[muse]

... between a full-blown personality disorder and a borderline personality disorder. Is it that the latter is less clear-cut and defined than the former, and less severe?

I've wondered about this for a while now, so info would be great. Thank you.

[Rapunzel]

Borderline personality disorder is one of the ten currently recognized personality disorders in the DSM-IV-TR. Each personality disorder, including BPD, has its own criteria for symptoms or characteristics. YOu can find more information about personality disorders here: http://psychcentral.com/disorders/#person or specifically about BPD: http://psychcentral.com/disorders/sx10.htm

The name has always been confusing. At first it reflected the idea that people with borderline personality disorder were somewhere on the border in between psychosis and neurosis. Most of the personality disorders resemble one or more Axis I disorders (which include psychotic disorders, as well as anxiety, depression, dissociative disorders, etc.) in some way. The main differences are often that the Axis I disorder may be more acute and the personality disorder more chronic. People who have Axis I disorders tend to be more distressed by their symptoms, while with personality disorders it's more like part of what the person's personality is like, and it may not occur to the patient that there is anything wrong with that. For example, people with Obsessive-Compulsive disorder have obsessions and compulsions that they feel compelled to act on or else they feel miserable and can't stop thinking about it. Those with Obsessive-Compulsive Personality Disorder have a rigid and compulsive way of doing things - they may make a lot of schedules and be perfectionistic, but it's not necessarily troublesome to the patient. Such a person might be difficult to be around a lot though, because they insist on doing things in a certain way and sometimes that isn't very fun.

BPD has features of several Axis I disorders, such as Depression, Bipolar disorder, PTSD, paranoia, etc. To further complicate things, people with personality disorders often have Axis I disorders too, so many people with BPD actually have Depression, PTSD, etc. Sometimes the Axis I disorder is treated and the acute symptoms improve, but the person still has all the BPD symptoms because their personality incorporates the tendencies to dissociate and have mood swings, etc.

I hope that I haven't just confused you more. It isn't an exact science by any means, and diagnostic categories aren't chiseled in stone anywhere either. In the future, the experts might decide that dysthymia (long-term mild depression) is actually a personality disorder, or they could decide that BPD fits better in an Axis I category and isn't a personality disorder afterall. Especially in the personality disorders, they keep changing their minds. Where I work, many of the clients last had psych evals 20 years ago or more, and have diagnoses that don't exist now, such as "Immature Personality Disorder." How would that be, to have a dx that someone decides is not actually a disorder?

[muse]

ooh, that WOULD suck. :{

Thank you so much for all the info, Rapunzel--you rock!!

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Where I work, many of the clients last had psych evals 20 years ago or more, and have diagnoses that don't exist now, such as "Immature Personality Disorder." How would that be, to have a dx that someone decides is not actually a disorder?

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I don't think it should matter at all whether what one person has is a "diagnosis" or not.

What should matter(IMO) is how that person is coping in life and what difficulties they are having and then work on those coping problems and difficulties.

It's kind of sad how some people think that if they don't have a dx-- then they can't or shouldn't or aren't worthy of getting help...... I don't understand this cultural phenomenon?????

What is it with so many Americans and them wanting to have a diagnosis?? Wonder if other countries are similar?

mandy

[muse]

I other countries probably are, Mandy, and while I agree with you, I think people are more comfortable with a "diagnosis" because it brings them out of the unknown. It's a scary thing, not knowing what's wrong with you or having that definition shuffled around, because a definition can be dealt with, categorized, and fixed. An ambiguity, however? That's much harder to deal with.

Just my two cents, and again, thanks much!!
~muse

[Perna]

A borderline personality disorder is a "full-blown" one, the term "borderline" doesn't mean not-quite-full-blown, just one the "border" :-)

Back in the early 70's I was diagnosed with "borderline" and back then it meant between neurosis and psychosis :-) I lived in an "imaginary" world I'd created so wandered between reality and unreality (basically).

If I think about it, I think of "personality" as "me"? That, to me, is where the problems enter, I belive personality disorder/Borderline is about "who is "Me"? Notice the capitalization! I like "borderline personality disorder" as a diagnosis as it has a certain "questionable"/volatile aspect so it is more "open" and subject to change in ways one might like? It makes me think of "late bloomer" :-)

i think it is fair to say that other countries aren't so hung up on diagnosis. part of the reason for the concern with diagnosis in the US is the way the health insurance system works. that isn't such a pressure in other parts of the world.

that being said... i think that clients often want to be diagnosed / labelled. it is a way of taking this nebulous pain and confusion and hurt and the like and putting it in a little box so it seems maneagable. i think that the public awareness of how arbitrary diagnosis is is sorely lacking. part of that is in psychiatry's attempt to underplay inter-rater reliability and portray themself as a 'real science just like medicine' where there is a fact of the matter (and it makes a real treatment difference) whether a person has x pathogen or y pathogen.

i guess the tendancy also comes out with people reading about astrology (character descriptions and predictions) on the basis of sun / star sign... or little quizes that try and tell you your character / personality and the like... maybe it is part of... people wanting to see themselves as being like others. there must be others if there is a whole dx category for it - right?

sigh.

personally... i find it dehumanising.
but others find it humanising.

so i don't know...