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Bipolar and BPD
Does anyone know anything about a dual diagnosis of bipolar and BPD? Is it common?
Thanks!
KD
Thanks!
KD
I haven't been diagnosed with BPD, but it's an area of interest to me because of how much greater the stigma generally is toward BPD rather than bipolar disorder. BP is almost like a "diagnosis du jour", and so the increased attention and awareness have contributed to a greater acceptance. BPD has not received the same acceptance, I think, and neither have many other disorders. But anyway, to answer the actual question...
Like the others said, bipolar disorder and BPD share some symptoms, and their presentations can often be quite similar (especially when bipolar disorder becomes rapid cycling/ultra rapid cycling/ ultradian cycling). I think the personal preferences and opinions of individual doctors come into play strongly when distinguishing between the two disorders. Some may have a better understanding of the slight differences between them and the complex way in which they can present together.
Unfortunately, because of the discrimination against BPD that is often seen in psychiatric practice, some doctors will avoid treating these patients because of how difficult they perceive it to be, and how "difficult" the patients themselves are perceived to be (usually wrongly so). This is really unfortunate, because BPD can be extremely serious and debilitating, with or without an Axis I diagnosis on top of it, and it deserves some serious attention. While BP and BPD can share symptoms, they have very different treatment plans, and so some practitioners may feel more comfortable with certain modalities. I personally think that bipolar disorder should be treated with an emphasis on BOTH meds and therapy, but right now the emphasis is generally placed on medication. BPD often will not respond very well to medication therapy, but talk and group therapies, such as dialectical behavior therapy (DBT), are known to be helpful. So, if you receive both diagnoses, you will most likely be directed to pursue both courses of treatment simultaneously.
I think it's a pretty common thing to see both BPD and BP diagnosed together at present, for whatever reason. There are always trends in psychiatry, and this could be one of them. Again, it really comes down to the individual doctor and what he/she believes should be present to diagnose each disorder. They can both be hard to diagnose correctly, so individual interpretations are going to vary. I hope this reply made some sense!
Like the others said, bipolar disorder and BPD share some symptoms, and their presentations can often be quite similar (especially when bipolar disorder becomes rapid cycling/ultra rapid cycling/ ultradian cycling). I think the personal preferences and opinions of individual doctors come into play strongly when distinguishing between the two disorders. Some may have a better understanding of the slight differences between them and the complex way in which they can present together.
Unfortunately, because of the discrimination against BPD that is often seen in psychiatric practice, some doctors will avoid treating these patients because of how difficult they perceive it to be, and how "difficult" the patients themselves are perceived to be (usually wrongly so). This is really unfortunate, because BPD can be extremely serious and debilitating, with or without an Axis I diagnosis on top of it, and it deserves some serious attention. While BP and BPD can share symptoms, they have very different treatment plans, and so some practitioners may feel more comfortable with certain modalities. I personally think that bipolar disorder should be treated with an emphasis on BOTH meds and therapy, but right now the emphasis is generally placed on medication. BPD often will not respond very well to medication therapy, but talk and group therapies, such as dialectical behavior therapy (DBT), are known to be helpful. So, if you receive both diagnoses, you will most likely be directed to pursue both courses of treatment simultaneously.
I think it's a pretty common thing to see both BPD and BP diagnosed together at present, for whatever reason. There are always trends in psychiatry, and this could be one of them. Again, it really comes down to the individual doctor and what he/she believes should be present to diagnose each disorder. They can both be hard to diagnose correctly, so individual interpretations are going to vary. I hope this reply made some sense!
I have the history for BPD for sure.
I was digging through old posts on either this board or OCD and came across a reference to BPD. I had no idea what it was, but the symptoms match my issues pretty well. I showed the page to my husband (he's the sane one, LOL) without the term (because I thought he'd immediately say, no, you're not THAT before even looking). He thought it described me to a t.
On the other hand, I know I have bipolar... in that I have had the happy, life is awesome, I have so much energy, I love life hypomania that lasts a month or more and the horrible (suicide attempt) depression - that lasts forever.
Mental health stuff is so much more complicated than I could have imagined. My psych classes in college did not do this justice :P
I was digging through old posts on either this board or OCD and came across a reference to BPD. I had no idea what it was, but the symptoms match my issues pretty well. I showed the page to my husband (he's the sane one, LOL) without the term (because I thought he'd immediately say, no, you're not THAT before even looking). He thought it described me to a t.
On the other hand, I know I have bipolar... in that I have had the happy, life is awesome, I have so much energy, I love life hypomania that lasts a month or more and the horrible (suicide attempt) depression - that lasts forever.
Mental health stuff is so much more complicated than I could have imagined. My psych classes in college did not do this justice :P
I have been diagnosed as having both bpd and bipolar. I was diagnosed with bipolar first. They do have a lot of the same symptoms but I can tell you how I distinguish between a bipolar mood swing and a bpd mood swing. When I have a bpd mood swing it is almost always because of the environemnt I am in. With a bipolar mood swing, there is no external element that causes me to change moods. Also, bipolar mood swings last longer for me. I hope this helps some. Good luck!
Well, I was diagnosed with both. But, I have started to wonder about the BPD thing because in some ways I fit but in other ways I don't fit at all. When I go back to see the doctor I want to talk to them about it. I've met several others that were diagnosed with both. I've also heard that first some people get a diagnosis with BPD when their doctor isn't comfortable with diagnosing bipolar since they can mirror each other. I would assume it is common.
I happened to have asked the same question to someone of the name of psyvamp (a lady in the forum) through a PM. I received from her the following explanation, she said.
"there exists a subgroup within the borderline personality disorder domain where risk genes for bipolar illness may lead to a joint presentation of both illnesses (10). Hypomania (in the case of co-occurring borderline personality disorder and bipolar II disorder) may precede the emergence of borderline personality disorder in some patients, may surface a number of years later than when borderline personality disorder is first recognized, and in still others may become manifest at about the same time one is first diagnosed with borderline personality disorder." ("American Journal of Physchiatry")...
she iterated:
I believe that this-- along with other information that I have accessed, would demonstrate to me that one could have EITHER condition and develop the other as a co morbidity, or that BOTH conditions can exist in any given host.... BOTH genetics and environmental stimulii have impact on both conditions. A person can have both conditions, yet manifest only the symptoms of one disorder at a time-- or multiple symptoms of both disorders at once. The BPD, however, seems to be able to go into remission periods, similar to those remissions of cancer patients, whereas no symptoms occur for extended periods of time. BOTH BPI and BPII & BPD can be "controlled " fairly effectively for many patients-- with medications and/or psychotherapy...although that the greatest effects in "control" of either or both conditions is achieved through the continued monitoring, in depth family history, medication and psychotherapy in a long term setting.
That said... Yes-- to both, you may have either-- or even both. Many of the Symptoms of both disorders co-incide, they cross over so to speak. So that often times-- the two disorders are difficult or nigh impossible to completely distinguish one from the other.
she continued and said:
it is impossible to separate the two.... I think often times the bipolar is largely genetically predispostioned, environmentally triggered ( to a large degree) and that the BPD is quite often a 'side effect' or alternative coping mechanism caused by the initial bipolarity and it's affects on the individual psyche. As well as also seems to go hand in hand with the bipolarity -- is depression (major), PTSD (which can be a trigger for the onset of the bipolarity) generalized anxiety disorders, personality disorders ( coping mechanisms) and drug /alcohol addictions....
The reason why i was interested in BPD at that time and kept asking others like this lady, is the mania that i had, i also happened to have asked the same question to the BPD forum whether the BPD persons can get manic ?, and one answer i received as YES, so i didn't exempt myself from being possibly BPD instead of BP.
My modest view is that bipolarity is not a class of disease, because of the many many symptoms: fears, racing thoughts, ideal view to life: good and bad, distractability, procrastination, etc...etc...etc..endlessly, but a label that one call those who are amenable to being manic thus they need their brain to be stable using a mood stabilizer.
One other thing here that perplexes me is that many folks in this forum never took antidepressants, which i find EXTREMELY strange. bipolarity means 2 poles in english, so unless he is manic once and depressed once how can he be called bipolar. True some researchers (akiskal, Ghaemi, et al) classified BP into 6 types one of them as manic only, but i see the difficulty exists only for those who can be both. BECAUSE the unipolarly manic resembles the unipolarly depressed in some sense. Except possibly that at the time of mania he has psychosis whereas the 2nd can be more dangerous and harms himself. But both they need only one set of drugs: AP's for the 1st and AD's for the 2nd with no danger to revert to the other pole.
have a nice day
"there exists a subgroup within the borderline personality disorder domain where risk genes for bipolar illness may lead to a joint presentation of both illnesses (10). Hypomania (in the case of co-occurring borderline personality disorder and bipolar II disorder) may precede the emergence of borderline personality disorder in some patients, may surface a number of years later than when borderline personality disorder is first recognized, and in still others may become manifest at about the same time one is first diagnosed with borderline personality disorder." ("American Journal of Physchiatry")...
she iterated:
I believe that this-- along with other information that I have accessed, would demonstrate to me that one could have EITHER condition and develop the other as a co morbidity, or that BOTH conditions can exist in any given host.... BOTH genetics and environmental stimulii have impact on both conditions. A person can have both conditions, yet manifest only the symptoms of one disorder at a time-- or multiple symptoms of both disorders at once. The BPD, however, seems to be able to go into remission periods, similar to those remissions of cancer patients, whereas no symptoms occur for extended periods of time. BOTH BPI and BPII & BPD can be "controlled " fairly effectively for many patients-- with medications and/or psychotherapy...although that the greatest effects in "control" of either or both conditions is achieved through the continued monitoring, in depth family history, medication and psychotherapy in a long term setting.
That said... Yes-- to both, you may have either-- or even both. Many of the Symptoms of both disorders co-incide, they cross over so to speak. So that often times-- the two disorders are difficult or nigh impossible to completely distinguish one from the other.
she continued and said:
it is impossible to separate the two.... I think often times the bipolar is largely genetically predispostioned, environmentally triggered ( to a large degree) and that the BPD is quite often a 'side effect' or alternative coping mechanism caused by the initial bipolarity and it's affects on the individual psyche. As well as also seems to go hand in hand with the bipolarity -- is depression (major), PTSD (which can be a trigger for the onset of the bipolarity) generalized anxiety disorders, personality disorders ( coping mechanisms) and drug /alcohol addictions....
The reason why i was interested in BPD at that time and kept asking others like this lady, is the mania that i had, i also happened to have asked the same question to the BPD forum whether the BPD persons can get manic ?, and one answer i received as YES, so i didn't exempt myself from being possibly BPD instead of BP.
My modest view is that bipolarity is not a class of disease, because of the many many symptoms: fears, racing thoughts, ideal view to life: good and bad, distractability, procrastination, etc...etc...etc..endlessly, but a label that one call those who are amenable to being manic thus they need their brain to be stable using a mood stabilizer.
One other thing here that perplexes me is that many folks in this forum never took antidepressants, which i find EXTREMELY strange. bipolarity means 2 poles in english, so unless he is manic once and depressed once how can he be called bipolar. True some researchers (akiskal, Ghaemi, et al) classified BP into 6 types one of them as manic only, but i see the difficulty exists only for those who can be both. BECAUSE the unipolarly manic resembles the unipolarly depressed in some sense. Except possibly that at the time of mania he has psychosis whereas the 2nd can be more dangerous and harms himself. But both they need only one set of drugs: AP's for the 1st and AD's for the 2nd with no danger to revert to the other pole.
have a nice day
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