Pdoc suspects BPD alongside BP if not just BPD...

I saw my pdoc today and discussed my struggles with my meds. I told her I have been feeling very depressed lately and have been having very negative intrusive thoughts. She suggested trying Rexulti and I told her that I really felt the need to stop taking my meds altogether, and that they haven't really been helping me as much as I had thought they were. There were longer periods of stability, yes, but my anxiety is just as severe as ever and I have severe difficulties with separation (my boyfriend going to work). After telling her this, she told me that what I had just described sounded very typical of BPD and that if I really am borderline, these bipolar meds I've been on would instigate more depression and anxiety rather than easing it. She is unsure of whether I am both bipolar and borderline or if I'm simply borderline, because she has not physically seen me go through hypomania. I know for a fact I have and do sometimes still experience it because other people can clearly see it, including an old pdoc, but I have always been either depressed or in a normal mood while seeing my current pdoc.

She lowered the dosage of my lithium to 600mg and lamictal to 150mg. She said she can tell that my moods have been leveling out a bit, so she wants to keep me on these meds even if at a lower dosage. She also gave me a month's worth of a free sample of Rexulti, just to try it. I'm concerned because from what she's said, borderline is harder to treat than bipolar...and I'm probably both. I know a lot of people here are both. How can you tell when it's your bipolar or your borderline acting up...? I'm now really worried about not getting better, honestly. She suggested CBT but we really cannot afford that right now, on top of my pdoc visits.

I'm still trying to figure out how to tell the difference between BPD & bipolar 2. I'm inclined to think that they are very similar. I'm also inclined to think that psychiatry is a guessing game based on I have no ****ing idea what. All I want is to stop wanting something more!!

"I want something else to get me through this semi charmed kinda life."

Its pretty common for people to have Bipolar and Borderline.

Bipolar is "typically " treated with meds, CBT and coping skills

Borderline , Meds might help some ,, but DBT therapy is more helpful.

I dont really understand why your Pdoc would say that BP meds would instigate depression and anxiety

She said she can tell your moods are leveling out but dropped your dosages? Lithium only works if you in a theraputic levels , so dropping it down might take you out of the "window" in which lithium would help you or not. Lamictal typically only helps on the depressive end of Bipolar . so dropping that also doesn't really make sense to me

Call your local mental health services for your city or county and see if you Qualify for sliding scale or even free Therapy or group for BP and BPD

Hope you feel better soon

I think it's because she doesn't believe I'm bipolar anymore since she herself has not witnessed a hypomanic episode in me. I really don't think it's the case, but I'm very confused as to how all of this co-existence with BP and BPD works since this is the first time a pdoc has suspected I have BPD. And yeah, she said the meds (I guess at normal dosages) can cause anxiety and depression if you have BPD and that it wouldn't be the case with someone who was only BP.

Also, huh..she recommended CBT instead of DBT (I don't know anything about either of them).

I have BP 2 and BPD. I get hypomania and depression usually about four days at a time each. Within that I get really angry, do impulsive things, self harm, struggle with depersonalization, and am convinced that my husband is always trying to leave me. I am currently on 40 mg of Latuda and that's it, because I'm pregnant. If you don't think your doctor is listening to you, can you get a new one?

My hypomania and depression (before my meds) lasted about a week each. I don't get the way you are describing, during hypomania. I do experience irritability and a need to get things done faster, but primarily I feel elated, more motivated, and on top of the world. I do sometimes experience intense anger that makes me want to break everything in sight, but I don't act on it. I have a lot control over it than when I was a teen. I'm completely out of control when it comes to my separation anxiety. It's crippling. I feel totally lost when I'm alone, especially in public. I've broken down just from my boyfriend getting up to get popcorn in a movie theater, while I wait in the seat. I do not fear that he will leave me, but I often fear that he will die at work. That's why I was confused about this BPD diagnosis of mine, because I did not realize that could count as fearing abandonment.

My pdoc is definitely listening to me. I didn't mean to give off that impression.

Okay well that's good that your pdoc is listening! Do you self harm? That's another hallmark of BPD. At first I was diagnosed with BP 2 with Borderline Personality Traits. Maybe that's more what your describing. If you have clear episodes of hypomania and depression then it really sounds like you're still bipolar. And meds definitely help with that!

She's diagnosing me with the disorder itself instead of just with traits. But yeah, I do agree that I'm still bipolar regardless of BPD or not, and that she just hasn't seen my hypomania. I don't self harm. I have done some forms of it in the past, but nothing that left scars. For instance, punching myself, slamming myself into things like walls, or clamping my hands with those bag clip things (?) and then tearing them off repeatedly. I don't know if that counts. Any other urges I've had I have been able to dismiss by rubbing ice cubes on my arms, for instance.

Yeah that definitely counts as self harm. Why does your doctor need to see the hypomania? Maybe call next time you are? Lol just kidding, that just sounds frustrating though!

I'm not sure, since I told her that my pdoc even years ago caught me in a hypomanic episode, and clearly other people have noted my erratic behavior, pressured speech, staying up for sometimes 2 days at a time while still functioning, etc. She said "I haven't seen it so I'm not sure if it's actually mania". She didn't say there is NO possibility of it being hypomania, but she's strongly leaning towards borderline...or, if she does still believe I'm bipolar, she might think that my borderline is more of an issue than bipolar right now. Even during our first appointment she acknowledged it was bipolar 2 but possibly borderline.