BPD Ptsd vs bpd

[Friday]

When you're dealing with someone who is both borderline + PTSD? It's going to be virtually impossible to distinguish which is which, unless you're really expert in one or the other.

Similar to if you're dealing with someone who is ADHD + PTSD. Or OCD + PTSD, or really just about any disorder paired with another. All disorders share symptoms, and comorbid disorders usually feed into each other, often blurring the lines between symptoms until they're WTF is it??? I don't know! Until? You start dealing with someone who is only ABC. Then it becomes rather glaringly obvious the difference between disorders.

Even then, though, it can get a little quirky... As most disorders don't predict personality... And when you're dealing with PTSD there are a lot of 180 reactions (fight vs flight). So you've got people's individual personalities changing how symptoms present & are handled, as well as individuals who have these symptoms/expressions/coping mechanisms... But not those.

 

[Hojay]

Thank you! So the answer seems to land somewhere between "hard to tell" and "impossible to tell" :)

But deregulation of emotions is the best way to describe BPD for me.

That's interesting, and also clarifies why it's hard to make a distinction. I would say hyper-arousal in PTSD would be enough to "deregulate" emotions into their extreme, good or bad, which also goes back to the stress cup explanation floating around here. Perhaps mental health professionals are more likely to diagnose BPD rather than PTSD when the cause for the deregulation isn't immediately apparent or trauma history is ruled out?

My therapist says I am not the "typical BPDer", though, as most are very manipulative.

That's where BPD as a cluster of symptoms gets somewhat hazy to me. It's hard for me to understand how manipulation (for example) could be seen as a stand alone symptom and not as an expression of a symptom. E.g., deregulated fear may express itself in the need to manipulate and control one's environment. In that sense, I can see how PTSD could also display itself as somewhat manipulative, i.e. having to manipulate one's environment to control or prevent triggering situations. Perhaps the distinction would be that BPD manipulation is said to occur for the sake of manipulation itself, in other words, perhaps there is a narcissistic, psychopathic (in clinical terms) element in BPD that is not attributed to PTSD?

So you've got people's individual personalities changing how symptoms present & are handled, as well as individuals who have these symptoms/expressions/coping mechanisms

Which goes back to, "it's impossible to tell the difference" :) Perhaps there is a distinction between BPD and PTSD with coping mechanisms or expressions that mimic BPD. In that way, maybe it makes more sense to look at the symptoms displayed in PTSD that do not occur in BPD alone. Perhaps flashbacks (though I'm assuming BPD comes with emotional flashbacks as well? or non-relational triggers?

It's interesting to me that BPD may give way to CPTSD in the DSM some day. It make me wonder how people with BPD symptoms but no trauma history will be diagnosed...

 

[Sandstone]

ICD 11 isn't removing BPD, you can read their planned definition at ICD-11 Beta Draft - Mortality and Morbidity Statistics

They are adding CPTSD, and that is defined at ICD-11 Beta Draft - Mortality and Morbidity Statistics

The differences I see are

Relationships
BPD - unstable and intense interpersonal relationships .. extremes of idealization and devaluation;
CPTSD - persistent difficulties in sustaining relationships and in feeling close to others.
Self view
BPD - persistently unstable self-image or sense of self;
CPTSD - persistent beliefs about oneself as diminished, defeated or worthless, accompanied by deep and pervasive feelings of shame, guilt or failure
Origin of emotional volatility
BPD - affective instability due to a marked reactivity of mood
CPTSD - severe and pervasive problems in affect regulation

 

[Hojay]

This is really helpful @Sandstone. Thank you! The differences look subtle, but important.
This here:

extremes of idealization and devaluation

seems to have some similarities to NPD as well.

 

[lostforgottensoul]

That's interesting, and also clarifies why it's hard to make a distinction. I would say hyper-arousal in PTSD would be enough to "deregulate" emotions into their extreme, good or bad, which also goes back to the stress cup explanation floating around here. Perhaps mental health professionals are more likely to diagnose BPD rather than PTSD when the cause for the deregulation isn't immediately apparent or trauma history is ruled out?

Well, for me, BPD causes all emotions to be deregulated all of the time where PTSD stress cup (which is 100% correct) is only when the person is under a bit of stress. Theres more up and down motion for PTSD for me. There are times where I feel like I am on a more normal plain. Mostly when isolated as some of the most normal things in the world cause the hyper arrousal (which would give you one reason for PTSD isolation) but for BPD it is all emotions everytime I have them. It is a constant up extreme, down extreme. That was helped by the Seriquel but before that it was a never ending extreme roller coaster ride.

But, comorbidity causes a mesh together mess of symptoms. At one point I was a extreme emotion mess going off when someone asked me if it was raining outside. It was pretty bad which is why I was forced into therapy but for the longest time I had no even plain for emotions. It wasn't until I worked hard on both was I able to distinquish between them and even now it can be impossible to. But there are hallmark signs of BPD and then there were hallmark signs of PTSD when I first came into therapy. The BPD dignosis happened first as it was blaring obvious. But it still has a dignostic criteria that should be used to prevent misdignosis and then we went back to it once he made the PTSD dignosis to ensure it still fit and for what's in the DSM today, it does. But that's how you would prevent a misdignosis. My therapist also brings out the DSM and we go over the dignosis criteria and he ensures that we agree on what fits and what doesn't. So I am always part of my dignosis. Which helps prevent a misdignosis as well. I would encourage to ask a therapist to do that with you as I wouldn't accept the PTSD dignosis and it wasn't until we did that did I see that yes, it did actually fit me.

That's where BPD as a cluster of symptoms gets somewhat hazy to me. It's hard for me to understand how manipulation (for example) could be seen as a stand alone symptom and not as an expression of a symptom. E.g., deregulated fear may express itself in the need to manipulate and control one's environment. In that sense, I can see how PTSD could also display itself as somewhat manipulative, i.e. having to manipulate one's environment to control or prevent triggering situations. Perhaps the distinction would be that BPD manipulation is said to occur for the sake of manipulation itself, in other words, perhaps there is a narcissistic, psychopathic (in clinical terms) element in BPD that is not attributed to PTSD?

Manipulation of people. Like once I self harmed, took pictures of it, sent it to someone and said "look what you made me do". Stuff like that. Many BPDers talk about writing letters to people in their own blood. Someone in the service dog community that is a creator on youtube made a fake suicide attempt and posted a picture (was said to have been a friend) of what turned out to be an old picture of her in a coma in the hospital with a breathing tube (said person has a TBI and has seizures) on instagram (they have thousands of followers mind you) and then a friend ratted her out saying she was at work the very next day. I was rather affected by it and I spoke about it in therapy and my therapist said "what a BPD thing to do". So manipulation of people is what BPD is whether that's a cry for help, or a disprate attempt to avoid abandonment (which is the case for me) or what.

(though I'm assuming BPD comes with emotional flashbacks as well? or non-relational triggers?

Nope, not for me anyway. All flashbacks in every form is a PTSD thing for me.

Which goes back to, "it's impossible to tell the difference"

No, not impossible. Hard to tell when the person has both PTSD & BPD as they do mesh together but there are many things I can plainly say today "that's a PTSD thing" or "that's a BPD thing" which is how I know what to and not to post on here today. When i first joined I was posting a lot of BPD stuff as I really had no idea which things went with what disorder but today they are a lot clearer. Not fully clear and they do still mesh but a lot clearer.

The differences I see are

Relationships
BPD - unstable and intense interpersonal relationships .. extremes of idealization and devaluation;
CPTSD - persistent difficulties in sustaining relationships and in feeling close to others.
Self view
BPD - persistently unstable self-image or sense of self;
CPTSD - persistent beliefs about oneself as diminished, defeated or worthless, accompanied by deep and pervasive feelings of shame, guilt or failure
Origin of emotional volatility
BPD - affective instability due to a marked reactivity of mood
CPTSD - severe and pervasive problems in affect regulation

This is very helpful and I still see myself under CPTSD more. But the DSM doesn't have CPTSD yet thus no other dignosis can be made. The relationships, idealization & devaluation is the one symptom of BPD I don't have but I do have a difficulity in keeping relationships. And really same goes with all of them. I just fit so much more under CPTSD.

If the question was the differences of CPTSD and BPD then I couldn't help there. But PTSD and BPD do have many differences. And it seems even CPTSD & BPD in the ICD have some good differences.

 

[Friday]

Which goes back to, "it's impossible to tell the difference"

Only of you're not familiar with either disorder.

It's interesting to me that BPD may give way to CPTSD in the DSM some day.

I very much doubt it, as BPD is a personality disorder which requires being present from childhood... And CPTSD includes adult complex trauma situations like POWs & repeated tours of combat.

 

[Sideways]

seems to have some similarities to NPD as well.

No. Not at all. The idealisation and devaluation are in the way that they perceive others, not themselves. Often referred to as splitting, a BPD’er will have you on a pedestal one day, but then completely lose their trust in you the next day because of some perceived wrong.

NPD and BPD are both personality disorders, so they are both about dysfunction in the way the sufferers view themselves, others and the world. They both tend to result in major issues sustaining healthy relationships. But whereas a person with NPD has a pervasive of their own grandiosity, you’re more likely to find a person with BPD is the exact opposite.

 

[Hojay]

NPD also involves idealization and devaluation cycles. That’s about it in terms of similarities, (aside from manipulative behavior, too, I guess,) but that they do have in common.

 

[Cannottakethis]

I have CPTSD and BPD as well. I was able to work through a lot of my trauma while in the hospital, and then work more on the bpd through DBT and therapy. While I am definitely a work in progress, I know which symptoms are which for me...and where I may have been dysregulated by my past and/or current traumas...I’ve learned to manage my emotions more effectively so I can live a better life. So much work and still working on it.

 

[mumstheword]

It's seems like borderline people do a lot of projecting into others based on how they are feeling, rather than logically looking at the facts and assessing from there.

They cannot tell what is a perception based on their own extreme emotional state, from reality itself, in regards to relating.

I was misdiagnosed with BPD but a very slapdash psychiatrist who only saw me once. She didn't even bother to find out that I was in an abusive relationship from a very young age and had been badly gaslit.
I have never been a manipulative type, but I have suffered very bad depression and deregulated moods from a ton of abuse and neglect and trauma. I had very terrible self esteem from being subject to an abusive histrionic mother and depressed Aspergers Dad and sexual and physical abuse throughout childhood. I did self harm as a teenager, had eating disorder, substance issues, bouts of abusive and promiscuous sex with sexual predators (got stuck with one of those) and have had many episodes of hyperarousal and hypoarousal. But I identify with C-ptsd not bpd.

My current diagnosis, which is a consensus from my long term psychologist, New GP and new early sexual trauma T and I, is PTSD. But I believe that if it were in the current DSM manual I would fit the criteria of C-PTSD.

I'm pretty level in my relating. I'm considerate, honest, promote others empowerment and I'm consistently caring but I do avoid a lot and suffer quietly a lot. I still suffer from an extreme lack of confidence (although I'm a performance artist, go figure?) self esteem issues, shame, emotional dysregulation, I still struggle with food and alcohol a little bit not badly, I don't use any other drugs (anymore) . I am currently very hypoaroused a lot of the time.

My partner and I have both had relationships with people who fit criteria for BPD. I think when I got the diagnosis and I was still with my abusive ex, I had "bpd fleas" from him, because the symptoms went away when I left him but I still suffer from extreme PTSD symptoms. I have had and continue to have, a lot of therapy and will be attending a 3 week inpatients program soon.

Maybe I can help you clarify or may be some of my story helped? Disregard if not helpful.

 

[EveHarrington]

It's seems like borderline people do a lot of projecting into others based on how they are feeling,...

I don’t think anyone, regardless of disorder, is logically examining their feelings when their emotions are off the charts. At least not until further stages of healing.

 

[Sideways]

There seems to be a lot of misinformation now getting spread on this thread about what BPD is. Fundamentally, BPD is about instability in 3 core areas: relationships, self concept and mood.

While many people with BPD are perceived as being manipulative (and a lot of other horrible things), that’s not part of the diagnostic criteria. From the BPD people I know, there doesn’t usually seem to be an intention to be manipulative of others. Instability in their relationships and how they manage those? Sure. But BPD is not about a person setting out to be malicious and destructive.

While BPD doesn’t have to have any relationship with a history of trauma? There is an over-representation of people with a trauma history among those diagnosed with BPD. The link between BPD and trauma is not currently well understood.

Definitely I’d agree that having any kind of relationship with someone with BPD can be fraught with difficulty. But it is important to remember that (1) their illness is an indication that they are suffering a great deal; and (2) it is a mental illness, not an intentional maliciousness of character.

This is a forum for people with a mental health disorder (ptsd). I’m not a huge fan of promoting stigma about mental illness of any kind, which seems to be what’s now happening here in some posts.