BPD Bpd symptoms with a c-ptsd diagnosis?

[Blondie362]

Hi everyone,
Just wanted your thoughts, I have been under a shrink for two years, here in the UK you get can a CPA meeting which is where all your MH team have a collective meeting with you to see if you are getting the right support.

My previous shrink has left the recovery team, so meeting my new one was the first time at this discussion, after speaking about how I was doing she ask my coordinator if DBT should be arranged? this was after I was describing how I had been over the past few months( had many family and friend bereavements)

I only knew CBT so had a look on the net for DBT, and it seems to be tied in with BPD, reading the symptoms, I couldn't believe how acurate most were with how I had been since a child and my father was killed.

So do I approach this subject with my MH coordinator ? as this wasn't a one on one session with my shrink, and maybe she's seeing something else that the other shrink didn't, CPTSD and BPD can cross over from further reading on this subject...

Any thoughts appreciated, I am not looking for another label as I hate them, but just wondered what you guys think, would you pursue it and ask more questions?

 

[arfie]

I definitely pursue and question for as long as I have a doubt. I don't like to argue labels, but I do like a general understanding of what is being proposed and/or assumed. Yes, I often need to take leaps of faith in recovery, but I want explanations for each of those leaps.

 

[Hashi]

I'd be wary of symptom-checking. It's classic that you can look things up on the internet and come away with 15 new disorders you didn't have earlier that day. I know you're not self-diagnosing, but I don't know how helpful it is to be thinking about other conditions. If this feels like a missing piece of a jigsaw puzzle, that's one thing. If you're just looking at symptoms and thinking yes, yes, yes then I'd approach this a bit more cautiously. Symptoms of different conditions can really overlap, and it isn't only symptoms that make up a diagnosis.

Dialectical Behaviour Therapy (DBT) was originally developed for people with Borderline Personality Disorder (by the way, the forum asks everyone to put things in full the first time, because people don't know all the abbreviations other people might know. BPD, for example, can also mean Bi Polar Disorder, and people outside the UK - maybe inside it - may not know what an MH team is. I have no idea what CPA means.) Anyway, DBT is now widely used for other conditions including PTSD. I use DBT skills and I don't have Borderline Personality Disorder but I find it incredibly helpful for PTSD.

I didn't have the option of DBT outside paying for it myself in the private sector. I'm in the UK but in my area there are no mental health teams or anything available to me - they're broke. I certainly don't have access to a psychiatrist either, if that's what you mean by shrink. It varies, depending on where you live. Personally, I'd jump at DBT if it was offered to me on the National Health Service. For me, it's worlds apart from cognitive behavioural therapy (CBT), which I find much too limited.

I wouldn't necessarily jump at the idea of whether I might have another condition. Of course, ask your professionals anything you want to ask them. And if it resonates on a deep level, then for sure ask about it. What I'm not clear about from your post is whether there's some sort of missing link that Borderline Personality Disorder seems to explain for you. If not, if it's just looking at symptoms and relating, I think it might be a good idea to cross check those symptoms against the whole range of PTSD symptoms, before you start asking about the possibility of other diagnoses. Having done that, you might want to. I'm not saying you shouldn't, just saying be careful of lists of symptoms on the internet possibly distracting you from your main focus.

 

[macca]

Anyway, DBT is now widely used for other conditions including PTSD.

This was my understanding as well, especially complex PTSD.

 

[Abstract]

The UK has been a bit behind when it comes to using DBT for anything other than BPD. It was only offered to those with the diagnoses when it was already being widely used for trauma, complex trauma, eating disorders and other related conditions in the States, Australia and other countries.

But it has started changing in the last few years it seems and a scattering of those with PTSD are being offered it - without BPD. Not long ago most UK therapists didn't know anything about DBT.

From what you say I doubt she is recommending it as a result of an assumption of you having BPD. She wouldn't know enough about you yet from what you said here. It sounds like she is recommending it as a result of you having a difficult time recently and not being in a stable place. DBT is particularly useful to help someone cope with intense emotions and learn to moderate them.

As for BPD and "complex PTSD". The "complex" part of complex trauma mostly refers to personality issues that occur as a result of what happened. When those personality issues are severe enough then they may fit a personality disorder diagnoses.

You can have all of the criteria but if not severe enough it would still not be BPD.

I have to say though that like Arfie I would ask directly as I have a bit of a thing about professionals making assumptions which I don't know about. In that situation I would would want to know what they their reasoning is.

You are very lucky to be offered DBT. It's a bit like gold dust unless you are willing to pay a hefty fee.

 

[Hashi]

The UK has been a bit behind when it comes to using DBT for anything other than BPD.

The NHS is still behind - I agree with your gold dust comment. But I think the private sector is now fully embracing how helpful DBT is for all sorts of issues, at £200 an hour. :mad::mad:

 

[Abstract]

Agreed totally @Hashi! Its growing at an astounding rate - but the cost is truly shocking! With othher types of therapy you can always find a range of price choices.

It seems to me that they know that people are starting to be educated enough to ask for it and that they know thay can charge what they want!

I sometimes wonder if they are also doing it as a way of putting any extra levy on people who are likely to be demanding in therapy. It all seems very out of balance I have to say!

 

[Butterflywings]

Meh. Australia isn't as advanced as you think. In Qld where I was from, only those with BPD are referred to it. I was wrongly diagnosed as BPD (instead of my actual diagnosis which I had for years before that of bipolar and PTSD) and referred to a DBT group and in the end they withdrew the offer because the people running the group could clearly see I didn't have the impulsive behaviour or mood swings that respond well to DBT. It was so annoying for them to refuse to give me DBT because I didn't have BPD symptoms but keep insisting I had BPD so wouldn't provide me with any other treatment. The DBT could have helped by PTSD symptoms. Here where I live now there isn't any publicly funded DBT at all for adults. Only a child program. There is a one free 12 month group for adults run by a private organisation but it has a 12+ month waiting list. And a super expensive ($2000) group run over 4 months which starts once every 3 months. Neither asks for diagnoses - just for interest in doing it.

 

[Maggiemay]

I'm diagnosed with BPD as my primary diagnosis (or emotionally unstable personality disorder which it's now called - sounds even worse!!!) - I hate it!! So much stigma attached to it. If it was a label I could get rid of I would. I don't fit the criteria like I did 10 years ago but psychs I've seen still seem to think it's the best fit :( According to them I have 'PTSD symptoms' yet according to psychologist, who knows me better and seen me for more than an hour (!!!), says I have PTSD, and although complex PTSD is not an actual recognised diagnosis, she says that fits me far better than BPD...

In my head I feel BPD, although it's not the case, is saying I've done something wrong - I'm awkward and angry etc, whereas the complex PTSD tag respects the fact that I'm the way I am not due to me being at fault, but because of my past and various complex traumas... I feel very differently about them both and pick and choose which label to use with people e.g. Previous colleagues whilst I was off sick knew it was due to PTSD, yet I wouldn't disclose the BPD/Emotinally unstable PD as it sounds like I'm very unhinged (!!!) but with family they know the BPD diagnosis, but not PTSD - if they were to know it would cause issues as lots of my traumas are due to them and they will be awkward with me and say it's not as bad as I remember/I'm making things up/there's people worse off than me... Urgh!!! Too complicated!! :s 2 of my sisters are diagnosed as bipolar and I'm now showing traits (gone through a 2 month manic spell!) but they (psychs) won't officially diagnose me as apparently I'm already on the bipolar spectrum being borderline...

 

[Butterflywings]

Maggiemay, borderline PD is definitely not part of the bipolar spectrum. Never has been. Any psych who claims that doesn't understand the nature of bipolar and borderline PD. Bipolar episodes happens in discrete episodes, borderline PD does not have episodes (it can fluctuate in severity but there is no discrete episodes of it). Borderline PD also is something that is something that is there from early life and doesn't require a traumatic event as a trigger, PTSD on the other hand is always triggered by a specific event and a person does not have symptoms before the event. It can happen in early life but it can also start any time across the lifespan.

Misdiagnoses across bipolar/borderline PD/PTSD is an interest of mine. The three disorders are VERY different and the differences are obvious to any professional who bothers to study them properly.

Also, BPD/EUPD isn't about saying you've done something wrong. It's like any other mental illness. It's something people are born with. If you have it, it's not your fault, you haven't done anything and you're not a bad person. It's a difficult disorder to live with, and it's a difficult disorder for loved ones to live with, but it's a real illness and sufferers aren't bad people. My first husband and one of my best friends (of 25 years) both had BPD and I know first hand through knowing them that people with it aren't a bad person because of it. My exhusband is a bad person by choice, nothing to do with his BPD. And my friend is a wonderful person, one of the kindest people I know. She has BPD, it doesn't make her a bad person.

 

[Maggiemay]

I did some hunting online after she said it as didn't get it. It's relatively new concept - the spectrum is going from BPD at one end that is reactive and rapid mood swings that last hours/a few days, to bipolar 1 and months of mania. I don't like this concept however as makes BPD look less severe - for me it's equally as severe & debilitating as my sister who is bipolar 1.

I know people with BPD are not bad people and it's not their fault, but it's how I feel personally... I don't judge others, it's an internal belief about myself, just like the abuse being my fault... I have got. A place in therapy where I know this is not true, but really hard to undo what's ingrained within you...