Friday, May 14, 2010

back to the borderline/bipolar distinction

I think that borderline personality disorder and bipolar disorder are two different things, they can just really look like each other, especially when comparing BPD and BP-II. I'm worried about getting the wrong diagnosis. I have a long-standing pattern of extreme sensitivity to rejection, and mood/emotional reactivity/lability/instability, whatever you want to call it. I also sleep more and overeat when depressed, and I get that leaden feeling in my body. All if this is what defines atypical depression, but the first two could also point to BPD. In a previous post I went through the BPD criteria, but now I'm starting to wonder about it again...

1. Do I frantically avoid real or imagined abandonment? Not at the moment. I'm in a very stable relationship. I have in the past, but really I think it was more about rejection than abandonment. I also don't worry about being abandoned by most people. All of my stalking behaviours were related to becoming obsessed easily... this could be related to many things. Anyway, for me, it's more about fear/avoidance of rejection than anything else.

2. Splitting. Okay, I do tend to idealise people. But when do I devalue them? It's common to idealise people when one has low self esteem, but I definitely do not devalue people, especially not openly. Like I said before, I feel hurt very easily by people, but that's due to my sensitivity to criticism and rejection.

3. I may not be as impuslive as I think. I still manage to plan some things. I'm only really impulsive when I'm in a more manic-like state.

4. Unstable self image and sense of self. These have really improved with age, and I feel much more like my own person the older I get. I don't change my identity in any extreme way.

5. I really don't self harm that often.

6. Mood instability. Mostly my mood goes between depressed, normal and elated. I'm only irritable when I'm agitated.

7. Chronic emptiness. I don't always feel this way. It's only when I'm depressed, so I wouldn't say it's chronic.

8. I'm not really an angry person at all.

9. Paranoid ideation, delusions or dissociation. I've never been delusional. Any paranoia I've had was related to social anxiety or caused by drugs. I've only ever experienced the sort of depersonalisation that most people have experienced before.

I just think that even if I do have some of the symptoms, I don't have them often enough or across enough different situations. I also don't really have the most characteristic features. Maybe the psychiatrist is biased towards BPD, just like he's biased towards prescribing atypical antipsychotics.

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