[heyitsryan]

Greetings,

I joined this forum a while back when it was suggested I was bipolar by a clinician (MS in psychology). After a thorough eval by a psychiatrist, it was determined I was borderline instead. When I was first dx'd with bipolar, I naturally read a LOT of stuff about the disorder and kept thinking to myself, this just does not sound like me. I was esp. confused b/c I have ALWAYS needed and wanted 8 hrs of sleep, so that whole part about going through energetic periods of reduced sleep requirements was really baffling.

The reason I am writing is that I do not engage in any overt self-injury behaviors, but I am still definitely (in my opinion, and a psychiatrist's view) borderline. When I read through the checklist on borderline personality disorder, and read articles on it, it all makes sense now. I knew something is wrong with me, because no matter how hard I have tried, I usually end up alienating people (not always... I do have friends) and generally have a difficult time controlling my emotions, esp. when I feel criticized. I have improved a lot over the past few years, but I am still not where I need to be, and now I know why!

While doing my own research, I came across two research articles w/ important findings regarding bipolar/ borderline diagnoses. Investigators believe, based on their research, that a significant number of people who are actually borderline have been misdiagnosed with bipolar disorder. The reverse is also possible, and does happen, but is much less common. Again, there are a statistically significant number of people who have been misdiagnosed w/ bipolar disorder who are actually borderline.

I am writing because I believe that bipolar disorder, like ADD and ADHD before, has clearly become the "it" disorder over the past decade or more in the psych "industry." Suddenly, it seems everyone has it, and I know this phenomenon has been discussed before here. Additionally, I believe many people write off the possibility of exploring that they may have borderline personality disorder because they do not cut or engage in other overt forms of self-injury, a notable hallmark of the disorder. As has already undoubtedly been pointed out numerous times on the borderline personality disorder forum, it is entirely possible to be borderline and not to engage in cutting or other tangible forms of self injury.

Again, I realize I am probably not stating anything new, but since a misdiagnose in this particular case completely alters the treatment landscape -- psychomeds for bi-polar (largely thought to involved chemical imbalances) versus psychotherapy for borderline personality disorder (with no widely prescribed pharma treatment), it is critically important that patients be properly diagnosed.

Diagnosis seems to be such a difficult process for these two disorders, and this is clearly compounded by the fact that so many of the symptoms are similar/ overlap. I am pretty happy I have the right diagnosis. I know treatment is going to be very difficult to undertake, and I will have to find the right clinician (not easy.... a lot of biases and prejudice out there against borderline patients), but at least I am not being led down an entirely blind alley.

Thanks for reading my post, and good luck to everyone on here!!

Ryan

[BuggsBunny]

There is also the fact that one can have both disorders at the same time. I don't know how common that is, but I do know, from experience, that it does happen.

[Confusedinomicon]

To me it makes sense there are more people with behavioral issues then internal emotional issues. I am probably more borderline, admitably, but I refuse to get my dx changed because bipolar disorder is more well accepted and I prefer bp stigma over borderline. (but I asked my pdoc and she said I am def. bipolar so what do I know) I have chronic sleep issues as opposed to decreased sleep. 5 is like sleeping 2 or 3 for some.

[heyitsryan]

Originally Posted by BuggsBunny

There is also the fact that one can have both disorders at the same time. I don't know how common that is, but I do know, from experience, that it does happen.

This is a very good point, and was pointed out in one of the studies.

Also, is a link to one of the studies I found....guess I should have included this above.

The specifics (metrics) about misdiagnosis is in the "Discussion" section.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2849890/

[krisakira]

Thanks for this interesting thread. I undoubtably have bipolar disorder, since I have had hypomanic and mixed episodes, that fit the description to the dot. However, I have always wondered about having borderline personality disorder. Here are the symptoms PC says BPD's have that I have:

Frantic efforts to avoid real or imagined abandonment
-- I have nightmares of being away from my boyfriend, and constantly worry he will leave me, so much that I wish he would go ahead and ask me to marry him so I know he won't leave me

Identity disturbance, such as a significant and persistent unstable self-image or sense of self
-- I have extremely low self esteem

Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating)
-- Although this occurs during hypomania, except binge eating, which can happen in any mood I am in

Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.
--I've been a cutter for 9 years, and attempted suicide many times, hospitalized 7 times

Emotional instability due to significant reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)
-- I have mood swings that can sometimes last for just a few hours, which is different than my bipolar episodes

Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)
-- Especially when I was a teen I had horrible anger issues

Transient, stress-related paranoid thoughts or severe dissociative symptoms.
-- I am dx with dissociative disorder, so definitely have this

[Trippin2.0]

I have a dual diagnosis, aint I lucky LOL

[grlnmt66]

Trippin2.0~...LOL! Ryan~ Informative and intersting thread...thanks for sharing! Im the same way with sleep, however, there are times that I NEED to take a sleeping pill inorder to sleep...It could also be because I was diagnosed with cyclothymia.

Thanks, heyitsryan and welcome! (or re-welcome, as the case may be... ) I'm really glad for you to have gotten the right dx and wish you luck in your work with it. Was bringing up your experience of reading (and not relating to one, but to the other) and bringing this up with your professionals one of the factors in helping get the right dx? If so, good work, because our input is so important --we're the only ones that live inside our heads after all(!)

Though I'd heard the words, for years I didn't know what either one was about really. When I did finally read about BP (in the midst of reacting very badly to only ADs after a mis-dx as MDD), it was reading my life story, and I cried it rang so true and clearly. Later, when I started educating myself on other psych issues, I had the opposite reaction to reading borderline stuff. Really key features are totally foreign to my experience, especially "frantic efforts to avoid real or imagined abandonment". Try as I might to understand this frame of mind and the reactions that follow from it, I can't. It utterly boggles me. Also, the "Identity disturbance, such as significant and persistant unstable self-image or sense of self" (I think this is where the "empty" feeling thing lands too.) Again, can't relate. I may have low self-confidence (except when hypo, when I'm obnoxiously over-confident! ), -- years of depressions have taken their toll -- but I definitely know who I am and have, since forever, had the attitude that such things as peer pressure can go **** themselves. NO ONE will tell me who I am or what I should do. I'd be hard-pressed to think of a time I'd even asked for advice, let alone approval. Other symptoms I can't relate to either, but those, to my observation, are truly halllmark to those who struggle with borderline. (Thanks, btw, krisakira for putting the list close at hand. ) I'm sympathetic to those having to deal with it, I just can't personally relate.

Blah blah blah. Kind of rambling there (who? me? lol). I totally agree with you that BP seems to have become some kind of "it" dx, too quick to be jumped to, often for less-than-ideal reasons and that has unfortunate fallout. Like the waters aren't muddy enough(!) Again, good for you on doing your research in getting on the right track, and good luck!

[Victoria'smom]

I think because so many issues over lap it's important to take therapy and medication as prescribed. There is way to much debate over rapid cycling vs. borderline and stigma with border line is so bad that I don't think many doctors want to diagnose it.

[heyitsryan]

Hey all, thanks for the replies & encouragement!! Much appreciated.

Confusedinomicon, yes, I agree about the stigma. Why do you think that is? Is it because treatment for borderline involves more time and energy (psychotherapy-based) versus bipolar, which is often primarily about getting the dosing of psych meds right?

I have read that there is a good deal of bias and prejudice against borderline patients. Also, I've read there is a push in the psych community to have the name of this disorder changed, presumably to attempt to cut down on some of the stigma attached to it, and also, to better describe the condition, with names such as Emotional Regulation Disorder being proposed.

I'm still in the process of looking for a reputable doctor/ clinic to treat me. I truly have come to understand that mental illness can be one of the more difficult things to conquer in life, with access to quality care (insurance wise and geographically speaking) being a major issue, with so much stigma out there (even in places one would least expect it) attached to BPD affecting patients in many different ways, and brain science, one of the cornerstones for improving our understanding of the disorder and developing effective treatments, still in its infancy.

[3little.birds]

Originally Posted by heyitsryan

Greetings,

I joined this forum a while back when it was suggested I was bipolar by a clinician (MS in psychology). After a thorough eval by a psychiatrist, it was determined I was borderline instead. When I was first dx'd with bipolar, I naturally read a LOT of stuff about the disorder and kept thinking to myself, this just does not sound like me. I was esp. confused b/c I have ALWAYS needed and wanted 8 hrs of sleep, so that whole part about going through energetic periods of reduced sleep requirements was really baffling.

The reason I am writing is that I do not engage in any overt self-injury behaviors, but I am still definitely (in my opinion, and a psychiatrist's view) borderline. When I read through the checklist on borderline personality disorder, and read articles on it, it all makes sense now. I knew something is wrong with me, because no matter how hard I have tried, I usually end up alienating people (not always... I do have friends) and generally have a difficult time controlling my emotions, esp. when I feel criticized. I have improved a lot over the past few years, but I am still not where I need to be, and now I know why!

While doing my own research, I came across two research articles w/ important findings regarding bipolar/ borderline diagnoses. Investigators believe, based on their research, that a significant number of people who are actually borderline have been misdiagnosed with bipolar disorder. The reverse is also possible, and does happen, but is much less common. Again, there are a statistically significant number of people who have been misdiagnosed w/ bipolar disorder who are actually borderline.

I am writing because I believe that bipolar disorder, like ADD and ADHD before, has clearly become the "it" disorder over the past decade or more in the psych "industry." Suddenly, it seems everyone has it, and I know this phenomenon has been discussed before here. Additionally, I believe many people write off the possibility of exploring that they may have borderline personality disorder because they do not cut or engage in other overt forms of self-injury, a notable hallmark of the disorder. As has already undoubtedly been pointed out numerous times on the borderline personality disorder forum, it is entirely possible to be borderline and not to engage in cutting or other tangible forms of self injury.

Again, I realize I am probably not stating anything new, but since a misdiagnose in this particular case completely alters the treatment landscape -- psychomeds for bi-polar (largely thought to involved chemical imbalances) versus psychotherapy for borderline personality disorder (with no widely prescribed pharma treatment), it is critically important that patients be properly diagnosed.

Diagnosis seems to be such a difficult process for these two disorders, and this is clearly compounded by the fact that so many of the symptoms are similar/ overlap. I am pretty happy I have the right diagnosis. I know treatment is going to be very difficult to undertake, and I will have to find the right clinician (not easy.... a lot of biases and prejudice out there against borderline patients), but at least I am not being led down an entirely blind alley.

Thanks for reading my post, and good luck to everyone on here!!

Ryan

Thanks for posting this. I actually haven't even considered the possibility of bpd. I'm not diagnosed yet with anything, but definitely have something. Up until reading this I was almost sure it was bipolar 2. I just took the quiz for borderline personality disorder and scored "severe".. The bipolar I scored moderate. So I guess we will see. From what everyone posted I feel like it can possibly go either way. I'm going to have read up on this some more.....

Definitely need to get to see someone. Too bad the waiting list for the doctor I want to see is booked until the end of June. .

So far. away.

[heyitsryan]

3little.birds,

Best of luck and let us know how it goes. I hope the clinician who treats you takes the necessary time and steps to give you the most accurate diagnosis possible. Also, I think it's great you will use the time waiting for your appt. to read up as much as possible. Going in w/ some baseline knowledge will help you ask the right questions and strengthen your ability to advocate for yourself.

[catrules]

I spent a lot of years working with mental health professionals, and the stigma may come from them. Because the way that they talk about people with the disorder is upsetting. I have worked with borderline clients myself, and it is challenging but not impossible. Get a good doc.

[BipolaRNurse]

There is a youngish (mid-50s) resident at the assisted living facility where I work who is dx'd with borderline personality disorder, and I've never felt sorrier for a human being in all my life. This dude has NOBODY. No family, no friends, no one who gives a crap whether he lives or dies. Granted, a lot of his miseries stem from the fact that he is a miserable human being, but damn, it's not really his fault.

There is not a psych hospital in this entire state that will admit him, not even if he's in crisis. I know, I've tried to get him in multiple times. They always say "we don't EVER admit borderlines, it's not worth it to do inpatient because they just get worse". So what is the poor SOB supposed to do when he wakes up every morning and he knows there is absolutely nothing to look forward to, so why not cut, or burn himself, or drink too much, or refuse his meds?

By contrast, I've got it made, even with bipolar. I've got people falling over each other helping me get better, unlimited mental health visits with my current insurance, access to the meds I need.......yes, there is still a stigma, but like I've done with other challenges, I've made myself something of a poster child for the condition. IOW, once I've gotten over the initial shock of diagnosis, I'll not only admit I have a problem, I'll talk about it and refuse to be shamed by it. It feels good when someone says "I'd never have guessed you were an alcoholic" or "You're bipolar? But you're so calm and cool........" (yeah, and that's because I use up every ounce of energy and self-control I have just to get through a typical workday, and sometimes I don't make it).

But the poor devil with BPD at my facility, he gets a few meds and a weekly therapy session---he doesn't even have a psychiatrist---and ambles around the building, unable to connect with the other residents, almost all of whom are old enough to be his parents. It's sad. Makes me actually grateful to ONLY have bipolar d/o.

[Nixi]

I've been dx with both There is a lot of negative judgements towards BPD. My psych has changed the name to Emotionally unstable personality disorder!! :/

[Anneinside]

From what I read, the label will remain borderline personality disorder in DSM 5. The emotional dysregulation disorder is a new one for young children who behave like, but are not old enough to be labeled conduct disorder.

Oops, just looked it up.... temper dysregulation disorder. Still has borderline label.

[Confusedinomicon]

Conduct disorder can be diagnosed in young children and adolescents I thought? Antisocial disorder is sometimes the outcome of a child who had conduct disorder. (It can manifest into various Axis 1/Axis 2 disorders later on, though, not only antisocial)

I just googled and found that it's called "Temper Dysregulation Disorder with Dysphoria" and it's to separate classical cases of bipolar in children and another marker since the dx for bipolar in children has increased. These subset of children don't have a higher chance of having bipolar disorder as adults.