Borderline Controversy Debate: Possible Trigger

In your journeys if you should find the link to the university in Rhode Island it would be most appreciated if you post it here. Thank you for your input!

IMHO not very different at all. Take for example a bipolar stuck in the midst of a "mixed" episode. There does not have to be any manic or very little if any, just irritability and ups and downs, often appearing they are triggered by events. And as pointed out to some it makes no difference how the mood swings are triggered, we are still talking about mood swings. And there are some who are suggesting any mood swing involves changes in the thyroids as indicated by recent thyroid studies with BPD that show changes similar to bipolar suggesting there is some chemical play here. Again many seem to feel the similarities are greater then the differences.

Certainly greater then any similarities BPD has with any personalty disorder. I for one doubt I could play the devils advocate to support BPD has more in common with ASPD then with Mood Disorder. BPD just has so much more in common with mood disorders then any personality disorder!

I agree with Ultramar.

I have no training on the issue but I have been in hospital time and time again with BPD patients and have quite a few BPD real life friends. These are just my observations so please dont take offence.

Their mood swings are so different to mine (Im diagnosed BPII) and they seem to go ape **** at the smallest little trigger, then calm down, then its onto the next crisis. They were constantly in crisis, there is constantly drama in their lives. There was always a trigger even though they swore black and blue it was just a mood disruption, but from the outside we could see it clearly. Meds doped them up but had little effect on keeping their moods stable. Their thought patterns were so ingrained that they would swing though the meds.

Many of my BPD friends are now living productive happy, unmedicated, lives after being treated with DBT, CBT and group therapy. Some fought their diagnosis swearing it was bipolar and "they had no control" but in the end they came to realise the doctors were correct and they did infact have a lot of control over their extreme emotions and reactions to things. Now they have accepted that and threw themselves into therapy, some dont even meet the BPD criteria anymore.

Thats not to say bipolar patients dont have control, I think they definitely do have some control over the degree of which the moods escalate. There are sometimes triggers for BP moods but not always. I really do think with the right coping stratagies and therapies I can control the extent of my moods - but I cannot just wake up out of a depression because things are suddenly going my way - as many of my BPD friends did.

Im not in the US and I know of no insurance issue with diagnosis here but the BPD's still fight it. Every time I go to hospital I see it again and again, telling everyone they must have bipolar and the docs are wrong... Im not sure why they would prefer to have BP. I havent met a single person "cured" of BP but I know of a few "cured" BPD people.

Thank you. There is no denying there is a difference. We merely disagree on if it should be a mood disorder or personality disorder. And certainly you have seen psychotic episodes of manic that would dwarf even the worst BPD rant

Bipolar disorder is a disorder of mood and energy level with episodes, not swings, that generally last weeks to months in duration. Bipolar episodes are about broad mood states of depression and mania, while BPD mood swings are reactionary episodes, usually fairly brief by comparison, of very defined emotions such as anger, rage, sadness, rejection, abandonment. Mixed bipolar episodes are not episodes of quick swings between feeling good and feeling bad/irritable; they are states where full manic and full depressive symptoms are experienced concurrently. Most of the people I know personally or on PC who are diagnosed with bipolar disorder alone don't self injure or have issues of abandonment, etc., while those that do are generally also diagnosed with BPD.

It seems you want to focus strictly on mood and because mood swings can be drastic it might be better classified as a mood disorder. That, to me, is like looking at a piece of the picture rather than looking at the picture as a whole. I can only speak for myself but when I feel intense rage or intense sadness it's a result of an interaction with another person, and the changes in mood are usually linked. If someone doesn't phrase things correctly or if what they say doesn't match their facial/body language or if there's a perceived sense they're lying to me that can set me off into a rage, and it can be over something trivial. After the rage, I become apologetic and when that doesn't work, I become intensely angry again and when I don't get the desired results from that, I can become needy/clingy practically begging for forgiveness and then intensely sad/depressed. I'll give a recent example.. I exchanged some emails recently with someone and they said I could txt them if I want and if not they understood. That set me off. If they had just said "text me" I would've been fine, but the way it was phrased especially the part about if I didn't they understood, made me think they really didn't care one way or the other. I replied basically telling them to **** off and never contact me again. I've had interactions with people in the past where I've impulsively changed my phone number, and then contact them sometimes within a few hours to give them my new phone number. I don't rage or become intensely sad out of the blue or randomly it's as a result of some sort of interaction with another person.

We're like other personality disorders in the sense that we're manipulative too. "If you don't talk to me I'm going to kill myself", I do a nice gesture for you or get you something, it's not to necessarily be nice but it's really so you do the same for me. If you don't that can lead to intense anger/sad. Many of us don't know or have the skills to interact with others.

Many of us also lack a stable identity. I've read here and elsewhere situations where others with bpd have taken on the characteristics of someone they see on tv, and when that gets old or someone new comes around that they like better they take on those characteristics.

So it's not just mood, but it's the inability to have effective/rational interactions with others that affect the mood, and it's the pervasive pattern of interactions with others and the manipulative tactics that makes us a personality disorder rather than a mood disorder.

For me I try to keep people at a distance by not allowing them to get close to me. To do my best to remain detached so I don't have to deal with the intense anger/sadness. I'm not better. I've just taken on a new dysfunctional way of coping by cutting off my emotions and remain detached. It's when I make the occasional mistake of allowing someone to get to close to me at some point the pattern will repeat and there goes the friendship followed by intense sadness that will last weeks and sometimes months.

Those are my thoughts on the subject.

Indeed the strongest case to bind BPD to personality disorder rather then mood disorder is the fact that BPD mood swings are always present and can happen any second making it a very large part of the personality. Even playing the devil's advocate for this thread it would be very difficult to dispute that fact. All I can say is that those that would dispute it would attempt to argue the duration is not as important as we make it out to be. And once again we avoid recognizing an actual mood disorder and not a personality disorder.

It is significant we all stop and pause here because this is a important point that cboxpalace is trying to pound at us. In all fairness to everyone, this is the strongest arguement in favor of classifying Borderline as a personality disorder. But as strong as this point is, it does not end the debate, or has not so far in the field

I will add this I have issues with psychiatrist/psychologist making a diagnosis after only a couple of visits. I think it's something that has to be observed over a period. My psychiatrist didn't wasn't comfortable giving me that diagnosis until sometime after 6 months. I also think some sort of testing such as mmpi-II or something similar should be administered. It's not perfect but it does take out some of the subjectivity of a human. I've been dx by hospital psychiatrist, personal psychiatrist, psychologists, and I've had at least 2 mmpi-II tests admistered. 1 by my psychologist and 1 by social security.

That would very much be my opinion also, though I think you said it better than me.
I was first told about mine 20 years ago. When I was 21. I didnt look it up, there was no internet and I didn't go to the library to read more.
Years later I was told the same by a different Psych. And now, ten years later again.. except NOW I have been reading about it due to these amazing 'interwebz' ---

A big part of it is that many bpds are born over sensitive in my opinion, so the slights and hurts and anxieties that some people get through better... we don't. And as we grow, our reactions to the things in life around us become things we unconsciously (and then consciously as we are older usually) learn to trigger from.

I told my psych i didnt think I had abandonment issues even though i was raised with my grandma because she was awesomely loving and kind, he told me that it depends on the unique sensitivity a person is born with. For me, seeing mom only rarely, may have really affected me more than i realized. So.. anyhow, back to my original point, I agree with those points quoted above

*editing : My last two psychs both felt that there was a huge possibility that bpd was in the bp spectrum. But that instead of swinging back and forth over longer periods, you are swinging faster, more rapidly over a shorter space. However, one point my doctor recently made was that if you are bipolar, putting on a song to change a mood is hardly effective, whereas if you are bpd and in a state, you can change a song and feel differently. In the end, tis just a name used to better classify symptoms that they feel fall outside of one or the other. And if it results in help, then i dont care too much.

For the first part, I would like to see the sources for this. Treatment in my country for BPD is DBT . Also sometimes anti depressants to deal with the often very depressing part of hating oneself for all the chaos they cause. I have had 3 psychs in 20 years tell me that meds are not given for BPD. Therapy and hard work is what I was told. Now, because I went manic when given prozac years ago, it was suggested I could be bipolar 2, but my current psych is cautious about diagnosing it as such because he feels BP is over-used as a diagnosis.
So, at least in Canada, treatment is not the same for both, and I have seen no test results that show both BP and BPD people have the same results from meds. -- if I missed them in your initial post i apologize.
Also would like to see where duration and energy level is up for debate. MAYBE alot of those BP are actually BPD and one day they will realize that with more extensive diagnosis.

Someone interested in Psychology? I'm actually quite enjoying reading through this thread and seeing both sides of the debate. I've never thought much about it because all my text books always said it was a personality disorder and that just was. I never realized there was some debate about it despite realizing that some of the symptoms were very similar to mood disorders.

I feel the need to share a little here because I have a diagnosis of Bipolar II and BPD.

The swings are very different.

Hypomania, for example makes me feel like I am at the top of the world. There is no one smarter, more expert in my field. I could see double the clients in half the time on four hours of sleep and then go to the gym. And sometimes I would even be a psychic, goshdarnit!

And it would last a while, sometimes months at a time. The longest was close to a year.

And I can also tell you for sure that there is no hell like a mixed episode. The only way to describe it is burning with an energy of despair. Knowing that every injustice in the world lurks just outside your door. People are out to exploit each other and nothing is good, and you still can't sleep.

I won't even get into what the depression is like.

BPD is much more personal. A slight from someone turns into a personal judgement about myself that leaves me ruminating for days.

An emotional injury feels like a stab through my heart.

My BF, who is very supportive, tells me that he read something negative BPD website and I assume he is going to leave me, and this makes me burst out into tears.

I think bad things about myself all day long.

The major difference is that my Bipolar is completely controlled by meds. I can say this for sure. The BPD is only getting better now that I have started DBT.

Lol, I typed up an elaborate response, but I pressed the wrong button on my phone and the screen froze. I threw my phone so far and I just had a melt down. Well, to sum up what I said, I believe there is a difference. I can tell when I'm having bpd symptoms because it follows an event such as my android being a little ***** and freezing up. It also goes away and I don't have the same feeling unless the trigger is continuing. I'm in remission right now, but I still have problems with rage, abandonment, anger, sadness, etc. With mania it stays and doesn't go away for weeks, months even and I generally need to get hospitalized for them. I've never been hospitalized for bpd, I just lose my ***** over silly things then I'm fine later in the day.

The tests were in the USA and is some where in one of the links I provided in the start. The interesting thing about the med tests, it did not take in consideration the percentage of misdiagnoses but I guess it wouldn't matter if the results were similar. The results were so-so for both using standard treatment for bipolar meds and SSRIs, with the best results for both coming from using anti-psychotics instead of the bipolar meds and SSRIs. Meaning they tried both types of meds for each found so-so results from both on each. But both groups experienced the best results from anti-psychotics. I found that also interesting. The main difference in treatment was bipolar gets put on meds faster because they usually do not seek help unless in a manic or depressed state.

Where did you read this? I read a lot of research papers on BPD and never came across this. BPD was once thought to be on the border of neurotic and psychotic disorders. Before BPD was added to the DSM it was often diagnosed as schizophrenia.

In the links I provided, basically at first pdocs were not considering BPD as anything other then bipolar, many swearing the disorder is the same or related to bipolar.

Can you add some links that oppose your opinion?

What do u mean? This is not my opinion. I have no opinion on this matter. I guess I do lean towards a combo theory. I see how it is a personality disorder and a mood disorder, that would be my opinion, but I am not talking about my opinion here.

What?????

This is your thread. I thought you would have information on the opposing side.

Did you read the first couple of posts I made? I clearly said what my intent here was. Let me repeat for you so u don't have to re-read. I am introducing a alternative opposing perspective regarding BPD that has been and is currently being hotly debated by top mental health officials. I bring this to the table because a lot of people may not otherwise ever be aware such opinions existed. For the sake of providing a fair treatment for this topic I am merely playing the devil's advocate. I also clearly said I nether agree or disagree with this. I am focusing on the side that most people would never hear about. A lot of people have provided really good arguments against this view in this thread. So I'm not really sure what your asking me here to do?

I am done here.

I've read as much as my BPD brain with let me in one sitting and my conclusion is I.just.dont.care what umbrella it comes under. I struggle everyday with the way my mind works like most people in this forum. I personally don't need to debate diddly-squat and for you to post this thread for shits and giggles, isn't cool. Take it up with Dr Suess.

Thank for this thread! I was just given this diagnosis this past Monday and left to figure it out on my own. This has been helpful. I do struggle daily with moods, emotions, paranoid thinking and always knew something was wrong with me. That I was broken. I feel, inside, that it is biological, something misfiring in my brain. Not something I can control or a personality issue. I also always wished my moods would just be stable/even keeled. So tiring the roller coaster of moods/emotions daily, hourly. I am amazed I carved out a normal looking life and I do contribute it to a VERY calm husband that knows how to stable me instead being wounded and making the situation worse.

Sorry if I am ranting.

in the right hands knowledge is power but in the wrong ones, it can be dangerous. Fact is there is a lot of misinformation on any subject you can look up, controversy and opposing views.

I think 99% of the people here with bpd diagnoses are well aware of the opposing, controversial views and it's something that we have to struggle with everyday facing the public and the medical world

It would be an interesting/thought provoking subject if it were based on factual evidence. He stated that BPD was initially classified under Bipolar, which I have not found evidence to support that. In fact, on this website, Borderline Personality Disorder Demystified - history of the disorder , it states:

In 1938, the American psychoanalyst Adolph Stern first described most of the symptoms that are now considered as diagnostic criteria of borderline disorder.5 He suggested the possible causes of the disorder, and what he believed to be the most effective form of psychotherapy for these patients. Finally, he named the disorder by referring to patients with the symptoms he described as “the border line group.”

It goes on to add:

The psychoanalyst Robert Knight, in the 1940s, introduced the concepts of ego psychology into his description of borderline disorder. Ego psychology deals with mental functions that enable us to realistically perceive events, successfully integrate our thoughts and feelings and to develop effective responses to life around us. He suggested that people with borderline disorder have impairments in many of these functions, and he referred to them as “borderline states.” 4

And I will stop here:

The next major advance occurred in 1975 when John Gunderson and Margaret Singer published a widely read article that synthesized the relevant, published information on borderline disorder, and defined its major characteristics. Gunderson then published a specific research instrument to enhance the accurate diagnosis of borderline disorder. This instrument enabled researchers over the world to verify the validity and integrity of borderline disorder. Subsequently, borderline personality disorder first appeared in DSM-III as a bona fide psychiatric diagnosis in 1980. 4

These are only three paragraphs/statements which concern the history of BPD. No where on the site does it mention that BPD was first considered to be a "mood" disorder. In one of the uncited paragraphs, it distinctly labels it as a personality disorder, and was classified as such in the 1940's. Check the link, and notice the endnotes. This is all based on fact, not conjecture.