Q. I really need to know something that I've been searching for an answer for. I will tell you my present diagnosis but please don't let that change what your answer would be if you had not known my present dx. I have borderline personality disorder and also either unipolar depression or bipolar disorder. I need to know, how do you tell the difference between bipolar disorder and BPD? I know you may be thinking that the diagnosis is not necessarily so important if the medication I take is working. This is important to me. I can't seem to get a very straight answer from my psychiatrist. Although she has me diagnosed with depression and bpd she refers to "the day I was manic in the hospital". I have worked very hard to overcome the negative traits of BPD and there are times where even though there are NO BPD TRAITS coming through, my moods are still going all over the place. Most recently I had an episode of being high/manic/hypomanic for 3 days straight. It didn't stop. I wasn't sleeping nearly as much as I normally do, was talking really fast, ideas were coming to my brain very fast, and I was thinking I could do all sorts of things. This all changed in one second when my sister said the wrong thing to me and I flipped out. I started yelling and swearing at her all of a sudden, and my mood went down from there. I did not go into a bad depression but I was down for a few days. All this happened while I was not taking an antidepressant but was still taking lithium. This was not antidepressant induced.
How do you tell the difference? I am so tired of everything being blamed on BPD in my life. I know that I have gotten past the traits of BPD for the most part. It is a diagnosis which is truly not affecting my life very much anymore. Yet I still have moods that go everywhere on the scale. As I understand it, our moods swing so much as a coping mechanism, but if I'm not having trouble coping, why are my moods still so crazy?
A. No one can figure it out. The major problem is that you are neither diagnosis, and yet both. If they call you BPD, you have a personality disorder and the hospital does not get paid. Yet, you are clearly depressed and irritable at times. Both BPD and bipolar are mood disorders. Things we cannot fix we put on Axis II (personality disorders) and things we can we put on Axis I (bipolar). Depression, schizophrenia, and obsessive compulsive disorder were all on Axis II in my lifetime. As we learn to fix things, they move to Axis I.
You already have the right answer in a way. As long as your treatment works, all is okay, since no disorder is present. Get on the right medications, and go on with life. The diagnosis really does not matter unless it helps get the right treatment.