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Bipolar or Borderline?


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Guest Vapourware

My impression of the Borderline dx is that it is a description of various maladaptive behaviours bourne out of an inability to cope with distress constructively. There are mood fluctuations but the fluctuations tend to be brief, are reactive and are due to emotional dysregulation rather than mood cycles. They tend to last hours usually, and a few days at most, not the days on end that occurs with a mood cycle.

I think it is not uncommon to both have bipolar and borderline dxes, although differentiating the two can be a bit difficult. How stable are your symptoms, currently? I find that usually, before you want to consider another dx, it helps to have your current dx under control before looking at your symptoms more.

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How common is it to be dually-diagnosed?

I don't have an exact number for you, but both Bipolar Disorder and Borderline Personality Disorder can exist as a co-morbid diagnosis. Keep in mind that Bipolar Disorder is an Axis I condition and BPD is an Axis II.

How do you tell the difference? I've always felt my bipolar dx was "off" and now am seriously considering the Borderline symptoms.

Have you broached this topic with your current doctor (psychiatrist, therapist)? It's great to want to know what is going on with yourself, but also remember that self-diagnosis can be a dangerous game. Diagnosing is best left to the doctors.

What is your current course of treatment?

If you want to do some reading, here are some pages dedicated to BP vs. BPD:

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I have a dual diagnosis, after six years my pdoc doesn't know what label fits best, nor does he want to label me definitively with either. I'm being treated for mood problems with Lithium and all the self management that applies to bipolar, but I also do DBT which helps with the personality issues.

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I have both. I asked my therapist if it was common to have a diagnosis of both and she said it is not common but my various mood swings are different. My borderline mood swings have me happy one minute, wanting to slit my wrists the next, and then being angry as hell and these alternate throughout the day and I do not stay with one mood for longer than a day or two. My bipolar mood swings have me manic and/or depressed for months at a time. It can be really complicated but now that I know the difference with my moods it makes it a lot easier to deal with.

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I have Borderline + mood disorder (depression r/o bipolar or something like that) and the biggest problem for me in terms of symptom overlap is chronic low grade depression. Apart from that, I can generally tell what's going on (if it's sudden transient and triggered by abandonment, it's probably the Borderline, if I fall into a giant hole for months on end, it's probably a mood problem) Generally it hasn't really mattered because my doctors have focused on my symptoms and it hasn't been super necessary to really wrangle out which belongs to what. But as has been said before, there are some significant differences, though it is possible to have both.

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I think it is not uncommon to both have bipolar and borderline dxes, although differentiating the two can be a bit difficult. How stable are your symptoms, currently? I find that usually, before you want to consider another dx, it helps to have your current dx under control before looking at your symptoms more.

Not stable at all, unfortunately. I have a horrible history of medications not working. I fell into a non-compliance mood and stopped everything because I was just so fed up with it. I've been charting and recording moods/symptoms/etc and will bring it in to my pdoc on the 29th so he can get an idea of what non-medicated life is like.

How common is it to be dually-diagnosed?

I don't have an exact number for you, but both Bipolar Disorder and Borderline Personality Disorder can exist as a co-morbid diagnosis. Keep in mind that Bipolar Disorder is an Axis I condition and BPD is an Axis II.

How do you tell the difference? I've always felt my bipolar dx was "off" and now am seriously considering the Borderline symptoms.

Have you broached this topic with your current doctor (psychiatrist, therapist)? It's great to want to know what is going on with yourself, but also remember that self-diagnosis can be a dangerous game. Diagnosing is best left to the doctors.

What is your current course of treatment?

I'm trying extremely hard to not self-diag, but so much of it makes sense. Especially if there's two dx's going on here. I feel like I've never quite "fit" the bipolar dx completely.

Either way, I really need "real" therapy and not just come-in-and-talk. I need someone to poke and prod at me.

I guess on my appt I'll just mention to my pdoc and see what he thinks.

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Forty percent of people seen on an outpatient basis for an Axis I disorder meet criteria for an Axis II disorder. So super duper common. Another thing is people with an Axis II disorder often use higher doses or more medication to keep symptoms under control. So if it seems like meds don't work that great, that could be a reason why.

BP is kind of a weird dx. There are many flavors of it, and few people meet the criteria that the DSM lays out. So it could very well be a manifestation of BP that you have going on. But I hear you on the intuition that there's something more going on than mood issues. I had that sense for quite awhile, but I never knew what it was until my therapist and I figured out there was an Axis II thing going on. It definitely makes a difference. Hopefully you get it sorted out and will be feeling better soon.

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