BPD Diagnosis confusions - bpd/bipolar confused with ptsd - common?

[Lucycat]

My T and psychiatrist don't like labels for the very reasons presented in this discussion. I do have a diagnosis of CPTSD as I needed it for legal purposes - to explain my 'damage' in court. Other than that, we tend to discuss symptoms and treatment rather than whether it is due to X,Y or Z.

 

[shimmerz]

I am sensitive @Anna and can relate in a large way to the pain involved in living in this world when sensitivity in not seen as a strength. I have been lucky enough to find people who have helped me to use that sensitivity to tap into the natural intuitiveness that seems to come with sensitivity. Hang in there as there are people out there who understand what a beautiful gift it is.

@PureDogs , yes I think it is absolutely natural to want to get to the bottom of this - especially if - as you say in your post that with that diagnosis everything seems to 'fit' in looking back. It is a journey, I will not lie. Sometimes fascinating, sometimes terrifying, sometimes wonderous, sometimes so tiring, but definitely one that I embrace. If I had the chance to do it all again, I would not have chosen to ignore it - even after having been through all I have in healing.

Good luck @PureDogs and feel free to contact me at any time if you need support.

 

[Anna]

@Anna, not to cause further confusion but, the DSM actually states you have to meet 5 of the 9 listed criteria to receive a diagnosis of BPD.

Just wanted to clarify. :)

Yes, in this documentary the psychologist also says that as well. :)

 

[shimmerz]

@Anna, I really like this video as the doctor - rather than going with the normal attitude of BPD is SO horrible, says she embraces treating people who meet the criteria. She seems quite passionate and compassionate. Ah....to have access to doctors like this! Wouldn't it be fabulous @PureDogs if this were the standard in treatment provider models? Wow. What a different world this would be!

 

[anthony]

Bipolar is often confused for PTSD, however; BPD is not. Whilst the following link was about sociopaths, the rules apply to all personality disorders, and is still current under the DSM V: https://www.myptsd.com/threads/what-is-a-sociopath-personality-disorders-general.23710/

Personality disorders are complex, but having one does not mean you're a discarded piece of trash or such. Adulthood can be moulded for some, just not most when such disorder is present, OR; the person often reverts to personality disorder issues throughout their life as they deem required.

 

[Anna]

I found it had a huge impact on my relationships, even now as an adult. When under stress I find my illness becomes much worse.

Anthony, I heard that BPD and Bipolar often get confused, not PTSD?

 

[anthony]

Yes and no. Women are more likely to have BPD than men because people confuse their mood swings and irrational behaviour in adolescence for a mental health problem, when in fact all adolescents endure similar hormonal change.

Bipolar is severe mood swings... and whilst BPD encompasses that aspect, BPD MUST be present in adolescence and encompasses further issues such as self-harming and manipulating others. Bipolar does not encompass those factors. Bipolar is the old manic depression diagnosis.

The problem with many disorders is that they have overlapping criterion, unique criterion, and then trying to understand the specifics of the person in relation to the disorder... its all really a "best guess" from any therapist, as mental health can't be measured as readily as physical health can.

 

[joeylittle]

@anthony , I'm curious where you have gotten the statement "BPD must be present in adolescence". I've never interpreted the DSM criteria that way (in IV-R or 5) and am more aware of the reluctance to diagnose Borderline in anyone under 18, specifically because of the hormonal changes you mention.

"Early Adulthood", which does get referred to in the DSM, usually speaks to 18-25 as the age group (I believe). But I'm not an authority on the subject, and I'm interested in the questions around teenage and adolescent diagnosis for the personality disorders in general.

 

[TimeToHeal]

I agree, @joeylittle. I have always been told that one cannot be accurately diagnosed with a personality disorder until at least the age of 18, as the personality is not fully formed prior to that time. Also, some of the characteristics of BPD are often displayed in "typical" adolescents, simply as a part of adolescence.

I will say, that BPD - as any personality disorder - is FORMED in (early) childhood, however, a diagnosis cannot be given until much later.

 

[Anna]

In the documentary posted before by me in this thread, the psychologist says that people with BPD are born more emotionally sensitive compared to other people. Also there are recent MRI scans which show brain differences in people with BPD.

There is a reluctance to diagnose people with personality disorders as mentioned before the age 18 because of the personality developing. Problem is this can hinder therapy.

As a child I always felt different and I was always more emotionally sensitive to other people. I was invalidated on a daily basis. What other people would have brushed off had me reeling for days.

I know someone who had this happen to them, it was hormonal, maybe Bipolar, maybe BPD maybe this that the other, and due to their age noone could pinpoint it. As Anthony mentioned, it is not like a physical disease which can be measured that easily, and as we know even normal doctors often diagnose or take years to find out what physical ailments can be. :eek::rolleyes:

If you ask me, children and adolescents are very badly let down by the mental health system in general.

 

[TimeToHeal]

Yes, nature PLUS nurture (or a largely lack thereof).

 

[anthony]

"BPD must be present in adolescence"

What you say is correct, in that personality disorders are often diagnosed after the age of 18, however; that does not negate the primary criterion for all personality disorders to be diagnosed, which is what I'm saying above, is that they must form in adolescence in order to be diagnosed. You can't have a perfectly normal childhood, display zero symptoms of personality disorder/s, then at 40 be diagnosed with one, because as you stated, your personality is set in concrete pretty much beyond 18 to early twenties.

The characteristics of ALL personality disorders must be formed in adolescence.

Quoted from the DSM V, page 645, Personality Disorders:

"A personality disorder is an enduring pattern of inner experience and behaviour that deviates markedly from the expectations of the individuals culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment."

All personality disorders have a requirement that the features are traceable to adolescence / early adulthood, when the personality has not fully formed. If you read under each personality type in "diagnostic features" you will also read this per diagnosis basis, as well as symptom cluster requirements.