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Can one have mild BPD?


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#1 Keirelle

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Posted 17 July 2009 - 01:52 PM

I have been diagnosed with severe social anxiety/ agoraphobia and depression in the past. While I do know I have some weird social issues, I never really told my pdoc WHY. It is mostly because I feel so inferior to other people. I have an obsession with my weight, a complete hatred of parts of my body that leads me to despise leaving my house because I just feel fat/ugly/etc. It has really been bad since having my son nearly 5 years ago. I won't leave my house without makeup/hair done and I change my clothes several times.

Recently it was suggested I could have bipolar, and while some of it does seem to fit, I am just not sure that is all there is to it for me. I came across some info about BPD, and while I had previously had ignored it (what info I had come across before made it some absolutely terrible!) in reading further, a lot of it does sound like me, just maybe a milder version?

What I had read here: http://nimh.nih.gov/...eet/index.shtml
I felt was so similar that I emailed it to my husband.

I can get ridicoulously angry out of nowhere. Usually over simple things, often over the fact that I think my husband doesn't show enough affection. I will tell him I hate him, screaming it over and over. I really feel it at that time though, but then later I know I didn't mean it, which has been really hard to explain to him.

I split up with my husband a year ago and I am still not sure why. I felt, again, that he just wasn't affectionate and I was unhappy. But when I left, it was when I was on vacation visiting my family. It was like i did it because I was in a different situation and away from him. I was having fun where I was and didn't want to go back.Afterwards, I regretted it and yet couldn't work out what was going on. We have since gotten back together however.

During the time we were split, I was drinking a lot, which is NOT me normally. I was sort of seeing a much younger guy, but it was almost like I just needed someone there to tell me I was worth it? I was spending too much money and one night I went out and just got my tongue pierced, an hour after it came to my mind. I chopped off my waist length hair to my chin, 3 hours after waking up one day-- when previously I never wanted to cut my hair.

This stuff is what led my doc to think bipolar, but I am just not sure I agree. It was all weird and unlike me, but most of my time is spent being anxious around others, depressed, and getting really angry over stuff, and then forgetting I was.

I don't think I have ever really had a hypomanic issue, unless you classify what happened last summer as such, but I wasn't overly happy about anything at that time. I still don't know why it happened.

I also have issues with self injury when I am feeling too stressed, or if I have gotten in a fight with my husband. It's just me needing to put the anger somewhere else but inside me. I have had eating disorder issues in the past for the same reasons.

When I am feeling overly stressed/anxious I also tend to binge eat then got on a short starvation cycle, or sometimes, if I have access to money I will spend on random stuff because the act of spending gives me a focus.

I guess I just feel like I have multiple parts of what could be many disorders, but none is 'really' serious. If that makes any sense?

I guess the stuff last summer can be seen as hypomanic, and I do have social anxiety disorder and depression, but I really see myself in the description of BPD as well, just maybe not as severe. Any ideas? Sorry I am so confusing. I just don't wanna be the self diagnosing type and yet I feel stupid bringing this up to a doc. Right now I have no PDOC and have just been going to a clinic since i moved again. I am on no meds because I didn't want to get fat on the seroquel the clinic doc prescribed after I mentioned last summer, so I didn't eevn fill the script...and I hated celexa that I was on. I just have ativan prn.


#2 tryp

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Posted 17 July 2009 - 02:10 PM

Hey,

It's definitely possible to have some BPD traits without meeting the criteria for a full diagnosis, or to have them at a subclinical level (they have to be causing severe impairment in your life for a diagnosis.) It is also possible that you do, in fact, have BPD.

(what info I had come across before made it some absolutely terrible!)


Yeah, there is a lot of stigma associated with BPD, and there's a lot of inaccurate information out there.

Some people divide BPD into "high-functioning" and "low-functioning", and some people differentiate "acting-in" BPD versus "acting-out" BPD, so it's also possible that there could be some element of that in there, though those divisions aren't accepted by everyone, and they aren't official distinctions.

Anyway, it's definitely worth a mention to your pdoc, if you get one, or even to the clinic doctor, especially since you seem to be doubting your bipolar diagnosis. Better yet, do you have a therapist? Stuff like that can sometimes be better managed with therapy in addition to meds.

Edited by tryp, 17 July 2009 - 02:13 PM.

Dx: Complex PTSD
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#3 Keirelle

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Posted 17 July 2009 - 03:17 PM

I was seeing a pdoc for therapy just after I got diagnosed with social anxiety. I was so stressed over everything at school (nursing school) that I just wasn't doing well at all. I ended up in the ER trying to get a pdoc. Got on some meds which have never really helped honestly, and continued to see her for 'therapy'. She was so awful to try and talk to though that I was also seeing my school therapist every week too, even though i had dropped out of school, but I didn't get to do that for long.

I guess I am just confused because a lot of disorders seem to fit me in some ways but rarely all, or if they do, I don't find it 'that' severe in the way I think of most people with mental illnesses. I know I am just stereotyping on my own, lol, but I guess I figure if I am not at the point where I need to be in a hospital, then it can't be that big of a deal.

But it is all really affecting my life. A lot. I feel like crap all of the time. I am constantly screaming at my husband and son, I often think I need to just leave again because I am not doing any good for them here. I get too emotional over things that shouldn't be that big of a deal, and I have no energy for anything, which makes me sit around, getting fatter and then not going out because I feel so disgusting. Nasty circle I tell you....

#4 tryp

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Posted 17 July 2009 - 03:21 PM

I guess I figure if I am not at the point where I need to be in a hospital, then it can't be that big of a deal.


It sounds like it's a big deal. If you feel like crap, it's a big deal.

How difficult would it be for you to find a regular pdoc and a therapist? Sometimes pdocs don't make the best therapists. I like mine, but sometimes it can be better to see a psychologist or someone else with more therapy training. Or at least a pdoc who is decent at therapy.

Even if the meds didn't work the first time, there are other things to try - meds and therapy together is a great combo. I have BPD along with other issues, and the meds help the other stuff, while I'm trying to work out the core BPD stuff in therapy.

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#5 Keirelle

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Posted 17 July 2009 - 03:48 PM

it's not that difficult. I had one I was about to go to (my sister in law is bipolar and it is her doc). I got a referral, but the doc was moving offices and I guess it got lost. Because of my social anxiety, I will put things like this off forever. I was telling myself for weeks I was 'fine' but that only lasts so long before I have a hard go of things again (like now). So I finally got it together to call and find out why they hadn't set up the appointment and the referral was lost. So I have to go back to the clinic. I ironically got a call from the clinic doc the same day as I decided I needed help again, but I can't get a hold of him yet. So it is just a matter of doing that and waiting on my referral again.

Though really, I more or less was hoping to convince one of the docs to give me topamax and wellbutrin for the weight loss effects, and because I figured that's the best I can do given I refuse to take anything with any chance of weight GAIN- and that holds out a lot of meds, lol. I have no idea if those meds would matter for BP or BPD if that were the case.

#6 tryp

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Posted 17 July 2009 - 03:53 PM

You might want to reconsider that weight gain thing - it excludes a lot of good meds, and most docs won't be happy to just throw any meds that don't cause weight loss at you. Might be something to take up in therapy. I take/have taken meds with major weight gain stuff and not gained much - it's very individual and it can be managed more than the horror stories would have you believe.

I hope you'll manage to get the referral thing done soon. Keep us posted ;)

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#7 Velvet Elvis

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Posted 17 July 2009 - 04:17 PM

FWIW, the only proven treatment for BPD is dialectical behavioral therapy. Look for a therapist who has been specially trained in that. Lots of borderlines end up wasting years in therapy just because they are not getting the right kind of therapy.

[link=http://en.wikipedia.org/wiki/Dialectical_behavioral_therapy" target="_blank]http://en.wikipedia.org/wiki/Dialectical_behavioral_therapy[/link]

It typically consists of regular meetings with the therapist plus group therapy and guided workbook exercises.

Medication is typically not effective for BPD, though it might help with any comorbid Axis-I disorders you have hanging around.

DBT is supposedly pretty popular with the national health system in Canada because it's cheaper than meds and works. It offers a real cure rather than just treating the symptoms for a lifetime.

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#8 tryp

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Posted 17 July 2009 - 04:36 PM

Other types of therapy can also help, though perhaps not as much or as quickly as DBT. Especially since some proportion of people with BPD have been through trauma or abuse, so doing work with the past can also be helpful.

If it were me, I'd be inclined to just find a therapist and actually get diagnosed with BPD if that's going on, since it's not an official diagnosis yet, and maybe deal with some of the other stuff. Meds and therapy are also important for the other issues you mentioned - the depression and the social phobia.

Obviously, I'm no expert, but that's what I did.

For me, BPD is sort of a more underlying issue, more of a constant in my life. I had to get my PTSD/depression treated before I could take a stab at the BPD, and it sounds like the same might be true for you, since you have other severe anxiety/depression issues going on.

Edited by tryp, 17 July 2009 - 04:42 PM.

Dx: Complex PTSD
Tx: Lamictal (250) + prazosin (7.5) + "therapy"


#9 Velvet Elvis

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Posted 17 July 2009 - 05:05 PM

DBT is the only methodology with double blind studies showing efficacy for BPD. Other methods might be effective for co-occurring problems but they won't touch the BPD which, if you have it and aren't bipolar or schizophrenic, is likely the worst of your problems.

ETA:

Here's a pretty good writeup of how the whole thing works:

http://apt.rcpsych.o...ent/full/8/1/10

De-gnosis: ADD, recurrent depression (or maybe bpII in the guise of such), Asperger's, OCD, social anxiety
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Like other moderators and staff of crazyboards.org, I am not a health care professional. You have no way of knowing that I am not talking out my ass. Please do your own homework before making any health related decisions.

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#10 mika

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Posted 17 July 2009 - 05:19 PM

plus, DBT can help with other disorders such as BP, PTSD, OCD, etc. Even if you don't have BPD but have trauma, DBT is very therapeutic in treating the aftereffects of trauma.

Edited by mika, 17 July 2009 - 05:19 PM.

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#11 Keirelle

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Posted 17 July 2009 - 08:30 PM

Is DBT essentially the same as the CBT (cognitive behavioural therapy) that I had to do for my social anxiety, because I thought that was a load of crap. It made my anxiety just over the top and I hated going to see them every week, it was awful.

**I looked it up and it is basically the same stuff. Yeah.. not so sure how I would feel about that. But then, I guess I don't have the diagnosis anyway lol. Although my husband got a chance to look at the info I sent him and he said that it is pretty much me...

#12 Velvet Elvis

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Posted 17 July 2009 - 08:47 PM

Is DBT essentially the same as the CBT (cognitive behavioural therapy) that I had to do for my social anxiety, because I thought that was a load of crap. It made my anxiety just over the top and I hated going to see them every week, it was awful.

**I looked it up and it is basically the same stuff. Yeah.. not so sure how I would feel about that. But then, I guess I don't have the diagnosis anyway lol. Although my husband got a chance to look at the info I sent him and he said that it is pretty much me...


DBT is something else. See the links posted in the thread above.

De-gnosis: ADD, recurrent depression (or maybe bpII in the guise of such), Asperger's, OCD, social anxiety
Today's Pill Menu: Dexedrine, Wellbutrin (Budeprion), Strattera, Celexa, Risperdal, and clonazepam

Like other moderators and staff of crazyboards.org, I am not a health care professional. You have no way of knowing that I am not talking out my ass. Please do your own homework before making any health related decisions.

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#13 tryp

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Posted 17 July 2009 - 09:03 PM

DBT incorporates some CBT techniques, but it also incorporates lots of other stuff.

The Borderline PD Survival Guide says that while a lot of people with BPD don't like CBT, they do like DBT.

For what it's worth, I'm not a CBT fan at ALL, and what little I've done of DBT, I've liked.

However, as I said, there are other options too. In my personal opinion, since you're not officially diagnosed with BPD, I'd find a therapist and try to hash out exactly what's going on, and then if/when you get an official BPD diagnosis and it seems like BPD is your top priority issue, maybe consider DBT. Since you have other stuff going on, and since you are not officially diagnosed BPD, at this point, I'd work on getting a therapist and psychiatrist, getting some meds for your other conditions and so on and so forth.

Just what I'd do.

Edited by tryp, 17 July 2009 - 09:04 PM.

Dx: Complex PTSD
Tx: Lamictal (250) + prazosin (7.5) + "therapy"


#14 Penny Century

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Posted 17 July 2009 - 11:00 PM

if you have access to DBT, do it.

it is the only double-blind studied ANYTHING (med or therapy) proven to help BPD.

it is why i no longer dx BPD. one year and a lot of work, and it saved my life and stopped a lot of problems.

DBT is scientifically proven and it is really the treatment or borderline.

it has also been shown to help people with other disorders.

(i might also add, therapy, not easy to prove in a double-blind study, so i brought that up because it's a big deal.)

if you can find DBT, seek it out. it honestly saved my life, and you don't have to be a full-blown borderline for it to really help.
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