Hallucinations, Delusions, but not Psychosis

You generally can't have psychosis with BPD. It's called pseudo/quasi psychosis.

My question remains. Why? Nobody seems to give me a straight answer about how my experiences are any different and it's seriously frustrating. Perhaps it's the terminology that bugs me, the way that it says that well, those experiences aren't as bad because they're not real psychosis, and speaking to the other members of the forum here who have experienced it has only reinforced my frustration and confusion.

i believe it's more of a dissociation thing with BPD. I've had both, dissociation and true psychosis (affirmed by my pdoc) and they feel quite different. Don't really know enough to explain it any further. But from an american perspective borderline personality disorder is the borderline between psychosis and personality.

The psychotic-like symptoms (e.g. auditory hallucinations) associated with BPD are understood differently. These symptoms are related to interpersonal stress rather than a 'chemical imbalance'. The fear of abandonment causes a great deal of anxiety which can produce psychotic-like symptoms. Generally this is the reaction to that overwhelming fear and being alone. Since these symptoms appear to be related to abandonment fears and anxiety clinicians believe working on those issues in psychotherapy will eliminate the psychotic-like symptoms. The strong and erratic emotions, and rigid thinking seen in BPD also nourishes anxiety.

In BPD the psychotic-like symptoms are not as severe, and the associated paranoia is usually not bizarre.

Severe anxiety (in people who do not have BPD) can definitely cause dissociation and depersonalization and so can many prescription drugs such as benzodiazepines. Is it possible that one or some of your medications are causing your symptoms? When I a teenager I was given lorazepam and started hearing voices shortly after I started taking it. The drug made me drowsy and put me in a perpetual state of stage one sleep which caused hypnagogic hallucinations. These were very different from the psychotic symptoms I had years later.

If you do have PTSD getting it treated will reduce the psychotic symptoms. Note that it is very possible for someone with a psychotic disorder to have PTSD.

A lot of meds can cause hallucintations, i know trazodone always caused me mad hallucinations, and the z drugs for sleep.

Thank you for your explanation...I think it makes more sense to me now. It's never really been discussed or explained to me properly, but when I was in hospital one of the psychiatrists remarked that I appeared to be dissociating while in the review, and I've had other experiences that look now to make sense with something more dissociative. Anxiety is certainly a massive part of my problems and a lot of effort goes in to trying to reduce that in the hope that other things come with it. I kinda feel like I don't "belong", that my psychotic-like symptoms are particularly severe for BPD but then they definitely get fed by the possible PTSD and such. I guess I'm just looking for answers, and perhaps some understanding from those in this forum who know how it feels to be perceiving things which others aren't.

I don't think it's the meds...I may be on a lot, but all of this started during a period where I hadn't had any medication changes, even doses, for months. Things may have been more turbulent since but my meds seem to reduce the symptoms rather than increase them. That said, they're considering moving me to a different antipsychotic because the view is essentially that quetiapine isn't working and therapy isn't going to be quick enough as the psychotic-like symptoms are so difficult for me to deal with - they need to be reduced before I'll be able to learn to cope with them.