Borderline Personality Disorder Versus Bipolar Disorder

Q. I am currently in therapy for depression (dysthymia) and panic disorder. I tried to commit suicide in Arizona in April and there I was diagnosed with severe major depression, panic disorder, and a possibility of manic-depression. When I moved back to Ohio, I was diagnosed with dysthymia and a panic disorder.

I was concerned because I knew I had very unstable moods. I could change at any time without reason or provocation. It has been 3 months since I have been in therapy. My therapist just did an update on my accomplishments and my goals. When I went to sign the form I noticed that there was a third diagnosis that I was unaware of. It said r/o borderline pd. I had no idea at the time what it meant. Now I believe it means borderline personality disorder.

I often get very angry for no reason. Sometimes I feel as if I am losing it. I have tried to kill myself at least 8 times. (I am 23 years old).

As I read more about BPD I am more and more concerned. It all sounds so familiar. Could it be that what I always thought of as bipolar was really BPD? What is the main differences? Why was this not considered in Arizona?

I am also concerned that maybe my therapist or psychiatrist think I am either hopeless or just difficult. Does this mean that all those times I wanted to end my life I was really just looking for attention? I never told anyone what I was doing when I was trying to hurt myself. I also am concerned because I also get these strange urges to do really stupid things like put my fist through glass or punch a wall. Is this part of BPD? I have always controlled it before but now that my depression is starting to lift the urges are getting stronger. I know this is long but I am very confused and I don’t want to ask my therapist if she thinks I am hopeless.

A. First the major difference between bipolar and BPD is that the impulsive and self-destructive behaviors in bipolars is done as part of feeling great through hypomania and continuing on to mania – where the individual doesn’t believe he/she is vulnerable. Borderlines do their impulsive and self-destructive behaviors when feeling bad (dysphoric – anxiety, rage, depression, despair), because these behaviors work to stop the pain. They don’t care what happens to them.

The BPD is absolutely, positively not hopeless. It is also not your fault. Your symptoms are classic for the BPD. Spend time reading this website and learn more. You are ultimately going to be the one responsible for your treatment, recovery and life – and you can indeed have a great life.

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