bipolar v borderline

[rayea]

hi -

Does anyone know of any good articles distinguishing bipolar from borderline personality disorder? Or.....anyone with knowledge? Thank you :) I know I have a DSM but.....

[batgirl23]

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!

Be careful though. We all have "Borderline" tendancies when under stress or feeling powerless. IMHO this is a very over-used term in psych and almost always used in a judgemental way and/or with derogatory intent.

[rayea]

batgirl23 you are probably so correct (what is IMHO)

[batgirl23]

IMHO = In My Humble Opinion

[rayea]

haha batgirl23 i thought it was some psych thing :)

[pinkiepieRN]

In my opinion, BPD'ers are "on" all the time, as if life were a stage. Whereas you may notice a patient with bipolar disorder when they're unstable (either manic or depressed), there's often no middle ground with BPD. I agree with the other posters here, about substance abuse and mental illness (affective disorders and personality disorders) going hand in hand.

That said, acting out, dramatizing things, not taking responsibility, etc. does not necessarily mean there's an underlying diagnosis to explain these behaviors. We all have our moments and even though it's a pattern for this lady, personality disorders are a complex thing and it's hard to tease out what may be learned behavior or a "pathology", for a lack of better words.

[Meriwhen, ASN, BSN, MSN, RN]

Be careful though. We all have "Borderline" tendancies when under stress or feeling powerless. IMHO this is a very over-used term in psych and almost always used in a judgemental way and/or with derogatory intent.

That said, acting out, dramatizing things, not taking responsibility, etc. does not necessarily mean there's an underlying diagnosis to explain these behaviors. We all have our moments and even though it's a pattern for this lady, personality disorders are a complex thing and it's hard to tease out what may be learned behavior or a "pathology", for a lack of better words.

Thank you both. Few things aggravate me more than people who are quick to slap the borderline label on difficult patients.

Yes, they could have borderline PD.

Or like dolcebellaluna pointed out, it could be learned behavior.

Or it could be that they are stressed, frightened, confused, overwhelmed, angry, forgetful...let's face it: hospitals, psychiatric or otherwise, are not fun places to be in when you're the patient.

[rayea]

thanks dolcebellaluna and Meriwhen - wouldnt the treatment (although i dont know other than behavior therapy how to help borderlines) be the same whether it is a learned behavior or from stress or actual borderline? i only like the terms because it actually helps me think that the person cant help the behavior and is not acting a certain way just to get what they want or manipulate - i think it gives me more patience

[VivaLasViejas, ASN, RN]

I don't know if this post will be useful so long after your OP, but a couple of features of borderline PD are an overwhelming feeling of emptiness and exaggerated fears of being abandoned. These are not prominent in bipolar disorder, and their presence can help to distinguish between the two diagnoses, which do overlap quite a bit. Another thing to remember is that bipolar is episodic in nature and that most BP patients experience relatively long periods of stability between manic or depressive cycles, while BPD patients usually do not unless they're receiving effective therapy. Medications are also less effective in BPD than in BP.

BPD mood swings also tend to be more extreme in their cycling---some sufferers will go though several different and distinct mood shifts in the space of a day, usually in reaction to external triggers of some sort. By contrast, bipolar mood swings often seem to come out of nowhere, although they too can be triggered by stress and other stimuli, and the cycling is much slower (although there is a rare type called "ultradian" mood cycling, which is very similar to the BPD pattern).

As to whether a patient can 'help' behaving in certain ways......I know from my own experience that BP patients in the throes of an episode have a GREAT deal of difficulty "playing well with others". I'm not sure that those suffering from BPD cannot control their actions, seeing as how it's a personality disorder as opposed to a mood disorder. But I'd like to think that while they get a bad rap for being manipulative, they don't have as much control over it as it appears, and that's where therapy and limit-setting can help.

JMHO......I'm not a mental health nurse, but I've worked with a lot of psychiatric patients and am one myself, so I pay attention to these things. Hope this is at least somewhat helpful.

[rayea]

hi VivaLasViejas(sorry this is blue my computer skills are not so 16 year oldish )thank you for your information - it was a while back but i always check back on things - brilliant stuff you said here and seems to help me distinguish better - thank you - just like in nursing school when you learn about a disease everybody is like omg i got it - well when i read all the psych stuff - i am still like omg i got it - guess we all have a little of everything cuz i certainly have never met someone who has it together all the time :) moderation and learn to laugh i guess - I do thank you :)r[/url]ayea (yup now it turns randomly black at the sign off hahaha) thanks now that i posted it i see it is underlined too - ha

[rayea]

so now the above post comes out correct - what on earth?

[rayea]

and VivaLasViejas

"Weeping may endure for a night......but sanity returns in the morning light."---Me - did you write this? love it :)

rayea

[VivaLasViejas, ASN, RN]

and VivaLasViejas

"Weeping may endure for a night......but sanity returns in the morning light."---Me - did you write this? love it :)

rayea

Yep---it came to me right after a horrendous mixed mood episode a few months ago.