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Hi everyone,

This is my first post on CrazyBoards. I actually just found this forum thanks to Firedancer. Anyhow I've been diagnosed Bipolar 3 separate times by different doctors. I'm not discounting that I'm BP, just that I think my main illness may be Borderline. It just seems that when I try to fit my symtoms into the Bipolar framework of the DSMV criteria I'm stretching a little in some area's. When I try to place myself in the DSMV criteria for BPD It's like I fit into almost all criteria neatly except a few, which don't even relate hardly.

I know that no one but a medical professional can accurately diagnose me but I was just looking for some opionions from others who have BPD or are familiar with it if they think I fit into the BPD Criteria well.

1) frantic efforts to avoid real or imagined abandonment

Every romantic relationship I've ever been in at first is so overpowering I can't fathom ending it myself or more importantly having the other end it. The striking thing is it can begins so meaningless, but as I become attached the emotions of dependance compound, and rejection is multiplied by the emotion. In family relationships, they have existed since birth in most cases. I've built up a system which allows me to live independantly from them and not have to experience the pain of abandonment. By staying distant and appearing emotionless I retain my confidence and ability to repel abandonment.

2) a pattern of unstable & intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation

In most of my romantic relationships I fluctuate daily between these two extremes. Additionally I seem to gravitate towards partners who have similar afflictions of emotional unrest. This causes intense drama and emotional stress. Often resulting in constant breakup/back together scenarios. One day I'll hate her and her sight will make me sick, the next she will be almost a godess, and I should be so lucky.

3) identity disturbance: markedly and persistent unstable self-image or sense of self

I find myself always questioning myself and who I am. While trying to label, or stereotype myself as one person I end up confused and unable to function at a later time with a different self image. I always feel everyone sees me one way but I am actually another person, or I just don't know who I am. I change the way I dress sometimes, or the way I speak(a little), my mannerisms, or my beliefs(to an extent).

4) impulsivity in at least two areas that are potentially self-damaging (e.g. spending, sex, substance abuse, reckless driving, binge eating)

I have a 4+ year history of substance abuse, which seriusly impacted all areas of my life. This resulted in prolonged compulsive reckless behavior. Also I am sure it contributed to my illness, possibly as a major trigger.

5) recurrent suicidal behavior, gestures or threats, or self-mutilating behavior

Not so much like this one. Though in the past I have written pages upon pages in my journals which could be construed by others to be seriously suicidal. This I know as other have read the entries and expressed serious concerns.

6) affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)

I suffer from Panic attacks, and bouts of anxiety that do last at least 2 hours to more than 2-3 days. These times are always marked by increased irratabilty, disposition to anger and depression. I ussually can not realize these changes in mood until after the fact. A note though on most occasions I am seriously introverted. I don't act out in violence or scream, etc. I tend more to beat myself up, or hide from society.

7) chronic feelings of emptiness

I've suffered from this since childhood. Religion, nor spirituality, culture, family, or anything else has made me feel whole. I have no idea of what it's like to have direction, and meaning. But at the same time I feel it doesn't matter really, so long as I'm living a good life. This helps, but still it plagues me.

8) inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)

Like I said, I'm very introverted. I fear acting out against others for fear of reprival. I'd rather mentally beat myself up or release my anger on those who I feel are inferior. Mostly I withdraw and become depressed.

9) transient, stress related paranoia or severe dissociative symptoms

Due to hightened anxiety or stressfull triggers at times my percerption changes somewhat into a blur. This accompanied by panic attack type symtoms of elavated heartrate, and confusion. At these times others mannerisms, etc become amplified and more agressive towards me, and I become very paronoid of their actions, and intentions.

Also, separate from the above nine criteria, I have a mental disturbance of thoughtpatterns, I guess may be considered a delusion?! To me it feels like a defense mechanism. I have a theory or set of rules in my head that dictates what peoples emotions mean, aside from how they really mean it. This allows me to categorize them as harmful or harmless. I developed this "ability" as a filler for a lack of emotional interpretation skills. I feel very unable to process emotional response and find myself combing over a reaction for several minutes trying to interpret a simple grin or comment.

Anyhow, if you managed to read all my babble thanks for taking the time. It's helped me writing it all out here. Like I said if anyhone has any opinions or anything please post and let me know.

THANKS!!!

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wow, must say that you have very clearly explored and reflected on these things. i like your nick. i remember seeing it and liking it; kind of captures something i can relate to.

as someone who is also introverted and more oriented toward self-harming, i can relate and appreciate your honesty. i have had a dx ?BP and a dx ?BPD. the pdoc is more leaning on bpd with the main experience for me being the unstable sense of self part. i would almost venture to say that this is the main aspect for me, with the most shadowy/least prominent aspect being the frantic efforts to avoid abandoment.

anyway. in some way it's possible for anyone to stretch themselves into many of these traits. anyone. for instance we all change ourselves contextually, accommodating others and acting in ways socially appropriate or with the changing blood sugars or other mood/situation related factors. but this is not 'disordered'.

the fact that you felt you were stretching to fit BP but not stretching so much with regards to BPD, is significant. i think all i can really say is to point out this significant difference in your identification, and that your reflections are valuable to take to the pdoc.

it might also help (but careful, possibly confrontational) to ask someone who has been in your life for a good while to check on some of your reflections. you don't have to label it BPD. you can leave the label out, and just formulate them as questions to ask like, 'do i...' and see what they might say, and then share your reflections with them, and see if they can see it or agree. this isn't to say your perceptions of yourself, if different from someone else's perceptions of you, are wrong.

it it sometimes helpful though, because i something think a part of all of this, like you said not always being aware of behaviour in the moment or at all, is a kind of 'personality dysmorphia'. like i feel like i don't have a personality at all sometimes. or feel i behave in certain (icky) ways or out of certain motivations or personality characteristics, but i believe those ways to be far more consistent than they actually are.

sorry if this is rambling, not making sense, or not at all useful. in the end i guess i say, good work. i am somewhat projecting -- so ambivalent myself that my doctor is at all suggesting this. i guess i bought into the stigma and i'm resisting. but then, i cut  and there is sometimes a tendency for my 'kind' - cutting, elusive, moody, empty and anxious - to be put into this bucket, and really that does a possible disservice to pseudo-borderlines, AND most especially to actual-borderlines.

take good care,

pj

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Hi EgoLost, Welcome!

You have obviously spent a good deal of time thinking about these issues and you articulate them quite well.

As you are aware the symptoms of Bipolar and BPD overlap to a great degree and it can take even a dedicated Pdoc significant time to sort out and accurately diagnose the true disorder. 

I hope that you are working with a good Pdoc and therapist. Remember that in hard to treat situations, the dx really becomes of less importance than getting adequate treatment of the symptoms.

Glad to have you aboard.

A.M.

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Thanks guys I really appreciate the feedback.

It did seem for a while after my original DX of BP that I did buy into the stigma behind it. It wan't so much sterotyping myself to "fit in," but almost more like a release. You know....."Thanks god I thought there was something way worse wrong with me!!" So I kind of forgot about all the effects and damage that were resultant of whatever DX I really had. I just started on an active medication stint. But in doing this some things were treated while others weren't even touched. So I've been soul searching persey for a year or so, trying to figure out if I'm really BP or something else all together. I decided it would be best to find the problem first before deciding how to treat it!

Another point, fitting into 5 categories that seriously impact my life. I spent so much time in denial because the things that seriously impacted my life were for a large part in my head. Hence the introversion. Only some things broke through that other poeple could see, and this was just ussually boiled down to just overreaction, or a need for a chill pill. In fact the first time I approached my family about my problems they told me I was fine, and I just needed to think positive. They believe there is nothing wrong with me. So who is right them or me, I mean I am feeling these feelings right?!?! But most of the criteria call for changes those around you can see in some form or another. I mean for instance a person can be suicidal and no one else ever know it right? Then one day BOOM, there gone, and your at their funeral, etc.

So as you can see I'm in a big confused mess. I see the point of evaluating the issues that are seriously harming me. Perhaps I should focus most of my effort on treating those issues. But there is still that need to know why this is happening to me, what it is, and how do I treat the whole person and not just the surface.

One note, It does seem to me in most diagnostic criteria, the focus is only on those so ill that they will possibly harm themselves or someone else. This is a professional oversight in my opinion of those with less severe but equally potent forms of these illness's.

I will definatly make a list of what I call my issues and pass it around to some close family members and friends as suggested. That sounds like a great idea! Potentially damaging, but maybe I'll get lucky, and they'll all tell me it really is all in my head!!!!LoL

You're right Airmarshall forget the DX, I just need to treat the symtoms at this point!

Thanks for the welcome everyone!

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I have difficulty with the BPD diagnosis and pretty much agree with Dr. Akiskal's views that it is really better defined as an affective disorder (BD) not a personality one. You can read about Dr. Aksikal's views here.

http://www.blackwell-synergy.com/doi/full/...47.2004.00461.x

Within that context this is how I would explain your symptoms.

1) frantic efforts to avoid real or imagined abandonment

2) a pattern of unstable & intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation

Perhaps a manifestation of misplaced importance on the contribution of feelings towards the other person in the relationship. i.e. Giving credit where credit is not due.

3) identity disturbance: markedly and persistent unstable self-image or sense of self

If BD is the more accurate diagnosis it would be easy to posit that there would be an inherent obstacle in being able to form a stable view of ones self.

4) impulsivity in at least two areas that are potentially self-damaging (e.g. spending, sex, substance abuse, reckless driving, binge eating)

5) recurrent suicidal behavior, gestures or threats, or self-mutilating behavior

6) affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)

Mania, and all its flavours.

7) chronic feelings of emptiness

See above about the interference in the development of a stable self concept.

8) inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)

9) transient, stress related paranoia or severe dissociative symptoms

Mania and depression.

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Oh, one other thing... It is possible to have both Bipolar and BPD, since the former is organic and the latter is considered a personality disorder. So the three Pdocs and you could all be correct.

Therapy is critical for success in treating BPD, and has been shown to be equally important as meds in treating BP, so no matter what mix you might have a good therapist will be helpful.

Cheers,

A.M.

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Point taken Glen. It seems as said above, conditions and symtoms can be linked in most probability to any number of disorders. You could very well be right about every point you made. It's possible it is BP I'm dealing with here. In my initial post I was simply putting forth my hypothesis as to what might really be the cause of my affliction. I als note, what turned me onto the idea was my girlfriend buying me the book "Borderline Personality Disorder Demystified"-Robert O. Friedel, Md. So it is safe to gather she, if no one else is at least leaning towards this diagnosis, and she lives with me, and see's me the most. Also she has an in to hear about my feelings as they are, and not altered.

I have been in both rehabilitation as well as one on one therapy. I should definatly look into finding a therapist I agree. Also possibly CBT or DBT, I think either of these could be of great help. Medication I have learned and as you surely know IS only half of the treatment. I didn't realize this for a long time.

Thanks again!!

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Just chiming in to say that I was diagnosed with BPD before I was diagnosed BPII....

I COMPLETELY identified with the BPD, but never thought I was bipolar until they explained what mania/hypomania was and how both my pdoc and therapist had suspicions I was bipolar too....

They aren't always right, but even if it is bipolar it's not all that bad.  If you truly are, then you can get the help you need....like perhaps a mood stabilizer. ;)   Anyway, just thought I'd add an anecdotal experience..

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Heya EgoLost,

Not a lot to add except that I'm also impressed by your insight and your persistence in trying to figure this all out.

BPD and BP are IMHO different entities or whatever that frequently coexist, and that require somewhat different approaches to treatment.

Combo of appropriate meds and appropriate therapy is crucial for any disorder.  They both affect our brains, and both help.

The stigma around BPD is based on ignorance.  People are idiots.  If it helps you to identify with a certain personality pattern, good for you!

I fit in *mostly* with schizoid, though you'd never know it if you were my coworker.

And it also bugs me that we have to be *really ill* before we can get slotted into the DSM.

That's (IMHO) stupid.  So many of us wackos are just *really* good at hiding ourselves.  Nobody believed me when I said I was BP.  B/c I covered well outside of my marriage, in which the cover came off and I was quite evidently BP.

At any rate, I'm with you and the others on the whole DSM thing.  I like looking at it, it's interesting and useful as a classification system, but not so much as a guide to real people and what our needs are.

OK so I had something to add.

;)

--ncc--

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Hi!  Glad that you found the place ok. ;)

My pdoc is considering a dx of BPD.  The more my therapy explores my childhood memories (or lack of thereof), my SI and tendencies, I am agreeing to a degree.  He gave me a book to read and make notes (we are going through them now) that I recommend to anyone BPD or considering this dx.

Lost in the Mirror: An Inside Look at BPD by Dr. Richard A. Moskovitz.  The book is very easy to read and is very sympathetic.  The story that progresses at the end of each chapter, is a combination of the authors patients.  Here is the thread I started on it

http://www.crazyboards.org/index.php?showtopic=8414

You may want to check this book out also.

_jen

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Thanks for the replys everyone.

It does feel good to be able to kind of place myself in a certain bracket. I guess if your symptoms align well with one DX or another, there's nothing wrong with treating yourself for that DX. Of course if it really were not so you may hender your treatment. But you know most DX's are treated with similar therapies anyhow, I don't see how it could hurt. It's not exactly the difference of Cancer or HIV ya know.

At any rate, my medication seems to be helping a little more each passing day. My self help through BPD books, and talking extensivily with my doctor and my very supportive girlfriend seem to be adding up to a good combination. So I'm gathering a proper DX isn't really the important issue here. It's presice treatment of my symptoms.

Firedancer, I found the boards fine, thanks! I'm making a trip to B&N this Saturday I'm going to look for the book you mentioned. The title sounds familiar.

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  • 2 weeks later...

i disagree that BPD is just a form of bipolar.

i think that a lot of people with BPD also have comorbid bipolar or depression or anxiety or...

medication can help BPD.  BPD with comorbid BP can certainly be helped with medication.  but if you are truly BPD (and not just mis diagnosed, or possibly, or told you were by some asshole doctor who thinks everyone who cuts is BPD) then medication alone will not fix thing.

i am not bipolar.

i was BPD.  i am no longer BPD because of therapy (specifically DBT.)

if i did not have comorbid MDD, anxiety and ADD, i would not need meds.

meds helped me through therapy... but they did not fix the pain of BPD.  that pain is now gone.  if i went off of all meds, i would have ADD issues, and MDD issues, but BPD would not return.  (i have gone off all meds, so i've tested this.)

overlap doesn't mean they are the same.

a personality disorder is different than a chemical inbalance. they require different treatments.  even if meds for bipolar will help a borderline, they will not cure the borderline... meds and therapy can, in fact, cause a borderline to no longer be borderline.  nothing you can do to a bipolar will ever stop them from being bipolar.

sorry if i'm snippy.  i'm all for ditching stigma, but not at the sake of denying borderlines access to appropriate therapy that is clinically proven to help them.

penny

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