[Secretum]

I've done a lot of research in the past week, and this is the conclusion I've come to. Here are the commonly cited differentiators between BPD and bipolar, along with my comments:

1). bipolar mood swings occur over weeks/months, while BPD mood swings happen multiple times a day

Actually, many bipolar patients have a "cyclothymic temperament", a chronic, trait mood lability that causes them to cycle through emotions quickly at their baseline. Cyclothymic temperament is actually a "non-manic" marker of bp II.

Also, I believe that many more bipolar patients go through periods of extremely fast cycling during some point of their illness than professionals currently recognize. Many people I've met on the bipolar board over the years have reported mood swings that change multiple times per week, if not faster. They can't all have been misdiagnosed borderline patients.

Studies have found that the mean duration of hypomania is two days. Two days! The DSM ignores science and sets it at 4 days, because they are scared of "over diagnosing" bipolar. So they over diagnose MDD-leading to the dangerous prescription of antidepressants to patients with a bipolar diathesis-or BPD-leading to unwarranted shame, stigmatization, and demoralization, along with the absence of potentially life-saving mood stabilizers.

Nearly everyone with BPD has a co-morbid depressive disorder (one article I read said 100%!), and obviously most depressive episodes last for weeks. So nearly every borderline has experienced a depressed mood lasting for at least a week; thus, some borderline swings are slow.

2). bipolar mood shifts are untriggered, while BPD mood swings come from the environment

Maybe on average. I'd argue that every bipolar patient has mostly untriggered mood swings. But if someone with bp is already a little depressed, a disturbing life event is likely to drag them down a lot more. In fact, "rejection sensitivity" and "temporary mood brightening" are signs of "atypical depression", which happens to be another validated non-manic marker of bipolar!

Furthermore, I'm certain that borderlines experience untriggered mood shifts too. The symptom description on this forum states something like that in BPD "emotions swing wildly, often for no discernible reason". Not always triggered by rejection/abandonment, etc.

3). Borderlines feel "empty"; bipolars don't.

-"Empty" feelings are a well-known symptom of depression, whether from bipolar, BPD or MDD.

4). Borderlines have identity issues, while bipolars don't.

Maybe this is true for those lucky "textbook" bipolars that cycle extremely slowly, have long periods of remission, and don't have a cyclothymic temperament.

For the majority of bipolar individuals who aren't like that, however...mood instability will naturally lead to identity problems. If you can't predict how you will feel and how much energy you will have, it is impossible to plan your future. I started a thread in the bipolar forum a year ago on "constantly changing plans". Many people could relate. Here is the thread if you're interested: http://forums.psychcentral.com/bipol...ing-plans.html

Here is an article by Dr. Hagop Akiskal, a famous bipolar researcher on why he believes BPD is really a mood disorder, probably related to bipolar: Demystifying borderline personality: critique of the concept and unorthodox reflections on its natural kinship with the bipolar spectrum - 2004 - Acta Psychiatrica Scandinavica - Wiley Online Library

I especially like his point on how likely it is that nature devised two brain mechanisms for bipolar mood swings and borderline mood swings, versus the idea that the same neural substrate underlies both conditions.

A study has found that the prevalence of strictly defined bipolar (type I or II) in borderline patients is 44%. Much higher than what is found in the general population! Using more liberal criteria of bipolarity raises this percentage to over 80%.

You have a lot more in common with bipolar patients than you do with psychopaths and narcissists, despite what the prevailing professional wisdom says.

It's not your fault. It's not your personality. You're not evil at your core. You have a serious brain illness that creates symptoms that are actually no reflection of who you really are or what your personality is really like.

Just thought I would share this for anyone who needs encouragement.

[Secretum]

Information on bipolar spectrum disorders beyond well known mania and depression: Depression, Bipolar II - Diagnosis

Includes "soft signs", also known as "non-manic markers". I'm not making this stuff up. Bipolar is an incredibly heterogeneous illness. No two patients are alike.

[sideblinded]

Hey Secretum

That is some interesting stuff for sure! I was misdiagnosed with bipolar, and held that label for 18 years. Immediately the psych meds came and I lost my medical career. I come from an alcoholic abusive neglectful home where one could be diagnosed with bipolar, depression, anxiety, PTSD, borderline PD and the list goes on. Psychiatry is not a science. It is actually a mess in my opinion. Our lives are in these pdocs hands and we lose so much from their misgivings. Great info!

[Crazy Hitch]

Thanks for sharing this with us.

[Fuzzybear]

Originally Posted by sideblinded

Hey Secretum

That is some interesting stuff for sure! I was misdiagnosed with bipolar, and held that label for 18 years. Immediately the psych meds came and I lost my medical career. I come from an alcoholic abusive neglectful home where one could be diagnosed with bipolar, depression, anxiety, PTSD, borderline PD and the list goes on. Psychiatry is not a science. It is actually a mess in my opinion. Our lives are in these pdocs hands and we lose so much from their misgivings. Great info!

[dancinglady]

I have read several posts about the bad thoughts about who we are. I understand that we all stopped developing at the age of 2-1/2 years old and that a lot of our behavior is similar to the aged child.

No one hates 2-1/2 year olds. They just don't like some of their (our) behaviors. If any therapists does not understand this fact - run the other way fast.

[fletch33]

I think it is really hard to distinguish bipolar from BPD at times. My psychiatrist gave me several diagnoses before finally settling on what I am now. Besides, your diagnosis does not make you who you are, it really just is a code doctors use for insurance purposes.

[Cygnus8548]

Originally Posted by Secretum

I've done a lot of research in the past week, and this is the conclusion I've come to. Here are the commonly cited differentiators between BPD and bipolar, along with my comments:

1). bipolar mood swings occur over weeks/months, while BPD mood swings happen multiple times a day

Actually, many bipolar patients have a "cyclothymic temperament", a chronic, trait mood lability that causes them to cycle through emotions quickly at their baseline. Cyclothymic temperament is actually a "non-manic" marker of bp II.

Also, I believe that many more bipolar patients go through periods of extremely fast cycling during some point of their illness than professionals currently recognize. Many people I've met on the bipolar board over the years have reported mood swings that change multiple times per week, if not faster. They can't all have been misdiagnosed borderline patients.

Studies have found that the mean duration of hypomania is two days. Two days! The DSM ignores science and sets it at 4 days, because they are scared of "over diagnosing" bipolar. So they over diagnose MDD-leading to the dangerous prescription of antidepressants to patients with a bipolar diathesis-or BPD-leading to unwarranted shame, stigmatization, and demoralization, along with the absence of potentially life-saving mood stabilizers.

Nearly everyone with BPD has a co-morbid depressive disorder (one article I read said 100%!), and obviously most depressive episodes last for weeks. So nearly every borderline has experienced a depressed mood lasting for at least a week; thus, some borderline swings are slow.

2). bipolar mood shifts are untriggered, while BPD mood swings come from the environment

Maybe on average. I'd argue that every bipolar patient has mostly untriggered mood swings. But if someone with bp is already a little depressed, a disturbing life event is likely to drag them down a lot more. In fact, "rejection sensitivity" and "temporary mood brightening" are signs of "atypical depression", which happens to be another validated non-manic marker of bipolar!

Furthermore, I'm certain that borderlines experience untriggered mood shifts too. The symptom description on this forum states something like that in BPD "emotions swing wildly, often for no discernible reason". Not always triggered by rejection/abandonment, etc.

3). Borderlines feel "empty"; bipolars don't.

-"Empty" feelings are a well-known symptom of depression, whether from bipolar, BPD or MDD.

4). Borderlines have identity issues, while bipolars don't.

Maybe this is true for those lucky "textbook" bipolars that cycle extremely slowly, have long periods of remission, and don't have a cyclothymic temperament.

For the majority of bipolar individuals who aren't like that, however...mood instability will naturally lead to identity problems. If you can't predict how you will feel and how much energy you will have, it is impossible to plan your future. I started a thread in the bipolar forum a year ago on "constantly changing plans". Many people could relate. Here is the thread if you're interested: http://forums.psychcentral.com/bipol...ing-plans.html

Here is an article by Dr. Hagop Akiskal, a famous bipolar researcher on why he believes BPD is really a mood disorder, probably related to bipolar: Demystifying borderline personality: critique of the concept and unorthodox reflections on its natural kinship with the bipolar spectrum - 2004 - Acta Psychiatrica Scandinavica - Wiley Online Library

I especially like his point on how likely it is that nature devised two brain mechanisms for bipolar mood swings and borderline mood swings, versus the idea that the same neural substrate underlies both conditions.

A study has found that the prevalence of strictly defined bipolar (type I or II) in borderline patients is 44%. Much higher than what is found in the general population! Using more liberal criteria of bipolarity raises this percentage to over 80%.

You have a lot more in common with bipolar patients than you do with psychopaths and narcissists, despite what the prevailing professional wisdom says.

It's not your fault. It's not your personality. You're not evil at your core. You have a serious brain illness that creates symptoms that are actually no reflection of who you really are or what your personality is really like.

Just thought I would share this for anyone who needs encouragement.

This certainly is sophisticated research and poses at least two immediate questions: 1. is the difference between the two artificial and unscientific, and then 2. does it lead to Rx that is inappropriate for a give patient who is really more bipolar than BPD or vice versa? Thanks.

Thanks for this insight!