Whats The Difference Between Borderline Personality Disorder And Bipolar Disorder
While borderline personality disorder and bipolar disorder have similar symptoms and are often confused for each other, theyre distinct conditions.
BPD involves a longstanding pattern of abrupt, moment-to-moment swings in moods, behavior and self-image that are often triggered by conflicts in interactions with other people. Nonsuicidal self-injury is also common in BPD but not in bipolar disorder.
Bipolar disorder is different from BPD because it involves distinct, longer-lasting episodes of mania/hypomania and/or depression. Several things can trigger manic or depressive episodes, such as sleep changes, stress, medications and substance use.
Presentation In Primary Care Practice
Patients with bipolar disorder present in the primary care setting with a wide range of symptoms, including depression, anxiety, mood swings, difficulty sleeping, irritability, fatigue, and inability to focus and concentrate.2528 They also may exhibit physical consequences of their illness, such as alcohol-related problems or sexually transmitted or drug-related infections. Patients’ social histories often uncover other sequelae of the illness, including relationship and marital problems, financial trouble, erratic occupational histories, and legal issues .17,25
Psychosocial and Health Problems Reported by 600 Respondents With Bipolar Disorder in the National Depressive and Manic-Depressive Association 2000 Surveya
aData from Hirschfeld et al.17
Abbreviation: NA=not available.
Patients with bipolar illness often have family histories of mood disorders.27 Suspicion should be aroused regarding the true condition of absent relatives such as an uncle in prison or a grandparent who died at an early age. These personal and family history warning signs, particularly in patients who have been diagnosed with major depression, should suggest that bipolar disorder may be the correct diagnosis.29 As discussed by Dr Manning in this supplement,3 the Mood Disorder Questionnaire is a screening instrument that may aid recognition of bipolar disorder.
What Medications Are Used To Treat Bipolar Disorder
Certain medications can help manage symptoms of bipolar disorder. You may need to try several different medications, with guidance from your healthcare provider, before finding what works best.
Medications healthcare providers generally prescribe to treat bipolar disorder include:
- Mood stabilizers.
- Second-generation neuroleptics .
- Antidepressants.
If youre taking medication for bipolar disorder, you should:
- Talk with your healthcare provider to understand the risks, side effects and benefits of the medication.
- Tell your healthcare provider about any prescription drugs, over-the-counter medications or supplements youre already taking.
- Tell your healthcare provider right away if youre experiencing concerning side effects. They may need to change your dose or try a different medication.
- Remember that medication for bipolar disorder must be taken consistently, as prescribed.
Mood stabilizers for bipolar disorder
People with bipolar disorder typically need mood-stabilizing medication to manage manic or hypomanic episodes.
Types of mood stabilizers and their brand names include:
- Lithium .
- Lamotrigine .
Thyroid gland and kidney problems can sometimes develop when taking lithium, so your healthcare provider will monitor the function of your thyroid and kidneys, as well as monitor the levels of lithium in your blood, as levels can easily become too high.
However, other medications, such as olanzapine , risperidone and aripiprazole , are commonly prescribed as well.
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What Are The Different Types Of Bipolar Disorder
Mental health professionals distinguish between 2 main types of bipolar disorder:
- Bipolar I This is characterised by extreme, long-lasting highs as well as depressive episodes, and may include psychosis .
- Bipolar II This is characterised by highs that are less extreme that only last or a few hours or days, as well as depressive episodes, and periods of normal mood.
Other types of bipolar disorder include cyclothymic disorder and substance-induced bipolar disorder .
CHECK YOUR SYMPTOMS Try the Black Dog Institutes self-test to see if you have symptoms that may indicate bipolar disorder.
Types Of Bipolar Test
These are some that a Doctor can perform to examine if you have Bipolar Disorder:
Blood Test
This is one of the bipolar disorder test. This blood test is used to rule out other illnesses that can trigger bipolar disorder. Its also used to determine if the patient has any thyroid issues. . It may screen for anemia as well as various illnesses. You can also test vitamins and calcium using these tests.
Tests for a variety of diseases and disorders are also done, including MRA to look for organ abnormalities. Blood tests, thyroid function tests, hormone levels.
Screening Test
The doctor will now inquire about your symptoms, treatments used. He or she can also ask about other medications youre taking. He or she will enquire any other relevant information to diagnose Bipolar Disorder. These are some of the screening exams that can help:
Some Other Tests
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Types And Causes Of Bipolar Disorder
There are two different types of bipolar disorder. People with bipolar disorder I have severe manic episodes, whereas those with bipolar disorder II experience milder episodes.
Bipolar disorder tends to run in families, and research suggests that certain genes may increase the risk. The condition is usually diagnosed before age 25, although some people experience symptoms for the first time later in life.
Some people with bipolar disorder also have attention deficit hyperactivity disorder, which usually develops before bipolar disorder. Other psychological conditions, including anxiety disorders, may accompany bipolar disorder.
It can be difficult to distinguish between depressive episodes that occur due to regular, or unipolar, depression, and those that occur due to bipolar disorder. NYU Langone is home to nationally renowned psychiatrists who specialize in identifying bipolar disorder. A correct diagnosis is essential to the appropriate management of bipolar disorder. Medications to ease symptoms of unipolar depression can actually trigger manic episodes in people with bipolar disorder.
To diagnose bipolar disorder, a doctor performs a physical exam, asks about your symptoms, and recommends blood testing to determine if another condition, such as hypothyroidism, is causing your symptoms.
If the doctor does not find an underlying cause of your symptoms, he or she performs a psychological evaluation.
Exploring Bipolar Disorder Treatment Options
If your doctor determines that you have bipolar disorder, he or she will explain your treatment options and possibly prescribe medication for you to take. You may also be referred to another mental health professional, such as a psychologist, counselor, or a bipolar disorder specialist. Together, you will work with your healthcare providers to develop a personalized treatment plan.
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Reflect On Your Symptoms
To help better understand your symptoms and pinpoint patterns in your behavior and mood, consider these questions:
- When do you first remember experiencing intense mood changes?
- How long do these changes typically last?
- What happens when you feel this way?
- How do you behave during an episode?
- What does your daily life look like during these times?
- What symptoms are you currently experiencing? When did they start?
- When do your symptoms tend to worsen?
Understanding Bipolar Disorder Treatment
If you suspect that youre suffering from bipolar disorder, its important to seek help right away. Bipolar disorder is a lifelong condition that runs an unpredictable course of ups and downs. When left untreated, these ups and downs can be devastating. The recurring manic and depressive episodes that characterize the disease make it difficult to lead a stable, productive life. In the manic phase, you may be hyperactive and irresponsible. In the depressive phase, it may be difficult to do anything at all. Early diagnosis and treatment can help you avoid these problems. An experienced mental health professional can make an accurate diagnosis and start you on the path to recovery.
Successful treatment of bipolar disorder depends on a combination of factors. Medication alone is not enough. In order to get the most out of treatment, its important to educate yourself about the illness, communicate with your doctors and therapists, have a strong support system, and help yourself by making healthy lifestyle choices that may reduce your need for medication. Its important to stick to your treatment plan, reassessing with your doctor as changes in your life occur.
What can I do to start feeling better?
Educate your loved ones about bipolar disorder. The more your family and close friends know, the better they can help you to cope with symptoms, spot triggers, and handle any crises.
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Can People Tell They Are Bipolar
People can often tell that something is wrong , but may not always be able to accurately label it as bipolar. For example, it is frequently easy for people to know when they are depressed, but sometimes symptoms of mania go unnoticed, or feel good, so they are not as easily seen as an issue, says Simon A. Rego, PsyD, Chief Psychologist at Montefiore Medical Center and Associate Professor of Psychiatry and Behavioral Sciences at Albert Einstein College of Medicine in New York City.
Ruling Out Other Conditions
There are no specific blood tests or brain scans to diagnose bipolar disorder. Even so, a doctor may perform a physical exam and order lab tests, including a thyroid function test and urine analyses. These tests can help determine if other conditions or factors could be causing your symptoms.
A thyroid function test is a blood test that measures how well your thyroid gland functions. The thyroid produces and secretes hormones that help regulate many bodily functions.
If your body does not receive enough of the thyroid hormone, which is known as hypothyroidism, your brain may not function as expected. As a result, you may have problems with depressive symptoms or develop a mood disorder.
Sometimes, certain thyroid issues cause symptoms that are similar to those of bipolar disorder. Symptoms may also be a side effect of medications. After other possible causes are ruled out, your doctor will likely refer you to a mental health specialist.
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Coping With Bipolar Disorder
Living with bipolar disorder can be challenging, but there are ways to help make it easier for yourself, a friend, or a loved one.
- Get treatment and stick with itrecovery takes time and its not easy. But treatment is the best way to start feeling better.
- Keep medical and therapy appointments and talk with the provider about treatment options.
- Take all medicines as directed.
- Structure activities: keep a routine for eating and sleeping, and make sure to get enough sleep and exercise.
- Learn to recognize your mood swings and warning signs, such as decreased sleep.
- Ask for help when trying to stick with your treatment.
- Be patient improvement takes time. Social support helps.
- Avoid misuse of alcohol and drugs.
Remember: Bipolar disorder is a lifelong illness, but long-term, ongoing treatment can help control symptoms and enable you to live a healthy life.
What Tests Will The Doctor Use To Make A Bipolar Diagnosis
Your doctor may have you fill out a mood questionnaire or checklist to help guide the clinical interview when they assesses mood symptoms. In addition, your doctor may order blood and urine tests to rule out other causes of your symptoms. In a toxicology screening, blood, urine, or hair are examined for the presence of drugs. Blood tests also include a check of thyroid stimulating hormone level, since depression is sometimes linked to thyroid function.
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When To Seek Urgent Care
Sometimes, a person with a bipolar disorder diagnosis may need emergency medical attention.
People with bipolar disorder should go to the emergency room or call 911 if they are:
- having suicidal thoughts
- having thoughts of self-harm
- a danger to themselves or others
Also, in some cases, a person who has bipolar disorder may not realize that emergency help is necessary. When this is the case, a friend or relative may need to intervene and get the person the help they need.
What To Ask A Potential Therapist
Vanessa Kennedy, PhD, director of psychology at Driftwood Recovery, suggests asking prospective therapists about their approach to treating bipolar disorder. Make sure theyre familiar with evidence-based practices and an advocate for medication, she says.
While theres no single approach to treating bipolar disorder, medication can be a powerful tool to help manage your symptoms, including mood changes, seizures, and manic episodes, according to NAMI.
If medication is part of your treatment plan and it likely will be its vital that your therapist supports you in taking it and provides strategies to help you stick with your plan.
In sum, you might want to ask a potential therapist:
- What types of therapies do you use to treat bipolar disorder?
- Do you think medication is important?
- How do you typically work with people who have bipolar disorder?
Bipolar disorder is a biologically based illness that responds well to medication, stress management, and sleep hygiene, notes Kennedy.
Several types of therapies include elements that can help with these aspects. Examples include:
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Unspecified Bipolar And Related Disorder
This diagnosis is similar to specified bipolar and related disorder however, it’s used when a doctor doesn’t have enough information to make a specific diagnosis. By using the “unspecified” diagnosis, however, you’d be able to receive emergency medical treatment if necessary, without needing to meet the full criteria of a bipolar diagnosis.
Can Bipolar Disorder Run In The Family
Yes, a family history of bipolar disorder is the most influential risk factor for bipolar disorder. If youre concerned about your mental health symptoms, make sure to ask grandparents or older family members if they remember anyone else in the family facing similar struggles.
Your doctor will ask about your familys history of mental health during your diagnosis.
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Why Is Bipolar Disorder No Longer Called Manic
In the last few decades, the medical world, especially the field of psychiatry, has intentionally made a shift from using manic-depressive illness or manic depression to describe bipolar disorder. There are several reasons for this shift, including:
- Healthcare providers used to use manic depression to describe a wide range of mental health conditions. As mental health condition classification systems, including the Diagnostic and Statistical Manual of Mental Disorders , have become more sophisticated, the new term bipolar disorder allows for more clarity in diagnosis.
- Theres a lot of stigma and negativity associated with the terms manic and mania, especially due to the use of maniac. Similarly, people use the term depression casually to describe periods of sadness that dont qualify as clinical depression. Using bipolar disorder takes the focus away from these two words. Bipolar disorder is more of a clinical, medical term and less emotionally loaded than manic depression.
- The term manic depression excludes the cyclothymic or hypomanic versions of the condition.
What Are The Symptoms Of Mania And Hypomania
Mania causes an abnormally high or irritable mood which lasts at least one week – but usually lasts much longer than this. It can develop quite quickly – over a few days or so. When you are high you will usually have at least three or four of the following:
- Grand ideas about yourself and your own self-importance.
- Increased energy. You also tend to move quickly and need less sleep than usual.
- Being more talkative than usual. You tend to talk quickly.
- Flight of ideas. This means that you tend to change quickly from one idea to another. You may feel as if your thoughts are racing.
- Easily distracted. Your attention is easily drawn to unimportant or irrelevant things.
- Full of new ideas and plans. Often the plans are grandiose and unrealistic.
- Irritation or agitation, particularly with people who do not seem to understand your great ideas and plans. Sometimes this can make you aggressive towards people.
- Wanting to do lots of pleasurable things . For example, you may:
- Spend a lot of money .
- Be less inhibited about your sexual behaviour.
- Make rash decisions, often on the spur of the moment. These can be about jobs, relationships, money, health, etc, and are often disastrous.
- Take part in risky exciting adventures.
- Drink a lot of alcohol, or take illegal drugs.
Severe mania may also cause psychotic symptoms where you lose touch with reality. For example, you may hear voices which are not real , or have false beliefs . These tend to be delusions of importance .
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Who Will I See
You may see your GP at first, particularly if you have a depressive episode. But, if they make a diagnosis of bipolar disorder, they will have to refer you to a specialist a psychiatrist. NICE guidance suggest that mood-stabilisers need to be started by a specialist7, even if your care is later taken over by a GP.
When you see a psychiatrist, you will also meet other members of the community mental health team . They will be able to help with emotional support, information, psychological interventions, and help with sorting out practical matters.
Once any medication you are taking seems to established and effective, your GP can take over most of your care, although they will usually want you to stay in touch with a psychiatrist and the CMHT.
How Long Does It Take To Diagnose Bipolar Disorder
Diagnosing the disorder can be done in one or two assessment sessions, says Simon A. Rego, PsyD, Chief Psychologist at Montefiore Medical Center and Associate Professor of Psychiatry and Behavioral Sciences at Albert Einstein College of Medicine in New York City. However, because bipolar disorder can be confused with other disorders such as depression and borderline personality disorder, getting the correct diagnosis can take some time.
For example, some research suggests that it takes an average of three and a half years to confirm a diagnosis of bipolar disorder after the first major mood episode, with other research suggesting it can take even longer, Rego says.
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