Is It Bipolar Disorder Or Borderline Personality Disorder
- Borderline Personality Disorder vs. Bipolar Disorder: How Can You Tell The Two Apart Did you know that there are many similarities between borderline personality disorder and bipolar disorder ? There are so many similarities between the two disorders that there has been a controversy among psychiatrists for decades on how to distinguish between the two
- Definitions A bipolar disorder is characterized by changing maniacal and depressive modes. Bipolar disorder is sometimes referred to as a manic-depressive disorder due to the characteristic alternation between periods of turbulent activity which might be called mania, and periods of depressive state. Individuals suffering from bipolar disorder experience both manic and depressive stage.
- Borderline personality disorder, commonly known as BPD, is a mental disorder usually diagnosed in young or early adulthood and affecting between 1.6 and 5.9 percent of Americans, according to Psych Central.It is commonly misdiagnosed or missed altogether as some of the symptoms can mirror other disorders, and BPD often coexists with another disorder
Symptoms Of Borderline Personality Disorder
The symptoms of BPD can be grouped into 4 main areas:
- emotional instability the psychological term for this is affective dysregulation
- disturbed patterns of thinking or perception cognitive distortions or perceptual distortions
- impulsive behaviour
- intense but unstable relationships with others
The symptoms of a personality disorder may range from mild to severe and usually emerge in adolescence, persisting into adulthood.
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What Else Could It Be
BPD and bipolar disorder are often confused or misdiagnosed for one another. You may also be diagnosed with one of these conditions when you actually have an entirely different mental health condition.
Can you have both BPD and bipolar disorder? Yes, its possible but its rare. This is called a dual diagnosis.
Other conditions that might be confused with bipolar disorder and BPD include:
If you think your diagnosis may be incorrect, you can reach out to a mental health professional for a reevaluation. And its OK to get a second opinion.
It can help to look for a pro who specializes in treating BPD or bipolar disorder.
Frequency Of Borderline Personality Disorder In Patients With Bipolar Disorder
Twenty-four studies reported the frequency of BPD in patients with bipolar disorder . Most studies were of psychiatric outpatients, and only four were of samples of inpatients . The majority of the studies assessed BPD when the patients were in remission or with no more than mild symptom severity the remainder assessed BPD when the patient was symptomatic. The Structured Clinical Interview for DSM-IV was the most commonly used measure to evaluate Axis I and Axis II disorders. Most reports focused on either bipolar I or bipolar II disorder, and many did not discuss the bipolar I-bipolar II distinction. Two reports specified the number of patients with bipolar I and bipolar II disorder, but only reported the prevalence of BPD for the entire group without specifying the prevalence of BPD in the bipolar subtypes., Only two groups of investigators examined the frequency of BPD in patients with bipolar I and bipolar II disorder.,
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Understanding The Rollercoaster Of Bpd
People with borderline personality disorder often feel a huge amount of emotional instability. It impacts a persons self-image, likes and dislikes, and goals. This often makes them confused about their sense of self. The condition makes it difficult for a person to be comfortable in their skin.
Many people with BPD act impulsively, have intense emotions, and experience dissociation and paranoia when most distressed. This emotional volatility can cause relationship turmoil. Also, the inability to self-soothe can lead to impulsive, reckless behavior.
1.4% of American adults experience BPD
People with BPD are often on edge. They have high distress and anger levels, so they may be easily offended. They struggle with beliefs and thoughts about themselves and others, which can cause distress in many areas of their lives.
People living with BPD often have an intense fear of instability and abandonment. As a result, they have problems being alone.
The condition is also known for anger, mood swings, and impulsiveness. These qualities can dissuade people from being around someone with BPD. On top of this, many people with the condition struggle with self-awareness and how others perceive them. This makes them extremely sensitive.
BPD is a mind and body condition. Its symptoms begin to manifest during the early teenage years and gradually improve during adult life.
What Is A Personality Disorder
Since BPD is defined as a personality disorder, its useful to know whats meant by this term as well.
Personality disorders are defined by a persons way of thinking, behaving and feeling. Everyones personality is different, but when someone has a personality disorder their thoughts, feelings and behaviors veer from cultural expectations, cause problems in functionality and lead to distress, especially for the people around them.
There are ten personality disorders, and these typically begin to appear by early adulthood.
Personality disorders can be treated, and some people see good outcomes. Psychotherapy, also known as talk therapy, is the primary form of treatment for personality disorders including borderline personality disorder.
While doctors and researchers arent entirely sure what causes personality disorders like BPD, its likely a combination of genetics and differences in certain areas of the brain. In particular, someone with BPD might have differences in the parts of the brain that manage emotions, aggression, and impulsivity.
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Are Bipolar And Borderline Personality Disorder Related
Although it is not yet clear-cut, research has not found a strong relationship between BPD and bipolar disorder. There is some evidence that people with BPD are diagnosed with bipolar disorder at higher rates than individuals with other personality disorders.
One study found that about 20% of people with BPD are also diagnosed with bipolar disorder. Only about 10% of people with other personality disorders also have a bipolar disorder diagnosis.
Another study looked at people diagnosed with both BPD and bipolar disorder within a 10-year timeframe. The results showed that the disorders appear to be completely independent. The studys authors stressed that its extremely important to treat each disorder individually for the best chance of symptom relief.
The 9 Symptoms Of Bpd
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How Is Bipolar Disorder Treated
Once properly diagnosed, bipolar disorder can be extremely well-managed, Cairns says. You probably know someone whos bipolar and you dont even know it, she says of treatment success.
Bipolar disorder is usually treated with a combination of medications and talk therapy. Following a regular sleep routine is also crucial, Cairns says. Once a sleep cycle is thrown off schedule, it can trigger symptoms and lead to a depressive or manic state, she sayswhich can make traveling across time zones risky for people with bipolar disorder.
Like many health conditionsphysical and mentalhaving a support team is also important. People with bipolar disorder who successfully manage their condition often count on friends, family, a significant other, a psychologist, and a psychiatrist, Cairns says.
Bipolar Disorder Vs Bpd
One of the most common misdiagnoses for BPD is bipolar disorder. Both conditions have episodes of mood instability. When you have bipolar disorder, your mood may shift from depression to mania, in which you experience elation, elevated energy levels and a decreased need for sleep.
Mood swings are also common in BPD, but they are usually more short-lived. In bipolar disorder, mood changes can last for days or weeks, but they dont usually last that long in BPD. Episodes of mania or elation dont usually occur in BPD. Instead, mood swings usually range from feeling fine to feeling full of rage or other negative emotions.
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Some Of The Symptoms Of Borderline Personality Disorder Can Include:
- Self-destructive behaviors such as reckless driving
- Impulsively spending large amounts of money
- Self-harming issues, such as cutting or burning
- Drug or alcohol misuse, dependence, or addiction
- Suicidal thoughts or ideations
- Confusion about ones place in the world
- Tendency to have a black or white view of events, along with habitually shifting interests and values in their own life
- Intense, sometimes volatile relationships with family and friends who they may hate in one moment and cherish in the next
- Periods of severe depression or anxiety
- Chronic feelings of loneliness and fears of being alone
Its important to note that intense stress or emotion can trigger many of these symptoms, even when these situations may appear normal or somewhat minor to others.
The severity and number of symptoms an individual with Borderline Personality Disorder experiences will also vary from person to person.
Differentiating Between Borderline Personality Disorder And Bipolar Disorder
While borderline personality disorder and bipolar disorder do share symptomatology, there are important features that can help clarify diagnosis:
Duration of Mood Disturbances
People with borderline personality disorder can experience profound mood volatility, with moods shifting on a day-to-day basis, often in response to environmental factors. People with bipolar disorder, however, have prolonged episodes of mania, hypomania, and depression and do not experience the day-to-day or minute-to-minute changes so often present for people with borderline personality disorder. As Dr. Allen points out, There is absolutely not one bit of credible scientific evidence that short-duration mood swings are in any way related to bipolar disorder. Additionally, while bipolar mood episodes can be prolonged, they are typically not ever-present people with bipolar disorder can have periods of wellness lasting weeks, months, or even years while people with borderline personality disorder typically have pervasive symptoms.
Both bipolar disorder and borderline personality disorder appear to run in families. The nature of mental health disorders present within ones family can provide important diagnostic clues.
Self-Harm and Suicidality
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Borderline Personality Disorder Vs Bipolar Disorder
BPD is a type of personality disorder that causes people to feel, think, relate, and behave differently than people without the condition.
Bipolar disorder is a type of mood disorder, which is a category of illnesses that can cause severe mood changes.
People with BPD experience an ongoing cycle of varying self-image, moods, and behaviors.
These patterns typically cause issues that affect a persons life and relationships and the way in which they understand and relate to others.
According to the National Institute of Mental Health, about 1.4 percent of adults in the United States have BPD.
Bipolar disorder affects a persons mood, energy, thoughts, activity levels, and functionality in cycles that can last for days to months. It is more common than BPD and affects an estimated 2.6 percent of the population in the U.S.
People with BPD experience instability in their self-image, moods, and behavior. These symptoms can lead to impulsive actions and problems with interpersonal relationships.
Symptoms of BPD include:
- impulsive or reckless behavior, such as unsafe sex, drug misuse, reckless driving, and spending sprees
- intense episodes of depression, anger, and anxiety
- chronic feelings of emptiness
- fear of being alone
Not everyone with BPD experiences all of these symptoms. Some people may have only a few minor symptoms, while others experience severe and frequent symptoms.
Some of the most common symptoms of mania include:
- extremely elevated mood
How Is Bipolar Disorder Diagnosed
Bipolar disorder is diagnosed in two major types: Bipolar I and Bipolar II. These types are defined by the experience you have with manic episodes. There are other types that involve less severe moods that dont qualify as type I or type II. Both manic major depressive episodes are identified by a set of symptoms. According to the fifth edition of the DSM, to qualify as a full manic episode, you have to experience three of seven common symptoms. These symptoms must last for one week or require hospitalization. The symptoms include:
Experiencing fewer than three of these symptoms or experiencing them briefly may qualify as a hypomanic episode, mild mania that falls short of a full-blown manic episode. A major depressive episode also has a set of symptoms in the DSM. To qualify as a major depressive episode, you must experience five of nine common symptoms, which include:
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Diagnosing Borderline Personality Or Bipolar Disorder
Welcome to Priory Bitesize, your monthly e-bulletin in which a mental health expert will discuss dealing with certain conditions to support your patient discussions.
This month, Dr Judith Mohring, Consultant Psychiatrist at Priory Wellbeing Centre Fenchurch Street in London, talks about the challenges in diagnosing borderline personality disorder and bipolar disorder.
A common question asked by GPs is whether a patient has BPD or bipolar disorder.
Having worked in a specialist BPD service and having set up a service in Holloway prison for women who self-harm, it was a question I felt reasonably confident to approach.
Despite this, teasing out different symptoms and making a clear diagnosis takes time and is complex. Changes in the understanding and description of bipolar disorder have added to this complexity. A thorough assessment by a specialist in general adult psychiatry can be enormously helpful to patients and GPs in guiding further treatment.
This article focuses on the diagnosis of the two conditions including:
- Controversy over diagnosing BPD
- The benefits of making a distinction between personality and mood disorder
- The core features of BPD
- The core features of bipolar disorder
- Distinguishing between the features of each condition
- A brief overview of treatment options for each condition
Here Are Some Of The Symptoms Of Bpd:
- Constantly changing ones interests and/or values
- Uncertain about their role
- Tendencies to view things as black and white
- Changing opinions about things quickly
- Patterns of unstable and intense relationships, with feelings alternating between love and hatred
- Distorted and unstable sense of self
- Intense mood swings
- Attempts to avoid real or imagined abandonment
- Finding it difficult to trust people
- Self-harm behavior and/or recurring suicidal thoughts
- Dissociation feelings
- Intense depressive, anger, or anxiety episodes
- Fear of being alone
Treatment and Outlook for both
When diagnosing BPD or bipolar disorder, mental health professionals will ask patients questions regarding the symptoms experienced, their frequencies, and durations. They will also ask about the patients family history and other information to come up with a diagnosis.
As for treatment, it will take time and patience for both disorders. With BPD, there is no medication used as standard treatment, nor are there any approved by the US FDA yet. The standard of treatment for BPD is therapy and behavioral treatments.
Certain medications may help in managing symptoms though, like anxiety or depression.
As for bipolar disorders, there are various treatments, such as:
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Bpd And Other Personality Disorders
Many people with BPD also meet the criteria for a second personality disorder. Personality disorders that often co-occur with BPD include:
- Narcissistic personality disorder
- Antisocial personality disorder
- Histrionic personality disorder
Narcissistic personality disorder, antisocial personality disorder, histrionic personality disorder and BPD are all part of the Cluster B group of personality disorders. Overlapping traits include manipulative behaviors and impulsivity. Histrionics and borderlines both tend to engage in attention-seeking behavior and emotional displays that can quickly shift.
People who have both BPD and narcissistic personality disorder are typically very destructive when it comes to relationships. Extreme fear of rejection, intense emotional displays, lack of empathy for others, and manipulative behavior make interpersonal situations very difficult.
Schizotypal personality disorder traits that overlap with BPD include ideas of reference and paranoid ideation. Odd or eccentric behaviors and beliefs, and excessive social anxiety are characteristic of schizotypal individuals.