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Bipolar Disorder and Comorbid Borderline Personality Disorder

July 31, 2013 Natasha Tracy

Bipolar disorder and borderline personality disorder have crossover traits and so a person with bipolar disorder can often mistakenly be diagnosed with borderline personality disorder. In fact, some feel that diagnosis with both disorders is inappropriate unless the patient’s bipolar disorder is in remission.

But some people do meet the diagnostic criteria for bipolar disorder and borderline personality disorder. I would have put this number much lower than it actually is thought to be. From the research I’ve done, it appears that borderline personality disorder is comorbid to bipolar in about 20% of people with bipolar type II and 10% of people with bipolar type I (Note: this statistic was updated September 22, 2019).

But what is borderline personality disorder and what does it mean if you’re diagnosed with both bipolar and borderline personality disorder?

What is Borderline Personality Disorder?

Borderline personality disorder is so called because it was considered to be on the border between psychosis and neurosis. According to Medscape Reference, the Diagnostic and Statistical Manual of Mental Disorder (DSM-IV-TR) provides the following diagnostic criteria for borderline personality disorder:

Borderline personality disorder is marked by a pervasive pattern of instability of interpersonal relationships, self-image, and affects and marked impulsivity beginning by early adulthood and present in a variety of contexts as well as five of the following:

  1. Frantic efforts to avoid real or imagined abandonment (Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.)
  2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation
  3. Identity disturbance: Markedly and persistently unstable self-image or sense of self.
  4. Impulsivity in at least 2 areas that are potentially self-damaging (eg, spending, sex, substance abuse, reckless driving, binge eating) (Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.)
  5. Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior
  6. Affective instability due to a marked reactivity of mood (eg, intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)
  7. Chronic feelings of emptiness
  8. Inappropriate, intense anger or difficulty controlling anger (eg, frequent displays of temper, constant anger, recurrent physical fights)
  9. Transient, stress-related paranoid ideation or severe dissociative symptoms

Some of those symptoms, like suicidal behavior, do overlap but many do not.

Impact of Borderline Personality Disorder on Bipolar

The trouble is when people are diagnosed both with bipolar disorder and borderline personality disorder their courses of illness tends to be worse. People with both diagnoses tend to have a history of substance abuse and have had childhood symptoms of attention-deficit/hyperactivity disorder. Moreover, this dual-diagnosis group is at a higher risk of suicide.

Treating Bipolar and Borderline Personality Disorder

Two medications have shown usefulness in treating this subgroup. Divalproate has shown usefulness in treating symptoms like irritability, anger, volatility and impulsive aggression. Lamotrigine has also shown usefulness.

Of course, I would be remiss if I did not mention dialectical behavior therapy. This therapy was specifically designed to treat borderline personality disorder and is currently being tested in bipolar populations. While I know of no research on a dual-diagnosis group specifically, it stands to reason this group would see benefits.

In all, it’s critical to take any comorbid condition seriously as it can complicate treatment of any other condition.

You can find Natasha Tracy on Facebook or GooglePlus or @Natasha_Tracy on Twitter or at the Bipolar Burble, her blog.

APA Reference
Tracy, N. (2013, July 31). Bipolar Disorder and Comorbid Borderline Personality Disorder, HealthyPlace. Retrieved on 2024, March 28 from https://www.healthyplace.com/blogs/breakingbipolar/2013/07/bipolar-disorder-comorbid-borderline-personality



Author: Natasha Tracy

Natasha Tracy is a renowned speaker, award-winning advocate, and author of Lost Marbles: Insights into My Life with Depression & Bipolar. She's also the host of the podcast Snap Out of It! The Mental Illness in the Workplace Podcast.

Find Natasha Tracy on her blog, Bipolar BurbleTwitter, InstagramFacebook, and YouTube.

Bex
February, 24 2017 at 11:53 am

I have both. The personality started at a very young age mum wouldn't get nowhere with gp ECT as back then kids weren't labelled and helped like today. At 18 started antidepressants tried far too many up to 23 still not seen by mental health. Until I OD. Then from 23-30 DBT CBT got knows how many meds tried finally at 32 they tell me I have an emotionally unstable personality disorder with bipolar type 1. At 34 finally find lithium and lomotrogen combined work for me I'm 35 and I still ride the roller coaster of both setting each other off but more stable for longer periods. Find it so hard for people to under 1 let alone both combined and when triggered trying to explain which is what playing up ect is a nightmare. On top of this I have non specific widely spread chronic pain. Both physical and mental upset each other. I'm a single mum of 3 young children so very good at hiding my pain and mental illness from them the best I can. I find meds routine excersise good diet mindfulness using DBT CBT techniques and using my WRAPs folder together helps get me through it.

Twilight2016
June, 6 2016 at 12:12 pm

Hi All,
I know this article is old and most people haven't commented in over a year however I'd like some insight from the POV of someone who suffers/diagnosed with BPD and BP2. I was dating someone for about 3 years. We were really close friends with benefits. We eventually became closer over the course of 2015. He told me in 2014 (while in a hypomanic state) that he had been diagnosed with both as a teen. He is living unmedicated because he says he hates the way it makes him feel. For as long as I've known him he has not been on medication or therapy that I am aware of. With that being said I didn't do my homework on both conditions. I thought I knew what Bp was. I had friends that were BP and he did not act like them. In any case of course I started to see red flags and was always confused as to why he alienated me from his friends, always wanted to stay in, wanted to spend my money, would disapear for days sometimes weeks and also triangulate with another female friend of his. We definitley loved each other and I understood that sometimes he needed space but he started becoming distant in Feb. right after Valentines Day.
He began pushing me away. He took a trip to Las Vegas after he had been borrowing money from me left and right. I was shocked when he told me he was going. When I asked why he said he "Just needed it" and "it was time". I was confused and felt like there was something wrong so I didn't get mad at him I just told him ok and to call me when he got there. He did and he told me that he had a dream that his dead bestfriend told him he was going to win. I was then pretty worried but knew there was nothing I could do. He also was honest with me in the past about hookers etc when he goes to Vegas so I started to also wonder what was coming back with him. In any case he sent me a photo at 2 am, he was alone. He also tired to call but I was asleep. He called the next day and said he won and was going to leave early. He never called me when he came back until I reached out 4 days later asking what's going on. He was kind of strange so took him to dinner to tell him I cared and I was hoping the fight we had on Valentines day didn't drive him to run away like that. He told me it wasn't and we both said I love you's. He was fine for about 2 weeks however he was borrowing more money from me. Then he told me he needed $200 to go see his bestfriend. I told him no and gave him $50 and asked him to leave. He never takes work off yet he took 2 days off and went no where because no one would give him money. In my gut I felt like he was borrowing money to go out with another girl but I thought there is no way...
I see him a couple more times and he's getting more and more distant. We woke up and he said something mean to me in a joking way. For whatever reason with all the constant stresses I was really hurt. Plus what he said was awful. I called him out on it and he said sorry. He felt really bad etc. He didn't want to talk about it. After that night he left and blew me off for 2 days. When I spoke with him he sounded different on the phone. Like the call was staged or being had for someone else in the room. Really weird. That really made me mad because I felt like he was cheating. Usually I'm right. We went to dinner and had a great time and he paid me back the cash he owed me. Then he just ghosted me. Told me he was going to start buying furniture for his room etc. Told me he was going to buy a coffee maker and he doesn't even drink coffee. I was really over it and thought he was just using me and obviously cheating.
Finally on St. Patricks day I felt like he was blowing me off for the 2 time in a row even though he said he'd meet up with me. He told me he was going to go running (at 8pm) and call me after. I knew where this was going so I drank. I emotionally drank and ended up flipping out. I got really angry and felt used. I texted him a bunch of mean and horrible things telling him he was using me and a loser and he should F*** off and stay that way.
I didn't talk to him for about week. Sent an apology email. He told me he'd call me. Never did. Texted me we'd talk about it. Then not respond to me. I eventually started to freak out and went out again drinking with friends. I texted him I was in pain and to please talk to me blah blah. He continued to ignore me. I called and he blocked me. I was frusterated and went to his apt to speak with him in person. Long story short I was obnoxious knocking on the door till his roommate answered. She told me he wasn't there. I didn't believe her. On the way out I told her he was a peice of sh** and that he does stuff like this because he's bipolar. (quick side fact---months before he told me that his roommate knew and had a friend with BP)
I was drunk and ended up coming back about 5 minutes after she told me he was not there and knocked again. I called an uber to come get me. Then the cops showed up. When that happened I knew he was inside hiding. My uber came just in time and I left.
Woke up next day and caught myself feeling like an idiot for being pushed to my limits like that. I'm usually more controlled when it comes to situations like that. Now, I know he knew exactly what he was doing and just playing me to react crazy. It's not like this is the first time he's done this.
So going on we didn't talk. He iced me out and we didn't really communicate. I'd try but he'd ignore me. Finally one night I sent him a text and he called me. He told me some BS story that he was being kicked out of his apt and it was all my fault. He said that his roommate told him he had to move a couple weeks after I came over and caused a disturbance. He said she told him it was because she got a promotion but he thinks it was because I told her that he was bipolar. I knew this was BS but he was also nuts on the phone, blaming me for everything. Telling me he was really angry with me and thought about hurting me he was so mad. Then he told me that loved me but he was too angry to be around and he "never ever ever wants to talk to me again." I asked him what happened and why was he pushing me away. I told him I thought there was someone else. He told me there wasn't and some BS line saying "don't believe all those things you think in your head" In my head I was like whatever dude, your cheating.
Then he told me maybe we could be friends in a couple months but he's not sure. He then told me "good luck" and said "I'll talk to you later". I was heartbroken and shocked. I tried reaching out a couple times after that via text and no response. I finally cut all contact and changed my number. I had to reach out to him last month due to emails from my landlord that I had to ask him about. I called and we spoke. He was indifferent and the call was short. He asked about my dog and just sounded angry. Told me he didn't want to talk because he was at work. After that I sent a text that I was done with reaching out to him and I was cutting my phone line off again. That was the last time we spoke.
Any thoughts on this? Will he have any regret once he crashes? Do BP/BPD suffers regret when they have done breakups like this? Any advice on what I should do here?
Thanks!

In reply to by Anonymous (not verified)

Amahria
May, 16 2017 at 1:11 pm

This probably wont get seen as it was a while ago you psted this but hey worth a go..
I went threw something along the lines of what you were put threw but I allowed it to be repeated amd repeated and youre right, it makes you feel like an idiot and its true they do it to make you seem like youre the crazy one for losing control. It friggin hurts. Im 21 and my "friend with benifits/ partner" had bipolar and he was an addict which made things soso much crazier. The thing is that when they snap out of it that they will 8/10 will come back or make contact with you in some way and try "rekindle what you both had" becuase of some bs reason. But the BP will be works as their excuse or reason. Its honestly and i cant stress this enough, not worth accepting that reason and having them back with you again. Espesially if they arnt getting any treatment, because in a few months maybe even a year or more, it WILL happen again.. They will use you for money and leave. It will hurt just as much but you will feel even more stupid for letting yourself let it happen again.
Sure they regret the things they have done or said but they arnt sorry because it was the BP or it was the drugs or it was them feeling traped and too comfortable blah blah oh and that their wasnt anything to be commited too. Even after you lend them money or cook them breakfast (he even got me plucking his fucking eye brows and i hope you never had to do that lol).
But yeah if this helps just know youre always vunerable to letting his wedge back in to your life and youll think everythings back how it should have been before he went all fuck wit on you and it will feel like that for a time.. just if you do dont let yourself beleive you have the upper hand this time because you have your guard up or what ever, because you know how to "have your boundrys towards what he does" sure maybe you do but when he does it all over again and youre trying not to go crazy over it like last time, it means nothing.. It just hurts you the same all over again but you just feel completely out of control because you tryed to control it better this time and it didnt work for you or him. This might seem like a fuck men and BP but its not that, because he is still the person you love/loved but mental illness makes them someone else aswell that is damaging to their mindsets and lives untill they get legit help. Youve known him for 3 years but you have only known his BP for a short amount of time and It was cruel and crept its way to your head as it is for him. So im giving you insite to the likelyness of what could happen it you let it...
My X and I were living together for 2 years together on and off for 4 and its was a hell pit of anger hope naiveity, hate love hurt list goes on. He ended up getting a girl preganat when we lived together and went to jail 2 times, the amount of times i called the cops on him just to make it all stop and then be too scared to show them where he was hiding because i didnt want him to get mad at me is stupid. I help him when he was sad i laughed with him when he was happy and tolerated him when he was on drugs for so long and i trusted him when we opend our hearts in conversation and I loved him more then is healthy for a human being. And he left, came back when he was "better" then got bad and left agin and again and each time i put up more walls and rules for myself so i wouldnt get hurt becuase i expected he was going to leave i just hoped he wouldnt.. so only i get left with all these emothional and spiritual barries that only fucks me up when trying to make friends becuase he made me disconect from all my closest friends. Any way im rambeling.. sorry.. But if you get this i hope it helps, its also comforting to just have the insite even if you dont agree idk. Good luck with it all xxx

Emma
December, 22 2015 at 6:21 pm

I'm 38 and I've recently been diagnosed both BPD & BP1. My history suggests I was very stubborn in reflecting and identifying I had a mental health disorder. I am great at performing, especially my wellness. I've been violent and have taken huge risks which each time I have scathed jail time. My baseline is a loving and caring professional but in the past 9 months I have been in a mixed state which has sent me plummeting to the darkest depression then sky high - my behaviour has prevented me from working. 1 month ago I identified I have a real problem after I hurt someone close to me. The guilt led me to my Dr. I now take medication ritually and see a psychiatrist, psychologist and a counsellor fortnightly. This dual diagnosis has helped me come to terms with myself but still in the throes of working out the correct medication and dosage

Carl
December, 8 2015 at 12:20 am

I can honestly say I don't feel alone for once in my life!! I feel so at home reading the words of people who suffer just as I do. It's like reading words of people who suffer and live with the same issue as I do. The relief I now feel knowing I'm not alone is unmeasurable and such a stress relief. Like yes I know I wasn't alone out there in this world, but to read it and see it with real people on here is so different then I could have ever imagined!! God bless us all!!

SW
October, 14 2015 at 12:56 am

I've been diagnosed twice with BPD between the ages of 17 and 23 but something never felt fully right. From time to time (More common now at the age of 31) I get long periods of moods lasting a week to sometimes 2 weeks becoming pro something like religion, secret societies etc. I end up doing masses of research for days on end, excited over what I learn and talk non stop about what I've learned. This then turns bad, I've always said any high or "good day" I have is always followed by a major low and this leads to being frightened, normally thinking bad of what I was pro before, sometimes believing that secret societies are the evil and control everybody's day to day lives. Still inbetween those long periods I sometimes feel I'm having a mood swing within a mood swing, anger and irritation arise a lot. My vision also now seem to be effected, sometimes its a little like a music video. its hard to explain but I can tell the difference from the world I see while writing this and the one I experience then. I don't know really why I'm writing this but I'm hoping someone has pointers because this does not feel like just BPD. The NHS in the UK is a failure and I'm worried they may have missed something. As a teen I was wild, did many silly things and had a sex drive like no other, apart from being wild, its like most of what I was like as a teen is back, 14 years later. Any help would be appreciated and to my brothers and sisters out there, we aren't alone :-D

In reply to by Anonymous (not verified)

timber
December, 3 2017 at 2:30 pm

Hi SW, I am curious if you're referring to Borderline, or, Bipolar, when you say BPD. I literally do the exact same thing; obsess and research a specific topic or hobby for a couple of weeks and then I lose all interest.

Mag
September, 22 2015 at 1:08 pm

I was diagnosed BP1 in my 30's (will be 47 in a few weeks) and as Ive gotten older it has gotten worse. When I am manic I have done all sorts of things I wouldn't normally do, I have spent money like crazy. Its put such a strain on our marriage. We've been married almost 30 yrs. In the last few years Ive found a wonderful T, after I was inpatient 2x. He is amazing and I have been diagnosed not only BP1 but BPD. He said I am textbook both.
I wonder why my husband even stays with me. I am a disaster. He loves me but when is enough enough... My T said some BPD people are not nice underneath but I am, it was wonderful to hear... things I don't hear from my husband..
The other day when I got upset when once again we were arguing about money when I turned away and started crying he actually told me "oh don't do that, don't go down that rabbit hole because your upset" that hurt so much.... Doesn't he get it. I can't control it.
I am angry, frustrated, depressed and my anxiety is so bad.. I cycle and its the BP and I guess the BPD... I feel lost. To where I want to cut again, but I know he would just be frustrated with me and not strong...
His motto is to ignore me at times in stead of fighting with me when he knows he will never be right when Im Manic or Depressed... Again, why try...
Does anyone feel this way? I know he loves me deeply but is it enough?

In reply to by Anonymous (not verified)

Karen Walker
September, 8 2017 at 6:05 am

Sometimes it is important to put ourselves in the other person's shoes, as your spouse may be frustrated himself and is just trying to cope with his own ups and downs of life as it is. Empathy on both sides is very important.

Louise
May, 21 2015 at 5:24 pm

Thank you everyone for writing.
I am currently separated (via a restraining order) from my estranged husband. I am positive he has some kind of undiagnosed mental illness (bipolar, BPD, etc) due to his erratic behaviour and denial of the same.
For years now he has blamed our problems on me or his family or coworkers. He's always telling me I am 'crazy,' cannot self-regulate, emotionally stunted, looking up my 'illness' on websites, etc. But he utterly fails to see how charges of domestic abuse against him were his fault ("you overreacted"), or how child services investigated him for going after our son ("I just hit my head and reacted badly to that, that's why...it's an old head injury"). He has a spotty job record, serious anger and control issues, hoards, goes through periods of isolating or sleeping a lot, blames everyone and cannot see how his own behaviour brings his problems upon himself, can get very arrogant, is very smart, codependent (self-confessed), in recovery off/on for drug and alcohol abuse, twice tried to kill himself in his early-mid 20's (once when prescribed anti-depressants), and will go through periods of acting out sexually (dating sites, Craigslist, hookers, etc).
He can get verbally abusive and rages, is irritated easily, demands respect and nonresistance if you try to point out his behaviour (cannot take criticism), is hard to understand as he will talk fast and bounce from thought to thought (even a previous marriage counsellor asked him to stick to one subject!), and will go through phases where he's telling everyone he's going to write the next best selling novel,(then I'll regret being such a bitch all the time) while at the same time can't finish anything he starts, etc.
And now he is blaming me for there being a restraining order against him. Says he going to counseling but then sends me nasty, vindictive emails! What sane person would do that knowing there is already an order against him that could be used against him? It makes no logical sense to me.
Does this behaviour ring a bell for anyone (besides alarm bells)? I cannot help but think he's either really sick and mentally ill, or he's just a very abusive person living in denial of his actions.
Oh, and his family thinks he's bipolar but he just thinks its all us who are messed up!
Help!!

Leanne Corbett
May, 18 2015 at 5:01 pm

I was diagnosed with bp-1 and BPD in 2012 at the age of 31, (despite seeing psychiatrists since I was 14) following a particularly bad episode. Resulting in my family having to step in and look after my children. Following this I made the decision that I wanted my children to have a more stable home environment.
Since then I have enrolled on a degree course and will be going into my final year in Sept (studying sociology). Studying has become an obsession, even though assignments take me 3 times as long to finish because everything I have read becomes jumbled up in my head with all my other thoughts.
I agree with you bipolar artist about feeling stigmatised. For me this comes from one particular member of staff
at the university. Each time I phone to explain I need an extension on assignments she advises me to suspend my studies. This hurts because I persevere against all odds, often increasing my anxiety levels to the point of being physically ill.
I don't expect a pat on the back or any sort of recognition from her for my determination. I've done this for myself and my very supportive partner, but mostly my children. My daughter was bullied for having a mental mum. I want them to see that no matter how tough things get I am more than the diagnosis. Bp and BPD are not only a part of who I am. Its really difficult to remember that though when you come across people who make yourself feel like you have a neon flashing arrow pointing at you.
That's my mini rant over.
Would just to add I'm glad I found this site. Its really helpful to read other people's experiences and reflect on my own.

bipolarartist
May, 2 2015 at 4:29 am

I have been diagnosed with bpd. since age 18 recently diagnosed with bipolar 1 my psychiatrist says it doesn't change diagnosis but adds to it. though when ended up in er they sent me home even though mania pretty bad when I came out of the drug and alcohol fog that led to me overdosing on med's. my phyciratrist said likely because my borderline diagnosis. I am starting to realize how stigmatized I was every time ended up in ER because of diagnosis of BPD now that been manic she said that if mania gets worse to go to ER and say phyciratrist said to go and that in mania snd med's still being adjusted so they don't see it as bpd behavior of going to ER. Sad I've been flagged that when I have other issues they figure all bpd. kind of like being bipolar it's less stigmatized though I have both.

Helen
April, 20 2015 at 8:32 am

I've recently been diagnosed as having both bipolar and borderline by a very good psychiatrist. I can tell you from my experiences over the last 6 months that the two feel very different indeed (for me). I've had a period of Hypomania and depression in this time. I made some major improvements in my life and I came out of the depression (I would say i'm in remission from the bipolar at present). But in the weeks since i've been in remission, the borderline personality disorder has 'come out' and i'm feeling pretty much how i've always felt. I am now seriously insecure, paranoid, angry, very emotionally sensitive and volatile, I do not have these feeling when i'm depressed or hypomanic. The two probably interact with each other at times to a greater or lesser degree but I can definitely say they feel very different and in all honesty, I cope more easily with the bipolar aspect. Hypomania is easy to deal with because I guess i'm one of the lucky ones who doesn't have the negative aspects, just the energy and euphoria. The depression while very painful, I can cope with because I know it isn't going to last forever (it's normally only a few months).I wasn't bipolar as a child but I would definitely say (looking back on how I felt etc) that I was borderline (I was sexually and emotionally abused from a very young age).
I don't think for one minute that all dually diagnosed people will have the same experiences as me, but for me the differences stick out like a sore thumb.

Larysa
April, 17 2015 at 6:16 am

Hello,
I stumbled onto this blog researching my own dual diagnosis of Bipolar and Borderline. I am familiar with most of what all of you folks have posted regarding it's impact on one's quality of life and relationships . . . and I have a question. How many of you have experienced problems obtaining and/or maintaining gainful employment?
I am 44 and I have a degree majoring in Sociology. I was able to "keep it together" for some time until I had a major break that should have seen me hospitalized. However, that very night I met my husband . . . a pretty incredible guy who I am still with to this day. BUT . . . he is frustrated because I cannot seem to keep a job anymore. It only takes a few days before my suspiciousness and paranoia kick in and I am running for the door (literally). I have so many gaps in my work history and no references for anyone to call. I have tried several non-profit agencies for help buy I have yet to find anyone who can help someone with a personality like mine (ours, I guess!).
I am quite isolated as all of my friends and family have fallen away many years ago (although I argue that my family members are "touched" as well so it's probable for the best).
I spend most of my time alone. Trying to convince myself that I'm not really lonely . . . . .
Any thoughts on this would be most appreciated.

Robert C
October, 16 2014 at 5:38 pm

I have bp and I suspect that I have bpd as well. It may be a misdiagnosis or I may have both.
I took Celexa once and it made my anger episodes much worse. Stay away from SSRI's.
Anyway I wanted to reply to Megan. Whether you believe it or not, your family needs you. My parents were nowhere to be found when I was growing up. You need to be with them.
However, taking a day or two a week to yourself sounds to me like a great idea. You need more breaks than the average person, or you will be overwhelmed. You need lots of "me" time. You need a "safe room," for when you get overwhelmed, away from your family, for a few hours or a day. Is there any family members you can visit when this happens?
"I really do fear that once they leave they will see what it is like to have some type of structure around them and never want to come back to me."
Not true!!!!
About the husband, it's impossible to be certain. Many women would like to think that their husbands are understanding and supportive, but many times these same husbands often appear ignorant and just want to run away from the marriage. That's biology. That's reality. He can't help it any more than you can help getting bpd. It all depends on the kind of man he is, and how disciplined he is.
Your husband is a fully-grown man. If he knows what's best, he'll be willing to go to therapy, alone or not.
The breaks I'm talking about will help your kids. They don't need their mommy all the time, but they DO need you! Also you need to start going to therapy, read bpd articles and selfhelp books. You need to do everything you possibly can do to help yourself. When you help yourself, you help your family.

Megan
October, 15 2014 at 10:36 pm

Hi there
I recently found out that I am Bi Polar 2, Borderline Personality, and PTSD. I am not on here to ask what I should do. I am asking for my family's sake.
I know that I have many problems and with my children being as young as they are (3yr and 9mnth), they don't need to see or be around this. I have family near me but they are "unable" to help. They have their own issues. I wonder if it is a good idea for my family to leave me until I am stable????
I really do fear that once they leave they will see what it is like to have some type of structure around them and never want to come back to me.
My husband has been with me since high school and he didn't know what he was getting into. When my symtoms got worse and nearly being placed in a hospital he realized that I had something wrong with me.
For the longest of times he thought that I was being lazy and not working. I have had 6 jobs and I have quit or it was a seasonal job. But still since 2006 I have had huge time gaps in between jobs. I have tried to get a job again and most places will not hire me because of something. I don't know.
His family is learning about all this with him. They have never heard or seen this before. And now that they understand and are learning what they can do to help.
Sorry went off topic.
Anyways, what can I do for my family??? Husband doesn't want to go to therapy alone and my kids are having nightmares. My eldest will say "time out, Mommy, time out."
What to do???????

Debi Ryan
October, 2 2014 at 1:41 pm

It is so great and a real relief to find a site that is still active and not three years old. Some people do fine on prozac, some people do not. For me, I was the poster child for Prozac. I was an alcoholic, after alcohol poising and a suicide attempt, my doctor sent me to detox and then over to out patient therapy. I started prozac and antabuse. I have not drank since then and I have taken prozac every day since. My past diagnosis were from my early 20's, ADHD, agoraphobia, Major depression. Most people after a year or two prozac just doesn't affect them any more. Mine did. I started pretty low, 10mg, started getting migraines, they upped it to 30. Had a crushing year in 2012, I moved three thousand miles from home, started law school, my teenage son who is adhd and borderline personality tried suicide and was hospitalized twice, my dfad had two strokes. Ugh you name it, oh yeah got married. But the higher they upped the prozac, the more tired I got. Just really lethargic and run down, sleeping 10-12 hours a night and then taking a nap. My doctor has been fiddling with my meds since May and I would love to talk to someone about it.

Ally3
September, 19 2014 at 7:24 pm

I am not diagnosed yet, went to a dr for help a couple years ago wanting to find out what was wrong with me. I suspect bipolar and/or BPD because since I can remember as a child I have had problems. Experienced abuse and abandonment in the family, had trouble in school and could never make close friends until I was older and they were only ones I could be destructive with. I had a loving 6 year relationship with a man and basically destroyed it to find out he may have bipolar. I stopped seeing my pdoc because of cost and no insurance and didn't like the effects of Prozac, one being easily set off to go into rages. I am trying ways to naturally relieve symptoms, particularly depressed mood that sets in every fall and I want to ignore life, fear of abandonment also sets it off. I also go into mania states in the spring which are more hypomamia and I haven't been self destructive for a while but always fear when it might happen and try to stay ahead of it. Hoping to find a way to afford treatment or to get insurance, but hearing others talk about their experiences helps.

Jane1958
September, 2 2014 at 2:50 am

I am 56 and have suffered with severe depression and mood swings since I was about 11 years old. Prior to that, I can see that I had a very unstable sense of 'self'. But in those days, psychiatric illness in children was just not even considered. 10 years ago I was diagnosed with Bipolar and BPD. I have recently started adjusting my own meds, so that I am looking after the bipolar aspect through meds. It makes sense to me that a personality disorder cannot be treated by meds ..... you may be able to alter the way a person acts and feels by meds, but it is a temporary blanket that cannot change how you are inside as a person. Life's events shape you and make you who you are. I don't think meds can 'cure' or change that. Although I am now more unstable in so much as my moods are swinging far more rapidly, I am feeling better in that I am not doped up all the time. I spend each day praying that something will come along to bring my life to an early close, as I am not prepared to let my children down by taking my own life. I am flawed, but aren't we all in one way or another. Living with any psychiatric/personality disorder is hard, so very very hard. And maybe just as hard in a different way for those that love us. To be really frank, I don't give a flying f what labels doctors out on me, it is just a label which is the consequence of an individual doctor's personal opinion of what they know of you. A label won't change anything.

korinmuffin
August, 28 2014 at 12:30 pm

I am 17 and have been diagnosed with Bipolar NOS for almost two yeas now. After my last hospital stay in May my inhome clinicians diagnosed me as Bipolar 1 with Borderline PersonalityTraits. Frankly I dont really know much about the disorder but I do see some of the signs. Ive spent a lot of the past 3 years in hospitals with each stay decreasing than my first 32 days in a ward. That was back in ninth grade and I have come a very long way. I used to have substance abuse problems starting in seventh grade and self harm in eigth. Ninth grade was a real shit year for me, I began abusing alcohol while still self harming. I tried committing suicide three times numerous ways until I let slip to someone that I wrote a suicide note. Thats when I was sent the hospital. Ive come a long way since then (even though Im on a lot of meds) and just started my senior year and am ready to kick ass. I start DBT in October; it will be my first therapy outside intensive treatment like the hospital or in home therapy. I also met an amazing patient guy and our one year is in October too. Im not trying to write a sob story I just want people t o understand that there is hope.Im not saying everything is perfect but my world has changed entirely even though I sometimes dont see that because of the bumps I have. I went from thinking I wouldnt live to see sixteen to now planning my future and college and everything. Just dont give up even when there seems to be none.

hope
August, 28 2014 at 5:21 am

Recent research has found that biochemically bipolar and borderline have the same flaw in a specific series of reactions in cell signalling systems. So despite currently being considered a psychiatric illness and a personality disorder in the DSM-V there is discussion of changing that definition to make them both part of the bipolar spectrum. At the cellular level they exhibit the exact same chemical response in the same area(s) of the brain. The outward behavioural symptoms of rapid cycling bipolar and borderline also present very similarly. After all The DSM definitions are drawn up by the medical community and change regularly as our knowledge changes.
Bipolar has several subcategories already (bipolar I, bipolar II, cyclothymia and rapid cycling etc.) and Borderline is starting to be considered another extreme form of the spectrum.
So don't get to hung up in the 'Borderline is a personality disorder and unchangeable' mind set. If research can progress to understanding how that cell signalling system can be re-set there is much hope for effective treatment. Even now with DBT, medication and better understandings of the physiological and psychological components of both bipolar and borderline many, many people are in recovery and doing well. But like so many contributors have said here they have to want to get well first. So keep working on it and keep your minds open to the possibilities.

Alicia brown
July, 30 2014 at 6:41 am

It took jail time to help me get a proper diagnosis. I would ask the psychiatrist why I would black out if someone attacked me physically. She said to me you are bipolar and BPD. I read up on BPD and everything became clear. Bottom line I needed mental help. Finally I accepted the fact that I was mentally I'll. My life growing UP I was first diagnosed with ADHD at the age of three my mom chose the natural way of eliminating foods with no sugar or caffeine. I look back and wonder now if life would have been better for me if I had medicine. In my teenage years were a disaster. That's when the black outs started. I always felt different than everyone else. I was bullied at school..raped at 15, and my mom was an abusive drunk. I turned to drugs at 16. That was also the time I was diagnosed with being bi polar. I became a hermit. I slept all the time, and that is how i found out about depression. In my twenties I was badly into drugs. At 29 I went to jail for kicking a cop in the face. I became very aggressive. But I would have to have a trigger. My relationships were very abusive and very drastic filled with fighting and drama. In jail I got clean and on medicine. After three months I was stable for the first time in my life. After being on medicine for five years and being stable I am now ready for therapy. Its hard to talk about my life with someone but in order for me to get the help I need I have to be honest with myself. I hope this helps someone because my mental illness cost me my children. Don't let that happen to you. Be honest with the Dr. I promise you that will help. Good luck to you.

east midlands
July, 20 2014 at 12:53 am

hi,
I have recently bin diagnosed with emotionally unstable PD, I don't disagree with the diagnoses but from the relentless info searching and home work I have done, I believe I have a combination of personality disorder and bipolar. I remember feeling very different from a young age....5/6....and my childhood was accompanied by trauma violence control and sexual abuse, at 16 I was diagnosed with depression which was correct at the time, I was offered no therapy or help which means I have bottled my feeling and emotions up, there has bin a few things happening over the past year that I couldn't mentally deal with, these problems are what I believe have triggered a start to my illness, (doesn't seem to be uncommon for a bad situation to bring a persons illness out)I started smoking weed at a the age of 15 and it helped a bit, at 17 I tried heroin for the fist time and continued to use it, not often just 5/6 times a year, how ever I have found that since my illness started I have bin using heroin at least once a week, on my good days I don't give it a second thought, how ever I have more bad days then anything now and I find heroin is the only thing that makes me feel normal, I don't inject and I don't smoke it to the point of falling asleep, I smoke a little bit every few hours and it numbs the pain.....im desperate for help now though as I can see myself spiralling into a very dark place and more then anything I don't want to have the need to use heroin any more, I've seen how it devastates families as my mums sister had a fatal overdose on it, I have told my mum that I have dabbled with it but I cant ever tell her the full extent as she is very poorly and I don't think she would be able to cope knowing the true mess im in, (she also suffers from depression and had a major breakdown a few years ago)my dad although he tries is as pig headed as they come and doesn't seem to understand me....my nan (mums mum)was diagnosed as schizophrenic 30 years ago and committed suicide before I was bourn, my mum now says she disagrees with my nans diagnoses as me and my nan are the same in many ways, my eldest sister also has bipolar with phcychotic traits, she also has a very tough life (sexual abuse and violent boyfriend that regularly beat and raped her) but also started taking drugs to help take the edge off from the age of 13 onwards, I would say its clear that it has bin passed down threw out my family, but me and my sisters didn't have the greatest of childhoods and my mum had a devastatingly traumatic childhood as did my nan!......I start therapy soon at Francis Dixon lodge in Leicester and can honestly not wait, im hoping its as good as they say, this really is my last hope and option, if this doesn't work I don't hold much hope for my future because I think I will end things before they go further..........HOW EVER although I said my dad is pig headed about it I now realise that pushing people away is a strong train with these illnesses please don't walk away from your loved ones, they need you more then you can possibly imagine!!

Texas9red
November, 4 2013 at 6:59 am

I have bipolar I, but I am very lucky to have a good psychiatrist and good care. I still have to watch, caffeine, chocolate, and stay away from alcohol too. I have never smoked or done illegal drugs. I also have never had any abuse in my life. I am a very fortunate bipolar person who had a sheltered life and a very supportive family. After my first and only episode 13 years ago, my family worked as a team with my doctors to get me back to my old self. I am 38 now and I still have struggles but I am one of the fortune cases of bipolar. I have less baggage.
All of the above being said, I do feel sorry for those who do have bipolar and bpd at the same time. I am no doctor. But I am pretty sure I know such a person. She is offically diagnosed with bipolar but she is a major alcholic. Sadly, her mood swings go from euphoric to rages. She gets very combative and conflictive. She becomes a brick wall. She has an idea that she is always right. She has a sense of entitlement to everything. She lies all the time. She lives in her own fantasy world that does not make any sense. It seems as though her bpd actually stabilizes her bipolar I disorder and allows her to remain in a very negative pattern. She is a miserable person with no sense of self-esteem or true identity. She is a manipulator and you have to check her stories all the time. I have had to give up being around her. She wants to argue frenquently or create drama. She is caustic to my own bipolar. I just hope she can get help somewhere. I can't be her friend.

Pamster
September, 18 2013 at 4:46 am

I have Bipolar Type II. My mom had it and her grandmother had it. There are others in my family, too, plus depression and alcoholism. I strongly feel my sibling has undiagnosed bipolar and borderline personality, as does her son, who is doing time for meth charges. She and my nephew will more than likely never get treatment as both deny that there's anything wrong.
I have to limit my interactions with them, esp. my sister. I can't take the stress of the drama she's continually making. Luckily, both live over 400 miles away.
I have to take care of myself and my own illness. Part of that care is limiting as much stress in my life as possible. They are definitely that stress!

carol kva
August, 12 2013 at 7:25 am

I have a son who was diagnosed as personality disorder, he was adhd as a child, when he was in the county jail he was diagnosed with bipolar but then another doctor come in and said he didn't have bipolar, he's has never been in rehab. He won't Have anytHing to do witH tHe family because I was able to get temporary custody of his two children. I've come to the conclusion there's nothing I can do.

Julia
August, 8 2013 at 7:37 am

Man, I found a typo and I can't go back and fix it. Last sentence, no 'are'. There. Considering it fixed.
I did have an additional and unrelated question for Natasha, and there's no other way to contact you that I could find. My question is if you've ever written and/or done research on the presence of catatonic symptoms (whether they meet full diagnostic criteria or only partially) in bipolar mania, and how they present themselves. I'm also wondering about any first-hand accounts.
Thanks,
Julia

Julia
August, 8 2013 at 7:31 am

As to a previous comment, bipolar and borderline personality disorder are completely different, though there are some overlaps and co-morbidity is not uncommon. Bipolar disorder is a psychiatric illness, and as such can be treated effectively with medications . . .not only can be, but usually must be. The personality disorders, of which borderline is one, however, are not psychiatric illnesses. They are marked differences from the norm in personality (i.e. attitude, outlook, general thought orientation, behavioral patterns, etc) that cannot be treated with medications. Hence the DBT for borderline personality disorder. That is its most effective treatment.
Furthermore, though, personality disorders exist in a much higher degree in patients with psychiatric (mental) illnesses. This makes sense, particularly if those mental illnesses have been untreated or undiagnosed in the past. In fact, I am of the opinion that any personality disorder cannot be really diagnosed (certainly not treated) until underlying psychiatric illnesses have been treated, and treated successfully for a substantial period of time. Then if those abnormalities still appear, though perhaps to a lesser degree, despite stability (let's say bipolar for now because that's what this blog is about), then those issues may not be a result of the bipolar disorder. They may be due to an additional disorder, be it another mental illness, or perhaps a personality disorder.
These are all things that a well-trained psychologist AND psychiatrist can pare out. Sometimes treatment is nearly impossible because of the additional personality disorders that a patient may have. Lastly, I don't know what they are, but it would be neat to find out the prevalence rates of personality disorders are in the population of those without mental illnesses.

Sarah
August, 5 2013 at 10:36 pm

You are a stayer, to put up with all of that. If you love him, and you can still breathe, then by all means stick by his side. I doubt that he is still as intelligent as he once was. Untreated bipolar and alcoholism erodes cognition. There are other men, and nobody would blame you for leaving. It's your life. I have bipolar and its not easy for anyone. Many have left. Some stay.

george
August, 5 2013 at 5:32 am

hi i hope yopu heard of al-anon, if not i would recommend looking it up on there web site and try a few meetings, good luck.

northstar
August, 5 2013 at 2:28 am

Hello, I have been with a man for 18yrs. It has been a long haul and to be honest, I am about to walk away from this relationship for my own peace of mind.
The man I am with was diagnosed in 2005 as being bi-polar. He was given medications which he took but he never bothered to refill them. He claims he is not bi-polar. His mood swings are bizarre. He can be "normal" acting for a day or two then, he goes off on these tangents about anything and everything. I mean...he will go on...and on...and on...for days. Hollering, name calling, threatening, gets on the internet and gets into verbal fights, he uses alcohol when he feels tense, which is most of the time. Some days, it seems like his mind is just rushing because he goes from one topic to another and I can barley keep up with his line of thinking. His actions are just insane....and very embarrassing too. He has been in and out of jail multiple times for drinking issues. The ironic part of all this is, he is actually a very intelligent man. Seriously, he is. Probably one of the most intelligent people I have ever met but....his mood swings are off the charts. Is there anything that can be done if he will not admit he is bi-polar? Or will he have to crash himself before he gets help. I know if I stay it will not be mentally healthy for me. Any comments or advice will be welcomed.

In reply to by Anonymous (not verified)

sherl
July, 13 2018 at 6:03 pm

yea two thing id like to say 1 is sometimes people w these metal illnesses cant except it themself and so they dont continue treatment . or when treatment starts to work they think oh well i better now or i never had bipolar to begin w the other thing id like to say is he emberise u but put r self in his shoes for a sec living w someone w bipoar is dificault and ruff and challenging but u can leave go out for a walk people w bipolar cant leave there owen minds and bodies were r trapped . and yes the rush of though and jumping from 1 to another so fast i have had to deal w that 2 and how ever hard it is on u well when i had that rush of though and was talking about this and then jumping to the next is cause of manic emposode and thing just rush throw r brain all at once and y cant stop it and there is now clearlity and its just jumbled mix up peices of though that all happen at the same time its hard to discribe to a person who has never exsperiancing it . my point is hpw ever hard it is on u . try exsperiancing it i dont know if he is aware of it but i am when this happen to me and i am powerless to do anything about it i am trapped in side my body and mind

Lisa
August, 4 2013 at 5:08 pm

I too was diagnosed with BPD and HDAD, and last year I was diagnosed as Bipolar 2, and I have made a big turn around since then. I wonder how many others have been misdiagnosed too. I am 53 and have been fighting mental illness since I was a child,, for the first time in my life I feel there is hope.

In reply to by Anonymous (not verified)

sherl
July, 13 2018 at 5:37 pm

my name is Sherl and i have struggled w mental Illnesses for ever and a day when i was 3 or 4 yrs old i was missdiagnosed w scizoprania but later in life around 20 25 yrs old after manny eposiode of being engery (manic) being put on downers only to go to down side where i could not function case i was so sleepy only to be put back on upper repeat symptom again . want i really want people to know is some drs dont know the difference between bipolar 1 and 2 . but in my case i often confuse them sice the main differance is energy leval bipolar 1 is people who r on the depressed side and bipolar 2 is people who are on the manic side . But here a though want if y have A D H D and also u r a verry engergetic person but y r in the hospital because y r exsperiancing depressed side of bipolar 1. ill tell y so r on uppers to bring r mood up and stablize it right so then y start actting like r normal self . ur getting better but the dr doesn't know this so he thinks r still mantic so he keeps upping r does of upper to stablize u . only really hes zombiefy u r now a drolling zombie . so talk about misdiagnosed scizoprania to bipolar . and sleep disporder to

In reply to by Anonymous (not verified)

sherl
July, 13 2018 at 5:44 pm

yes Lisa there is hope i have been diagnosed with bipolar 2 by the right dr who listened and did not push pills on my just lisened and i got medication that has worked and i have stable and my bipolar disorder 2 has been remisson for 12 yrs so i am living proof that there is life for people w bipolar disorder who r not stable and in remission and people who r just keep fighting never give up .

Kathleen Brannon
August, 2 2013 at 10:17 am

I have had the borderline diagnosis off and on since I was 20. It was apparently based solely on my self-harming. At that time it was a very stigmatized diagnosis, to the point that therapists would decline to treat you at all. There were no meds thought to be effective.
I did received the diagnosis of Bipolar II at age 40. That was a turning point in my life because getting the right treatment and the right understanding of myself and my illness was crucial. It opened a door to recovery.
I recently was an in-patient and then out-patient for several weeks. In a psychoeducation session, I asked the psychiatrist what was the difference between borderline and bipolar -- and she said they were simply different points on a spectrum. She added that many experts maintained that BPD was just a subtype of bipolar and should be abolished as a separate diagnosis.
I have the sense that BPD is diagnosed mainly to signal to the treatment team that the person self-harms and is volatile, nothing more. It holds no separate implications for treatments or outcomes.

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