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What are some key features that distinguish Bipolar from BPD?


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You are asking a question that plagues the finest of diagnostic psychiatrists with loads of expert training.

 

At the risk of talking out of my ass... I tend to think of BPD as flaming and bipolar as rusting. If you're familiar with chemistry, you will recognize both of those processes as "oxidation", so maybe not a fantastic analogy.

 

Bipolar moods tend to last longer than BPD moods. Though to be fair, there is rapid cycling/ultrarapid cycling bipolar that would confuse the issue.

 

BPD tends to have a more substantial idealizing/devaluing of others. Though to be fair, there can be a severe difficulty maintaining relationships when one moves through depression and mania/hypomania.

 

There's more, but I'm not thinking clearly about what they are at the moment.

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I thought BPD mood episodes were brought on more by external stimuli while Bipolar mood episodes can come on at anytime for no reason at all?

 

Your correct. Actually the only similarity is the rage. The mood swings are totally different in many ways. Bipolar moods can last for days weeks or months, BPD can last for minutes, hours and rarely a day or 2. Bipolar moods are wider in spectrum from depression, paranoia, hypomania, mania, irritable, anger, excited, delusional, hallucinate. Where as a BPD mood is much more narrower and pretty much will be either ok (normal), depressed, and angry. And yes they are caused by actual triggers, like some one emotionally hurting them or if they feel offended or abandon or feel the risk of being one of them. The difference is actually very easy for professionals to separate and even for a lot of us too. A bipolar even in a mixed state is easy to distinguish from a BPD, because again, they have a wider spectrum. BPD is a personality disorder, bipolar is a mood disorder. Bipolar is easier to treat. With BPD it requires more therapy with ADs for the depression and anxiety. Every one gets anxiety, it can be a comorbid condition or separate.  BPD will rant and rave very frequently, every thing is either black or white (splitting). While bipolar can go months in between episodes. It should be noted however that you can have both! In which case You can be bipolar with some BPD traits or actually comorbid. If your both, it could be a problem to distingush what you are because you could be in a stable bipolar episode and be exhibiting only the BPD traits and the bipolar may not be immediately diagnosed until a longer episode of bipolar shows up.

Edited by IndieVisible
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I think it's important not to generalize - about any disorder but particularly about BPD.  There are nine criteria and you can get diagnosed as long as you have any five.  Pretty decent amount of clinical variability going on there.

 

And it's actually not always easy to separate - which is why many people go misdiagnosed or have their diagnosis changed back and forth for years.  Yes, if you look at the stereotypes it seems easy, but once you get into the individual stories, it can get murky.  Sometimes it's clear cut and sometimes not.

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Probably the best article I've read on this topic - the whole website is good:

 

http://www.psycheducation.org/depression/borderline.htm

 

that page is from a very controversial psych, he actually believes BPD does not really exist and is actually just another form of bipolar. He is shunned by most professionals. He is not always honest about this but if you read enough of his stuff it becomes apparent he actually does have a rant page some where about why he believes BPD should be under Bipolar, Even in this link if you go to the home page you'll notice that BPD is under mood swings and does not have a separate section for BPD. Because he believes there is a complete overlap of the two. No not the best link to provide :)

 

Here's what he really thinks..

 

 

On the other hand, Dr. Akiskal, one of the most outspoken researchers on bipolar disorder, often states that he does not believe "borderline" exists. Those who would like references on this point of view will find them in his rant against the borderline diagnosis from December 2004

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I've seen it - that being said, I think that the tables he provides are accurate and provide a decent comparison.  I also think that this particular article, whatever the author's personal biases, is relatively evenhanded.

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I've seen it - that being said, I think that the tables he provides are accurate and provide a decent comparison.  I also think that this particular article, whatever the author's personal biases, is relatively evenhanded.

 

and you are absolutely entitled to your opinion, I just wanted to make it known no professional pdocs agrees with him. He is considered way off base with modern science and psychiatry in believing that BPD completely overlaps with bipolar and does not exist as a separate illness and should fall under bipolar. He's just not always honest or clear in what he believes and other times he is. I would just caution folks because that page and contributors to it is not mainstream or accepted very well. If this was religion, he would be considered a cult.   :)

Edited by IndieVisible
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None?  Because you've surveyed every single pdoc on the planet?  That must have taken a while.

 

Of course not. There may actually be a few that believe the same thing tho most would never publicly say so. He does have at least to doctors that agree and are regular contributors. I challenge you to find one other. You don't have to if you don't want. I firmly support free speech and everyone's right to their opinions. At the same time I just felt it necessary to mention what we are really dealing with here. Peace.

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Indie, we aren't dealing with a cult. 

 

We're dealing with a legitimate (I think) ideological, etiological question.

 

I actually agree with tryp that that particular article is one of the best I've seen on the subject with transparent references for people to seek out more information.

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Indie, we aren't dealing with a cult.

 

We're dealing with a legitimate (I think) ideological, etiological question.

 

I can understand that view, however doesn't it mean any thing that only 2 or 3 professionals are talking that way? I can not find one other modern day psychiatrist or psychologist that shares this opinion. Perhaps my cult comparison was not the best as I am all for questioning every thing! However his believes and reasoning are not shared by any respectable doctor. Should we not be aware of that?

What ARE we really dealing with?

Well, the OP asked what makes you say "I know that I'm BP" or "I know that I'm borderline" with certainty.

 

I believe that has been covered thoroughly already. Was there a specific point you were addressing?

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I think you're losing the forest for the trees.

 

The article itself that tryp linked to from Dr Phelps' website is a really good and thorough overview of the topic, including the controversy that BPD/BP may not be as different as some people think.

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I think you're losing the forest for the trees.

 

The article itself that tryp linked to from Dr Phelps' website is a really good and thorough overview of the topic, including the controversy that BPD/BP may not be as different as some people think.

 

Again I respectfully repeat that opinion is not shared by the majority of professionals and that was my main point. Whether some one wants to believe that or not is their personal business and I am not trying to interfere. What I am doing is pointing out a known fact that their views are far from mainstream and shared by a very small handful. And that I do not believe is losing the forest for the trees. I believe what it is is reminding people that this view is not widely accepted at all. Is there a problem with that? Being honest? Presenting counter facts? Let me know if the official position this website is to follow Dr Phelps opinions and not the DSM or most professionals and I will keep quiet :)

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You aren't presenting ANY thing to back up your assertions. You are making assertions that are critiquing an otherwise well-balanced article.

 

If you'd like to dig up peer reviewed research critiquing Akiskal or Phelps, please feel free to do so.

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You aren't presenting ANY thing to back up your assertions. You are making assertions that are critiquing an otherwise well-balanced article.

 

If you'd like to dig up peer reviewed research critiquing Akiskal or Phelps, please feel free to do so.

 

I will be happy to though I am surprised I am asked to as his views are not inline with the DSM so I have to disqualify that right from the start but I will provide additional sources, I find it odd any one here believes that BPD completely overlaps bipolar though and those where Akiskal's words before he used Phelps rant as a reference. It should be fairly clear to most people what's going on. Apparently my task is to now prove Akiskal and Phelps are wrong without using the DSM and must find other sources. I will do that when I have more time. It should be fairly easy to refute both.

 

I must say this is very interesting. I almost got crucified on another forum just for quoting Akiskal lol. Here he seems to have some fans. Interesting indeed.

Edited by IndieVisible
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