DID mistaken BPD?!

Hi -
About 4 months ago I stopped seeing the Psychiatrist I had been going to when she referred me to someone who specializes in trauma recovery (I was r**d by a step-father and neglected by my mother). I had been seeing this Psychiatrist on and off for about two years.

About two weeks ago I started reading about BPD and noticed some of the symptoms fit me so I asked my therapist (the trauma specialist) via email if I have BPD. He said "if you think that borderline is right for you then I won't object." I started reading up on it more and lot of pieces fit in terms of how I react to people (always find it hard to get along, people are either good/evil, etc...).

But I don't have intense relationships, I'm not emotional, I don't rage or scream or injure myself. My therapist said that those symptoms are not the "core" of BPD. The "core", he said was my responses to the inner turmoil.

So, I happened to be back at my Psychiatrist today to get a refill on my Clonex and asked her about this. And she said I don't have BPD, I have DID(!). She said nothing presented indicated BPD and she cited the same things I mentioned (no raging, no chaotic relationships, etc..).

She said I have severe dissociation and even though I don't amnesia between 'alters', just amnesia from my childhood (I have large gaps). She said unlike people with BPD, I simply get 'triggered' into dissociation. When I read the DSM 5 criteria it fits me to a tee. But so do some borderline traits as well. And even my therapist said I have severe dissociation, but he seems to think it is part of BPD.

I saw this Psychiatrist for a few years and the therapist for the last 4 months. I like the therapist - I am making progress and feeling better, etc... Im just really confused about the diagnosis.

I'm not asking anyone for a diagnosis. I know I meet all 5 of the criteria for DID, but only some for BPD. I have an appointment with my therapist tomorrow and will speak to him. I'm just wondering if others have been diagnosed with BPD rather than DID or vice versa?
Again, I'm just really curious to know if others have been in this situation regarding diagnosis.

in general there are many diagnosis's that carry the same symptoms which results in people getting many different diagnosis and sometimes getting confused when there are shared symptoms.

with dissociative disorders (and most others in the DSM 5) the criteria is now worded that the problem can not better fit another disorder. this allows treatment providers to look closer at the symptoms and decide whether those symptoms are better explained by a different diagnosis before slapping the label on someone.

I have in yrs past been diagnosed with other disorders and dissociative disorders due to the fact of shared symptoms of the diagnostics. I also know many that have been diagnosed with things like depression, schizophrenia, schizoaffective, bipolar and BPD before they were diagnosed with a dissociative disorder. I also know many who's diagnosis has changed from another diagnosis to a dissociative disorder and vice versa from a dissociative disorder to a different diagnosis since the DSM 5.

I was diagnosed with bipolar, then bpd and finally DDNOS, which is basically (in my case) DID without lost time. I HATED being diagnosed with bpd, as I noticed most professionals treated me as an issue and a diagnosis, without focusing on the cause of my issues. For me, any symptoms that fit into the bpd (those that I met) were also a part of the ddnos and complext ptsd, my new diagnoses.
My world has improved immensly since getting the new diagnoses, as I was suddenly treated as a person, instead of as a diagnosis.
My suggestion is that you think less about the diagnosis, and more about you as a person: what symptoms/issues are the most significant for YOU, and what strategies work for you? No matter what label they attach to you, you will still be the same person you always were. Most professionals have a level of bias when it comes to different diagnoses, and each person with the same diagnosis are still individual people. Having a label is a grest starting point, but it doesn't help much farther than that. Any therapies, strategies, meds, etc are all based on you as a person. What experiences you have had, etc.

I would suggest that if you really like the therapist and he is working for you, that is fantastic. But it doesn't mean that his diagnosis is the correct one. It just means that he works well with you.
It's also possible to have more than one diagnosis. People get second opinions from doctors all the time because diagnoses can often be wrong: it is the doctor's opinion based on the information they have the the knowledge and experience they have accumulated. They are not 100% perfect.

Just some food for thought. I would suggest going with your gut feelings on this one, and to keep in mind that labels change fairly regularly, just look at all the new changes is the latest dsm. You, however, will always be the wonderful, interesting and unique person you always were.

Sorry if that's not really what you were looking for.
Best,
IJ

I don't think it's so black and white, people are a mixture of things and they can have more than one illness at a time. Severe trauma is a causative factor in both those things isn't it? So it would make sense if you had elements of both.

Hi -
Thanks innocentjoy - I think you are right about diagnosis. Whenever I find myself thinking about my diagnosis I seem to be less in touch with what is going on inside of me.
What I do like about a diagnosis is that it allows me to learn more about it. I started reading a lot online about BPD and even bought a book from Amazon.
I also like it because I feeling like I have to rely on my therapist. Not because I don't like him but because I want to be able to help myself and not feel dependent on him.
Thanks again.

I have bad amnesia from my childhood.
When the Psychiatrist mentioned DID from trauma, I started to panic in a way I had not in a couple of weeks. I'm in constant fear of remembering more and I thought with the BPD maybe I could set aside this fear (like maybe my anxiety was just problems with uncertainty and not fear of more flashbacks, etc...).

IMO (both professional and personal) the term of borderline personality disorder came into being because of symptoms doctors saw but refused to "believe in" Multiple Personality Disorder/Dissociative Identity Disorder...and they needed to "put" the patient somewhere so they could be paid for "treatment."

Or it might be used by a doctor who agrees with the DID but hasn't seen at least 2 personalities/alters/ego states (whatever terms they decided to use) yet.

In any event, YOU are still Whom you are! A different term for your behavior won't change for you, it will only change for your treatment program plans...and any T worth their salt (again IMO) will tread gently in these matters anyway.

I feel the need to clarify this. DID is only 1 of the many forms of dissociative disorders. What you are describing about having amnesia is also another form of dissociative disorder. Not DID. DID means you have alternate personalities when you dissociate, whereas other forms of dissociative disorders include some form of amnesia, depersonalization, or derealization. If you have a dissociative disorder, yet no alters, its most likely DDNOS. Unless the doctor specifies which form you have. DID does NOT mean "Dissociative disorder" it is merely a TYPE of it.

Also, you can have BPD without rage and cutting. There are 9 criteria and you only have to fit into 5 of them to have the diagnosis. One of them is dissociation when stressed out.

What you are experiencing, sounds to me like PTSD.

Some people with DID do have problems with amnesia, depersonalization/derealization....Im one of those people who did not have very much co consciousness with my alters therefore I lost time/had amnesia when my alters were out, during the dissociating from one alter to another and from host to alter I had depersonalization derealization and many other symptoms too....

for those that want to know what america standards for dissociative disorders are now here is what the DSM 5 states....

http://forums.psychcentral.com/disso...s-dsm-5-a.html

as you can see it does take into consideration those with DID that do have symptoms of depersonalization, derealization and amnesia with in the diagnostics for DID by using terms like

for amnesia symptoms theres this diagnostics....
B. Recurrent gaps in the recall of every day events, important personal information, and or traumatic events that are inconstant with ordinary forgetting.

for symptoms of depersonalization and derealization and other symptoms theres this diagnostic criteria..
accompanied by related alterations in affect, behavior, consciousness, memory, perception, cognition, and or sensory-motor functioning.

I was trying to make the point that DID includes alters, and if you don't have alters, then you do not have DID.

Gosh this is a tough one because I understand what you're saying, but it's not an easy one to pin. I was diagnosed with bipolar and BPD a few years ago. I know bipolar is wrong. I had a great therapist back then who thought it was DID, not bipolar. I saw someone else a few weeks ago who is inclined to agree with my old therapist and said he didn't feel by reading the vast medical notes on myself and what I'd written, that it fit BPD as much as it does DID. I was also told that I probably have PTSD which was originally diagnosed years ago. It's hard because I have read up both and I can relate to much of the BPD symptoms, but perhaps not as well as those of DID. I would keep digging until you feel satisfied you're all on the same page. A correct diagnosis IMO is very important but you need someone listening who is actually listening. I have felt many occasion I'm being humoured, rather than listened to. You'll get there, but for now

I'm not sure I understand the difference between 'alters' and dissociation/having distinct selves that do no interact with each other and are in conflict.

Just to follow up on this....
I spoke with my therapist yesterday and he explained that it is never cut and dry and BPD is closest because of extreme reactions to internal conflicts.
I asked about "Fear of Abandonment" (which I don't have) and he said you can replace this with just "Fear" (which I do have, in spades). I also don't have unstable relationships, self-injury, etc.. but he said none of these are central to BPD.
As far as my dissociation (I'm dissociated a good part of the day and have been since I can remember), he said extreme dissociation, depersonalization, and identity confusion is also part of BPD.
He has also referred to my symptoms as Complex-PTSD.
I actually feel a bit better about this now. While it would be nice to have a "neat" diagnosis in which everything fit, I can live with a BPD/C-PTSD diagnosis.
My main desire for a diagnosis was being able to learn more about the condition on my own. I'm able to do this with BPD and PTSD/c-PTSD books and information.
Not all of it applies to me 100%, but I can discern which are applicable and which are not.

here in New York State they are the same thing...

Alters are parts of a persons personality /self that has been split off from the rest and takes on their own distinct patterns of ways to be, jobs, purposes, and reasons for being.

some have more co consciousness (ways they interact, share, communicate) then others., some are so in my therapists terms categorical that they have little to no co consciousness with each other and the one they reside inside of.

there is actually two dissociative disorders now where a person can have alters / parts / or in your words distinct selves.

DID which is where a person with the disorder with alters, has time loss (amnesia symptoms)

OSDD (Other Specified Dissociative Disorder) where a person has alters (alternate selves) but does not seem to have amnesia /time loss symptoms.

that said other locations, cultures, religions, .....may have a different way of explaining what alters are to those with DID.

Yes that is what an alter is. Dissociating while another personality takes over.

Some things I found to contain helpful information pertaining to C-PTSD ...

Pete Walker, M.A. Psychotherapy

And the book Trauma & Recovery by Judith Herman ...



In the past, so many negative connotations were associated with a diagnosis of Borderline Personality Disorder that many doctors today shy away from hanging that millstone around their patients' necks!

Heal Well ...