Why are people with BPD so often misdiagnosed?

For years, I was diagnosed with major depressive disorder. One of my doctors said I had a form of bipolar disorder and only a few years later was I diagnosed with BPD. It seems that it is a frequent occurrence.

People with BPD typically also meet the criteria for multiple other diagnoses, including depression, anxiety, post-traumatic stress disorder, substance use disorders, eating disorders, bipolar disorder, and so on. These disorders, of course, are not independent of BPD, but are connected and related through shared psychological, social and biological pathways. However, when these other diagnoses are the focus of treatment, they can dominate professionals’ attention, preventing any significant focus on the whole pattern of difficulties, resulting in missed diagnosis of BPD.

This is one of the factors. It also doesn’t help that so many people keep important details about themselves a secret while being interviewed by a mental health professional.

woman-2696408_640

The fact that the diagnostics requirements are so arbitrary is also a reason why so many people go undiagnosed.

To be diagnosed with borderline personality disorder, a person must demonstrate a number of core traits or symptoms, as identified in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).But there is an inevitable degree of randomness or arbitrariness built into such standards. If an individual experiences just a few of these symptoms intensely or in a broad range of situations, their lives might be disrupted even more than someone experiencing even more symptoms at a manageable level. Nevertheless, they would not pass the diagnostic threshold for BPD, and if they had a BPD diagnosis in the past they might now be considered “in recovery.” If borderline personality disorder exists on a continuum with varying levels of severity, its rate of incidence may still be underestimated, given the requirement that a certain set of symptoms be detected before a diagnosis can be given. Should standards ever change to include those seriously impacted by fewer symptoms, the rates of diagnosis for borderline personality disorder could rise once again.

This is a major problem and something that should be solved by the mental health community. You can be severely affected by only a few symptoms and improve with DBT or medication for BPD.

There is also the myth that BPD isn’t treatable.

Some of the problems with diagnosing result from the fact that there was no evidence of effective treatment for BPD until the 1990s. The first published evidence for the effectiveness of Dialectical Behavior Therapy was by Marsha Linehan in 1991. Before then, many clinicians blamed people with BPD for not getting better, rather than acknowledging that professionals had not yet figured out how to treat people with BPD successfully, or trying to find more effective pathways for treatment. Today, unfortunately, many professionals continue to think that BPD is not treatable despite growing evidence that it is. This leads some professionals to avoid giving the diagnosis even when someone meets the criteria.

It’s a shame that so many psychiatrists and psychologists don’t know about DBT and how helpful it is for people with personality disorders like BPD. Though, according to my psychiatrist, every kind of psychotherapy can be helpful. If you don’t have DBT in your area, you can buy a book or ebook and do the exercises. You can ask a psychotherapist to do exercises from the DBT book. Some psychotherapists agree to it. Mine did. In my case, DBT was very expensive and now I’m doing therapy for a fraction of the price.

directory-466935_640

If you feel like you have been misdiagnosed, find another doctor. Find one that specializes in BPD or personality disorders. Don’t give up. It happened to me and a lot of us. Be as descriptive as you can, take notes during the week to discuss with your therapist. This helps doctors and therapists to have a clearer picture of what is going on with you.

Sources:

https://www.bridgestorecovery.com/borderline-personality-disorder/common-borderline-personality-disorder/

https://nami.org/Blogs/NAMI-Blog/October-2017/Why-Borderline-Personality-Disorder-is-Misdiagnose

Advertisements

When people with NPD and people with BPD are in a relationship

I have dated at least one person with NPD (narcissistic personality disorder) and it was a fatal attraction. It made me wonder if there is a reason behind that. It was the relationship that most impacted my life. So, I did a google search and it turns out that there is, in fact, a reason for that.

NPD is characterized by:

-Arrogance and being domineering

-Grandiosity

-Preoccupation with success and power

-Lack of empathy

-The belief of being unique

-Sense of entitlement

-Needs excessive admiration

-Exploitative

-Envious of others

https://howcanweknowus.weebly.com/the-9-characteristics-of-npd.html

Most people choose romantic partners who are their approximate equals with regard to understanding how to sustain intimacy.

https://www.psychologytoday.com/us/blog/understanding-narcissism/201711/why-do-narcissists-and-borderlines-fall-in-love

It feels addictive to date someone with NPD. There is an unusual bond and attraction.

We have the BPD woman, for example, who is emotionally volatile and has a fragmented sense of self. The NPD man, on the other hand, is emotionally numb.

It does not feel good for the person with NPD to be numb inside, so all that feeling the person with BPD provides is like nourishment for the person with NPD—it allows him (or her) to feel “something”—someone else’s intense affect. And the NPD provides safety and stability for the BPD.

If the person with BPD is a woman, she can’t blow her NPD man away or flood him the way she has all the more “sensitive” men in her life. He allows her to feel more secure and contained. BP Disordered people are often desperately dependent and their dependency can make NP Disordered people feel very important, which is necessary to them.

https://blogs.psychcentral.com/therapy-soup/2014/03/narcissistic-and-borderline-attraction/

The woman with BPD is attracted by the grandiosity and larger than life personality of the man with NPD. He seems cool and calm, it gives her security and stability. The adoration and charm of the woman with BPD are highly attractive to these individuals because of their need to be the center of the world.

It’s often an explosive combination: rapidly falling in love with each other only to find themselves trapped in an highly conflicted and ultimately disappointing relationship.

https://www.quora.com/Why-do-borderlines-attract-sociopaths-narcissists

My experience

Dating a narcissist is very challenging. The idealization phase of the relationship is very rewarding. We are showered with attention and gifts. The man is kind and flatters us. It’s all fake. Most people have a strong PR sense and narcissists excel at this. So, the person with BPD opens up and vents. This information starts to corrode the idealization. Then start the unkind comments and mocking, which are very invalidating. This invalidation leads the person with BPD to crave it more and more, always hoping that the person with NPD delivers. They tell you the sweetest things and then put you down as if you were the worst person in the world. This creates the type of “I hate you, don’t leave me” relationship, that people with BPD know so well. This conflict can be addictive and rewarding, in a twisted way.

It’s a destructive type of relationship and you know that people with BPD can have self-destructive tendencies so it can last for a while. In my case, it lasted almost 1 year and a half. I broke up with him twice. I was tired of being let down, of believing when he said he would change. He would cry and make promises like some abusers do.

Living with him was a nightmare. Arguing, bickering, the whole nine yards. An experience that hurt me and affected me for many years. Maybe still a bit today but nothing compared with the past.

I still seek his validation but not as much. We share songs and talk once in a while. We may see each other soon, have a cup of coffee somewhere and talk. It would be good.

Don’t hate the narcissist. He has his own limitations and reality tunnel. He is doing the best he can with the tools he was provided. But don’t forgive him so much that you go back to him unless you are aware of what you will deal with. Some people do it. I don’t know if they turn out fine or if the relationships last but I’d love to know.

Borderline personality disorder symptoms are different for men and women

As I was doing my morning google searches, I came across this article.

It states that according to two American Universities( University of Minnesota and Harvard affiliated researchers) BPD symptoms can be different for men and women.

The article also talks about the associated mental conditions:

“Very few people with borderline personality disorder are unaffected by other diagnosable mental health problems, the National Alliance on Mental Illness notes. Roughly 70 percent of all individuals with BPD have a form of relatively mild or moderate depression known as persistent depressive disorder or dysthymia. In addition, roughly 60 percent of all individuals with the disorder have symptoms of the more severe form of depression known as major depression. Other mental illnesses found in a substantial minority of BPD-affected people include substance use disorder, narcissistic personality disorder, antisocial personality disorder, eating disorders (binge-eating disorder, anorexia nervosa or bulimia nervosa) and bipolar disorder.”

BPD symptoms manifest differently for men and women. According to a study conducted on 770 adults (men and women) published in the Journal of Personality Disorders. It states:

“(…)The researchers concluded that women commonly develop BPD symptoms that differ substantially from the symptoms commonly found in men. Examples of the distinguishing characteristics of the disorder in women include a higher overall number of symptoms, a greater tendency toward depression-related and anxiety-related symptoms, more severe disruptions in the ability to maintain stable relationships with others and a rate of eating disorder exposure that’s even higher than the rate found among women in general. Conversely, men with BPD have meaningfully higher chances than women of developing the symptoms of antisocial personality disorder, as well as somewhat greater risks for the development of narcissistic personality disorder.

Interestingly, the researchers also concluded that some gender-related differences in mental health found in the general population do not tend to occur among men and women affected by borderline personality disorder. Examples of normally gender-centric problems that occur roughly equally in men and women with BPD include panic disorder, substance use disorder, obsessive-compulsive disorder, and suicide. In addition, men and women with BPD have unusually small gender gaps for two other conditions: post-traumatic stress disorder (PTSD) and major depression.”

Furthermore, BPD is more common in women than in men: “Women are diagnosed with the disorder about 200 percent more often than men, although men may actually have substantially higher chances of developing BPD than this statistic indicates.”

Source: https://www.borderline-personality-disorder.com/borderline-personality-disorder-research/borderline-personality-disorder-symptoms-differ-for-men-and-women/

Image by StockSnap, courtesy of Pixabay.

BPD is treatable

I see a lot of misinformation out there so I wanted to make one thing clear: BPD is treatable, it can remit.
I have found this article about it and also, this article.

The first one is a post from 2004 but still relevant today. It says that clinical trials show promise in treating BPD. It talks about how many people with BPD don’t seek out treatment and the ones who do are likely to drop out of treatment. One of the reasons is the black and white thinking. We start by idealizing our therapist and sometimes, for minor reasons, we start seeing them as bad. I’m guilty as charged, I have dropped out of therapy many times. I’m trying to stick to therapy now, I know it’s very important.

“the therapist needs to appreciate the reality of the client’s emotions. BPD patients require emotional acceptance–a DBT staple–because they often lacked it as children, says Linehan. In an invalidating environment, for example, a child might express anger and be told by a parent that she is jealous. “They never gain a sense that their needs, wants and desires are reasonable,” says Lynch, adding that such circumstances can lead to emotional difficulties and a problematic sense of self. DBT helps these people restore their sense of self, and legitimizes their emotional experience.”

The second article covers the evolution of effective BPD treatment and the prognosis of the condition.

“According to a longitudinal study by Dr. Mary Zanarini, over 90% of patients treated for BPD setting reported remission of symptoms for two years following treatment and 86% reported remission for at least four years. These findings are in line with previous studies that have shown similar results and paint a significantly more hopeful picture of borderline personality disorder prognosis than that typically advanced in popular culture. According to Dr. Jerold J. Kreisman, an associate clinical professor at St. Louis University,”

“It is now becoming clear that most [people with BPD] get better. Indeed, the long-term prognosis of remission of many symptoms is better in BPD than in major depression and bipolar disorder … As we develop better ways to define, treat, and, especially, understand patients with BPD, we will improve the ability to relieve the suffering inherent in this illness.”

So the prognosis is good for us. There is hope.

A combination of psychotherapy (DBT) and medication can help improve symptoms. In my case, DBT (dialectical behavioral therapy) and proper medication (including antipsychotics, two anti-depressants, a mood stabilizer and an anxiolytic for sleeping). I stopped being so moody, anger disappeared. I feel more serene and in control. Mental health apps like Wysa have helped me deal with the negative thoughts. They have decreased. Mindfulness meditation (which is the basis of DBT) is now a part of my life and it’s very helpful.

Medication by itself isn’t enough. It’s not going to teach you positive coping skills and strategies for dealing with BPD.

You and I can overcome this, I know it.

Image by ShonEjai, courtesy of Pixabay.

An interesting study on BPD and hypersensitivity

When I became a young adult, I became very good at reading people. I am hypersensitive. I see things that others don’t. It’s not something paranormal or out of the ordinary. It’s just the way I am. I notice things like actions, facial expressions etc.

Then I found this article:
“People with borderline personality disorder (BPD) may be better able to read subtle emotions on others’ faces than people without the mental illness, according to a study in the November issue of Emotion (Vol. 6, No. 4). An enhanced ability to recognize expressions of happiness, sadness, anger, and fear might contribute to the unstable relationships and intense emotions characteristic of the disorder, says Thomas R. Lynch, Ph.D., a psychology professor at Duke University”
Wow, if this doesn’t describe me, I don’t know what does.
“People with BPD’s sensitivity to the feelings of others might fuel some of the disorder’s emotional regulation problems, Lynch says. Slight annoyance on the face of a therapist, for instance, might be seen as heated anger, which could kick-start an easily tapped fear of abandonment, he notes. Even being hyperaware of positive emotions could lead to trouble for people with BPD, who might see intense love instead of mild happiness. That tendency could lead to the ill-advised whirlwind romances typical of people with the disorder, Lynch adds.

I’m very sensitive to detail but I’ve grown to accept that I’m not a mind a reader, neither do I want to be. Sometimes we think something is negative and it’s not.
Furthermore, it’s a skill, an important life skill. Once you have more stable emotions (it happened to me due to medication, and a more stable life), you will be able to choose your friends wisely and use that information you gather instinctively in your favor (as long as you don’t do it with malicious intent, or at least, I hope you don’t).
As you see yourself in a position to distance yourself from people that might be unstable, for the sake of your own mental health, you start to understand better those who chose not to stay in your life. You are not to blame if you distance yourself from someone who is unstable and doesn’t want help. In some cases, you don’t need to cut ties, just be more distant, while trying to understand how that person is progressing.

If you see yourself as strong enough or willing to accompany that person in their journey, please and encourage them to seek help.
If you are unstable, please seek help and know that I understand and I know how it feels to be that way. You will find solace, I promise. You are valid and loved. I hope my blog can help you on your journey.

Image by darksouls1, courtesy of Pixabay.

Reddit as a resource center for BPD

One website that I find useful for finding all sorts of information about mental health and many other subjects is Reddit.

Reddit is a social news aggregation site, which means you can access the best ( and sometimes worst) content online, from various sites, that is user-submitted. These posts are then voted up or down by other members. Posts are organized by subject into user-created forums called “subreddits”. Whatever you can think of, there’s a subreddit for it. Submissions with more up-votes appear at the top of their subreddit and, if they have many votes they can end up on the site’s front page.

I don’t recommend every subreddit but I will recommend the following:

º /r/mentalhealth

º/r/mentalhealthsupport

º/r/BPD

º/r/borderline

º/r/BPDsupport

º/r/dbtselfhelp

º/r/psychology

There are many more but these will suffice.Some of these subreddits are very active and it’s a good place to find information.or to vent anonymously. Never stop looking for answers and ask questions about mental health. I’ll be posting resources and information that I find in my searches.

I would like to share with you this post.

It’s about VR and the potential for being used as a means to treat mental health patients, in this case, with DBT (dialectical behavioral therapy).

I recommend /r/dbtselfhelp because it’s a complete guide to DBT and a place where you can ask questions about it.

I highly recommend DBT and you can do your own exercises if you can’t be guided by a professional.

Image by 27707, courtesy of Pixabay.

A frustrating day

Today was a frustrating day. I had two appointments and I missed both of them. I asked to be woken up and they forgot. One of the appointments was with my psychologist. I shouldn’t have missed it, I really need it. I need urgent help, this is unbearable. I wanted this day to be a different day. I wanted it to be a day where I did what I had to do. Alas, it was not.

Just another day inside, more frustration and more despair. I won’t see my psychologist this week, as the week ends tomorrow.

I feel frustrated, hopeless and numb. I feel like someone is blocking my path and that someone is me. I need someone to guide me in this darkness. I don’t know what to do and that is unsettling. I have to wait, once more. But I’m so tired of waiting.

I took a shower and that helped me a bit. I feel better but I still feel sad.

I need to go outside and I don’t want to. Same old story.

When will this end?

It has been so long since I went out “normally”. It feels like it was a lifetime ago.

I see upcoming events on Facebook and I feel like going but not really. I could see me going if I was teleported there and then back. The way to the places is the problem But no, once again, I am the problem. My conditions do not help and I feel weak for not being able to overcome this. I’m trying as hard as I can.

Image by Ponciano, courtesy of Pixabay.

Late afternoon thoughts

During the night, I feel this energy I don’t feel during the day. This creative flow of ideas and thoughts. Like my brain only wakes up at night. I feel alive at night. The worst hour of the day is from 6 pm to 8 pm. I don’t know why. It’s like I’m not used to it being dark already but when I fully adapt, I am ready to work on whatever I feel inspired to. I’m so glad I have my inspiration back. 3 psychotic episodes in, more or less, 5 years is too much for someone. lots of things have been taken away from me because of my reckless behavior. All because of a personality disorder. One that is very distressing and chaotic. I understand that some people chose not to be in my life because of my poor choices. I could do the same. Not everyone could take what I sometimes had to offer. My pain and despair; endless and chaotic drama. A never-ending stream of problems and seemingly unsolvable issues. One can argue that it is not us but the BPD and that is true. However, other people have the right to be scared of us. There are people out there who aren’t threatened by us and they love us no matter what. Those people are precious. Some people can see our potential and help us along our way. It’s wonderful when someone can see the potential in us, even when we don’t see it ourselves.

Sometimes, we are so buried in negative thoughts that we can’t see clearly. If you have BPD and are struggling, I believe in your potential. I know you are hurting and life can be overwhelming but don’t give up. It does get better with time: you learn how to identify symptoms early on and you know yourself better. You can overcome this.

I’ll be researching ways to help us and sharing here. We’ll find a way.

Thank you for reading this.

Image by MabelAmber, courtesy of Pixabay.

Daylio – a mood diary/tracker

Daylio is a free app I use every day. It allows me to track my mood, add what I am doing when I feel in some way. It has a good user interface and it’s easy to use. There are charts about many aspects. for example, what you usually do when you feel good or any other way. You can add an entry so it’s a low maintenance diary or journal, something that will only take a couple of minutes of your day. I usually several entries every day, as my mood changes. It’s also a way to keep track of your habits, to keep some and lose some. Sometimes superfluous things take a lot of our time. Daylio can help you take charge of your time, as you want.

Daylio for Android and iOS

 

 

It’s now or never

Hello, my dear readers. I’m feeling a bit overwhelmed. I have mixed feelings about this situation. I’m trying to focus on the positive side of quitting:
I won’t risk going to a police station one of these days. They would send me to a treatment facility since it would be the second time I would be caught.
No need to buy that and look for that.
More money for important things.
No more lies.
No more interference in my life.
More energy and life.
Could resume studying.

There is a world of possibilities and I want to be positive but I’m so scared. The next three days will be very hard. It’s going to be a challenge. Which is kind of exciting, I want to see if I can overcome this.

Quitting weed while having BPD (borderline personality disorder) is even more challenging, so I will be on my emotional wellness apps, all day.
I will also be meditating a lot tomorrow and I’m going to buy a few things to reward myself for quitting. This positive reinforcement is important.
I can finally stop dreaming and act to build my dreams. That’s exciting. I want to do something with my life. I want to live and experience more. I want to study again and work. I plan to get a part-time job at first. That would be great to keep me active and to be more independent. It’s important to make plans and deciding what is best for you.

I’ll give you updates tomorrow, my first day.

Image by rubberduck1951, courtesy of Pixabay.