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Old Sep 12, 2013, 07:34 PM
ultramar ultramar is offline
Poohbah
 
Member Since: Mar 2013
Location: USA
Posts: 1,486
I believe there are very important -and glaring- differences between bipolar disorder and BPD. I do not think there's any evidence to prove that 'abandonment' is an issue with those with bipolar -except in instances where they have been diagnosed, additionally, with BPD.

The difference between duration of 'episodes' between bp and bpd are very important. Because it's not just a matter of 'duration' per se, but of the origins of the moods and behavior. I think one of the reasons mood episodes last so much longer in the case of bipolar is because they are not being *constantly* triggered from one mood to another. And it's this triggering (and relative lack thereof, or not on such a constant basis) in the case of bipolar, that sets it apart from BPD.

Once someone with Bipolar enters into an episode, of course they may be affected throughout by things going on in their environment. But these do not cause them to 'switch' so radically up and down and otherwise due to those occurances. *Despite* them, in fact, they will continue down the road of the mood-episode they have entered into. On the other hand, my understanding is that in the case of someone with BPD, each mood that is triggered by something going on in the environment is all-consuming; the mood radically changes, and the new mood, whether it lasts for minutes or hours, *is* the mood, all-encompassing. It is a rollercoaster, of up and down and other moods, each very intense, rather than a *pervasive* (relatively consistent) mood that goes on and on and on, not *suddenly* and *abruptly* brought down into depression and then into irritability because of something that happened.

So, pervasive versus sudden and short lived.

I think BPD is more about triggers (and the nature of those triggers) than mood per se. I think it is because of this that treatments such as DBT, from what I know about it, works on triggers so as to avoid the 'moods' in the first place, whereas treatment for bipolar concentrate on changing the mood (a bipolar episode may begin with a 'trigger' but it will not typically then go on a roller coaster of different emotions/moods due to a series of triggers after triggers, within a given day).

Lastly, the latest DSM incarnation has added to the bipolar criteria, that not only a change in mood must be present, but change in energy. And I think this makes an important distinction between bipolar and BPD: someone with BPD may vascillate between depression and irritability, but that irritability -with the new criteria- would not be considered 'hypomania' by virtue of the 'mood' itself --what has to come along with it, is an enormous increase of energy, often characterized by little or no sleep and yet an enormous of amount of energy/not feeling tired.

Okay, now lastly, I think much of BPD is a 'disorder' of relationship and the kinds of triggers from which BPD symptoms ensue, have to do with relating to others, in one way or another. Bipolar triggers are not so limited to this. I have also not read/seen evidence that black and white thinking, projective identification, feelings of emptiness, lack of stable identity are part and parcel of bipolar disorder. Some of these may be present to some extent or another, but they are not at the core of the disorder, or the moods.

I do believe they are very different disorders. I don't know if one should be classified as a 'personality disorder' and the other a 'mood disorder' but however the distinction is made, as far as label, I think the distinction should be made, because they are very different. And treatment is different.
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