How to Test for Borderline Personality Disorder
How to Distinguish Borderline Personality Disorder from Bipolar Disorder
Consider how long the extreme moods last.Bipolar patients will switch between mania (extreme highs and/or irritability), depression (sadness, hopelessness, despair), and sometimes periods of more "normal" mood in between. Each mood may last months or as long as five years. (People with rapid-cycling bipolar may switch faster.) In BPD, however, moods can shift in seconds or minutes.
Recognize the signs of mania in bipolar disorder. For both mania and hypomania, three or more (four if the mood is only irritable) of the following symptoms must be present and represent noticeable change from the person's normal behavior.
- Inflated self-esteem or grandiosity
- Delusions, such as believing you are famous or have special powers
- Decreased need for sleep - able to function on only two or three hours of sleep, or going for several days without any sleep at all
- Increased religiousness
- Unusually high energy
- Unusual talkativeness
- Racing thoughts
- Increased goal-directed activity—either socially, at work or school, sexually, (agitation)
- Unusually risky, dangerous behaviors—sexual indiscretion, spending sprees, reckless driving, drug/alcohol binges, foolish business investments
Consider relationship stability and fears of abandonment.People with BPD have an intense fear of abandonment by family and friends, and they may frantically try to avoid feeling abandoned.Their intense mood swings may mean rapid shifts between saying "I love you" and "I hate you," and this can put strain on interpersonal relationships.People with bipolar disorder tend to have more stable relationships.
- People with BPD have an intense fear of abandonment (real or perceived), and will take extreme measures to avoid separation or rejection.
- People with BPD often have extremely variable opinions of their loved ones. For example, a man with BPD might idolize his girlfriend in the morning and believe her to be flawless, then think that she is cruel and heartless after she cancels their lunch date.
Look at their past relationships.While both people with bipolar disorder and BPD may experience friction in relationships, people with bipolar disorder are usually better able to maintain stability in relationships, while people with BPD tend to have intense and unstable relationships.
Watch feelings of low self-esteem.People with bipolar disorder may struggle with self-hate during depressive episodes, but not during manic episodes. People with BPD experience chronic low self-esteem, which can lead to self harm and suicidal tendencies.
- In BPD, self harm or suicidal ideation/attempts are often in response to fear of rejection or abandonment.
- People with BPD experience chronic feelings of emptiness or worthlessness.
Consider emotional regulation.People with BPD struggle with emotional self-control, often leading to wild and unstable moods, impulsive behavior, and unstable personal relationships. They also have tendencies towards reckless and impulsive behaviors such as reckless spending or driving, and intense mood swings comprised of anger, rage, irritability, and depression that can last for several days. Watch for:
- Rapid changes in self-identity and self-image that include shifting goals and values, changing interests and self-concept at the drop of a hat
- Periods of stress related paranoia, loss of touch with reality—psychosis and/or disassociation, that can last from a few minutes to several hours, or sometimes longer.
- Impulsive, risky behavior—unsafe sexual escapades, gambling, food/drug/alcohol binges, reckless driving, reckless spending, self-sabotage (e.g. quitting a job or ending a good relationship)
- Intense mood swings that can last from a few moments, to hours, or days, such as rage, irritability, depression, self-loathing, anxiety, or shame.
- Inappropriate intense anger/rage, frequently losing your temper, sarcasm, bitterness, getting into physical fights.
Closely examine the person's mood changes.People with bipolar disorder may have symptom-free periods for weeks, months, or even years. They still have a "baseline personality" that is unaffected. People with BPD deal with more constant emotional turmoil.Furthermore, their emotions tend to change more quickly, and can be sudden and strong reactions to events in the person's life (like work, school, or family).
- Bipolar symptoms usually aren't triggered abruptly by a life event. People with BPD often have extreme reactions to life events due to their emotional insecurity.
- People with bipolar tend to have more discrete symptoms: either a manic episode, a depressive episode, or a period of time with no symptoms. Issues like impulsivity and grandiosity are limited to manias, problems like suicidality and terrible self-esteem are limited to depressive periods, and the person feels more normal when they don't have symptoms. The situation can be much more "messy" and unpredictable for a person with BPD.
Look at how the person sleeps.Bipolar disorder tends to impact sleep, with people going with little or no sleep during a manic episode and feeling especially fatigued during a depressive episode. People with BPD typically do not have sleeping difficulties, unless another disorder is involved.
Look at the person's history.Looking at the person's past can help you find signs pointing to one disorder or the other.People with bipolar disorder may go without symptoms for a long time, while people with BPD were often abused and have led chaotic lives.
- People with bipolar disorder may show no symptoms for years or decades until they have their first episode.
- People with BPD will usually have a history of turbulent relationships, which may end badly. The person with BPD can become extremely clingy, and may take drastic measures due to an acute fear of abandonment.
- A difficult childhood can cause BPD. BPD is often caused by a history of abuse and mistreatment, leading to issues with abandonment and identity. Bipolar disorder, however, may appear with no real explanation.
- Family history may be useful to look at.
Consider the possibility of both disorders. Some people have both bipolar disorder and BPD.Though these disorders are difficult to live with, with the right treatment, people can better learn to manage their disorders and lead better lives.
Talk to a doctor or mental health specialist.A doctor is best able to closely analyze the patient and their history, and arrive at a conclusion.
- Speak up if you have any concerns about misdiagnosis. Doctors are human, and aren't perfect, so it is possible for them to overlook things or make mistakes. Explain your observations and concerns.
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- Though these disorders can be difficult to treat, new methods of treatment are constantly being developed. Do not lose hope. Help is available. It is possible to enjoy a full and productive life.
- Look into treatment. Bipolar disorder is more of a brain-based issue, and is typically treated with mood stabilizers and/or antidepressants. BPD is based on difficulties coping with strong emotions, and is usually treated with talk therapy, especially Dialectical Behavioral Therapy (DBT).
- If you or someone you love is struggling with self-harm or thoughts of suicide please seek help immediately. ALWAYS take threats of suicide seriously. Contact your doctor right away, or if you are in immediate danger, please call 911. Counselors at the National Suicide Prevention Hotline are available 24 hours a day and can offer counseling referrals in your area. Please call 1-800-273-8255.
Video: Bipolar, Borderline or Both? Diagnostic/Formulation Issues in Mood and Personality Disorders
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Date: 10.12.2018, 01:35 / Views: 95371