Thank you, Tucson.

I wanted to add that in order to make this all important distinction (as the treatments are vastly different), pdocs need to take their time in making the BP diagnosis. You cannot discern if someone has certain issues with relationships based on one, two, three appointments. It will likely come out at some point, if nothing else then with the relationship with the pdoc him/herself, but it takes time.

I do not believe the BP diagnosis should be made until BPD has been fully ruled out.

Unfortunately, too many pdocs do not take the time and some are even loathe to officially diagnose BPD due to the stigma (and I do think it carries more stigma than BP, which is kind of the diagnosis du jour). On the other hand, there are some people with BPD who prefer the less stigmatized BP diagnosis, and do not share with their pdoc symptoms that might be more attributable to BPD.

Again, I do think you can legitimately have both, but I think BP is over-diagnosed in some cases. Some pdocs just don't bother...

And I do not agree with the stigma surrounding BPD: it is unfair and invalidating. Nowadays there is treatment: DBT. And I think, or assume, that if you put in the work, you can overcome it, or at least some characteristics of it.

I say all of this as someone whose brother was misdiagnosed for some time. Meanwhile, he had left a trail of very contentious, chaotic and hurtful relationships, including with me, and it just didn't have to be that way. He has worked at DBT and is now much better, not 100%, but much better, and I admire him for this, for putting in the work, and for accepting the diagnosis.