bipolar v borderline

batgirl23 · Aug 27, 2013

These two presentations are nothing alike. Do you have a specific question or an example?

Orca, ADN, ASN, RN · Aug 27, 2013

Bipolar disorder is an Axis I diagnosis and borderline personality disorder is Axis II. They are not competing diagnoses. I have known people who have both, and they are a handful. Take a person with a nasty disposition and give him/her a lot of energy to fuel it. It's a little piece of heaven.

rayea · Aug 28, 2013

I do know that they do not compete clinically - this is someone that cannot or will not keep a job, demands to be the center of attention or is angry, angry as hell all the time and states that everyone else is mean, lies to get money or get out of doing anything she doesn't want to do, recently states she is depressed and has threatened suicide several times, second marriage is completely falling apart and she will take absolutely no responsibility for her big part in it, talks (gossips) about everyone in a very negative way, has an addiction to percocet and blames the doc when he wont refill it early and on and on and on. (the depression seems to come on suddenly when her unemployment ran out and is now trying to get disability for three years and has been turned down three times and is appealing .) Thanks everybody!!!!!

batgirl23 · Aug 28, 2013

Could be personality issues and/or bipolar but very hard to assess with a current opiate addiction (may be a chicken-egg thing: addiction could be causing the "syptoms", could be exacerbating underlying/pre-existing issues and/or may have started as a means of self-medication). Sounds very challenging!

Meriwhen, ASN, BSN, MSN, RN · Aug 28, 2013

Unfortunately, personality disorders and substance abuse often go hand-in-hand. Not necessarily cause-and-effect, but each can exacerbate the other.

Whereas bipolar can be stabilized/controlled with medication (among other things), it's a lot harder to do that with personality disorders because a personality disorder can be likened to how the person is wired to function. Medications can help somewhat, but therapy such as DBT will go a lot further in addressing a personality disorder.

rayea · Aug 29, 2013

thanks batgirl23 and Meriwhen you guys are GOOD :)

Orca, ADN, ASN, RN · Aug 29, 2013

Dual diagnosis cases are particularly tough. The only way to eliminate the opiate as a causative factor is to discontinue, detox and see what remains. That may be difficult, if not impossible, to do depending upon the circumstances.

The way your original question was posed, you seemed to be asking how you tell bipolar disorder apart from borderline personality disorder. Since they may coexist and are not mutually exclusive, there is not a straight answer to that question.

rayea · Aug 29, 2013

thank you Orca - everybody on here is sooo refined in their knowledge - I think I better hit the books more often :)

Orca, ADN, ASN, RN · Aug 29, 2013

None of us started out that way. Time and experience teach you a lot. Reading it in a textbook is one thing, seeing it play out in front of you is quite another. People can describe pressured speech or borderline behavior to you all day long, but nothing beats having a front row seat for it.

Meriwhen, ASN, BSN, MSN, RN · Aug 29, 2013

None of us started out that way. Time and experience teach you a lot. Reading it in a textbook is one thing, seeing it play out in front of you is quite another. People can describe pressured speech or borderline behavior to you all day long, but nothing beats having a front row seat for it.

This.

A lot of what I learned in the textbooks (and hitting the books is never a bad thing, BTW) didn't really click or make sense to me until I saw it in action. Then it was like, "Ohhhhhh......."

imapsychrn · Aug 30, 2013

I'm fairly new and still learning and experiencing everything, but I can tell you - you learn to pick up on borderline tendencies right away! :)