I know the topic is a passionate one for some in this community, and I’m hesitant to speak on it but at the end of the day – this forum is about seeking support and having an open dialogue (or at least I hope that’s how others see it too) and I’m hoping I can benefit and maybe some others can too. The topic at hand is about co-morbidity with bipolar disorder and with a lot of general overlap in mental illness, have you had any issues that I’ve experienced in my journey with mental health. As I said, I know some people in this community are very staunchly support the idea that while some overlap in mental illness criteria and symptoms can be seen – X is not a symptom in Y and therefore X cannot be Y or vice versa. To be clear, I’m not looking to debate that idea. As complex beings many of us may have been diagnosed with multiple disorders, in which one may exacerbate the other, or perhaps the opposite is true, we are diagnosed with multiple disorders because of the idea that X can’t fit into Y… -- all in all, I don’t think there is much benefit in arguing that topic here, I want to start with my experience with co-morbidity and some other interesting things I’ve experienced, and then I want to open it up to see your experience. I just want to be clear first and foremost what my intent is.

For me and my experience – a label for it does make me feel at least I’m not alone and I have something to sum it up a little simpler than just being a sum of symptoms or experiences. I know there are many who don’t like labels and I understand and respect that point of view as well (things are misunderstood, not everything fits every person etc) , but for me – I feel better just having a name for it and knowing where to look for others who may suffer the same. I bring that up just so you understand why I’m eye some of these terms and ideas that have come about. They’re not so important on some levels, but on some I hold them with importance. It’s a weird situation, lol. I don’t guess it has to make rational sense, but it’s just where I am.

So, my mental health journey encompasses a lot of childhood traumas and issues there – I didn’t reach out for help until I was 23. I was diagnosed then with dysthymia and major depression with generalized anxiety disorder. After a few years my therapist came to the conclusion he feels I am bipolar. Most psychiatrists I have had haven’t been too concerned with figuring it out as much as just trying or tweaking a medication and seeing what happens. However I did have one psychiatrist kind of oddly after our initial assessment claim a differential diagnosis of a personality disorder (NOS). I remember talking to my therapist about it and he explained there could be a much simpler reason for it than honestly concluding it’s a major possibility. He mentioned how billing of insurances sometimes require some excessive stuff or perhaps it was just trying to be thorough and not ruling out something until enough evidence was there to support it. He also mentioned personality disorders are very much stigmatized because they are hard to treat and therefore he’d rather not see that label put on me in the event I would have to see another therapist/psychiatrist – in his experience. I trusted my therapist very much and he was speaking candidly, I trust his knowledge in the matter. He told me he didn’t feel I had a personality disorder at the time. This was a few years ago, maybe 5. Also as early as last year I randomly got pegged with PTSD, which I have my own qualms about, but anyway.

All of that said, why bring that up now? Well, I realize not everything comes down to being a psychiatric disorder, especially when we start talking about lifestyle, but there are a lot of habits and ingrained feelings that I guess come from my upbringing and could be kind of explained away by that – color it with mental illness and maybe that’s the result, but it’s something I’ve been thinking about lately. In concrete terms, I isolate a lot. I don’t have or keep friends, and those who I do we usually fall out at some point. Even before the pandemic, even when I was independent, even since I was a kid -- I’ve kept to myself. I don’t leave the house often and it’s more or less when I’m forced to. On any given day the amount of text messages I will receive will be 0-2, a high probability one is my mother, and my phone doesn’t ring. I just don’t connect with the outside world. I don’t use a lot of social media (I technically have a facebook but I don’t have friends or use it. I have utilized messenger some). For the most part I do feel OK because this is my normal. This is me. I engross myself whatever thing I find fitting at the time – a videogame, politics, learning something (languages especially), religion… just depends. I have some high levels of social anxiety and in general I’d rather be closed off from the world than deal with the people in it.

None of that is for me to suggest I have a personality disorder and I’m not asking you to try to diagnose me either lol. My point in that is, none of that is inherently a bipolar feature. It may overlap with another disorder, or maybe it’s just the lens in which my world manifests and bipolar plays its own role. It’s complicated lol. I don’t pretend I understand assessment and diagnostic principles of mental illness enough to know how to read into it. If a DSM checklist was all we needed, we wouldn’t need professionals – I’ll leave it to them lol.

So, with all that said I want to sum up what I’m saying. The context of mental illness and symptoms you experience can augment (add) , change, or even remove certain diagnoses from the board in lieu of a better fitting set of symptoms under X name. I don’t have any research on the topic off hand, but the idea of a personality disorder and a mood disorder being comorbid is a researched concept so it happens enough to warrant that. Just curious how many of you here have has multiple diagnoses, especially a more pervasive pattern type such a personality disorder? Do you think the diagnoses better reflect the experiences you have?
So, my questions are:

1) Do you have any co-morbid mental illness diagnoses with bipolar disorder?

2) In your opinion, does having the multiple diagnoses better help you understand or explain your set of issues and experience?


3) Just curious – is having a label important to you? I’m curious your perspective. As far as treatment goes – I’m definitely a “whatever works, works.” – to hell with whatever label you wanna give it. However, as far as feeling a sense of being understood and belonging, I do like having a label to help guide that discussion, but that is just my personal opinion.

Thanks for reading. It’s early in the morning here and I don’t think my thoughts are super clear or concise, but I hope you get the gist of what I’m asking and I’m looking forward to reading your responses. Also, if this topic gets quickly buried with no responses, I’ll take the hint this time around. Haha. I’ll try to limit my posts when I get into an insightful mood. Lol

[P.S. I am posting this in the bipolar forum. I feel it is pertinent since I’m specifically asking about bipolar disorder + other mental illness diagnoses. I ask that it does not get removed from this board. Thank you.]

[FluffyDinosaur]

It's true that many bipolar people have comorbid diagnoses. In fact, I believe that's true of most any mental illness. If you can be diagnosed with one, you can probably be diagnosed with more than one. That said, just because you're bipolar, for example, it doesn't necessarily mean that you have to pathologize every other aspect of who you are, as well. Just because you're bipolar doesn't mean that every last aspect of who you are must be explained as a bipolar feature. Everyone is different and nobody fits the DSM checklists perfectly. And you don't have to in order to be diagnosed.

When it comes to personality disorders, I would say a diagnosis is only meaningful if your personality causes you issues separately from your other diagnoses. For instance, I'm also quite reclusive. In my case it's not because of any social anxiety. I just don't feel the need to socialize much, if at all. I'm just happy being alone. I don't see it as a disorder, because it doesn't normally cause problems for me. Similarly, I haven't had the best childhood, but normally that doesn't cause me any issues either.

However, I find that in the context of bipolar episodes, sometimes things that were fine before become a problem. You might start to ruminate about things that you normally don't give a second thought to. You might have a much harder time dealing with stress than you normally do. At that point, some Pdocs start to get things backwards and claim that since you're ruminating about some particular thing or having trouble keeping your life together, that must be the cause of your issues. That bothers me because it doesn't make sense when it's bipolar depression that triggers the ruminating and that messes with your ability to cope, not the other way around. In my experience, depression latches on to all aspects of your life and twists everything until it starts to look like a problem, even if it wasn't before. You'll always end up ruminating about something. Similarly, it will wear you down until it's hard to cope with even the slightest problem. And since everybody has stuff going on in their lives, it's easy to point to that stuff and say that if you just fixed that, you would be fine. It doesn't work that way.

Besides that, the way I see it, everyone's illness, whether it's bipolar or something else, manifests through the lens of their personality. Your personality influences how your symptoms present. In that respect it can be useful to know a bit about your personality. Similarly, it can be useful to know a bit about your childhood, especially since some theories, such as kindling theory, would imply that childhood trauma can be a trigger for bipolar. It's also good to know what your stressors are so that you can try to minimize stress to hopefully prevent new episodes from starting up. But despite all that, I think it's important to remain focused on the real problem at hand, which in my case is the bipolar, and focus treatment on that. I prefer not to get sidetracked by other diagnoses unless they cause issues outside the context of my bipolar episodes.

Originally Posted by FluffyDinosaur

It's true that many bipolar people have comorbid diagnoses. In fact, I believe that's true of most any mental illness. If you can be diagnosed with one, you can probably be diagnosed with more than one. That said, just because you're bipolar, for example, it doesn't necessarily mean that you have to pathologize every other aspect of who you are, as well. Just because you're bipolar doesn't mean that every last aspect of who you are must be explained as a bipolar feature. Everyone is different and nobody fits the DSM checklists perfectly. And you don't have to in order to be diagnosed.

When it comes to personality disorders, I would say a diagnosis is only meaningful if your personality causes you issues separately from your other diagnoses. For instance, I'm also quite reclusive. In my case it's not because of any social anxiety. I just don't feel the need to socialize much, if at all. I'm just happy being alone. I don't see it as a disorder, because it doesn't normally cause problems for me. Similarly, I haven't had the best childhood, but normally that doesn't cause me any issues either.

However, I find that in the context of bipolar episodes, sometimes things that were fine before become a problem. You might start to ruminate about things that you normally don't give a second thought to. You might have a much harder time dealing with stress than you normally do. At that point, some Pdocs start to get things backwards and claim that since you're ruminating about some particular thing or having trouble keeping your life together, that must be the cause of your issues. That bothers me because it doesn't make sense when it's bipolar depression that triggers the ruminating and that messes with your ability to cope, not the other way around. In my experience, depression latches on to all aspects of your life and twists everything until it starts to look like a problem, even if it wasn't before. You'll always end up ruminating about something. Similarly, it will wear you down until it's hard to cope with even the slightest problem. And since everybody has stuff going on in their lives, it's easy to point to that stuff and say that if you just fixed that, you would be fine. It doesn't work that way.

Besides that, the way I see it, everyone's illness, whether it's bipolar or something else, manifests through the lens of their personality. Your personality influences how your symptoms present. In that respect it can be useful to know a bit about your personality. Similarly, it can be useful to know a bit about your childhood, especially since some theories, such as kindling theory, would imply that childhood trauma can be a trigger for bipolar. It's also good to know what your stressors are so that you can try to minimize stress to hopefully prevent new episodes from starting up. But despite all that, I think it's important to remain focused on the real problem at hand, which in my case is the bipolar, and focus treatment on that. I prefer not to get sidetracked by other diagnoses unless they cause issues outside the context of my bipolar episodes.

Very well said -- I agree and I think you elaborated and were much more eloquent about to the nuances I was talking about. Co-mordbidity is very common in mental illness for sure. I truly believe mental illness manifests and is understood, coped with, and expressed in a way very unique to the individual. I guess it also depends on how you want to look at the issue -- am I my illness or am I independent a entity from it? You're right about not everything about us has to stem from the same source or be explained by it. However mental illness is just one of those areas I do feel consideration for its effects is an important factor. In my case -- I wasn't being conclusive either way, I wanted to say I don't know how to I wish to interpret it.



Thanks for your thoughtful and insightful reply.

[Nammu]

The thing with PD and PTSD. Is if you acknowledge them, work on them they can go away leaving you with only the bipolar to deal with and it would be easier to deal with as a single issue. Deny PD it’s just going to keep tripping you up. I had ptsd diagnosed first then later bipolar. At first all they did was throw the kitchen sink at me in terms of drugs. Which just made therapy impossible. I stopped taking pills and therapy became easier I work specifically on the ptsd. And got a handle on it. That made the bipolar much easier. To treat and I’ve been stable for more than 5 years now. It was hard and at times I wanted to give up but my therapist would point out the progress. The first thing I got a handle on was the hyper vigilance. That did help a lot. For a PD you would need a therapist trained in DBT, for the ptsd a trauma based therapist for the bipolar a pdoc. Preferably one that doesn’t over medicate or try to medicate other symptoms but sticks with the bipolar.

[*Beth*]

Originally Posted by MarcusAurelius

...
1) Do you have any co-morbid mental illness diagnoses with bipolar disorder?

2) In your opinion, does having the multiple diagnoses better help you understand or explain your set of issues and experience?

3) Just curious – is having a label important to you? I’m curious your perspective. As far as treatment goes – I’m definitely a “whatever works, works.” – to hell with whatever label you wanna give it. However, as far as feeling a sense of being understood and belonging, I do like having a label to help guide that discussion, but that is just my personal opinion.

...

I was diagnosed with CPTSD a fairly long time before I was diagnosed with bipolar disorder. I didn't want to have that diagnosis, but it certainly fit with my inadequate coping skills.

The double diagnosis definitely explains my issues and experiences. What's most difficult is discerning PTSD from my native personality. With therapy, however, it's becoming easier to do so.

I believe a label is important for the purpose of treatment. For example, bipolar disorder needs mainly medication, whereas PTSD primarily needs therapy

[MickeyCheeky]

i don't have much to add since i have never had bipolar or multiple diagnosis. i just wanted to say that i appreciate your insights. Thank you for this thread. Sending many safe, warm hugs to ALL of you, @MarcusAurelius, your Families, your Friends and ALL of your Loved Ones! Keep fighting and keep rocking NO MATTER WHAT HAPPENS, OK?!

[neverending]

I have had comorbidities with the bipolar diagnosis. Anxiety disorder, borderline personality disorder, and PTSD as a child. However, at this point I am only dealing with the bipolar. The rest, finally, seem to have resolved. Meds and therapy for decades. Finally I have some stability in my life and no longer have to deal with the issues of the other stuff, including dissociation.

Though I too prefer 1-2 people to keep in contact with and pretty much keep to myself I don't view this as a problem. It's just me.

I don't really do social media either. Just have no use for it.

It was good to have the various diagnoses to get proper treatment. I am glad also that at this point I am really only dealing with one.

[wolftrap]

Originally Posted by MarcusAurelius

1) Do you have any co-morbid mental illness diagnoses with bipolar disorder?

2) In your opinion, does having the multiple diagnoses better help you understand or explain your set of issues and experience?

3) Just curious – is having a label important to you? I’m curious your perspective. As far as treatment goes – I’m definitely a “whatever works, works.” – to hell with whatever label you wanna give it. However, as far as feeling a sense of being understood and belonging, I do like having a label to help guide that discussion, but that is just my personal opinion.

I have dual-diagnosis BP I (alcohol), ADHD, and related anxiety disorder.

I find the multiple diagnosis has definitely helped me to understand the constellation of symptoms I experience.

I like the labels because the medical community has defined each label by a certain set of symptoms (some of which overlap), which helps me to understand what I'm feeling and why I'm taking the meds I'm taking.

[wildflowerchild25]

I have thought that bipolar disorder was the source of all my issues for a very long time. It took me years to get BP under control. Now that I have...surprise! I may have PTSD also. My therapist has said the memory remained buried for so long because everything else was out of control. Now that I am physically safe, and mentally safe from bipolar, the memory has come to the surface to essentially kick my ***. Now I must do trauma work with my therapist while before I was focusing on coping skills for bipolar episodes and processing my first husband’s sudden death.

One psychiatrist a couple of years ago tried to throw the borderline label in our first meeting and I truly believe it was simply because I was a woman who was suicidal and had a history of self injury. How else could he even touch on that dx without knowing any of my personal history? I specifically said I was there because I had bipolar and was in a depressive episode and my previous doctor was no longer taking my insurance. So sometimes I think labels just get thrown around out of prejudice.

There is one php/IOP program near me who also decides that if you’re suicidal you must go into the DBT track, no questions asked, I do not think this is necessarily beneficial.

Anyway, my point is for me, though I may have co morbid illnesses, I can only tackle one at a time, and only one needs medication. Maybe I am lucky that way.

[Soupe du jour]

1) Do you have any co-morbid mental illness diagnoses with bipolar disorder?

At this time, no. My only psych diagnosis is bipolar disorder type 1. My psychiatrist also notes that my worst episodes (psychotic and/or very severe) tend to be mixed states, particularly mania w/mixed features, but I have also had my fair share of pure elated manias and pure depressions.

I was labeled with alcohol dependence/abuse, in the past. They gave me the code for them, but it turned out not to be bona fide alcoholism. My past abuse seems to have been linked to my bipolar manic states, particularly mixed states. For the past 6 or 8 years, I have been able to drink quite moderately without any risk of abuse. I suppose now, when in such states, I do substitute...meaning I grind/clench my teeth, perhaps have period of overeating, picking skin. I try to use positive coping skills.

During one hospitalization, they labeled me as having Generalized Anxiety Disorder (GAD) along with bipolar disorder 1. Indeed, anxiety has been an issue for me, throughout my life. However, not always. It's more episodic. I think it is linked to certain bipolar episodes, but not all. Or stress periods.

I have experienced some mildly traumatic events that affected (and maybe still affect) my behavior, but was never labeled with a trauma. The issues either disappeared, or in one case serves as a social challenge for me. Like a unique and focused social anxiety...meaning I don't have it for every category of people.

2) In your opinion, does having the multiple diagnoses better help you understand or explain your set of issues and experience?

Well, if the diagnosis is legit, I think it's useful to have the label(s). However, I do think sometimes what I'd rather call an "issue" or "challenge" might be better. For example, my bp1 diagnosis is firm and surely permanent. The alcohol abuse was an "issue/challenge". I had to address it seriously, but I did not really feel that "alcoholic" should have been branded on me. It can be distressing to be told something you're not.

3) Just curious – is having a label important to you? I’m curious your perspective. As far as treatment goes – I’m definitely a “whatever works, works.” – to hell with whatever label you wanna give it. However, as far as feeling a sense of being understood and belonging, I do like having a label to help guide that discussion, but that is just my personal opinion.

I think what I wrote in #2 answers this, for me.

[FluffyDinosaur]

Originally Posted by wildflowerchild25

One psychiatrist a couple of years ago tried to throw the borderline label in our first meeting and I truly believe it was simply because I was a woman who was suicidal and had a history of self injury. How else could he even touch on that dx without knowing any of my personal history? I specifically said I was there because I had bipolar and was in a depressive episode and my previous doctor was no longer taking my insurance. So sometimes I think labels just get thrown around out of prejudice.

Sometimes I get the feeling that certain Pdocs will challenge any diagnosis you already have, on principle, just to demonstrate their superiority and mark their territory.

[HALLIEBETH87]

I was diagnosed with borderline p/d at age 17-right after I left an abusive home and was still really struggling! Since then I’ve had many diagnoses added or ruled out. My signature has my current diagnoses. My psyd Says instead of it being called borderline he considers it complex trauma which is basically what bpd is-a reaction to trauma.

[Fuzzybear]

Originally Posted by HALLIEBETH87

I was diagnosed with borderline p/d at age 17-right after I left an abusive home and was still really struggling! Since then I’ve had many diagnoses added or ruled out. My signature has my current diagnoses. My psyd Says instead of it being called borderline he considers it complex trauma which is basically what bpd is-a reaction to trauma.

I also think that what was called borderline is complex trauma - a reaction to trauma.

I've also had a couple of diagnoses added or ruled out. It seems that more pdocs are clued up than say 10 years ago (in some areas anyway)

[Victoria'smom]

I call mine Bipolar +
+schizophrenia
+Eating disorder
+trauma
+ anxiety disorder
+ self-harm
+.... whatever else is listed on my dx

2) In your opinion, does having the multiple diagnoses better help you understand or explain your set of issues and experience?

I stopped listening after the SzA diagnosis. Not because I disagreed with it but because it's so complicated. I like larger overall Dx's. I'm only on a med for my psychosis. I'm suppose to be on a med for anxiety, depression, ED but damn pills and they don't do much for me. I have many people in my life that have similar Dx's in my life and we're all so different.

3) Just curious – is having a label important to you? I’m curious your perspective. As far as treatment goes – I’m definitely a “whatever works, works.” – to hell with whatever label you wanna give it. However, as far as feeling a sense of being understood and belonging, I do like having a label to help guide that discussion, but that is just my personal opinion. Yes having a label is calming to me. I can stop myself mid-thought and be like no that's bipolar+ lying. As far as meds go I'm on the bare minimum for the MH team to be willing to work for me. It helps the dr's ask the right questions.

I’ve come to many of the same conclusions. I could almost tell the story of my life in a series of diagnosis. Unfortunately there are many more symptoms (both new and re-occurring) that continue to arise. I will continue to embrace the healing processes as I come to know them while doing what is necessary for myself, to maintain a balance of humility and pride.

[*Beth*]

I've read a few articles recently that said there's a push in the psychiatric community to drop the "BPD" label and called it Emotional Dysregulation Disorder instead. Also, to recognize that EDD is trauma-based. I think it's an excellent idea. The old BPD diagnosis (which meant on the borderline between psychotic and neurotic) is misleading.

[buddha1too]

I'm sicker than most, even! There's absolutely no doubt that I have BP1...the physiological symptoms are as undeniable as the damage I've done while symptomatic . Staying awake for several days straight is a lot of fun...until it isn't! The list of physiological symptoms goes on...

During the course of my work in therapy, I was diagnosed ("gently nudged into believing" is probably a better way of putting it) as having BPD, too! For the longest time I fought that diagnosis tooth & nail due to the stigma attached. "It's' just the BP1 disorder!" I objected. Fact is, I now see that some of the symptoms & tendencies overlap (at least in my case). By using the DBT skills learned in therapy I can mitigate some of my more severe BPD tendencies. Accepting the fact that I have a personality disorder in addition to BP1 has been valuable.

Oh! I forgot to mention that I'm a recovering alcoholic, as well! I think professionals in the field are trying to call alcoholism something more clinical these days, but I just consider myself a garden variety drunk with over 10 years of continuous sobriety. That's a daily reprieve, by the way.

So, ladies! How about a date with an old, fat & ugly bipolar, borderline, drunk!? Sounds mighty inviting, doesn't it? That's comorbidity city!

I hate to make light of comorbidities that have wrecked entire swaths of my life, but I'm in a space where I can do that right now. Sometimes, not so much. Beating myself up isn't a luxury I can afford too often. The depressive tendencies of the BP1 coupled with the suicidal ideation which often plagues folks with BPD can lead me down a very dark path if I let that happen. I choose to avoid such spaces...Just for today.

[*Beth*]

Originally Posted by buddha1too

....
So, ladies! How about a date with an old, fat & ugly bipolar, borderline, drunk!? Sounds mighty inviting, doesn't it? That's comorbidity city!

....

Don't forget "Has a gift for writing"

[The_little_didgee]

Look up "borderpolar".

[Gabyunbound]

This has gotten off-topic, but I'd like to give my 2 cents regarding BP and BPD.

I think that there are symptoms that overlap, but it's a question of context and pervasiveness. If you're experiencing x symptom/behavior and it fluctuates on a daily (or more frequent) basis, then you're more likely to be experiencing BPD. Also if your behavior is, more often than not, a reaction to interpersonal strife. Bipolar Disorder is not pervasive, as PD's are, it is episodic: episodes last for weeks, not hours or days, and although episodes can be triggered by any number of things, everyone is different, it's not necessarily so frequently triggered by interpersonal issues.

That said, I do think you can have both. But this doesn't bely what I believe to be two very different issues.

I do believe it is important to know your diagnoses, if for no other reason then to receive the right, targeted, treatment. It also helps many of us to know why we are experiencing what we are experiencing.

And I'll end with what will probably be an unpopular opinion, which is that I believe CPTSD, whose symptoms hugely overlap with those of BPD, is a form of BPD caused by trauma, especially early trauma. However, there truly are plenty of people with BPD who have not experienced this kind of trauma, and yet suffer from BPD nonetheless. So I think something else is often going on there for those diagnosed with BPD. Personally, I think that they should separate what could be BPD with early trauma, CPTSD, and BPD without early trauma. I expect some of the treatment would be the same (i.e. DBT), but those with early trauma might also require trauma-focused therapy.

Again, just my 2 cents.

[FluffyDinosaur]

Originally Posted by Gabyunbound

This has gotten off-topic, but I'd like to give my 2 cents regarding BP and BPD.

I think that there are symptoms that overlap, but it's a question of context and pervasiveness. If you're experiencing x symptom/behavior and it fluctuates on a daily (or more frequent) basis, then you're more likely to be experiencing BPD. Also if your behavior is, more often than not, a reaction to interpersonal strife. Bipolar Disorder is not pervasive, as PD's are, it is episodic: episodes last for weeks, not hours or days, and although episodes can be triggered by any number of things, everyone is different, it's not necessarily so frequently triggered by interpersonal issues.

That said, I do think you can have both. But this doesn't bely what I believe to be two very different issues.

I do believe it is important to know your diagnoses, if for no other reason then to receive the right, targeted, treatment. It also helps many of us to know why we are experiencing what we are experiencing.

And I'll end with what will probably be an unpopular opinion, which is that I believe CPTSD, whose symptoms hugely overlap with those of BPD, is a form of BPD caused by trauma, especially early trauma. However, there truly are plenty of people with BPD who have not experienced this kind of trauma, and yet suffer from BPD nonetheless. So I think something else is often going on there for those diagnosed with BPD. Personally, I think that they should separate what could be BPD with early trauma, CPTSD, and BPD without early trauma. I expect some of the treatment would be the same (i.e. DBT), but those with early trauma might also require trauma-focused therapy.

Again, just my 2 cents.

FWIW there's a comparison of BPD and C-PTSD here. In my mind some of the most important characteristics of BPD are things like fear of abandonment, splitting, manipulation, impulsiveness, etc. Those things are not part of the proposed diagnostic criteria for C-PTSD. I see them as very different disorders, and I think it's good to keep that distinction because of the stigma associated with BPD; I wouldn't wish that stigma to be transferred onto people with C-PTSD who don't share the most negative traits inherent in BPD. For the same reason I prefer the old term for bipolar disorder (manic depression), because the abbreviation BD for bipolar is all too often confused with BPD.