety and adoption in better homes.

I dunno. Complicated issue really - all of this. But getting back to the point, yes, I believe other illnesses can be involved in those with pd's.

[GENERAL ANNOUNCEMENT]

GENERAL ANNOUNCEMENT This board is intended for general questions about BPD and other personality disorders, trait definitions, and related therapies and diagnostics. Topics should be formatted as a question. Please do not host topics related to the specific pwBPD in your life - those discussions should be hosted on an appropraite [L1] - [L4] board. You will find indepth information provided by our senior members in our workshop board discussions (click here).

[BlueCat]

and I've thought a lot about mental and physical pain they were trying to drink away. What I'm getting at is that I don't think it is easy to always identify what all is going on with any one person.

I see that in my family. I don't know where it started, but going back at least 3 generations we have abusive parents who raise children who grow up to be abusive parents. And the alcohol abuse/alcoholism is part of them trying to make the pain go away.

[BlueCat]

I dealt with depression and anxiety and for me it was mostly the anxiety.

When I was at my worst my house got pretty bad (happy to say not close to what I grew up in, but pretty bad). It was definitely anxiety. I'd try to clean and get overwhelmed by it all and not know where to start. Or I'd pick up an object and then get anxious over whether I should give it away or keep it, and if I keep it, where do I keep it?

Getting on thyroid meds helped that a lot, and then getting on anti depressants helped even more. I will never be a neat freak, but my house is comfortably lived in and I'm usually happy with the state it's in (and when I'm not, I actually do something about it).

Thyroid meds and then SSRIs have made such a difference for me, I can't stop myself from thinking that maybe my mom would be a different person if she got on them. She's had a goiter (an enlarged thyroid) for years and her doctor ignored it so she's not on anything for it. And if anyone could use meds for anxiety it's my mom. But of course she tells me she doesn't need meds. She's fine . . .

[GP44]

Unless you know for a fact that they have been officially diagnosed by a mental health professional, it's speculation and conjecture to say that they have a personality disorder.

But I will say that you didn't end up on this board by accident.

You still witnessed bad behavior and were traumatized by your ex's actions. If it turns out that your ex doesn't have BPD but his behavior is cruel, does that change anything? Does that lack of a BPD diagnosis suddenly make him a healthy candidate for a stable, mature relationship?

I find that the need to "prove" that my ex has BPD is not so important. I told the story of my ex to a lot of people, and some said "You need to go check out bpdfamily.com" and others said "I don't think BPD is the answer here, but I can tell you that something was amiss inside of her to do what she did."

So to me it is the behavior that is important and the label not so much. What I can tell you is that the feelings I have had, and the journey that I am on, I have seen others here with the same feelings, the same questions, and they are on the same journey that I am.

So whether my ex was BPD or not, I feel like I belong here.

I've had relationships end before, and had women behave in inconsiderate fashion towards me before when it came to romance, but I never felt the need to seek out answers like this and I've never felt so traumatized. When my ex-ex and I broke up, I never felt like something was wrong with her or that she might be psychologically unwell. I read somewhere that it is normal to continually need reassurance that it was them and not us, that what you went through was not "normal." If you get involved with somebody that is not well, it is going to have an impact on your mental health and I think this questioning, the Whys when it comes to what they did and the reasoning behind it, as well as questioning whether or not they were sick, is normal. Your brain is trying to process and make sense of something that doesn't make any sense.

Is it typical for a Cluster B/borderline to abruptly spring a breakup on you when things are going well? Yes. It is typical for them to avoid any responsibility for their actions and evade accountability? Yes. Is it typical for them to carry on in the aftermath as if you don't exist and ignore you as if you are a non-entity? Yes.

[lucnatmar]

One's actions and behaviors are all that really matters, not whether they have an "official" diagnosis of BPD or anything else.

Heck, there are a few experts that question whether BPD even exists and the one's that do acknowledge it, are probably just as likely to not have the appropriate experience to diagnose someone correctly.  In the end, the only thing that matters are the behaviors over a period of time.

All of us are flawed individuals, but when it comes to relationships, I believe two reasonably healthy people can work through issues as long as lines are not crossed and signficant damage is done that can't be reversed.  People with BPD traits cross the line and that is a reality each person exposed to it have to deal with, because it isn't going away.

[runninggal81]

From the time I read about BPD after my breakup, I knew that my ex was indeed personality-disordered (he even mentioned that he had been diagnosed with a PD). He exhibited all 9 of the DSM characteristics to varying degrees of severity. I had read about BPD before, in the context of a friend who committed suicide about 5 years before I met my ex.

Whether or not you'll ever learn about a diagnosis is irrelevant. Questioning ourselves on the severity of our loved one's problems is how a lot of us got really deep into destructive relationships.

[lucnatmar]

"What I still can't understand is how they get such a strong hold on you.  What makes me want to be with crazy so bad?  I really don't get it."

There is a psychological term for this, but it escapes me at the moment.

It is quite common, for those exposed to abusive relationships (whether physical or emotional) to feel like they are helpless to get out and the abuser has a hold on them.  Believe it or not, this is the norm, for people who go through this and it happened to me as well.

Eventually, the line is crossed once to often and the victim of the behavior breaks out of the chains.  Others will ask you; why did you stay in that relationship for that long?  Well, we all wish it was that easy, don't we.

[lucnatmar]

The term I was looking for is; "Operant Conditioning"

[chaann]

I think it is always best to leave it to a professional to do a diagnosis as serious as BPD(or ANY other PD/mental illness).

From my personal experience and from what I have read, there is indeed a high risk of comorbidity between BPD and other mental disorders.  In my personal situation, my dBPsil was first diagnosed with Anorexia Nervosa and OCD years ago (early 20's). (in fact, it is when I got more information about these disorders that I kept bumping in BPD as being often co-morbid with these 2 and started to suspect that she had that as well). Now in her 30's her BPD came to take over all of our lives and she finally got the official diagnostic of BPD after spending 5 weeks in an external clinic (at a mental health institution).  Fortunately, she checked in at the hospital by herself (she was suicidal) and she is willing to get help. She is now in a treatment program (external clinic, but full time) that should last a minimum of 2 years. 

All that to say that a "full" diagnostic by a mental health professional is preferable in order for them to get the much needed help they need.  My dBPsil said that all these years she felt that there was more to it then the anorexia and OCD and that she now feels relieved to finally know what is wrong with her... .She has got her work cut out in front of her and so do we, but at least we now know what we are dealing with... .

[flatspin]

Something I read online. The most co morbid diagnosis with BPD's is eating disorders. How many of you folks here on this message board know if your ex BPD has an eating disorder. Mine does. In fact she has had it ever since she was in her 20's and she is now 49 yrs old. She was able to keep it from me for 8 years by staying up later than me, binging, then she would go and vomit. Once in awhile I would hear her vomit and she would say that something did not agree with her. I took it at face value, being the naive trusting person that I am.

Dear jalk,

My wife does too. The more she's stressing, the more she eats. Later, she'll spend entire days starving so she doesn't gain weight... .It's like a cycle.