Bipolar and BPD

Written by Dr. Leland Heller

QUESTION:

Doctor Heller-

I have been diagnosed with cyclothymia/bipolar II by four different psychiatrists. Only one said I had BPD tendencies after administering a MMPI test. I've extensively studied manic-depression through the writings of Jamison/Goodwin, Jamison, Whybrow and it's like they wrote their books about me. The DSM IV clearly states that these conditions are not exclusive of one another. I only have a DSM III, which is a bit outdated, but seems fairly consistent in the area of mood disorders,

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both bipolar and unipolar. Scientific research is being done to determine the cause of manic depression through disruptions of the double helix, indicating strong genetic factors. can you provide medical, physical evidence for the cause of BPD, or is this merely a socially/environmentally affected disorder? Please understand that it is not my intent to diminish what I've read on your pages, simply a means of understanding its foundation. It seems to me that BPD includes symptoms of just about every mental illness that's been defined: psychotic disorders, OCD, mood and anxiety disorders and it's labeled under an umbrella title of borderline personality disorder. Your thoughts would be greatly appreciated. Thanks.

DR. HELLER'S ANSWER:

They are all different disorders. There is also a huge difference between a symptom and a diagnosis. The BPD has many physical abnormalities, which are listed in the BPD section of my Website. The BPD has abnormalities in many brain systems, including the serotonin system. Bipolar has no serotonin system abnormalities. Unfortunately most of the abnormality is deep inside the brain and not easily accessed for studies. I believe the BPD is damage to the brain's "cornered animal" or "trapped animal" response areas. This is not the case in bipolar. One of the biggest mistakes made in mental health is the assumption that individuals have only one diagnosis, which actually is relatively uncommon. Bipolar and the BPD are very, very different. I'm suspicious that those who get agitated mania may have both disorders, and interestingly mania and dysphoria are successfully treated with the exact same medications.

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