A question? Wondering?

I think this might have been asked before. Is it possible to have both Bipolar and BPD?

Hugs and respect to all

Sure, I don't see why not. I've seen many people on this site and on Reddit who've been Dx'ed with BP and BPD. BP is a mood disorder, while BPD is more of an emotional dysregulation problem.

Do you suspect you have both, or are you questioning your diagnoses?

Hi Fuzzy!

Great question! This question comes up often.

There is the idea that BP and BPD are basically the same "disorder." There is also the idea that people with BP all have BPD traits.

Bipolar Disorder is a mood disorder.
Borderline Personality Disorder is a personality disorder.

Both experience mood swings. Mood changes in Bipolar tend to last for longer periods of time.

The mood swings of Borderline Personality Disorder can occur rapidly and even several times a day. These rapid BPD mood changes have a tendency to be highly emotional responses to something occurring in the environment. The rather rapid, frequent mood changes/swings demonstrate what Bluebicycle has noted as "emotional dysregulation." BPD also includes other features which are not found in in BP.. I won't go into those.

A person challenged with both "conditions" will likely show/experience signs/symptoms of both.

I want to add some very important information:

Pdocs and T's used to fully believe a person suffering BPD would never recover. I mention this because there is still some old/outdated info around which reflects these old beliefs. Please do not be dismayed should you/anyone stumble upon any source of info which portrays BPD as a condition which cannot be successfully treated. These old beliefs are not true.

There are approaches available now (which were not available before) that truly assist the person suffering BPD to learn how to better regulate emotions, which helps in learning to negotiate healthier relationships and , quite often, assists in achieving very successful lives. While some medications might be used in treating BPD, BPD treatment now tends to focus upon learning/employing DBT and/or CBT skills, etc. This is extremely wonderful and very hopeful news for all!

I hope this answers your inquiry, Fuzzy, my friend!

@Wild Coyote very well said!

Diagnoses:
PTSD with Dissociative Symptoms, Borderline Personality Disorder, Generalized Anxiety Disorder, Fibromyalgia and Chronic Pain

Thank you Wild Coyote and all for your replies

Very well said Wild Coyote

Much love

Dr. Marks weighed in on this today...

YouTube

Perfect!
You are an amazing person, Fuzzy!
You are also a very precious friend!

I love you just as you are!

I would only add, having been the partner of someone with bbd for many years, that, while the episodes of extreme emotion dysregulation in bpd may be more sort of sudden, I guess, and brief, some folks with bp 1 have far more mood instability/lability at times during their/our illnesses than others. For example, I recently had a period of maybe 36ish hours in which I was extremely hypo, out of nowhere. Then, it vanished.

So, in practice, it can, in fact, be quite difficult to sort out the purely mood-related issues in these two illnesses. But as WC wisely states, there are a whole universe of other things that distinguish the two.

Years ago I was diagnosed with BPD. This was before I was diagnosed with Bipolar. I did show most of the symptoms and have a trauma history so it seemed to fit at the time. Later I was diagnosed with Bipolar 1 after a clear manic episode. I have had the same T throughout all of this and he believes I have had Bipolar since my teens and may have also had BPD. He thinks the BPD like symptoms I used to have were treated with intensive therapy. He actually specialises in BPD and that is why I was referred to him 10 years ago. He said it is a grey area between BPD and Bipolar at times so he still ins't completely sure if I had both or if it was just the PTSD and severe Bipolar with rapid cycling and mixed features at play. All I know is that my abandonment issues are gone and I am much more sure of myself and stable in the relationships I do have. Only therapy and a lot of working on myself could have achieved that. Not meds. With the Bipolar it is the opposite. Only the right meds got me stable. therapy helped me cope but without those meds I would still be in an episode.

I think that when pdocs, or when people self-diagnose, decide the diagnosis purely based on mood lability, you can get into a gray area, especially if one accepts the existence in BP of ultra-rapid cycling.

I think that when pdocs diagnose only on that basis, they can make serious mistakes. You have to take into account other characteristics, such as fear of abandonment in the case of BPD, and the extended length (usually) of episodes in the case of BP, to make an accurate diagnoses.

So I do believe the two can coexist, but I think there's a lot of faulty diagnoses out there as well.

The post above this one is the most intelligent one on this subject that I have come across. There are many pdocs that do not believe in extreme rapid cycling, such as intraday, for these same reasons. As a corollary to my arguememt, there are allot of poorly trained and vetted tdocs and pdocs out there.

Thank you, Tucson.

I wanted to add that in order to make this all important distinction (as the treatments are vastly different), pdocs need to take their time in making the BP diagnosis. You cannot discern if someone has certain issues with relationships based on one, two, three appointments. It will likely come out at some point, if nothing else then with the relationship with the pdoc him/herself, but it takes time.

I do not believe the BP diagnosis should be made until BPD has been fully ruled out.

Unfortunately, too many pdocs do not take the time and some are even loathe to officially diagnose BPD due to the stigma (and I do think it carries more stigma than BP, which is kind of the diagnosis du jour). On the other hand, there are some people with BPD who prefer the less stigmatized BP diagnosis, and do not share with their pdoc symptoms that might be more attributable to BPD.

Again, I do think you can legitimately have both, but I think BP is over-diagnosed in some cases. Some pdocs just don't bother...

And I do not agree with the stigma surrounding BPD: it is unfair and invalidating. Nowadays there is treatment: DBT. And I think, or assume, that if you put in the work, you can overcome it, or at least some characteristics of it.

I say all of this as someone whose brother was misdiagnosed for some time. Meanwhile, he had left a trail of very contentious, chaotic and hurtful relationships, including with me, and it just didn't have to be that way. He has worked at DBT and is now much better, not 100%, but much better, and I admire him for this, for putting in the work, and for accepting the diagnosis.