My therapist seems to think that I have bipolar II disorder. This was the first time anyone has ever suggested such a thing to me. I underwent a lengthy two hour psychiatric evaluation to someone he subsequently referred me to, and came up with a long list of diagnoses, which actually came out like this:

1. Generalized depression.
2. Anxiety.
3. Borderline personality disorder.
4. OCD.

My therapist has not mentioned the words borderline before, though he did say once, "...because you have a personality disorder!" Now I'm wondering, can a person have both? BPD and bipolar? Do I even have anything? Whose opinion/diagnoses should I trust?

Anyway, I realize I've struggled most of my life, and have often been described as "irritable," "intense," "irrational," "sensitive," etc. My moods can jump around in a split second, from feeling "okay" (which is my normal baseline) to wanting to literally jump off a bridge. I do ridiculous things sometimes such as speeding, tailgating, even buzzing off my hair entirely. One perceived slight and I kind of fly off the handle. I'm obsessed with the idea that I am ugly, unlovable, and a disgusting human being.

I've never been really able to have a successful romantic relationship because there is always eventually arguing. Unfortunately I often end up with narcissists who are controlling, which I figure is what I need to make me "shape up." Very rarely have I ever been happy. What makes me think that I don't have bipolar is that I never get mania or elevated mood. I'm ALWAYS depressed or very very agitated.

I've decided that it might be time to give meds a try. I've tried several SSRIs, and they either didn't work, or had awful side effects. I smoke pot on a daily basis. So, considering that my therapist thinks I am bipolar, I'm considering trying some atypical meds to see if they work. I'm at my wit's end. I just do not want to exist anymore but am afraid of suicide because of the "unknown." Therapy only does so much, and obviously getting high on pot only helps so much. I've been described as a terribly angry person, and sometimes I'm sick of it.

So, again, how do I know what I have? A therapist is not a doctor, so I'm wondering if I should take his opinion with a grain of salt. Do diagnoses even matter in the long run? Sorry if this is the wrong place to post. And also sorry if none of this makes sense. I most likely have a flu and have been forcing myself to stay at work when I really, just really, want to be in bed. Thanks!

With bipolar your moods are longer lasting.

With BPD, they fluctuate during the day, or minute.

It is possible to have super rapid cycling bipolar.

It is possible to have BPD and bipolar.

Only a doctor can diagnose you properly. Get more than one or two opinions.

[wildflowerchild25]

To me, and please, I am not an expert, what you have described sounds more like borderline. Mood shifts are typically much shorter with borderline, and the anger you described also fits in with borderline. As does the negative self image.

I suggest you do research on both and see if one or the other describes you more. Also, it is possible to have both. There's a few people here that do.

But don't despair. Both are treatable. The standard for borderline is now dbt, which can also help to a certain extent with bipolar.

[Victoria'smom]

certain meds help with irritability and anger. These are usually anti psychotics. I would get a second opinion and have someone go with you.

[Sad Mermaid]

You sound borderline rather than bipolar. Instead of atypicals, I would try the older typical AP called Haldol, which has shown promise in BPD. You can use it PRN (as needed as opposed to on a maintenance basis). Nothing in your description fits bipolar as far as I can see. If you have bipolar, trying SSRI's alone (without atypicals or a mood stabilizer) can be very dangerous. It sounds like you need a deeper evaluation. A neuropsychological assessment would help clear things for you, but costs a lot of money. If you have an insurance that would cover it, I would definitely recommend it.

[mindwrench]

Katie Morton has a good video about the difference between Bipolar & Borderline.

[Faltering]

I agree that your symptoms seem to match borderline personality disorder instead of bipolar disorder due to how quickly your moods shift. Other indicators are unstable relationships, poor self-image, anger outbursts, and impulsivity. I have a background in psychology but cannot diagnose you. It might be helpful for you to seek a second opinion from a psychiatrist or a clinical psychologist. A psychiatrist is your best bet if you feel like you might benefit from medication, which would probably be an antipsychotic or a mood stabilizer. I would also recommend DBT. Diagnoses are useful for selecting appropriate treatments, which differ by diagnosis but may overlap.

[Wander]

BP and BPD can be often misdiagnosed as the other. Or, as some have already pointed out, you can have both. The key to BP (bipolar) is that you have to have had a clear hypomanic and or manic episode. If euphoric, they are easy to spot but if dysphoric or 'mixed' it can look a bit like BPD as you become very agitated, volatile, irritable, inpatient, depressed, impulsive and at times a danger to yourself.

Before 2014 I had gone through many diagnosis's such as Major Depression, PTSD and BPD. At the time I was diagnosed with BPD (2010) I did exhibit almost all the symptoms and felt it fit. However after years of therapy and life circumstances calming down my psychiatrist said to me early 2014 that my BPD had evaporated and he wasn't sure I ever had it, instead blaming trauma on my behaviour.

Then In June/July 2014 I had a mild manic episode which my doctor saw. This convinced him I was bipolar. I then fell into a mixed episode and it was similar to some of the BPD symptoms, they do overlap a bit. I have since been seen to have multiple hypomanic episodes and don't have the interpersonal issues that come with BPD. So either my BPD was cured through therapy or misdiagnosed.

have you looked into symptoms of mixed episodes to see if they fit you. Clinical Psychologists can diagnose. If you don't have a psychiatrist I would recommend you see one.

Good luck.

Originally Posted by Wander

BP and BPD can be often misdiagnosed as the other. Or, as some have already pointed out, you can have both. The key to BP (bipolar) is that you have to have had a clear hypomanic and or manic episode. If euphoric, they are easy to spot but if dysphoric or 'mixed' it can look a bit like BPD as you become very agitated, volatile, irritable, inpatient, depressed, impulsive and at times a danger to yourself.

Before 2014 I had gone through many diagnosis's such as Major Depression, PTSD and BPD. At the time I was diagnosed with BPD (2010) I did exhibit almost all the symptoms and felt it fit. However after years of therapy and life circumstances calming down my psychiatrist said to me early 2014 that my BPD had evaporated and he wasn't sure I ever had it, instead blaming trauma on my behaviour.

Then In June/July 2014 I had a mild manic episode which my doctor saw. This convinced him I was bipolar. I then fell into a mixed episode and it was similar to some of the BPD symptoms, they do overlap a bit. I have since been seen to have multiple hypomanic episodes and don't have the interpersonal issues that come with BPD. So either my BPD was cured through therapy or misdiagnosed.

have you looked into symptoms of mixed episodes to see if they fit you. Clinical Psychologists can diagnose. If you don't have a psychiatrist I would recommend you see one.

Good luck.

I requested DBT therapy. In the first 1 and a half hour class I learned one possibly useful tip. The rest wouldn't help while truly manic. But DBT does teach some valuable techniques that can be useful for daily struggles. Every parent, heck every person could use some of the techniques it teaches. I would see if it's offered regardless of your diagnosis. It's just good life skills. I stress getting several opinions and explain to them you are concerned you might have either one. They may be able to reassure you or clarify your specific circumstances. But like Wander said, they may not get it right the first time. Most of us have been diagnosed with several things before getting to where we are now. Good luck and I hope they figure things out and provide effective treatment quickly.

[Theresa1991]

Very interesting that you're questioning about this. I was wondering the same thing. Since I started therapy bpd has always been in the picture and I have been diagnosed once, but then the therapist after that one said I definitely didn't have it. I have that poor self image as well but for me it can turn to a self overestimating in my good episodes. I also feel that I am barely really happy, but I have my times of a few weeks that I really feel pretty happy (and get a little speedy I guess). Just coming back from my first time of really trying to get a diagnoses and have them put me on meds because I am going crazy and the therapist said I might have borderline of bipolar or both. So seems to be possible anyway to have both.

[Wander]

Originally Posted by Theresa1991

Very interesting that you're questioning about this. I was wondering the same thing. Since I started therapy bpd has always been in the picture and I have been diagnosed once, but then the therapist after that one said I definitely didn't have it. I have that poor self image as well but for me it can turn to a self overestimating in my good episodes. I also feel that I am barely really happy, but I have my times of a few weeks that I really feel pretty happy (and get a little speedy I guess). Just coming back from my first time of really trying to get a diagnoses and have them put me on meds because I am going crazy and the therapist said I might have borderline of bipolar or both. So seems to be possible anyway to have both.

Did you experience a very tough or traumatic childhood? That can lead to BPD, or at least there is a correlation between the two.

Getting the right treatment is the key, diagnostic labels are secondary.

Originally Posted by Wander

Did you experience a very tough or traumatic childhood? That can lead to BPD, or at least there is a correlation between the two.

Getting the right treatment is the key, diagnostic labels are secondary.

My doctor also told me that in over half his bipolar patients without BPD, a traumatic childhood was present. I've also been told on this board that certain behaviors are not bipolar related and are character flaws or BPD and my doctor confirmed that what I was told was false and that my behaviors were directly related to bipolar. The illnesses are pretty similar but I would recommend reading some BPD forums and Bipolar forums and see what resonates. They say to try not and diagnose yourself (leave that to the trained professionals) but I think reading both forums will enlighten you and offer good food for thought. Get more than 1 or 2 opinions and be as open as possible, even about the embarrassing stuff. I worry I have schizoeffective or schizophrenia in addition to or in place of BIPOLAR. I now also believe the doctor who said PTSD was correct. I just realized a few months ago that I had been actively delusional about something for over 3 years. My diagnosis may change but my medication and treatment likely won't. My paternal Grandmother had schizophrenia and so did her brother. My brother might as well or it could be drug damage. He was a heavy abuser of various mild altering substances and a dealer so he had access to large quantities on the regular. My brother just seems to live with his symptoms and not seek treatment that I'm aware of.

The most important part is treating the symptoms effectively and not the diagnosis. But having a diagnosis you agree with and can focus and learn from definately has its benefits. I hope you get good treatment

[Theresa1991]

I did have kind of a disturbing childhood, with both parents depressive, my father abusing alcohol and things and like a very ambivalent, distructive atmosphere. But my borderline traits were in recession for years, what is left of it is the idealisation of persons with the upfollowing disappointment in them but neither that I get as strongly as I used to.

Originally Posted by Theresa1991

I did have kind of a disturbing childhood, with both parents depressive, my father abusing alcohol and things and like a very ambivalent, distructive atmosphere. But my borderline traits were in recession for years, what is left of it is the idealisation of persons with the upfollowing disappointment in them but neither that I get as strongly as I used to.

Seeing people in black and white terms can be a borderline trait if it's constant. When I'm manic, I get paranoid of people and turn them black but that is because I'm delusional and it's bipolar related.

[Theresa1991]

I am not really seeing them in black and white, I like all of my friends a lot and really care about them but I know that they all have their wonderful traits but also their weaknesses. I never get to the point of getting so disappointed that I hate anyone. With the guy I am dating I am rather withdrawing now because I don't really feel stable and I don't wanna take it out on him and don't want him so see the shape I am in. Anyway I have been talking to him and told him about my fear that he won't like me anymore if he knows what I am actually like. So I don't think it sounds too much like borderline. It's rather that sometimes I tell so much stupid stuff that I feel I can never leave my house again or that I am just unable to see anyone and feel utterly lonely with my thoughts because they are spinning so fast.

Originally Posted by Theresa1991

I am not really seeing them in black and white, I like all of my friends a lot and really care about them but I know that they all have their wonderful traits but also their weaknesses. I never get to the point of getting so disappointed that I hate anyone. With the guy I am dating I am rather withdrawing now because I don't really feel stable and I don't wanna take it out on him and don't want him so see the shape I am in. Anyway I have been talking to him and told him about my fear that he won't like me anymore if he knows what I am actually like. So I don't think it sounds too much like borderline. It's rather that sometimes I tell so much stupid stuff that I feel I can never leave my house again or that I am just unable to see anyone and feel utterly lonely with my thoughts because they are spinning so fast.

I can relate very much to what you've written. It's rough and I'm sorry. (((Hugs)))

[Theresa1991]

I try not to step out of contact and get paranoid about people thinking that I am crazy. I am very lucky to know a lot of good persons that do not go away from me even if I behave completely depressed and unbearable in one moment and then go chattering off about all my plans four days after. That topic led me to another question, gonna open a post (I am working at home, great distraction haha)...

Originally Posted by Theresa1991

I try not to step out of contact and get paranoid about people thinking that I am crazy. I am very lucky to know a lot of good persons that do not go away from me even if I behave completely depressed and unbearable in one moment and then go chattering off about all my plans four days after. That topic led me to another question, gonna open a post (I am working at home, great distraction haha)...

I am glad you have these people and look forward to your new post.

Whatever you're suffering from, the weed on a daily basis may be obscuring or exacerbating your symptoms. I don't know anything about BPD, but I've heard of psychiatrists insisting that a patient quit weed for at least a month so that they can get a clearer picture of the patient's underlying condition and make a diagnosis. One of my doctors, who after completing his medical degree in Canada went on to complete a second doctorate in Chinese medicine, was convinced that my heavy (state-licensed) weed intake was the root of all of my problems. I will be stopping weed altogether in 2017 due to practical and financial considerations, so I hope that he was right.

Originally Posted by Lefty the Salesman

Whatever you're suffering from, the weed on a daily basis may be obscuring or exacerbating your symptoms. I don't know anything about BPD, but I've heard of psychiatrists insisting that a patient quit weed for at least a month so that they can get a clearer picture of the patient's underlying condition and make a diagnosis. One of my doctors, who after completing his medical degree in Canada went on to complete a second doctorate in Chinese medicine, was convinced that my heavy (state-licensed) weed intake was the root of all of my problems. I will be stopping weed altogether in 2017 due to practical and financial considerations, so I hope that he was right.

I recommend staying off the cannabis for awhile....even a year would be very useful in seeing what happens. Cannabis can and does have effects on the mood. I've spoken to some very educated and experience cannabis doctors and it's too bad it isn't a more well explored field of science because cannabis is much safer than most if not all psych meds. Give me cannabis over lithium any day. As a matter of fact I have lots of left over lithium and will gladly trade it for pot if anyone is interested. In case of apocolypse, I've got enough lithium to supply a small city. But you really need to be off the pot for awhile before bipolar can be diagnosed with more certainty. If you are having trouble quitting, get some help. We will support you through it as best as we can too.