[Curiosity77]

I've been asked to do a presentation with a couple other people from work about updates from DSM-IV to DSM-V. It's for staff education because I work at a mental health team. People do not know about my illness, I was asked to do this because I am the team NP. I'm presenting with a social worker and a psychiatrist. We've split the presentation up into diagnostic areas, and each of us will do part of it. My section is mood and anxiety disorders. I have to cover DSM-V updates, but there is varying levels of knowledge about diagnoses in general on the team, so I also need to give an overview of what these disorders are. The audience is social workers, nurses, rehab staff, support workers, and psychiatrists.
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Anyways, I have to make some power point slides. I'm going to make slides that list the criteria straight out of DSM, and I'll point out changes like removal of the bereavement specifier from depression, but I'm looking for suggestions about things to say about bipolar. There haven't been any changes to DSM-V, except that I think mixed might now be part of BP2, but I'll need to double check that. Aside from listing the criteria, what do you think is important to tell them? I know there will be questions about distinguishing bipolar from borderline for example, so how would you answer that, beyond making slides that list the criteria for each.

I'm open to suggestions, and I have some time to make the slides because I'm presenting mid July.

[kaliope]

I think it is important to mention that because of the labile moods and the suicidal nature of both that the bipolar person is often confused for being bpd. sorry but that is all I got...because I am bipolar and I have often been told I am bpd because of those two things.

[BipolaRNurse]

One of the things that changed with the new edition is that medication-induced bipolar symptoms are now counted toward a diagnosis of BP. And some of the definitions have also changed, e.g. instead of a "mixed episode" they call it " bipolar x with mixed features" or "psychotic features". I think they're splitting hairs on that one, but I didn't write the book. And bipolar 2 can have mixed features.

I think it would be interesting to do a compare/contrast with bipolar and BPD. A lot of the symptoms do overlap as you know.

I'll try to think of some other stuff later. I have to go see my sister at her assisted living facility, which I don't do very often because she is one of my worst triggers. But duty calls, so off I go.

Originally Posted by kaliope

I think it is important to mention that because of the labile moods and the suicidal nature of both that the bipolar person is often confused for being bpd. sorry but that is all I got...because I am bipolar and I have often been told I am bpd because of those two things.

Definitely, as I have fathomed so many different ways to do it it's not funny and tried a few times.

[Skitz13]

I agree totally with BipolaRNurse. I have been diagnosed with BPII and have just come down from a mixed episode. I also have been recently diagnosed with BPD. My pdoc said I don't meet all the criteria so she uses the term loosely. It is so hard to pull the symptoms of BP and BPD apart.

The only identifying factor for me in terms of BPD are my mixed moods.

Is it truly a mixed episode or an symptom of BPD? All I know is that, the episode has died right down. With BPD they aren't regarded as episodes as they are continuous.

I work in the mental health field and I certainly would like to seen a more specific distinction between the two. That grey area can be confusing and people are being misdiagnosed all the time.

Good luck with this and I hope you post to let us know what the outcome is.

How ironic you would be working on mood and anxiety. I'm sure you will do some great work with your practical experience.

I think one of the most confusing things for people is the word "mood". Everyone has moods, right? So it becomes a matter of range. But for BP it's more complicated. It's also in how the energy levels are so extreme in their shifts.

I'm going to be lazy and link to something I wrote before about the energy shift aspect:
http://forums.psychcentral.com/3655841-post11.html

And I'd add to that duration.

Oh! The other BIG thing is that for BPD, big mood shifts are precipitated by situational things. They don't come out of nowhere. (Though it can seem that way to those around them -- at least, that is, till one learns to tune in to how the BPD person hears and interprets words and actions/inactions). This isn't a sometimes thing (like it might happen in BPers), but a consistent pattern. Situation> react. Situation>react. Situation>react.

The other real biggie is the idealization/devaluation switching thing. I know that'd be something listed in the criteria, but it might be worth reiterating in contrasting them, because it's very distinctive and pretty easy to discern.

There's a good description of this right here on PC (under Conditons>BPD):

Unstable and intense relationships.
People with borderline personality disorder may idealize potential caregivers or lovers at the first or second meeting, demand to spend a lot of time together, and share the most intimate details early in a relationship. However, they may switch quickly from idealizing other people to devaluing them, feeling that the other person does not care enough, does not give enough, is not “there” enough. These individuals can empathize with and nurture other people, but only with the expectation that the other person will “be there” in return to meet their own needs on demand. These individuals are prone to sudden and dramatic shifts in their view of others, who may alternately be seen as beneficient supports or as cruelly punitive. Such shifts other reflect disillusionment with a caregiver whose nurturing qualities had been idealized or whose rejection or abandonment is expected.

I got a late start today and need to get some stuff done right now, but am happy to help out more later if you would like. I really don't think they're nearly as hard to tell apart as is commonly thought. (Me: BP, BF: BPD… Because we're each solidly and clearly within our respective camps, maybe it's the vantage point. Nothing like almost 5 years of 24/7 observation/experience to be able to see it, lol. I'm not saying everything's cookie-cutter. We're representations of each, but not THE representation of either. Still, it was quite awhile before knowing that he was, so the "AHA!" moment clarified those aspects of behavior I could not understand. Which, as it turned out, are the differences between them.)

[Nammu]

Check out Psycheducation.org the home page and click bipolar vs borderline. It is written by a practicing Pdoc and is pretty good. His page on bipolar II is also good.

An excellent thread, lots of good info. BipolaRNurse - yep, very good post.

If I was giving a presentation I'd be sure to include something on what it feels like from inside to be bipolar. Not just the way it looks on the outside. For example, it feels really scary to constantly live with not knowing what kind of mood you'll be in in a half an hour.

As for BP and BPD - someone mentioned what I was thinking - the devaluation/idealization thing is, to me, the red flag for BPD.

[Curiosity77]

Thanks... This is all really good so far! I'm probably going to start making my slides tomorrow, but these are all good ideas. I wish there was a way to post power points to PC so that you folks could edit and add to it! I want this presentation to be really good!

Sent from my iPhone using Tapatalk

I wish I was well enough to participate in this discussion, these topics really interest me. Good luck for your presentation.