Comparing Bipolar Disorder Vs Borderline Personality Disorder
Bipolar disorder;and;borderline personality disorder;are two mental illnesses that can cause significant disability and disruption in someones life. Despite being commonly grouped together or even used interchangeably in movies, TV, and other pop culture references, they are two separate and distinct illnesses that have different diagnostic criteria and require different treatments. Find out more about how psychiatry distinguishes these two disorders and how families, treatment organizations;and;communities can help support individuals with these diagnoses.
Properly Diagnosing Treating Patients With Bipolar Disorder And/or Borderline Personality Disorder
A proper diagnosis between bipolar disorder and borderline personality disorder have important implications as treatment decisions differ based on the diagnosis
A proper diagnosis between bipolar disorder and borderline personality disorder have important implications as treatment decisions differ based on the diagnosis. Moreover, some of these patients may actually have both disorders. The American Journal of Managed Care® recently spoke with Mark Zimmerman, MD, professor of psychiatry and human behavior at Brown University, about ensuring proper diagnosis, the prevalence of having both disorders, and the role of family history.
AJMC®: What are the consequences of not differentiating between bipolar disorder and borderline personality disorder?
The importance of differential diagnosis very much relates to treatment. The cornerstone of treatment for bipolar disorder is pharmacotherapy with psychotherapy being an important adjunct, whereas the cornerstone of treatment for borderline personality disorder is psychotherapy with pharmacotherapy being a potentially important adjunct. So, if you make the incorrect diagnosis, you may very well not be delivering the appropriate level of care.
AJMC®: What are best practices for ensuring proper diagnosis? What symptoms indicate one diagnosis or the other?
AJMC®:How prevalent is it to have both disorders, and does this make it harder to ensure a correct diagnosis?
What Is The Treatment For Bipolar Disorder
Treatment of bipolar disorder can help almost every patient. With the help of a suitable medical approach and expert guidance, you can control the symptoms of bipolar disorder.;
The process of battling the ailment usually depends upon how serious the patients condition is.; Here are some of the most commonly used methods of treatment:
- Psychotherapy:Psychotherapy, also known as talk therapy aims at identifying the thinking pattern of the person with bipolar disorder. You and a psychotherapist will sit in a closed room and have a conversation about your experiences. You share your troubling thoughts, emotions, and behaviors with the therapist to find a pattern and eliminate the issue.
- Cognitive-behavioral therapy: The therapist will talk to you about your problems and help you in identifying a pattern behind your behavior, thought, and emotions. They help in understanding your thinking patterns to come up with possible solutions.
- Psychoeducation:;Psychoeducation is a counseling pattern in which you along with your loved ones are made aware of the disorder. Just like any other disease, if you have complete information about bipolar disorder, you will be able to manage it correctly and reduce its effects on your body.
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Comorbidity Of Migraine And Personality Disorders
One previous study on borderline personality concluded that BPD comorbidity with migraine is associated with increased disability from the headaches.4 In addition, among those with BPD, there was an increase in medication-overuse headache, and headaches were more pervasive. There was a higher degree of depression among those with BPD, more unscheduled visits for acute headache treatment, and a lesser chance of adequate response of headache medications. Those with BPD were more severely affected by headaches, and more inclined to be refractory to treatment.4
Another study indicated that the incidence of BPD was increased in migraineurs.5 My recent study of 1000 migraineurs indicated that 5.5% of patients had a moderate or severe personality disorder.6 There is ample evidence that transformed migraine is associated with more prevalent psychopathology, including PD, than is episodic migraine. BPD itself is the mental health equivalent of chronic pain. In my experience, the two most important prognostic indicators for those with PD are impulsivity and substance abuse.
Explore The Role Of Nurse Practitioners In Treating Mental Health
Those in advanced nursing roles can play an important role in addressing mental health issues. Often, advanced practice nurses help care for those with conditions such as borderline personality disorder and bipolar disorder.
Psychiatric mental health nurse practitioners, for instance, use their analytical skills and knowledge in advanced concepts, such as contemporary psychotherapies and advanced psychopharmacology, to build effective care delivery strategies.
Regis College offers an advanced Master of Science in Nursing degree with an option to specialize in psychiatric mental health. The program cultivates expertise in assessing and monitoring mental health conditions.
With this knowledge, psychiatric mental health nurse practitioners are better prepared to effectively distinguish the difference between borderline personality disorder vs. bipolar disorder. They are also trained to ensure the proper diagnosis of other mental health conditions so patients receive appropriate treatment. Coursework also deepens nurses skills to develop and administer effective mental health treatment plans, as well as help patients develop healthy coping mechanisms.
Explore how the Regis College online Master of Science in Nursing specializing in psychiatric mental health prepares nurses to deliver vital care that can change lives.
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How Can You Receive A Diagnosis With Both Conditions
Most people who have a dual diagnosis of bipolar disorder and BPD receive one diagnosis before the other. Thats because the symptoms of one disorder can overlap and sometimes mask the other.
Bipolar disorder is often diagnosed first because symptoms can change. This makes it more difficult to detect BPD symptoms. With time and treatment for one disorder, the other may become clearer.
Pay a visit to your doctor and explain your symptoms if you think youre showing signs of bipolar disorder and BPD. Theyll likely conduct an assessment to determine the nature and extent of your symptoms.
Your doctor will use the newest edition of the Diagnostic and Statistical Manual to help them make a diagnosis. Theyll review each of your symptoms with you to see if they align with the other disorder.
Your doctor will also consider your mental health history. Often, this can provide insight that can help distinguish one disorder from the other. For example, both bipolar disorder and BPD tend to run in families. This means if you have a close relative with one or both of the disorders, youre more likely to have them.
The treatments of bipolar disorder and BPD are different because each disorder causes different symptoms.
Bipolar disorder requires several types of treatment, including:
BPD is primarily treated with talk therapy the same type of therapy that can help treat bipolar disorder. But your doctor may also suggest:
Characteristics Of Bipolar Disorder
Formerly known as manic depression, bipolar disorder is characterized by wide swings in mood and energy level. Periods of extremely high energy, euphoria, and feelings of grandiosity are some of the symptoms of mania, while extreme sadness, low energy, and hopelessness indicate the depressive cycle of this disorder.
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Medications For Bipolar Disorders
Once the bipolar diagnosis is established or suspected, mood stabilizers often are very helpful for both moods and headaches. Divalproex sodium is effective for mania, hypomania, depression associated with bipolar disorder, and for headache prevention. It has been extremely well studied for these conditions and has become one of the primary migraine and chronic daily headache preventives. Lithium carbonate is underutilized; it should be used more often. One or more of the newer antiepileptics may prove to be helpful for bipolar disorders and migraine. Carbamazepine has some utility as a mood stabilizer, but not for migraine prophylaxis. Oxcarbazepine is a milder form of carbamazepine, and may be useful.
Lamotrigine is becoming one of the most commonly used mood stabilizers. It is one of the few effective medications for bipolar depression.15 Doses must be slowly titrated due to the 1 out of 2,000-5,000 occurrences of toxic epidermal necrolysis, or Stevens Johnson Syndrome.
The atypical antipsychotics are also used for bipolar symptoms.16 When a mood stabilizer is effective, the underlying agitation, anger, or depression improves. Quetiapine has reasonable efficacy data. As a class, the atypicals do carry the risk of metabolic syndrome.
Access To Unapproved Drugs
Governments worldwide have created provisions for granting access to drugs prior to approval for patients who have exhausted all alternative treatment options and do not match clinical trial entry criteria. Often grouped under the labels of compassionate use, , or named patient supply, these programs are governed by rules which vary by country defining access criteria, data collection, promotion, and control of drug distribution.
Within the United States, pre-approval demand is generally met through applications , or single-patient INDs. These mechanisms, which fall under the label of expanded access programs, provide access to drugs for groups of patients or individuals residing in the US. Outside the US, Named Patient Programs provide controlled, pre-approval access to drugs in response to requests by physicians on behalf of specific, or “named”, patients before those medicines are licensed in the patient’s home country. Through these programs, patients are able to access drugs in late-stage clinical trials or approved in other countries for a genuine, unmet medical need, before those drugs have been licensed in the patient’s home country.
The was established in November 2001 by Frank Burroughs in memory of his daughter, Abigail. The Alliance seeks broader availability of investigational drugs on behalf of terminally ill patients.
In 2013, was at the center of a high-profile debate regarding expanded access of cancer patients to experimental drugs.
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Is There Another Way To Deal With Bipolar Disease
In Needlers experience;one way to deal with this condition is to have the therapist or healer communicate with ALL;the;souls concurrently;to get an agreement among them. He explained how and why this is beneficial:
- The primary soul is allowed to regain the status to animate the vehicle, while the passive soul will go back to being passive, so that the incarnation will be;successful.
- This can be done through the Quantum Healing Hypnosis Technique created by Dolores Cannon, as long as the healer can communicate with all the;souls together.
- A very good healer can also interact with the body energetically. They can communicate with the energies associated with the way in which the souls are positioned.
Needler said the;energy healer can reassign or repair the walls that may have been broken down in between the souls, and re-establish the demarcation lines between the passive and dominant souls.
When To See A Doctor For Borderline Personality Disorder Or Bipolar Disorder
Having occasional mood swings and feelings of sadness or depression is a normal part of life, but if you begin to have these symptoms or any of the symptoms of BPD or bipolar disorder on a regular basis, then it may be time to see a doctor. Because the symptoms of BPD and bipolar disorder overlap with other mental illnesses like anxiety, its important that a mental health professional checks out your symptoms to make an accurate diagnosis.;
Borderline personality disorder and bipolar disorder that go untreated can make life really hard. Psychiatrists and psychologists are trained to help people with these disorders have a higher quality of life, so its always best to seek medical advice if you think you have one of these disorders.;;
In addition, people with bipolar disorder or BPD who are having suicidal thoughts or behaviors should seek immediate medical attention and go to the emergency room. Not seeking help could result in self-harm or the harm of another.;
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Getting A Proper Diagnosis Is Key
Diagnosing psychiatric illness isn’t easy. There’s usually no lab test, physical indication, or quantitative measurement that can distinguish one illness from another, and often no magic bullet that can ensure effective treatment. Clinicians are dependent on a description of symptoms and patterns over time to make a diagnosis and these often appear similar even when the underlying illness is very different.
One example of this difficulty is in the incidence of borderline personality disorder being misdiagnosed as bipolar disorder. Both are characterized by impulsive behavior, mood swings, and suicidal thinking but have different causes and different treatments. Only an experienced medical professional can make the right diagnosis and determine appropriate treatment, but patients and their families can help by paying attention to their own thoughts and feelings and describing them accurately.
The key difference between bipolar disorder and borderline personality disorder is that bipolar disorder is a mood disorder and borderline personality disorder, as its name implies, is a personality disorder.
Mood disorders are characterized by drastic changes in mood that may come on suddenly or randomly without an apparent trigger. Depression is the most common mood disorder.
There Are Personality Traits That Are More Common In People With Bipolar Disorder That Arent Necessarily Related To Symptoms
Theyre not descriptions like narcissistic, depressed or irritable that only show up during episodes. These are traits that are always present, and it just so happens that we tend to have more in common than the items on the checklist used to give us the diagnosis. Here are a few examples:
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Environmental Factors That Aggravate Bipolar Disorder
Environmental factors can possibly trigger the development of bipolar disorder in people with a genetic predisposition to it. Diagnosis of bipolar disorder often follows traumatic or stressful events. Life-changing occurrences such as job loss or a death in the family can also be linked to the onset of the condition.
Environmental factors exacerbate bipolar conditions. Stress and lifestyle habits can act together to increase the likelihood of developing bipolar disorder and worsen its symptoms. Consider the impact of the following environmental factors on bipolar disorder.
- Lack of sleep: Not getting enough rest can provoke manic episodes
- Inappropriate medication treatments: Antidepressants when taken alone can trigger manic states
- Excessive alcohol use or drug use: Using these substances often triggers bipolar symptoms
- Traumatic head injury: Brain injuries such as concussions can trigger the onset of bipolar disorder
- High stress levels: Rape, abuse, and other traumatic life events can induce bipolar symptoms
Personality Traits Found In Those With Bipolar Disorder
Bipolar disorder is known for shifts in mood. People with the disorder go from manic or hypomanic to depression to remission in a mostly unpredictable pattern. These are just moods. They are not constant. They are not permanent aspects of a persons personality. Recognizing personality traits consistent in those with bipolar disorder may be important to predicting the course and severity of their illness. New research has come closer to confirming that there are three personality traits that those with bipolar disorder tend to have more than the general population.
There are hundreds of personality traits that can be used to describe a person. Are they adventurous or risk-aversive? What about innovative, intelligent, forgetful or disorganized? Rather than study each of the traits individually, psychologists have divided personality traits into five different categories, often called the Big 5. These are extraversion, agreeableness, openness, conscientiousness and neuroticism. Each of these acts as an umbrella to the other hundreds of traits.
A new study, led by Timea Sparding and published in BMC Psychiatry, sought to find if there are differences in personality traits not only between those with bipolar disorder and the general population, but also between those with bipolar I and bipolar II.
The researchers found that people with bipolar disorder scored higher than most of the healthy controls on:
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Does Bipolar Disorder Qualify Me For Social Security Benefits
The symptoms of bipolar disorder can be extreme enough to prevent an individual from working. If this is the case for you, you may qualify for Social Security disability benefits.
Bipolar disorder is a mental health condition characterized by alternating periods of mania and depression. There are two main types of bipolar disorder, Bipolar I and Bipolar II, and each may have slightly different criteria for diagnosis.
Bipolar I is characterized by distinct periods of mania and depression, though some individuals will also experience symptoms of hypomania, a state of mania where symptoms are milder. In order to be diagnosed with Bipolar I, manic symptoms must last at least one week and occur for most of the day every day or result in hospitalization.;Approximately 30% of individuals diagnosed with Bipolar I experience severe symptoms.
Bipolar I is most commonly diagnosed around age 18. Individuals with Bipolar I are often diagnosed with additional mental health conditions, such as anxiety. In order to be diagnosed with Bipolar I, individuals must also experience a period of significant depression.
Borderline Personality Disorder Treatment
There is not a Food and Drug Administration approved medication for the treatment of borderline personality disorder.
However, some medications, such as antidepressants or anti-anxiety drugs, may be prescribed to treat some of the symptoms.
Other treatment approaches include one-on-one counseling and group therapy.
Treatment methods like Cognitive Behavioral Therapy or Dialectical Behavior Therapy are also useful in helping patients with BPD express themselves and communicate with family and friends.
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How Bipolar And Borderline Personality Disorder Are Different
What is the difference between BPD and bipolar disorder, then? Some major components separate the two.
- Quality: While the disorders are both characterized by mood changes, the quality of the mood changes can be very different. People with bipolar disorder tend to experience mania and depression while people with BPD experience intense emotional pain and feelings of emptiness, desperation, anger, hopelessness, and loneliness.
- Time:;In BPD, mood changes are often more short-lived. They may last for only a few hours at a time. In contrast, mood changes in bipolar disorder tend to last for days or even weeks.
- Cause: Mood shifts in BPD are usually in reaction to an environmental stressor, such as an argument with a loved one, whereas mood shifts in bipolar disorder may occur out-of-the-blue.
- Degree: The mood shifts typical of BPD rarely involve elation. Usually, the shift is from feeling upset to feeling OK, not from feeling bad to feeling a high or elevated mood, which is more typical of bipolar disorder.