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I recently started a partial hospitalization program, and I see a new psychiatrist while I'm in the program. This pdoc diagnosed me with borderline personality disorder, and says I don't have schizoaffective disorder - bipolar type. I can believe the BPD as I read the symptoms and I relate to them a lot, explains a lot, but I'm having a hard time believing I don't have schizoaffective disorder as I've had this diagnosis for 8 years and have had three regular pdocs say I had this disorder. I know you can't diagnose me and I'm not asking you to, but for those of you who have BPD or traits of BPD have you experienced anything similar? Being misdiagnosed for a long time before your BPD diagnosis. Or can I have both disorders?

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I'd ask for a second opinion if you can. Misdiagnosis is common (in both directions) but it seems strange that you are consistently told one thing only to get told all of that was wrong. I can't think of a reason why you can't have both? I have experienced BPD related psychosis, but during brief periods and infrequently. It got to a point where I considered hospital, but it passed before that was necessary.

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1 hour ago, ananke said:

I'd ask for a second opinion if you can. Misdiagnosis is common (in both directions) but it seems strange that you are consistently told one thing only to get told all of that was wrong. I can't think of a reason why you can't have both? I have experienced BPD related psychosis, but during brief periods and infrequently. It got to a point where I considered hospital, but it passed before that was necessary.

I definitely plan on getting a second opinion. Since I plan to start DBT after the partial program, it looks like I may have to switch therapists too as I guess I should be seeing a DBT-certified therapist, which my current therapist is not.

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Do you like your current tdoc? Was DBT in the works the whole time? Cause if the DBT is for the BPD diagnosis it seems to be moving very fast

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3 hours ago, ananke said:

Do you like your current tdoc? Was DBT in the works the whole time? Cause if the DBT is for the BPD diagnosis it seems to be moving very fast

Yes I do like my current tdoc. I had to switch a year and 3 months ago when my old tdoc retired and I don't really want to change. Yes the DBT is for the BPD diagnosis.

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IDK it seems pretty sketchy that you are being asked to move away from a tdoc you like in order to receive treatment for a disorder you've just received. I mean, I have BPD traits (and OCPD) and it might just be that DBT really isn't as common over here, but I've been doing other kinds of therapy and improving a lot. It just seems like it would make more sense to try and work with your current tdoc with this, and get the second opinion, rather than making big changes in your treatment plan. You don't have to answer with any sort of detail (or even at all!) but did the psychiatrist who diagnose you explain why BPD fit better than schizoaffective disorder?

Sorry, I'm being super cautious because I don't get this situation, but that might be more a cultural difference as I'm in the UK!

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it seems like a really quick move for me as well.  just as an outsider's perspective.  I wouldn't feel comfortable saying only BPD unless at least one of hte former psychiatrists agreed with that.  Because they've known you longer and, presumably, better. 

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12 hours ago, ananke said:

IDK it seems pretty sketchy that you are being asked to move away from a tdoc you like in order to receive treatment for a disorder you've just received. I mean, I have BPD traits (and OCPD) and it might just be that DBT really isn't as common over here, but I've been doing other kinds of therapy and improving a lot. It just seems like it would make more sense to try and work with your current tdoc with this, and get the second opinion, rather than making big changes in your treatment plan. You don't have to answer with any sort of detail (or even at all!) but did the psychiatrist who diagnose you explain why BPD fit better than schizoaffective disorder?

Sorry, I'm being super cautious because I don't get this situation, but that might be more a cultural difference as I'm in the UK!

Yeah I would feel a lot more comfortable with it if I could keep my current tdoc. The partial program pdoc explained why he thought it was BPD rather than bipolar, and that made sense to me, but either I don't remember or he didn't explain why it wasn't schizoaffective. I haven't had a chance to talk to my regular pdoc, I've been seeing her for 2 years, I don't see her until after the partial program is over.

Thanks all for your responses.

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I also think it sounds kind of abrupt changing your diagnosis after just meeting you. My hospital pdocs for example kept pushing BPD on me because of my history with SH but my outpatient doctors are convinced this isn't the case at all. They know me much better and I trust them more. 

Of course, it all depends on your situation, and I don't want to say one way or the other what your diagnosis is because I'm not a doctor and I don't know you. But if you don't feel comfortable with the switch I'd get a second opinion.

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I remember you saying aura. If I'm honest I think it was your experience thats making me question what kittyloaf is going through. Again, it's not the BPD diagnosis necessarily, it's more how suddenly you are being moved into DBT without being given space to discuss it with a t/pdoc you can trust. I hope you are able to see your pdoc soon so you can get some clarity.

Also, if you want any insight into therapeutic stuff outside of DBT that has helped my BPD I'd be happy to talk to you about it, but obviously you have a lot going on so that's an open offer should you want it :) 

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1 hour ago, ananke said:

I remember you saying aura. If I'm honest I think it was your experience thats making me question what kittyloaf is going through. Again, it's not the BPD diagnosis necessarily, it's more how suddenly you are being moved into DBT without being given space to discuss it with a t/pdoc you can trust. I hope you are able to see your pdoc soon so you can get some clarity.

Also, if you want any insight into therapeutic stuff outside of DBT that has helped my BPD I'd be happy to talk to you about it, but obviously you have a lot going on so that's an open offer should you want it :) 

Thank you ananke. I'm getting a lot of info from the partial program right now and I think that's enough for now though.

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Having worked in inpatient psych for the last eight years with people who have severe psychotic/mood disorders, IMHO it's usually easy to tease apart psychosis/mood/personality with rare exceptions. That being said, anything's possible and I've met people who had co-occurring psychotic/mood and personality disorders, people masking personality disorders by feigning psychosis/mood dysregulation and people whose personality vulnerabilities weren't visible at all until the psychosis/mania started clearing.

Normally, I would suggest trying not to get too hung up on the diagnosis as much as the treatment, but since the treatments for schizoaffective and borderline pd are so different (i.e. psychopharmacologically-based vs. talk therapy-based) it might be worth looking into. 

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I’m not convinced it’s that easy.  I had an inpatient unit conclude that mine was BPD rather than bipolar and PTSD.  Not to the degree of putting it on discharge paperwork, but definitely letting it impact treatment.  When I got out and got put on the right medication combination, by a doctor who knew me, the symptoms gradually went away.  I was doing therapy also, but the med change piece was critical because you could track the changes to directly match when the meds hit the right therapeutic level.  

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