Disentangling Rapid-Cycling Bipolar From Borderline

A while back I wrote an essay titled
"Blurring
The Boundary Between Mental And Physical
" in which I
suggested that the scientific research establishment concerned with
health care has produced pretty convincing evidence over the last
several decades that many of the so-called mental illnesses have
strong physical component causes and that
many physical illnesses have strong mental or behavioral component
causes. Mass consciousness of this realization (which breaks down
the old ideas about the mind and the body being different things) is
seeping into cultural awareness, but not fast enough to have yet
substantially influenced public policy. Insurance parity for mental
illnesses (vs. physical illnesses) isn't yet a mandate, and disease
prevention programs for maintaining people's health throughout the
lifespan are underfunded when they are present at all. If the nation
was really serious about improving people's mental and physical
health status, these reforms would be no-brainers for policy wonks to
enact.

Even thought the government doesn't
(want to) 'get it' (make the structural changes necessary to respect
reality), the health care establishment increasingly does. For
example, more and more physicians recognize the role bad lifestyle
choices (such as poor diet, lack of exercise, smoking and obesity)
play in promoting serious diseases such as diabetes, heart disease
and cancer, and numerous research studies document linkages between
depression and mood disorders and serious illness. The mental
health establishment has helped lead this charge by
institutionalizing the view that both biological and psychological
perspectives are important in conceptualizing illness into their
method of diagnosis, and by utilizing multidisciplinary
treatment teams composed of diverse professionals, each attuned to
particular aspects of patients' experience (e.g., biological,
psychological, social, spiritual), who each can contribute treatment
recommendations. In short, the "BioPsychoSocial" diagnostic
approach pushes clinicians to think outside the blinders of their own
professional disciplines to consider how
medical, developmental, psychological, and social conditions and
symptoms come together to produce a particular patient's illness.

While for the most part biopsychosocial
diagnosis processes work out well and create a more holistic
picture of patients than would otherwise be possible, sometimes such
approaches can create confusion as well as illumination. When there
are multiple possible causes of troublesome symptoms to pay attention
to, how does one know which causes to treat? Nowhere is this sort of
confusion illustrated so well as when DSM axis I (one) and axis II
(two) diagnoses conflict.

The next few paragraphs are
intended for people who don't know about how DSM diagnosis works. If
you know this stuff already, feel free to skip them.

Some words of explanation are in order.
DSM stands for "diagnostic and statistical manual." The DSM is
the bible of psychiatric and mental health diagnosis; All providers
who would like to get paid for their work must subscribe to the
categories and procedures described therein. A DSM diagnosis is
divided into five axes, each of which asks the diagnosing clinician
to pay attention to a different aspect of patients' biological,
psychological or social reality. Axis I is the place where primary
mental illness diagnoses are made like depression - these diagnoses
are thought to occur as discrete events and to not be related to
developmental trends. Axis II is the place where developmental
trends and associated symptoms - many of which manifest as
personality and social skill problems - are noted. Axis III is
where physical disorders like cancer and heart disease are noted.
Axis IV is where social problems like not having a stable place to
live or a poorly developed social network are noted. Axis V,
finally, is reserved for a sort of global "how well is this person
functioning" rating.

That developmentally-influenced
illnesses are recorded separately from non-developmentally influenced
illnesses is the result of a political compromise of sorts. The DSM
started out life as a psychoanalytic document - before tools and
research-based approaches were commonplace in psychiatry. It stayed
that way until DSM III (three) was published in 1980 or so. At that
time (so I am to understand), the psychoanalytic viewpoint, with its
emphasis on how past events influence present behavior, was banished
from the mainstream and relegated to Axis II. Thus was born the
personality disorders, which are after all a family of diagnoses that
deal specifically with ways that developmental history influences
people to have maladjusted personalities in the present. With this
division of diagnosis into Axis I and Axis II components,
both 'empirical' diagnoses and psycho analytically
informed diagnoses could take place side by side and cross-illuminate
one another. It usually does work out that way too - except in cases
where the two diagnostic perspectives appear to compete to describe
the same thing.

I can think of two cases to illustrate
the point. First, there is considerable diagnostic overlap between
social phobia and avoidant personality disorder diagnoses, and second
there is considerably overlap between rapid-cycling or cyclothymic
forms of bipolar spectrum disorder and borderline personality
disorder. We'll use the latter case as our example.

Bipolar disorder - sometimes known as
manic-depressive disorder - is a form of mood disorder
characterized by periodic cycling between depressive-like (sad,
irritable, agitated) and manic-like
(energetic, impulsive, happy) states. Bipolar disorder is thought of
as a spectrum disorder in that there are extreme forms and mild forms
and everything in between. The classic bipolar presentation (e.g.,
Bipolar type 1) involves mood alternation between pronounced
depressive and manic episodes, possibly involving actual psychotic
states, several times per year, with each episode lasting months in
duration. But there are milder forms of bipolar where patients
complain of pronounced depressions only, depressions with mild manic
symptoms (bipolar type 2), mild depression and manic symptoms, etc.
There are also individual differences in the periodicity of bipolar
cycling, with rapid-cycling (more than four times per year),
ultra-rapid cycling (more than once per month) and ultridian
cycling (more than once per day) now discussed in the literature.
Ultra-rapid and ultridian cycling patterns were not accepted as
existing when I was in graduate school in the 1990's. If a patient
was cycling faster than four times per year, we were taught to think
strongly that there must be some underlying personality disorder
accounting for that. Things have changed a little in ten years.

Bipolar disorders are considered to be
disorders of brain chemistry. The dominant view is that the disorder
is 'hardware' driven - with mood swings being caused by
disregulated ratios of various brain chemicals and/or neural
sensitivities to brain chemicals in a manner similar to how some
forms of Diabetes are conceptualized as being disorders of blood
chemistry and insulin sensitivity. The chemicals go out of whack
and that causes the disorder. Not surprisingly, the common
treatments used with bipolar conditions are almost exclusively
pharmacological; Lithium, Valproic Acid (Depakote) and more recently,
anti-psychotic agents like Olanzipine (Zyprexa) and Seroquel. There is
little room in this
causal conceptualization for the possibility that higher level brain
functions such as thought or social representation might play a
causal role in producing the mood swings.

In contrast to bipolar disorder which
is diagnosed on Axis I, borderline personality disorder is diagnosed
on Axis II. Borderline personality disorder is understood to be a
disorder of fragile self-concept and disregulated emotional coping in
which sensitive people (generally who were abused in some form as
children) show a rigid pattern of intense interpersonally-directed
emotionality and unstable intimate relationships. Borderline people
also show pronounced mood variation, but this is thought to occur not
due to underlying brain chemistry problems, but rather to fragile
relationship coping skills and a tendancy
to view relationship partners in very high contrast "good or evil
but not a mixture of the two" manner any pole of which proves to be
difficult to sustain. Mood swings in the context of borderline are
thought of as 'software' problems brought on by changes in the
patient's perception and appraisal of their social situation.
If bipolar patients' rigid and unstable thought process have been in
place for some time (which in most cases it has been as the disorder
is thought to have it's genesis as an attempt to cope with early
abuse), then their personality (and even their evolving nervous
system tuning) grows up with unstable mood as a central feature.
After a while it becomes hard to say what is the product of the
unstable and rigid black and white thinking and what is the product
of having lived that way so long that it becomes normal for that
patient to be that way. In any event, a diagnosis of borderline
disorder does usually imply that underlying brain hardware is assumed
to be more or less okay. Not surprisingly, borderline personality
disorder is more likely to be treated with psychotherapy than are
bipolar conditions. Of course, this being America in the 21st
century, lots of medications are used for bipolar treatment too, and,
as they often prove helpful, this is a good thing.

Rapid cycling bipolar and borderline
disorders are not intended to be describing the same thing. It is
quite possible (and indeed is most often the case) that they are each
diagnosed in the absence of reference to
the other. However, there are these patients who seem to have both
things happening at the same time, and that is where things get
interesting. Exactly what does it mean if both disorders are
diagnosed to be present at the same time: Does it mean that one
diagnosis is more right than the other? Can a patient's mood cycling
be caused by more than one thing at the same time? The answer to the
first question sort of boils down to how much weight doctors making
diagnoses give to either chemical or interpersonal causal
explanations for why patient's moods are
swinging (which in turn is strongly influenced by their professional
training). The answer to the second question is most likely "yes."

Lest you think that moods can only be
caused by chemicals, you'd be quite wrong. The success of cognitive
behavioral psychotherapy approaches has established pretty much
beyond any doubt that thoughts are capable of influencing mood, and
that if a patient can be taught to think differently about his or her
depressive (or anxious) thoughts, his or her mood will lift. Knowing
this makes it perfectly plausible that
instabilities in someone's ability to feel secure in relationships
and someone's lack of knowledge with regard to how to sooth
themselves when they get agitated can
translate into mood swings as pronounced as anything chemically
induced. Both chemicals and thoughts are legitimate potential causes
of mood swings. It's a reasonable thing to disregard the influence
that thought and perception has on mood instability when dealing with
clear and pronounced 'hardware' problems (such as bipolar I), but in
more mild forms of bipolar disorder it is possible that chemicals and
thoughts - hardware and software - play a role in determining
patients' mood.

Fortunately, it is not really all that
important to get the diagnosis perfect - to disentangle
the possibilities of whether rapid-cycling bipolar or borderline
diagnoses are more appropriate. It so happens that the treatment
approaches used for one disorder are highly similar to those used to
treat the other disorder -at least in terms of medicines. This may
not be an accident, in that both disordered chemistry and disordered
thought may be pushing the same levers to move mood up and down -
the same levers that are manipulated by medications. It's hard to
determine if this is the case, but as per usual, more research will
ultimately settle the question.

To the extent that disentangling
rapid-cycling bipolar disorder from borderline disorder becomes
important, it make take creative assessment techniques to make it
happen. You'd perhaps expect some regularity to mood cycling if it
were truly uniquely caused by some underlying chemical disturbance.
In contrast, you'd expect more random mood
cycling, or mood cycling that is closely tied to events in patients'
emotional lives if it were caused uniquely by some interpersonal
problem. Right now mood cycling is basically assessed using
self-reports and it is easy for patients to just not know how
frequently or regularly their mood fluctuates in a given period. If
some future advance made it feasible to measure the proper chemicals
on an ongoing basis so as to establish cycling in a more objective
way, we might get somewhere. But that too will have to wait for the
future.

The purpose of my essay this month is
hopefully clear now: I am writing to show how the diversity of
causes that DSM diagnoses acknowledge can lead to situations that are
sometimes diagnostically confusing even as they better reflect the
complexities inherent in patients' presentations. Reducing the
diagnostic task to either biology or psychology alone would make it
simpler to accomplish, but would potentially harm patients seeking
help in cases where their disorder's causes were not recognized or
properly acknowledged. The present example suggests in miniature
both the progress that has been made and the progress that still
needs to occur before this type of diagnostic differentiation issue
can be cleanly resolved.

Comments
  • S Cairns

    I have had a 14 year battle to get my now ex husband the help and support he needed after he fell 26 ft straight through a roof...he physiologically healed from his wounds well but it was the change in his personality that I attribute to the near death experience he suffer when he had a pulmonary embolism that was the biggest problem. His personality changed markedly, he became withdrawn and his childhood seemed to haunt him more. His parents divorced when he was 11, but life had been traumatic and violent due to alcohol, his mother leaving him at that time profoundly affected him. He grew up, married, had children, emigrated to another country, worked, bought a house and tried to act like a citizen. The only label the man got was a bipolar label and given meds and left to deal with the way his experiences had left him feeling on his own. His life spiralled out of control as they wouldn't address the issues regarding his feelings, instead he actually has had his life destroyed by his hopitalisations. He becomes self destructive when he is having what they call a bipolar episode and they stand back and let him go on the ward. So far he has entered into 3 short term destructive relationships which have cost him his assets, his primary family structure and his sex life as he acquired herpes from sex whilst on the ward. At this moment he faces either homelessness or life in a state run residential unit, neither at 51 is an appealing choice. At no time would anyone look at his actions and attribute them to anything but bipolar and the problems that actually were the real problem have been ignored to everyones detriment. So I encourage you to keep on pushing for them to recognise and acknowledge the issues addressed in this article then maybe millions of people globally would not have their lives destroyed by the psychiatric profession.

  • serena w. coleman

    With resulting influences from family genetics, environment, and possible exposure to childhood abuse or neglect in the bipolar syndrome of family life on a daily basis, I would imagine that the chemical ''triggers'' are very closely linked to the environmental stressors or memories of your early life. ..Borderline Personality Disorder and Rapid Cycling Bipolar would be almost indistinguishable, especially in the milder bipolar ii...Later, if exposed to severe health risks, stressors both psychologically and physically, and environmental shifts in life styles by marriage, parenting, career would maKe bipolar and borderline almost identical ..Clinging to the behavior patterns which carried and guarded you through childhood, you would need medications for bipolar disorder to keep your chemical imbalances ''in checK' neurologically, if able to function in the realm of ''normal society''...and be outgoing and social..trusting and caring, nourishing and loving. ..Thank you...

  • david forrest

    I am now seperated from my wife who for the past 10 years has clearly suffered with borderline peronality disorder. This was not at first diagnosed medically, though she had voluntarily been having therapy for the past 8 years. When the impasse came in the therapeutic work, rather than face the childhood trauma, she would move to another therapist. Only the last four years was medication administered and whilst this gives a balance to her moods and behaviour it also allows her to resist and deny the therapeutic interventions. I wonder how this might get addressed. She has in this past year been hospitalised however the emphasis is only on drug treatment/stabilisation. I applaud the holistic approach yet when the patient is voluntary, yet severely damaged, I cannot see how functioning at an interpersonal level can ever be reached. I am glad to thave found this site and this particular article as I am now moving towards working as a therapist

  • Kim

    I found this article by typing "help" into a search engine. Have you ever thought that something happened on purpose? I have been looking for a comparison of bipolar and borderline personality disorder for some time now. I was diagnosed with bipolar type II 5 years ago. I have felt that I am a ultridian cycler due to the rapid changes in my mood within the same day. I have been in therapy working out lifetime patterns for 6 years. I have had the same therapist for 3 of those years. It took some time to get the "right fit". Recently I started learning more about the DSM V. I started my own research on Borderline Personality Disorder because I felt that I had many of the traits outlined. The first book I read on this was "I hate you, Don't leave me" by Jerold J. Kreisman and Hal Straus. This book described my life. All of the behaviors jumped out of the pages and attached themselves to me because they were so familiar. I cannot thank the authors enough for writing this book. I read it in a few hours. I have read it a couple of times since then. Anyway, I feel that the connection between Bipolar II disorder and Borderline Personality Disorder can be extremely difficult to separate. I live on the line between the two and on both sides of the line, constantly moving from the line to one side and then the line to the other side. I have been working out the details on disentanglement in therapy. I understand alot about both disorders and feel that I could help many people, but do not know how to go about helping them or finding them. It is a lonely road. It doesn't have to be one. Thank you Mark Dombeck, Ph.D for giving me the information to help in my progress.

  • Brooke

    I too like the previous poster, kim have struggled with the line between Bi-polar and Borderline Personality. I have been diagnosed as Bipolar Type 2 for 10 years, however for a very long time felt this didn't quite fit the entire picture of what I was dealing with. I was getting rather frustrated with trying to find someone who didn't see medication as the cure all. I had found a medication that worked for a few years, then I had a child and I think my chemistry changed and since then I have not found anything that does not make me just more aggitated to the point that no one wants to be around me. I too feel I am ultridian (sp?) cycler, my mood changes hourly or by the minute sometimes. I was given a copy of the book "I hate you, Don't leave me" And as Kim stated the words explained my life to me. It was such a relief to hear what was being said. I had been searching for 9 years for this information yet, no doctor was willing to provide it, or had a clue that it could help or was possibly part of my problems. I really wish the mental health community would embrace what you are saying in this article. I feel they both have alot to do with one another. I feel I have both, but have yet to find a therapist to acknowledge this or help me with it. I would love if someone would contact me with any info or help! brookeisnow@yahoo.com Thanks!

  • Bill

    The situation is even more complicated. Many of us with epilepsy have had a history of borderline or manic features that were usually "subclinical". Many of the second generation of epilepsy medications work well on and are an increasing first line of treatment for bipolar disorders. Some seem to have efficacy in Borderline Personality Disorder. Some theorists and researchers believe there is a causal link between epilepsy and bipolar disorder. Many also believe that there is a strong comorbidity or overlap of BPD and bipolar disorder. Could the trauma of early childhood cruelty that some people have to face cause structural damage to areas of the brain that we can't find or identify yet? Stay tuned, The data moves rather quickly.

  • niemac

    The government has be classified as disabled due to my manic-depressive illness. And I have had times when my mood swings were like clockwork and had little to do with situation. But more and more over the years I've seen situation totally control the mood. (Especially since I've been homeless, and/or transportationless enough times with no support system.) Now I live in an area where the state doesn't supplement the cost of mental health treatment and it's been 4 years since I've seen a psychiatrist. But I have a good medical doctor that's finally addressed what I feel is the underlying cause of my inability to function- my sleep problems. I've always, and still do, have trouble falling asleep. But he discovered I stop breathing and that's why I wake at night, too. When I worked 8-5, I only slept weekends- it's no wonder that I eventaully lost it! If I sleep when my body lets me (in the AM after the sun rises- not at night like "normal" people- and I use oxygen to get me through the periods when I stop breathing, I can do much better. But I'm distractible and have short term memory problems (the result of years of sleep deprivation), and I still get very depressed (due totally to situation). If I just had a support system and felt safe to believe that I'd always have a roof over my head and a way to get to doctors, pharmacies and grocery stores, I know I could get back my ability to function. But it's a vicious cycle- now no will even consider me for a professional position because of the ten year gap in my professional employment- then there's the fact that I have to work around my sleep disorder. Anyway, the point is- don't forget the importance of sleep!

  • cindy

    I feel I have finally found some useful information after searching for 15 years for help for my son who is now 33. We have been through several Doctors, and endless hours of research to try to help our son who is an ultridian cycler, with major sleep problems and possible eptileptic complications. He also displays all signs of bipolar depression and there is a family history of depression, manipulation, suicide. If this is too complicated for Doctors to figure out how are the rest of us supposed to be able to understand it and get help for it????

  • Larie

    My boyfriend has been diagnosed with Bipolar II and I have been trying to research his disease and assess how I should deal with it. Your article was very informative and gave me hope that he can learn to control his mood and reactions.

  • Jude

    I have started treatment for BP. Going okay. Moods seem like they are coming together. Today I started to cry and within seconds got agitated and overly active. Haven't addressed the anxiety truly yet, can tell you that there is a subtle difference. I am still surprised that there is such a stigma. The past 4 or 5 years economically has been challenging and I cannot help to think that there are several people becoming more unproductive as a result. It was very stressful to figure this mess out by myself having had several physical maladays that with relentless persistence I decided to go to a psychiatrist. I am fighting an insurance company for Short Term Disability Benefits that was exposed in a 60 Minutes expose for not paying. I am very fortunate that I am not homeless and feel for people that are because that only makes the situation worse. I will persist rabidly getting the benefits that I deserve. If I am unsuccessful, I will be going back to my corporate job dealing with peoples money and be basically useless and getting fired. Either way I become a burden on society. At this point, there is no other option. All I can do is VOTE!

  • Kate

    Thank you for this enlightening article! :) I have found that Minirth Mier, Rice-Lewis, and New Life Clinics have given me more help overall to improve my health (psychologically, physically, emotionally, intellectually, and spiritually). I attribute much of my stability to this approach of healthcare, and am very grateful to the high quality services I've recieved thur these clinics! I am 28 years old, and at age 23 was diagnosed with PTSD, Stress related depression, Obsessive Compulsive Disorder, and severe CFIDS (chronic fatigue immune defiency syndrome). It is only by the grace of God, and the balanced appoach of these medical proffessionals, that I am currently able to remain stable, productive, and in good health. I am also a mother of three young sons, ages 5,6, and 7, and have worked part time off and on as I am able. Thank you to all who help to push for this more balanced approach to healthcare, and for raising the standard expected from the medical proffessionals. It has made all the difference in this life.

  • annon

    i was looking at articles online to maybe diagnos myself or at least see what i can do to get help. ive been to a psychologist for a few months but i felt like i couldnt really explain my disorder effectively. so i took the perscriptions they offered. i am having a hard time realizing how isolated and confused i really am. reading the article makes me want to think.

  • Anonymous-1

    Trying to diagnose yourself in a biased manner isn't going to help you figure out what is wrong with you. Psychiatrists are doctors, and a great resource if you feel there is something wrong. Self-diagnosis is often innacurate because the individual may come to terms with what is going on in their mind. Go for a second opinion if you feel you need to, but determining it for yourself will just be more confusing and innacurate.

  • Vanessa

    I have been diagnosed with ultra rapid cycling bipolar 2. My doctor was also leaning towards BP (and probably OCD)as well, as I am adopted (read adandonment issues) and my brother killed himself when I was 15. I do not have the sex or money issues of a bipolar, or the good/evil and self abuse type traits of Borderline. I also have an overactive thyroid which has manic like symptoms. I have read that there may be links between thyroid problems, endometriosis, melanoma (which was a surprise) being auto immune functions, and many bipolar people have thyroid problems. As I have all of these conditions I have no idea which is causing what. I have resigned myself to the fact that I will never have children or a functioning relationship as it is all I can do to hold down my job

  • jennifer

    My future mother in law has only just now, after five years, shared with me the secret that her son was diagnosed on or around 1970 with what the doctor then called "split personality" She hid this information from the family, from everyone, including my fiance who is now 43. This revelation explains so very much about the last five years of bizarre behavior and drama that this man has created in our life, which I had up to now attributed to his tendency to "self medicate" and have been on the verge of leaving him having labeled him an addict. I see now that this was merely a symptom of the chaos in his head that he did not understand and that he could not silence....however, what they called "split personality" in the early 1970's might be called something altogether different in 2005. The symptoms he exhibits are those of someone who seems to cross the line between rapid cycling bipolar, borderline personality as well as some characteristics of the narcissistic and the obsessive compulsive personality disorders. Can you tell me what that doctor may have meant by "split personality" at that time?

  • dianne shaw

    i am 49 years old and was diagnosed with bipolar disorder II and borderline personality disorder in 1991 by my first doctor - and received the same diagnosis from another doctor in 2000 so feel quite certain that both of these exist in my brain biologically in the case of bipolar and in the case of borderline i feel as though i had a genetic predisposition to sensitivity and vulnerablilty to life and that the abuse of profound religious upbringing as well as this genetic vulnerability caused the borderline. what amazes me is the other diagnoses that have been also suggested by this very brilliant doctor - neurologist and psychopharmacologist - that i have been with since 2000. generalized anxiety disorder i am told frequently occurs with bipolar and that i have that and i have ADD a eating disorder and substance abuse in which i am in recovery for. it seems to me that having this bipolar has made it easier(?) or more susceptible to other disorders - including the borderline but not limited to. that just seems like a awful lot for one person to have "wrong" with them. any more i see the bipolar as having opened me up to other diagnoses. they are blended together somehow just as the bipolar and borderline are ambiguous where one starts and the other ends. thanks to alot of self-education and networking with other consumers as well as medicines and a fantastic doctor my life is finally becoming wonderful. p.s. i am also disabled and have been since 2000. private disability insurance has kept me from sinking financially .

  • Teddimae

    I am 43. My parents said I had a difficult temperment. I have childhood sexual abuse, physical abuse/discipline and verbal/emotional abuse. Mother was undiagnosed cluster B, possibly borderline and died of eating disorder at age 59, father may even exhibit some "traits" and sister has undiagnosed traits and PMDD issues I would say. I was dx w/postpardum depression, changed to depression, change or added bipolar and then added borderline and PMDD and then SAD, alcohol dependency and I also notice some eating disorder and OCD issues. I have been looking for info on a connection between the rapid cycling bipolar, borderline and PMDD and even the alcohol dependency. My behavior changes throughout my "female cycle." I can see it, my family can see it. I have charted it periodically throughout my life. The current trend is DBT and I could not get the medical community here to look at or listen to my connection after a recent near fatal overdose after work related stress diminshed and I had PTSD-like symptoms, which is a pattern also for me, but the overdose happened in the second half of my female cycle as has been the case with rages since then, with the exception of the two-month period in which I tested birth control pills to see the effect on my symptoms. It made them worse, and replaced my "good" week or two with rages. I stopped that. I was on Lithium, Lamictal and Risperdal combination until the overdose. It stabalized my mood the best in years, but stress is a key factor in the extent of my mood swings. The medical drs. replaced these meds with Celexa (SSRI) that my nurse practitioner had me on when they "took away" my bipolar diagnosis in August, 2004 after 15 years of this dx from various human service centers and another medical facility. The SSRIs tend to make my swings more drastic, especially at 60 mg or higher of the Celexa. i would love any information I can get my hands on with regard to the connection between rapid cycling bipolar , borderline, PMDD, even the alcohol dependence. Feel free to contact me.

  • karen

    you have not desangtled anything. just a long piece of paper. you call it an essay. i call it a load of bollocks.

  • Angst

    Your explanation of the DSM and the axes were astoundingly helpful. So that's how they work it. In the end, it's nothing more than a fanciful nosological conundrum, which would be okay, if people just realized that the labels are just that. Now if they could introduce real statistics into the Diagnostic and Statistical Manual, that would be "awesome." It's good, honest attempt at an article about the labelling problems. I really should get myself labelled.

  • Geoff Davies

    Thanks for providing substance to some rather nebulous ideas that I myself have entertained over the years. These ideas have developed concurrently my seemingly endless "white noise" of suicidal ideation. As a victim of childhood sexual abuse, and coming from a family history of suicide, attempted suicide, chronic depression, PTSD, and serial paedophilia, I find it very difficult to read anything that might even come close to making me feel like I'm the only one on this planet that has any concept of the pain associated with trying to live through, and indeed thrive, after all over these influences have washed over my life. I returned to study at 38, and became a registered nurse. I have worked in Mental Health(MH). I worked at the facility where my mother was given ECT after her attempted suicide. I must say that trying to untangle my own foibles whilst trying to increase my insight while working in MH was probably not the smartest of career moves. In fact once the facility's culture (my peers) was aware of my background, I felt more alone and ostracised than before I had taken up nursing. Imagine that? Cut a long story short: most of the friends I know with BP are survivors of child abuse. Many of the people I've nursed are survivors of child abuse. So I concur with many of the notions described in your article. The profession needs people with the insight and compassion/caring that you have demonstrated Mark. You have touched me. Thank you.

  • skye

    To get people and politicians to recognice that the brain is a part of the body ,start using the words..Brain Disease instead of Mental Illness. Then people whould hopefully better understand that Yes the Brain is an Organ. We need it to function. And that there are so many chemicals and hormones playing apart of our everyday lives.No more Mental Illness...Brain Disease is more accurate discription.

  • Lydia Myhre

    I have both bipolar and borderline personality disorder. I liked what you said about how to better manage bpd with readjusting your thoughts. I am on medication for both now but wasn't sure how else to treat the bpd. I agree that it's the worse one between the two. I have had numerous bad relationships and some I should have never gotten into. I am working through establishing boundaries as I feel that it would help with my problem. I also feel that for anyone else with bpd a good support system would be a big help even if they don't understad what it is. Thanks for putting out the article. I think it was very informative and the best one I have read yet that clears up the differences between Bipolar and Borderline personality disorder. Thanks.

  • Diane Wilkerson

    You succintly categorized the two areas of bi-polar disordeer which I have had since age 26 or at least been diagnosed since then, am now 48 and still on lithium, clonipin for panic attacks and thyroid med's for hypr-thy. I look forward to hearing new developments in the causes and treatments of this. I do remember being depressed and abused by my sibling when very young so I am now wondering if any of that could have caused my illness. I am glad we have the drugs to help people like me and kids in particular. I am and have been an Elem. Teacher for 23 years and am very interested in helping those with adhd, cerebral palsy and autism. My Mom used to think I was autistic. and also.. I was very low birth-weight 2" 3' at birth and now am healthy in my way of looking at it. Enjoy and am thankful for each day have a husband who loves and understands me and 3 wonderful kids. I still want to learn more about the disorders that affect children and be better able to help these children and parents, if I can in some small way. I love children very much. God Bless.

  • Lydia Myhre

    I am doing research for college on the differences between Bipolar, BPD and ADHD. This article is very helpful to explain to me as I have both Rapid Cycling Bipolar and BPD the differences bewteen them. It will also help me in doing my research for college to break down the differences and silmilarities. I think it states what they are better than the last 10 articles I have read that sounded foreign to me. Please keep sending them out. Thanks.

  • Anonymous-2

    i have bipolar disorder and also have tendencies of borderline personality disorder. There are quite similarities however, I know from my own experience that my borderline problem comes from intense, unstable relationships that I think are either "black or white". My bipolar disorder is different. I have the rapid cycling type and I can't always control my mood swings whereas I could control the relationship problems. I also do intense self-mutiliation and I also think that comes from both disorders. When I'm afraid that my companion is going to leave me I hurt myself and when my moods are unstable and I feel dead on the inside I hurt myself.....so are there really big differences except borderline disorder is a personality defect and the bipolar disorder is a chemical imbalance in the brain (which is connected to the body!)

  • Pamela Field

    Working as a psychiatric nurse, I am very familiar with the stigma the staff often have with borderline disorder, and I admit I have had it also. Possibly relating symptoms and treatment with bipolar disorder could decrease this.

  • sane one

    I have been in psychiatric treatment for many years and have finally found a doctor who put me on the right meds 4 years ago. Our perspective is that the label isn't important as long as the meds work. The one thing I've always thought fascinating about our body is how the nervous sytem converts all the elements of our environment, internal and external, through chemical processes. I am not sure that distinguishing chemical from cognitive is possible. There are just different initiators.

  • casey &kathy caswell

    Dear Sir: We have a bi-polar son. Seth has suffered with this for about 10 years. He was not abused at any time by either of us. He was,however, emotionally harassed by his school mates and to some extent by his teachers. We welcome your feedback?

  • Toni

    My aunt Cathy has been suicidal ever since her kids were signed over to her sister-in-law, and then after that she got help. She went to Rehab and that helped a bunch, she lives by herself. Today she called me and told me that she took 180 pills.:( she had lexoprin, halodol, and seroquin. she took all of them. I want her to get help again I want to see her happy. If only there was a way for her to see her kids again I am 16 her sons are 4 and 5 and the youngest keeps askin about here what am I to tell him when she does die!

  • Charles Beeler

    I am a recovering alcoholic with sixteen years of recovery. I just got back from an AA meeting which I attend every night. I was diagnosed with bipolar disorder in rehab back in 1988. Since then I have gone through a messy divorce, become unemployable and homeless. I took Lithium for ten years - untill my hand shook so much I couldn't sign my name. I see a physicians assistant every three months to have my meds monotered. I now take Zyprexa, Zoloft and Neurontin. They seem to be working - I haven't been hospitalized since 1995. I have been in some rediculous relationships since getting into recovery - they all ended with orders of protection. Your article was good - keep up the good work.

  • Jan

    Thankyou for this wonderful article and thankyou Charles, my ex partner was diagnosed 20 yrs ago with BP and later as an alcoholic. He has been a sober member of AA for ll yrs and attending meetings but believes he was never really BP just an alkie and was taking no meds, recently he up and left our 8yr live in relationship without real explanation and has completly changed,I have become the "enemy" I believe he is manic, I ticked every box in the questionaire. What can I do to help him as he is in such denial. How long can he go without meds before he "comes down"? I think his meetings have helped him but for how long?

  • Chris

    I have a diagnosis of borderline personality disorder but this is unhelpful as my mood changes hourly wuth great leaps from severe suicidal depression to manic bursts of happiness to severe agitation. I have no relationship difficulties as I chose to live alone and do not seek other people out or idealise their personalities. I am desperate to find a treatment that will work but no one listens.

  • Amy

    I suffer from bipolar I, anorexia, and borderline personality disorder, all waxing and waning in their own time. Unmedicated, I am actively anorexic and highly bipolar. With medication, I am more borderline and mildly manic than anything else. The thing that I have discovered most is that, no matter which problem is most prevalent at the time, each greatly impacts everything in my life. My husband and I have monthly discussions about divorce that dissolve into happiness within days. Sometimes it's triggered by me manically wanting to do everything now, like buy a house and have a baby, other times it's because I am angry that he's staying by me through all of my "stuff". I am in therapy, but still struggle with everything that goes on in my personal life due to my overlapping issues. There is no cure, which makes everything so much harder to deal with. I am glad that a link between such disorders has been established, and intend to discuss what I have found with my therapist and my psychiatrist to see what we can do to help me.

  • Kay

    At age 12 I became anorexic, and for the next 10 years I abused myself with alcohol, drugs, and bulimia. When I finally got sober and purge-free at age 22, I was met with rapidly-changing moods and thoughts, plus seemingly psychotic episodes during which I lost all sense of self. I was quickly diagnosed Bipolar II, and was put on anti-convulsants & antidepressants. Months later, however, I was also diagnosed Borderline PD, and the more I research it the more I see that mine is not a neurochemical problem, but a purely psychological one. My mood swings and episodes of dysphoria are a result of my extremely fragile sense of self, a sense of self that essentially stopped developing at age 12. I've got a lot of catching up to do! I am now planning to taper off the anti-convulsants (with the help of my doc) and start focusing on rebuilding a new life for myself by addressing the Borderline PD. I was thrilled to come across this article and all the responses...this information should be more mainstream! Thanks!

  • TAMMY D. PESHKEPIA

    I am so happy and hopefull that I found this wonderful and informative site, I am a newcomer here and feeling so depressed because my life is a mess and I can and have been paralyzed watching it all fall apart and unable to reach out and stop it. I am greatful that I now have a reason to live. Thank You, TAMMY

  • Anonymous-3

    Thank you, I was diagnosed with bipolar disorder as well as schizophrenia, I never knew what a lot of it meant but thanks to this site I am better informed and can maybe handle things a bit better. Thank you so much.

  • BP Mom

    I'm 30 years old, been BP for as long as I can remember. It's only by the grace of God that I am still alive. I study myself. I have noticed that mood swings can be caused by situation and by chemical. My family thinks if there was a awy for me to stay pregnant I would not suffer so. I'v noticed it too. What do you think?

  • Jo Pendleton

    Toward the end of the article you said that there aren't significant differences in the treatments for Bipolar and Borderline - but there is a huge difference here in Texas. The Department of Mental Health / Mental Retardation only recognizes Bipolar & Schizophrenia as eligible for treatment under their program - Borderline Personality Disorder (and everything else) doesn't qualify for assistance. This is thanks to the Texas Legislature, and my daughter, age 25 and with a Borderline diagnosis, is suffering on the street without access to help.

  • Lauralee

    I would be interested to find out where I could get information on the study of the possible similliarity between bi polar disorder and epilepsy. I have, for many years, felt like it is possible that there are some kind of seizures in the mood center of the brain that contribute to bi polar disorder just like the seizures in the motor part affect the body in epilepsy. I have never found anything from any source comparing the two or in any way letting me know if anyone else was thinking along the same lines. I was sure someone must be since it is such an obvious conclusion because of the fact that the anti-sezure meds work for both sometimes. But I haven't found anything about it.

  • Linda

    I have been trying to find a balance between bi-polar one and borderline for 7 years now and thought I had finally ( after years of therapy and workshops) come to be able to put the self-destructive behaviours aside. Unfortunately my friends don't understand this behaviour and all tell me to "smarten up" or "try harder". They don't understand the difficulty in dealing with both disorders on a day to day basis. Thank God for this site...now I can send them here to read for themselves just what it is all about.

  • jessica

    i too found this site after typing in help to my search engine. fate or not that i read this, it has helped me look at myself in a new light. i have not been diagnosed with anything, but have thought for awhile now that i might be bipolar. i also have ocd tendencies and thyroid problems run in my family. it never quite made sense, but now i see that i am probably becoming borderline to hold onto the way that i know how to function. i always look at the tests and they ask if you feel different in the last two weeks, and i do not understand, as i have felt this way for more than five years now. i still make it through each day, so i have not yet gotten help. that, and i have no experience of abuse or such, and i dont know if i can deal with telling my family that i feel like this. i am now 19 years old, and i cry at least every other day, and i also have times where i can't stop working, shopping, eating, talking, etc. one day i know that i will break down and then i will have to get help. until then, i just make it through each day at a time. please know that even if i am not strong enough to give in and fight this, it helps me so much to read about others who have and continue to do so. if you have advice or would like to chat online at any time, please do email me or add me to msn messenger sparkles_48@hotmail.com

  • mark Biernbaum

    It is possible that BPD and BD lie on the same continuum -- that the same chemicals that are assumed to underly BD, are also involved, maladaptively, in BPD. The problem with the DSM, as the article points out, is that it is strongly categorical in orientation, and does not recognize the continuum concept. BD is viewed as a major mental illlness covered by the ADA BPD is not. Disorders of personality are often seen as volitional, while mood disorders are not. The continued promulgation of the categorical approach to psychopathology benefits psychiatry and the insurance industry, but does not benefit patients. A continuum approach, that primarily looks at symptoms, rather than syndromes, would be best for patients.

  • Relative of BP person

    I have a relative who was diagnosed as bipolar, although I suspect that they also have post traumatic stress disorder. This person, in their mid 30's, is also an alcoholic. There was some abuse and abandonment in chldhood and teenage years and the person has lived a precarious, often homeless, life for about 15 years. Although intelligent and often charming there is a lack of self esteem and apparent inability to "get life togther". how can I help this person? What are the states with the best mental health facilities and programs? Are there any good ones in European countries? If so, where" I would really appreciate knowledgeable advice. Thanks.

  • Dorie LaRue

    I am not a practising psychologist. I have two unused degrees. But I have had some experience with a friend who I believe had borderline personality caused or exaserbated by a blow to the head. A woman doctor in Texas is researching borderline personality caused by trauma to the head.Tppe in BPD+TBI Texas md for a start. I have long lost her contact info. Good luck.

  • Anonymous-4

    Where do I start? After living for 36 years in what I call "pre-Hell," mental health issues are now robbing my children of their lives. Adopted, I grew up in a "normal" family as anything but a "normal" child. No spoke about my problems but I was certainly ostracized. As an adult, I have searched to find out why I feel so crazy and out of control at times and why the bottom is always dropping out of my life. Running from one bad relationship to another - carrying along a cargo full of personal baggage - meeting several abusive men along the way - I have been diagnosed with PTSD, depression, generalized anxiety disorder with panic attacks, and have stuggled with agoraphobia off and on for years. At 36, I am now being told that I have bipolar disorder and have probably suffered with it since I was a teenager. Throughout all of this, I managed to somehow crawl out of the ditches that I have a bad habit of frequenting long enough to put myself through three years of university only to quit three months before graduating. Sound familiar? It's the story of my life. I have little family support but did manage to find a couple of amazing friends that have helped me drag myself- at times literally - through the last few years. Along the way I found my birth family hoping that they might be able to shed some light and offer some understanding and acceptance. Unfortunately, the reunion was bittersweet. I did find understanding, as mental illness ran rampant within my biological family but things rarely work out the way you picture them in your mind... As seems to be often the case, instead of supporting each other, those that are not in prison, in mental hospitals or dead from suicide or drug/alcohol abuse, the rest are all alienated from each other. Most of them are struggling to simply survive. Anything beyond that is almost more than they dare dream of. My poor children are now the legacy I have left. My 11 year old son was diagnosed with ADHD when he was only 4. It has been an uphill struggle for all of us. Just recently, my 14 year old daughter has been diagnosed with an eating disorder. After years of feeling hurt, abandoned by my family and the medical system, lost, alone and scared - I am now angry. I feel robbed. I feel that my children's lives have been robbed. I hate the stigma attached to mental illness. I hate the look that people get on their face when you tell them that you or your child has a mental illness. I want to scream "It's not my fault!!" "I AM a good mother!!!" I am tired of being judged by those who have no idea what a struggle it is for some to just survive. I want a good life for all of us. Is there any way to break this horrible cycle? I would do anything to prevent this life sentence for my children. I love them so much. Is that too much to ask?

  • Sam

    For years I've lived thinkng that all my issues were the result of "weak will," that is, if I were just somehow "stronger" I could fix my anxiety, fear, anger, and mood swings, and all the bad things that come with them. I grew up with a mothe who was like this, and I knew she was mentally ill, but again, it was a fault of character, not of chemistry. I've lived like this for over 30 years, never suspecting there was anything really "wrong" with me, that it was everyone else who failed to "get" me. This article helped me put it all together, both the biological aspects of my difficulties and how they interact with the psychological aspects. The author is completely correct in his assertion, and I hope things have changed since he published it. As for myself, I'm approaching this through medication, therapy and working with a support group. I'm feeling that my future is going to be a lot different than my past, and I'm very happy for that. Thanks so much.

  • Anonymous-5

    Could these be derived from one disorder with different symptons for different people? I'm sure as research persists we will see something to that effect. I have epilepsy and bipolarII and I'm just now learning about borderline and also seeing myself. My epilepsy meds are nice and I am seeing a counselor.

  • TIGGER

    I WAS ABUSED FOR MANY YEARS AS A CHILD AND WAS DIAGNOSED WITH POST TRAUMATIC SYNDROME LATE IN MY TEENS. I AM NOW NEARLY 40 YEARS OLD, PLENTY BROKEN, DESTRUCTIVE RELATIONSHIPS LATER AND BEEN TOLD NOW BY A SPECIALIST THAT I HAVE BIPOLAR? I AM CONFUSED. THE LONELINESS IS THE WORST BECAUSE NOBODY SEEMS TO UNDERSTAND THE WAY I THINK OR FEEL. WHAT TO DO...

  • Cindy

    I'm a stay at home mother and we are a one income family. My doctor told me to see a therapist because she thinks I may be dipolar. I have to by groceries or pay for thearapist. The state of Michigan has cut almost all funding for mental health. What ever it is that I have I'm afraid I will never know for sure and I am hopeful reading your coments on this. I'm hopeful that some one will understand and help me some day. My marriage is suffering horrably and my children don't understand how being loud was ok yesterday but not today. I hope this falls on compasionate ears and hearts in power to change the mental health system and insurance companys.

  • karen

    I was emotionally, physically, and spiritually abused throughout my childhood. I experienced a major depression of 4 years duration at age 14. I was mildly to modertately depressed for the next 20 years. I experienced another major depression with suicidal thoughts and was hospitalized in my late 30's.At that time, I was also diagnosed with a thyroid disorder. 2 months later, I began rapidly cycling between 10 days and two weeks. This lasted 8 months and then I remained depressed for the next 12 years, despite trials of nearly every mood stabilizing medication and antidepressants.this was followed by 3 years of a severe depression with suicidal thoughts. It was during this time that I began seeing a new therapist. He told me that he thought I had BPD.I had heard of this disorder through the years. I was terrified when he told me this, because I had always heard that there was a very poor prognosis with BPD. I have a 12 year old daughter, and I know that I have to stay alive to raise her.I asked the therapist how I could get help with dealing with BPD, because I didn't want to cause unintentional harm to my daughter through having this disorder. He said "I don't know if there is any help for you."

  • Lee

    I was diagnosed with bipolar,PTSD ten yrs ago, then it was changed to bipolar II, PTSD, and Borderline Personality Disorder about 5 yrs ago. Now they say after 10 years .. you only have BPD. I feel as though 10 years of my life have been taken from me and as though I've been used as a guienne pig for all the drug companies. I'm not feeling any better. I've just lost everyone and have no idea what I have or who I am. As for your article ... I guess it's ok. I just wanted to tell someone how I felt who won't tell me I'm lying. that's all.

  • Meg

    I do loads of research on-line and off on both these disorders because I've been unsure of what the heck my problem is. and today I googled "mental help" because I'm at the end of my rope and it seems like nobody can figure out what's wrong with me. put this information everywhere!!!

  • M

    Hi Lee, I know its hard but be strong. Try not to put your identity in the label. No matter what they call it you are still you. I have not been diagnosed with anything but I identify very strong with the stories of people with BPD except for self injuring. Although I am not qualified in anything (except self hatred) I feel like all my hopes and dreams are just the pathology of an ill mind so am feeling very alone. I too am afraid of people not believing me when I tell them how I feel. I believe you and understand your fear. Be strong and try to find yourself a support base. :) M. - Riding the rollercoaster that each hour brings!

  • Anonymous-6

    I like to read articles on the internet everytime I receive a new diagnosis. When I was 19 I was hospitalized for a suicide attempt and they said it was Borderline personality disorder. They treated me with antidepressants and anti anxiety medicine which for the next ten years made me worse. Then I found a psychiatrist that said it was more like a rapid cycling Bipolar II or Ultridian Cycling. He put me on a mood stabilizer (Topamax and Welbutrin) It was the first time ever my moods started to level out ever in my whole life. Most recently, my new psychiatrist thinks that it is more Cyclothymic due to the iritability feature that presents itself almost constantly. Very annoying. Titles and for insurance as far as I am concerned at this point. They seem so closely related, it is hard to pin down or untangle. I just want to be normal.

  • Kerrie

    I read this article with great interest. I was diagnosed with BPD in 2003 after one appointment with a psychiatrist because I had been self-harming for less than 2 months. This is the only symptom of borderline that I have and the reason that I do it is because I have transmitters in my blood and I want to remove them. It has been clear for the last 2 years that I am bipolar- before I started on meds I would be so manic that I thought that I was invincible, omniscient and god-like and that I could fly. I tried to prove this by almost jumping off a cliff. It is the self-harm that has mudied the water. I do not, in fact never had, abandonment issues, no anger bursts, or the love you/hate you relationships that are classic signs of BPD. Since I've been on quetiapine (seroquel) I haven't had psychotic manias for a year and 3 months. I am now taking 800 mgs of seroquel and this keeps me calm but only just. My depressions are debilitating and I can't take antidepressants as the last ones I was on made me manic (venlafaxine). My close friends all think I'm bipolar and this has been suggested by other psychiatrists. I am lucky that I live in the UK and don't need insurance to recieve treatment but it is hard. I am due to change psychiatrists this month and I hope there will be a review of my "case"

  • Jim

    If you are indeed BiPolar, the presence of the seroquel, or some other mood-stabilizer IN CONJUNCTION with an anti-depressant might just be the ticket for treating the depression without inducing the mania...the reaction you described is quite common when persons with BiPolar are treated for Unipolar Depression with an anti-depressant.

  • jax

    hi, I 42 and have been dignoised with BPD and also depression. I realise now that I have had drepression for most of my life. As a very youg child having sucidal thoughts, about 8, and at 11 being on valilium. I am at the moment on antidepressants and mood stablisiers and an anti anxiety. But it has taken two years and 3 hospital stays and a few suicide attempts, before my medication is sum what at a level that I can start functioning again. But having said that I find myself(actually my partner) finds me up and down like a yoyo, One day I am going off to buy a business and the next day I'm not coping, because everything is too much. I wonder sometimes if I have a bit of BP 2 traits. One day I hope to wake up, and not wish it was night. And then at night wish that it was morning. I am waiting and working for that day.

  • Heidi

    HI, I am on the flip side here as to im the non Bp and my husband is BPD. But right to point, after 30 years of knowing him. Been together and married for 20 years with 4 beatiful children. Trapped Hell and Sadness would sum it up in short alittle. But if someone out there truely knows what being married or in a relationship with a BPD person is like and then" DIVORCING" one? Well im in the middle of mine now. I filed about 7 months ago. Never say never with Bpd, in our life and also with our children who are so affected also terrible. He has sabotaged every relationship be it famly, friends, neighbors, all. He has been to therapist,psychatrist, psychologist,. We have done couples coulseling over and over. He without fail manipulated and within 2 min of the sessions the focus was on me and he was fine. I am to blame according to him for everything as always. Which he has done knothing other than project lies onto me his whole life anyways. But it is his pain and in that i have given all i can give of myself to him and for this family. He has to want help. I feel deep down he does and knows there isnt something right with him. And things precisely he has said over the years definaltey. But also his fear inside is Big, and i see that also. It is so sad and i do want if i can guide him in a direction maybe or. How would i Bring up Bpd and suggest trying a dr specializing in it? Anyways thanks, sorry so long this is just so awful.

  • Reanna

    I'm 19 years old, and it took doctors over 4 years to figure out that I am bipolar rapid cyclier. I missed out on a lot of things that most teenagers get to do. I couldn't go to school becasue none of my doctors knew what was causing my symptoms. I was on home schooling until I droped out of school, I didn't get to go to my prom, I didn't get to see any of my friends that I had known my whole life graduate, I never got to go to parties my friends were having, I lost contant with all my friends that I had known my whole life. When I found out that I had bipolar I was so scared. It's taken about two years to get use to having bipolar. But I've had to try so many medcines to try and find the one that works good with me because I've also got all three anxity disorders. So I have to take a lot of meds. I still have problems with my medcines. Sometimes I have to try new meds then go through withdraws. I also have rages sometimes there not as bad as other times, but the one person I take all my rages out on is the one person who has been there for me my whole life, my mom. I scream and yell at her, throw things, then I relize what I've done and I feel so much guilt. I always say that I'm sorry, but I know she never forgets what happened. Yet she still sticks by me, never leaves my side, takes me to my doctor vists, helps me when I'm having a bad day. She loves me no matter what and thats what gets me through the day, knowing she's always going to be here for me. Bipolar Rapid Cycling is a very hard disorder to get diagnosed, a lot of people think its the "in" thing if you have bipolar, but its hard to live with and deal with and you have it for the rest of your life. But sometimes there are good moments and sometimes there are moments that you feel like your living in hell and that things will never get better. But they will all you need is trust in yourself that you can get through anything your going through.

  • Rick

    I am a 26 y/o with a degree in psychology. I had the best girlfriend ever, we were against all drug based treatments. However, things were always rough between us. I would obsess over whatever it was that was most important in my life, and if some sort of resolution could not be found my obsession turned to frustration which led to agressive tendencies. She would never acknowlede that I had a form of Bipolar with GAD. After 5 years my gf left me, and told me she could never date me again. At this point the level of obsession has increased to an intolerable level. I am trying to face this head on as best I can. Exposure-Response therapy should help me overcome the obsessions. I read that the effects of this therapy only last for a year or two. This means that if you suffer from this sort of disorder, you should learn to overcome these obsessive states by merely pushing your way through and thinking about something else as difficult as that may be. These new patterns of cognition must become part of who you are... for the rest of your life. Even writing this is unhealthy for me as at this point I am currently obsessing over my tendency to obsess.

  • Donna

    Hi, I am 32 years old and have been diagnosed recently with Bipolar type 2 and been on medication for about 9 months or so, (Lamictal) i hate the idea of being on medication every day for the rest of my life and really would like to know if there is an alternative medicine, i was also diagnosed with Cataplexy (it is a mild form of Narcopolepsy) Not sure if i spelt that right.... I found that it makes a lot of sense when i was diagnosed although sometimes i get confused as to what symptons are really the bipolar happening and what is just a every day feeling, i get a bit confused by it all. I am in a serious relationship and have been for a year now, it is so hard for him, and infact have just gone through another session of me pushing him to the limits and nearly leaving,,, jealousy is a big thing and even without him doing anything... is this a normal thing of bipolar - i am in a situation where i cant afford counselling right now so i am not really sure where to turn to, anyhow - i found this site and thought i would reach out although maybe reading back it doesnt really make sense and in fact i may not have asked any questions!!

  • Anonymous-7

    I am Bipolar type 2, and rapid cycle. I have OCD, PTSD, and a BAD self image problem. I have been in treatment for about 15 years. I have also had a therepist for about 2 of those years. I have been on a lot of drugs. Limited results. I have been in the hospital a few times for thoughts of suicide, and homocide. You know, the old take them with you type thing. I also have some ADD that makes any real learning kind of hard. I have ben marred for almost 4 years. She asked me. Why, I have no idea. I was not going to, but she pushed the matter, and I said yes. (I did not want to saddle her with my "issues". I have also had 3 spine operations on the past 4 years. I also have had stints put in. Three of them. I have bad CAD. All this and I am only 44! If I would have gotten help ealier in life, if they even had any real help, would I be any different? I fanticize about that alot. What if ?..... I am such a big looser. I disgust myself. I still would rather die than be livng in this crap hole I call a life. Sorry, just needed to "vent".

  • Ms. Diva

    when I was 24 (I'm 32 now). Myself, I think I started experiencing symptoms of the disorder when I was 14 and hit puberty. My teen years were "fun" to say the least and saw me struggle with issues regarding school (lack of attendance, crappy grades, few to no friends), promiscuity, rampant, excessive and varied drug use/abuse, my weight going up and my self-esteem going down and what-not. Anyways, when I was diagnosed, I was having more depressive episodes than manic (only 2-3 manic episodes a year) and was put on Welbutrin. I was on Welbutrin for about 1 1/2 yrs. and maxed out on the dosage. When that happened, I was switched to Paxil. I was on Paxil for 6-8 months, and was directed to take it originally in the AM (which I did). However, when I took it in the AM, it made me sleepy and as a result I was falling asleep at work. When I told my dr. what was happening, she told me to try taking it at night, but when I did that, it kept me up and awake so I couldn't sleep (and therefore was again falling asleep at work). *sigh* Again, I told my dr. what was going on and so she then put me on Celexa. I loved Celexa! I took it for 4-6 months but then I was laid-off from work and ended up losing my health insurance so now I'm un-medicated (and have been since January of 2003) Since then, I've seen a therapist ONCE (my friends) and from my behavior and my background that I gave him, he thinks that my Bi-Polar Disorder has morphed into Bi-Polar Disorder II, which is getting increasingly worse. I no longer know which one I actually have and suffer from now (since I have no insurance and haven't seen a dr.), but from all that I've read (thus far) on this site, I'm thinking it IS Bi-Polar Disorder II. Whichever one it is, lemme tell you it sucks ass big time. It makes me wonder now, if the disorder inadvertantly assists in me being over-weight, insecure, having feelings of worthlessness, and having little to NO Self-Esteem/Negative Self Image? I'm pretty sure it does and on the drug subject, I've struggled with (and have been struggling with) a methamphetamine addiction. I'm not proud of htis, but I'm not ashamed of this either. It is what it is and I do my best to live the best way and the healthiest way (and cleanest way) I know how. Sometimes I'm successful, and other times not so successful. But I never quit fighting and trying. Thanks for listening and letting me ramble. I think I needed that.

  • Yvonne Canny

    I found all these doctors do was provide a label i was unwilling to go to hospital because things in my life had gotten out of control , i had not wished to tell my family about this, its all become a bit stigmatising now, i have the name of a nutter i don't know but i do tend to disengage myself from life mentally. i lost a lot of my power and used to be a doctor , unfortunately did not inherit good character nor consistency . also i unfortunately made a lot of sexual faux pas, and this is really a way to get rid of who i am , this has culminated in diminished meaning from life, i think i have a really lethal mental abnormality and probably would have died at four in the sea had someone not recognised . now i seek to end my time , i know i have an intellect but i don't have a normal personality at all, probably exhibit extreme malfunctionism everyone says its always about me i don't even reflect normal feelings of remorse from my life, i made poor choices in my career and this reflected in my breakdown . its like , only parts of me work

  • Morgan

    I am 21 years old and have been in therapy since suicide attempt at 15. At first, they didn't know what it was. The docs tried everything, and not until they put me on Lithium did anything have an effect. But my medication combination didn't work as well as it should have. So then they tried almost all the SSRIs - they worked somewhat, but not as well on my OCD as they could have. Of course, the sexual side effects are horrible! Do I want to stay sane or feel human... My psychiatrist thinks I either have Borderline personality disorder or Bipolar. I made the decision to stop my Lithium about 4 months ago because I wanted to see if I was still "crazy." You have to remember I've been on meds since 15 yrs. Well, my "stable cycling" every year or half a year turned into every two hours when Lithium was out of my system. One hour I'd be on the top of the world and could do anything, the next I would be in horrible depression without confidence. So, Bipolar II Ultradian or Borderline? Now I'm back on the meds - Lithium, Lexapro, Buspirone (which really helps put the breaks on OCD), and Seroquel for sleep. This is the best combo yet. Sometimes I get down, yes, but not as far down or as long. Interpersonal relationships are tough, but therapy helps. Something that's also helped a lot is "Attacking Anxiety and Depression" 15-week session by Lucinda Bassett. It really helps because it let you focus on one aspect of the mind. It reminds you that it's okay, and you can get through it. I haven't finished it, but it's really helped so far. All of this started during puberty. First with the anxiety, then severe depression without typical mania. Then the million-dollar question - does my anxiety cause my depression? Who knows. It does contribute. So I exercise every day, take my meds, sleep regularly, and try to connect with friends. All this is hard from GAD, OCD, IBS, agoraphobia, and Bipolar or Borderline. Why me? Who knows. Deal with it. I help people because I have this knowledge and experience. Medicication will get you only so far. There is no magic pill or quick fix. But you don't have to like it - find a medication combo that works for you and a therapy plan that works (either face-to-face, tapes, books), but keep doing it. Exercise! All I want is to be normal, but there is no normal. Everybody deals with this crap on some level. It takes work, and it never stops. Tomorrow will be better. I'm not ashamed. Feel free to e-mail (heycowgirl@iinet.com). And if you find the magic pill, let me know!

  • Anonymous-8

    I have to ask the question... Do we all truly believe that these conditions are caused by chemical imbalances. Were we all raised in loving homes that nurtured us as children? Have any of you researched what can happen when your inner child has been stifled, and what can happen when our spirit is recovered? I often wonder about what therapists are doing for us, and exactly how badly we would like things to be better. Each one of us has the power within us to get better, we just need the courage and self love to start. God bless each and everyone of us.

  • Anonymous-9

    Yes, I am diagnosed. I am also a very good actress. I can go from crying and pulling my hair out to answering the phome in a friendly calm voice. Why, because I do not want anyone to see the true turmoil. Going to the folks? Visiting the nieces and nephews? The perfect Aunt. Home? Crying. Freaking out. Throwing things. The other side? Hmm lets go out of town where no one knows me. Raise a little roof..Smiling, the FUN party gal... go home-not mine... Does the doctor ask if I'm okay, of course (the actress again) I just need my refills. What if I wasn't being treated?!! Sometimes I cry, but the tears dry quickly once the actress takes over... Yes.. I am sick, and I have been institutionalized--thought of suicide, yes. I have a journal... and a number, I will not die until Ii have achieved that age or someone else has decided for me. Yes, I am sick. My medications help, for without them I am going to die.

  • Nikki

    What causes the inner turmoil that you hide so well? What if someone really wanted to know the true you, and loved you unconditionally? Would you still pull the actress routine? Do you have any close girlfriends? Can they ALL be manipulated? And does that make you smarter than them? Tell me more about where you come from, and where you are going. Then think about where you would like to go, if you had complete control of how you felt all the time.

  • Debra Jean

    For years I went crazy just thinking I'm crazy. Then I found a book titled " I Hate You Don't Leave Me". About Borderline Personality Disorder. My sister 8 years my senior rides high on her Bi-Polar fed lithium induced wave of content. Insisting that I join her. Showing the same, somewhat similar symptoms I was afraid to go in for fear of a misdiagnosis. I know whats wrong once I read this book. I thank you for sharing your concept of two minds and being thought to look too much alike to be different.

  • Anonymous-10

    Nikki, I am On of Many Faces. The Daughr, The wife, who never was (Mother died took over)and neve has been, raped, beaten, slut, murder witness, friend, lover, sister, finacial supporter, ROCK. I do not have the means or time to find out who I am or where I am going. I am in therapy, this is my fifth, and latest, she is very nice and maybe the ONE, who can help. And the same in Physchiatrists. This has been going on since a very young age. I have been wise beyond my years. And I am also a very little scared child still who has been locked up in an adult body (42 yrs), who would love to be released, but alas it is too late. Thank you for your concern, my friend.

  • Ron

    I was diagnosed with Bipolar-type I in October of this year. I knew absolutely nothing about psych disorders, but everything I've read about type I bases diagnosis on the occurance of manic episodes, rather than depression. I've never had, to my satisfaction, any episode that fits the definition of manic, but depression is no stranger to me, and neither is anxiety. It was when depression and anxiety ganged up on me that I sought professional help. However, I'm not sure if I'm actually getting any help, or the right kind of help. I've questioned my doctor's diagnosis, but he insists that I'm Bipolar type I and depressed, so I keep taking the Lamictal and keep waiting for it to work. It was actually a friend and not my therapist or psychiatrist that suggested that I keep track of what's occuring when I have my meltdowns. They only happen when I'm angry at my partner, or worried about my partner, or insecure about my standing with my partner--an obvious pattern has emerged. Should I get another psychiatrist? Does Lamictal work for Borderline Personality Disorder too?

  • Nikki

    Hopelessness of sanity? Your comment of it being too late, at 42 years of age??? Pleassssseeeee... You are convinced that you are beyond help because no one ELSE has been able to make you feel better. You haven't found someone to own YOUR guilt, shame, humiliation. But all the while you have had everything that you need to make a really nice life. You sound smart, and very capable. Your esteem is gone, you've been places and seen things that needn't be lived, but you made those choices and can't accept responsibility for what you have put yourself through. You didn't know better, you were never taught. You have the ability to be, do and have anything in life that you desire. But you are convinced that you don't deserve it. There is nothing more that you deserve in the world is the freedom from this pain. You are capable of achieving that, when you begin to love yourself.

  • Nikki

    To each and everyone of you...This can be the hardest time of the year OR the most wonderful time of the year. Even though each of you may feel all alone, you must recognize that you have made that choice and that everyone of you could be part of a group of some type. A family that you aren't in touch with, friends that are doing other things that you don't feel a part of, organizations of people that are a little further along in their self-acceptance than you. All you need is love to make the loneliness leave. When you begin to love yourself you will attract people that will love being with you. You will meet people that want to listen to your stories and help you to get past them. You will want to spend time with people that seem a little more cheerful when you are in their presence. It can and will happen if you believe in yourselves. The Year of 2007 is about to begin, it could be the best year of your life. It can be whatever you choose it to be. You can rebirth yourself and change all of your thought patterns. You can be the person that you have always admired. A healthy, handsome, successful person that feels beauty on the inside and radiates beauty on the outside. I want this for each of you. Merry Christmas to everyone!!!

  • Ian

    To Who Am I Really, I dig your writing style. I think I understand you well. I used to write just like you, but I decided I didn't want to feel that anymore. I want to let you know that you should write a book and consider making a decision about what you desire your future to look like. It's all up to you. If you have the power to fake it, then you have the power to be it. The thing is that I understand that dark side. I got overwhelmed at a certain point in my young adulthood. I met a girl who was bi-polar, and it seemed to be so fascinating and alluring. I wanted to be bi-polar too. Next thing I knew, I was in a very depressed state that took me a year and a half to get out of. I was sleeping all day and writing mad poetry and prose at night. I could have easily gone down further. For some reason, I kept on trying to change my thought patterns. For years after, I still suffered from mood swings, that would get more and more mild. I kept on climbing out of that insanity until, years later, I am totally "normal" and productive. No meds, just relaxation into contentment. I'm not saying that people shouldn't take meds, just that I did not and the symptoms of bi-polar have almost completely gone away... Perhaps, based on this article, it was borderline all along. We need to learn so much more about the chemicals in the brain and our possible ability to control them through our conscious thoughts. We also need de-stigmatization of disorders so that people can focus on being content with themselves and not be worried about other people's judgments. Yeah Nikki for your inspirational words!

  • Nikki

    Happy New Year!!!!! Hope that the start of the year has been good for everyone. Thank you Ian for your kind contribution, it is awesome to hear about people that have made the choice to really live!!!

  • Nerissa Belcher

    The post is well thought out but I do have one section I question. From the post: "You'd perhaps expect some regularity to mood cycling if it were truly uniquely caused by some underlying chemical disturbance."

    This would only be true if the chemical disturbance was not affected by things the person was likely to encounter in their environment. For example, consider the physical problem, diabetes. Blood sugar (BS) is affected by diabetes. Using the logic in the post one would assume BS would fluctuate the same day after day, hour by hour. But does it?

    Not really. BS is influenced by physical and emotional stress. By time and type of medication taken. By time, size and type of meal last eaten, etc. If we did not know what caused diabetes we might well assume it to be a psychological problem since the BS levels are so random.

    Nerissa

  • JustMe

    I find alot of the posters here blaming their parents and childhood. Did any of you ever think that your parents were also not well. And that all of your perceptions are a bit skewed? To negate the impact of faulty neurotransmission, is to harken back to the days when mental illness and demonic possession were considered to be the same thing.

  • Rob

    Most psychiatrists/psychologists and most of the public only view their external world in reference to themselves and thier own biases and goals. Thus someone who stands to gain from selling pysch drugs will favor a biochemical model, and those who stand to gain from therapy will favor a social model. Someone who is out of control and a failure in one or more ways will, being all too human, favor whatever excuse seems the best, shifting from excuse to excuse as a new one seems better than an old one.

    Only game theory can actually explain what is going on. Briefly, mother nature purposely spins out variants of every life form, and rather sardonically pits them against each other in a battle of all against all, for her entertainment. Some she spins out purposefully weak, to serve as an easy meal for a predator - for instance, a child or gazelle born lame, or a polio victim.

    Blindness, which afflicts humans and all game animals, is another gift for predators.

    Sometims groups of creatures will cooperate, in both defense and hunting, in order to better their odds of success. But a group which cooperates for defense, may, after the victory, disband to various degrees and prey on each other, as the inhabitants and invaders of India have been so famous for throughout their history.

    What is true in the "animal world", as frreqently seen for instance on the "Discovery Channel" or "National Geographic" shows, is true of humans also. When we are not committing outright predation and seizing of territory, we engage in subtler predations and seizures within the boundaries of the laws of the the society we find ourselves in, and sometimes outside the laws. Even the so called "honest" businessman, in seeking his success, often seeks at the same time the demise of his competitors. When a competitor succumbs, he may find himself bankrupt, even homeless, and may take to drugs and suicide. But the "honest" businessman, who put him out of business, did not break any laws, and does not assume any responsibility or guilt for what then happened to his vanquished competitor. And so while the vanquished prepared to blow his brains out, the successful business played with his children in his pool.

    This is how it is. And this is, for the most part, what makes people mentally ill. It is a combination of misfortunate genetics, being born in misfornuate circumstances, and then, failure to admit you are an animal, and essentially bad. The lies of societies, regarding the goodness of humanity, creates confusion and the possibility of all sorts of excuses, which then make you worse. It is entablement upon entanglement, and truth, if there is such a thing, disappears. Then, if you find yourself in a state of misery, you seek truth from unenlightened doctors and ersatz holy men, who only further confuse you, because they claim, publicly and to themselves, to be "good".

    The way out of this mess is to acknowledge what you are, an animal, and a bad human, and stop making up pop psychology stories and entertaining those and other false stories in your fantasy mind. Stop. Take a breath. Relax. You are an animal on planet earth. Now deal with it.

    Virtually all persons diagnosed with bipolar, depression, borderline, ADD, etc., can overcome to a large degree without meds if they will it. In order to will it you have to let go of all stories about what "humanity" is, and accept your animal nature and your place in the social heirarchy, which may very well be a stinking rotten place. Once you accept that you are an animal, and basically selfish and bad, not good, then you can begin to see what you have to do to improve your situation. Letting go of grudges and demonizations of others is a good first step in rehabilitiation. This can best be done by acknowledging that you really are not better than those you demonize, and you may in fact be weaker than those you demonize.

    Holding onto grudges and demonization of others has the strange result of making you weaker, and less attractive to others - both disadvantages. Think only in terms of advantage and calm. Relax. Stop intoxicating ( a sign of weakness) and begin, one little step at a time, to do what is most advantageous for you in your situation, in order to improve your situation.

    Be conscious of your thoughts and question their validity and orgins. Most thoughts are not your own, but only reactions to external events, and literally triggered by those external events. The event does not trigger "you", it triggers thoughts to occur, in a very mechanical way.

    Those who react mechanically, without standing back and thinking it through, are seen as oafish by those who think more carefully. If you act oafishly, you will be marginalized, and if you do not find yourself alone, you will find yourself only in the company of similar oafs, using each other as excuses to validate each other, and therefore deny your oafishness. You will suffer low income, and then think you have a "right" to various types of governmental support, which is, as it turns out, exactly how the tick thinks. The tick thinks it has a right to suck the blood of it's host animal. But you will deceptively call such thinking "humanism", or "progressive", or some other such label that you think makes you look good. You will pretend that your demands of support are for the good of humanity, or all the other weak people, when in fact you are only making such demands for your own gain. Again we see that problem that you are denying that you are bad, and weak. You are being nothing but an animal in this state, which would be OK, except that you are emulating a very weak and fearful and sneaky animal, rather than a lion or elephant.

    The human oaf is not new, and was the main reason Manusmurti ("Manu") wrote the Upanishad over 5000 years ago. He literally informed the other humans and half humans around him how to act more nobly, including such minutae as how and where to defecate, and to wash the hands after defecation.

    Manu was living in what is today India, and later, around 2500 hundred years ago, Prince Guatama, aka The Buddha, who had read Manu's scripts, elaborated on the matter, creating the philosophy/psychology now known as Buddhism. Like Manu, Prince Guatama was writing to inform people how really wretched they are, and how living more calmly and happily and cooperatively is actually possible, but only after one acknowledges one's wretchedness. Today one often notices that Buddhists are remarkably calm and in control. Their faces, voice and body language show a lack of anxiety.

    And 2000 years ago a man reputedly named Jesus of Nazareth, likely schooled in Buddhism, further explained the human condition and gave more recommendation on how to live happily and at peace with one's nature. They killed him, as one would expect, just as they killed Socrates, Gandhi, and Martin Luther King. It's amazing that Prince Guatama was not killed. Truth tellers are hated by many, because it is only by the words of a truth teller that one may come to know one's wretchedness. Many, being faced with yow horrible they are, react violently, allowing thoughts of homicide to be triggered in their minds. And as they are oafish people, they allow the triggering without second thought. Oafish people think a thought is valid, for the reason that the thought has appeared in their minds. They never question a thought.

    And I will spend a paragraph here on homliness. If you are homely or ugly, humans will be unkind to you and avoid you. This will make you sour inside, and depressed or bipolar, and if a woman or feminine man, borderline. This is because life is scary and uncertain, we all feel anxious and stressed to some degree, (except the masters), and so, if you percieive yourself to be particularly weak or disadvantaged, like by homliness, you may try to cling to another person, like clinging to driftwood when awash in the ocean. This clinging takes the form of seduction and other kinds of manipulation, whereby you try to bond another human to you, as you might use rope to bond the driftwood to you. But, you adopt a facade of denial that this is what you are doing. And when the person you have bound and sunk your claws into objects, and wants freedom, you over react, primarly because you have been found out.

    And in yet further actions of denial and deception, you search around for pop psychology explanations for why you are right, and the victim, and the person you manipulatively clung to is wrong, and unjust. There are probably a thousand such phony pop psychology excuse du jours. The real solution is to admit to what you are, a homely thing clinging desparately to something you need to keep you afloat, like an ant on the back of a beetle during a flood.

    To make matters worse, the mean and desperate people who will not control themselves or be honest about their animal nature, who are shunned by more honest and successful and beautiful people, end up in the company of each other, and the manipulations and chicanery go both ways, like two strings knotting with each other into an undeciferable ball of misery.

    How hard is it to finally make the admission of your abject horribleness, especially late in life when most of your life is behind you! It is very hard, yet this admission is the pass key to the end of your psychological problems, your mood swings and your feeling of desperation and self hate.

    Admit to how horrible you are, and how horrible your spouse or significant other is, and let all the misbegotten past go, forgiving others and yourself in one deep breath.

    Forget every excuse you have ever used, including the many you have been fed by your psychiatrist/psychologist.

    Eat a simple, healthful diet, low on fats, sugars and carbs, high on vegetables and legumes. Give up the alcohol, recreational drugs, (yes give up the weed), the gambling, the porno. Begin to exersize, and stop dwelling on negative thinking, aka stinkin' thinkin'.

    Gradually, like a freighter turning on the open seas, your life will turn around, and more and more people will like you, you mind will clear and become sharper, and your social situation will improve.

    Read the Buddhist texts, the Upanishads, the New Testatment, and the works of other well known spiritualists, like Gandhi and Soren Kierkegaard. Focus on being kind and just, but not overly kind or just, which would be people pleasing, a kind of weakness. Recognize that everything that tortures your psyche is nothing but the conflict between wanting to be more than animal, while being an animal.

    You may have to be very indulgent once and a while, for instance, having a lost weekend, since virtue tends to be strongest once it has slept. But during these lost weekends, do nothing to harm or cheat anyone, nor create an unwanted pregnancy, or spread a disease. Just drink and be merry, do not drink and drive, and then on Monday, admit that you are animal, and being human is not that easy. Then try to be a better human all over again.

    This is all you need to know. If you are on meds, taper off gradually. If you are on meds for schizophrenia, you may not be able to go med free - work with your pdoc to taper down as you get more in control of yourself. Most people with one or the other diagnosis, other than schizophrenia, can live med free, and be happier than on meds, just by following the course I have described.

    Cheers

  • E Lacy

    All I can keep saying is, do your research. Depression does not cause a person to stay up for days, make life changing alterations and cause rage attacks. If you are willing to admit that you do experience any or all of the above yeah you are bipolar. Which kind? More research. Most people go for help when they are depressed and either the physician doesn't ask about these significant symptoms or the patient isn't forthcoming. Be honest with your doctor. Medication can definitely be a diagnostic agent. Lithium, Depakote, Lamictal, ( and on and on). Please read the book: Listening to Prozac. Easy read but with some nice research and history. Some people "blame" nurture for bipolar. Genetics, people!!! There is no such thing as one bad apple, its just a matter of what flavor of apple effects others in your family, and past generations also. Alcoholism, drug abuse, suicide, the aunt that never came out of her room, the nephew who couldn't get along with anyone, homelessness. To me, this all says that there are brain malfunctions just like there is with any other organ in your body. Yes, the brain is an organ too! Our bodies are incredibly complex and the brain, most mysterious, delicate, and unknown of all. And to make it even more interesting, toss in electrical impulses that are firing off in our brains at the speed of light! Think about it! I say, god speed to all researchers who are striving for better test and medications. Until then, we also have to try to take responsibility for our own maintenance. Take your meds and take them in the manner prescribed. Never! Stop taking your meds cold turkey!!! Talk to your physician about what you would like to change or see happen. Me? I'd like a little more sparkle in my life. That's kind of a subtle and hard thing to create. I need to go for more walks. I need to get a job. I need to not get involved with people who are toxic and don't respect my issues. People who say, you should just be able to fix your self. Serious brain disorders can effect everything your body does. Serious illnesses need serious medication. And bipolar disorders are serious. Get over the dependency schtick! Otherwise, you're just blaming the victim: yourself! Join a group! You may actually help someone else and also see that you are not the only one, at all! If you are able, get test for other things that might effect the way your body functions, like thyroid, hormone levels, liver function,and ask! Research and ask and suggest. Be your own advocate. Take someone with you when you see a doctor, someone who can help shed some light on symptoms. And that way, the dr. will know someone cares and is paying attention. I go to a mental health system and a general health system. Try to find one, if you can't afford otherwise! And these people are so nice! Really! Open your heart and let help come in.

  • Anonymous-11

    Here are my thoughts on Borderline vs. Bipolar. I grew up in and out of fosterhomes due to my abusive home life. At the age of 12, I started exhibiting behavioral problems. I had trouble sleeping, frequent mood swings, and trouble socializing. I was diagnosed as having Bipolar II disorder.

    Between the ages of 12 and 25 I saw between 10 and 20 doctors and was prescribed everything med under the sun. Nothing was working. At that age of 25 I had given up hope.

    While sitting in the psych ward at the hospital, I discovered a flier for a study on Borderline Personality Disorder and Dialectical Behavioral Therapy (DBT). No one had ever mentioned borderline to me. I only noticed on the flier that the symptoms seemed to describe me. I was accepted to the study and went through a year of DBT. I graduated last year.

    DBT has changed my life. I was able to be weaned off all of my meds and have lost 30lbs. I no longer hurt myself or others. I get along better with my friends and family. I have almost completed my BA and am gainfully employed.

    Things aren't perfect. There are times when my emotions are intense and painful. But I learned the skills to tolerate painful emotions without acting on them. I would recommend that anyone who has been diagnosed with Bipolar type II to investigate DBT. It is possible that you have been misdiagnosed.

    Editor's Note: DBT is indeed a wonderful therapy for Borderline Personality Disorder. You can read or listen to an interview we've recently conducted with Marsha Linehan, Ph.D. if you'd like more information on this therapy.

  • rapid bp daily cycler and borderline personallity

    I appreciate your article it helped me to understand my disorder a little more than I did. I have been on disability since 98. Sometimes i just feel like a freak of nature and feel bad for my children. I can not take much of the meds out there but they have found some to calm it down i gave up therapy been it it for years does not work. Anyway my story is long, i also have anorexia because of the disorders also. it comes and goes just like my moods, sometimes, lol. keep on writing about these two things that make me miserable at times. ty

  • coworker of Patient

    My Coworker makes our lives a living hell. She's gorgeous, ITALIAN, fabulous figure. Because of this combination, our male bosses while visibly enjoying her looks, enable her to get sicker & sicker, more bizarre & abusive. She and they blame it on her being "Italian & Passionate". Personal life is chaos.

    Throughout the day, she screams, cries, shouts, laughs, growls, moans, swears, beats her laptop & furniture (kills a laptop/yr), bouncing around, stomps rapidly up & down the hallway incessantly looking for somebody to soothe her (discuss phoney work issues). She used to scream out every 10 minutes for other coworkers to assist her with phoney ultra-simple help issues, but they have moved away. Zero boundaries, Zero. Very weird, rude, invasive, extremely judgemental comments. I wear a headset & appear to be working desperately hard to keep her from riding me like a stripper-pole. I also pretend not to hear any screams for me--if she really needs me, she eventuallly walks over and talks like a grownup.

    She's too impatient to learn about work projects, take work related courses, too impatient & abusive to comprehend when experts explain to her, so I'd say she's wasted over $100k in the last 12 months in mismanaged projects. We've been working on a project for over a year. When she hears the word database or metadata, she starts acting like the "Exorcist" for the rest of the meeting, the rest of us have to talk through it and ignore her. We've learned to talk in code around her, very simple-seeming language.

    The company & managers deserve every penny of waste for conspiring to abuse the rest of us. What's wierd is she can shut off the batshiat-crazy when a more alpha dog is in the room, but it's uncontrollable when there's peers or below her.

    I'm forseeing either physical abuse or killing in her future by lovers driven insane, or abandonment. My friend in the assisted care industry sees the end result of abandoned bipolar/borderlines who're too "difficult" & create too much work, and bounced from facility to facility.

  • susan

    i have bipolar 1 and borderline personality i have tryed dbt it is great but for me i am not into groups,i quit going,i have yet to find out what is the diffrence in bipolar 1 and borderline but it is hard either way i also have a heart condition,my daughter has rad and adhd it is realy hard dealing with my issues and hers

  • Anonymous-12

    I have been diagnosed with bipolar II rapid cycling with borderline personality disorder. My mom is also diagnosed bipolar type II and I have endured some childhood abuse and neglect that has led my pdoc to make the dual diagnosis. I would have to agree that you really can't disentangle the two all of the time. I started keeping a mood journal and I can definately say that bpd "perceived threats" can be a trigger for a depressive cycle. On the flip side, I do have pronounced hypomania which is completely bpd unrelated. I tend to believe that you can't really take nature and nurture and break it down to which one is more important. The real question should be how do they work together...

  • Breezie

    I was interested to read a comment by Nerrisa disputing the biochemical element of mood disorders in which she raises the point or question that if those suffering Mood disorders which were trully caused by a chemical imbalance ,they would surely show some regularity, and would not be affected by what events take place in their environment. I can not quite understand how she has arrived at this this rationale. Even those with or without a mood disorder will have some mod variation during a crises or stressful period or evnt, it will just be more pronounced or go on to trigger a more extreme or prolonged effct in those whose mmods can not regulate themselves and return to normal. With regard to regularity, I think in many cases there is a strong level of regularity alomngside these stress induced moods. Baring in mind everyone's brain chemistry differs initially anyway on some levels, which is why I think people respond differently to different medications,Even if you look at episodes of mood disorder that "appear" to occur "irregularly", if you look closely enough over many years there often is a regularity in some respect , though not apparent at first glance. For examle some people seem to always have their epiosdes of mania or depression at specific times of the year, or they have a specific duration of short or long epiosdes, or maybe every year or every 5 years, or every month for 2 weeks or every 3 months for 4 months etc. In the midst of this there will always be life changes and events that appear to be the tirigger, or are assumed are the cause for an episode,however some times if examined closely these have not necessarily been the trigger, and the episode will occur the mnext year at the same time for the same time, but just coincidentally occurring at a time when a person would usually be due fr another epiosde anyway. REgularity also shows in individulas returning to identicla sets of symptoms or paticular patterns of behviour in one mood state that is re[peated every time they are in that mood state, and then adopting a different set of behaviours which are also repaeted fir the opposiote pole of mood. I have observed this regularity, in my husband ove many years, and there is no reason why stressful events should not have any impact just becuase the mood is thought to be cuased by a chemical imbalance. In fact it seems more likely to me. Those who are sensitive to brain chemistry changes or whose regulation of these chemiclas id faulty and not fully functional will be more susceptible to changes when normal stress hormones are released in response to suddend changes or ongoinmg stress which will in turn work on destabilising other brain chemicals. Corticosteroids released during sudden or prolonged stress will act on other brain chemicals. The attempts to get well and battle with the illness , appointments, and treatments and expectations of self and of others can cause sufficient stress to act as its own trigger on already sensitised chemicals in this respect, even in the absence of other moreobvious triggers. This is where self maagement can really help to reduce or minimise he severity or frequency of moods experienced, with relaxation, exercise to reduce blood pressure, and relax muscles, cutting out stimulants that trigger adrenaline, such as caffeine, stimulant drugs, cocaine and amphetamines, alcohol sugar that also causes a sudden rise in blood sugar and insulin release, followed by a rapid drop in blood sugar, and shifting mood and energy levels, improving diet and aregualr meal pattern, regular sleeping habits to reduce cortoisol levels. All these things have an impact on body chemistry, hence brain chemistry, hence stress levels. In addition to these spontaneously occurring episodes of mood change, common stress triggers, may truly trigger a unexpected mood epiosde or aggravate or extend it. We are all affected by crises,and change which causes stress hormones to be released . Some individuals appear more sensitive to these stresses , and the chemicals released during them,than others depending on our learnt abilities to cope with change and stress, and interestingly some reserach suggests we become sensitized in the womb by the amount of circulating stress hormones in the mothers bloodstreamand her response to stress, as well as the observed responses and coping we witness during childhood. However, we all have subtle or sometimes obvious ups and downs in response to these events, but someone with this increased biochemical sensitivity , which seems to go hand in hand with mood diorders, naturally stress hormones being released will have a more pronounced impact on other brain chemicals, and the response is just experienced or expressed in more extreme moods in those with exaggerated moods as in bipolar. Nevertheless, there is definitely regularity on many levels either in patterns of behaviourm frequency, severity or type of response I feel. Biochemistry and environment seems to interplay, each influencing each other, and ones subjective experience.

  • Olivia

    My 24 year old daughter was diagnosed two years ago as having Bi-polar disorder. She has mixed state, and is an ultridian cycler. The interesting things is that it answered so many questions her father and I have had from her childhood. From the day of her birth I had questions in my mind about why she was different in so many ways. These ranged from the way she breastfed to the the way the word "no" was like waving a red flag in front of a bull to the unbelievable time we had with her learning to tell the truth. In doing much reading in the last two years I have come to realize that she has had bi-polar disorder since birth.

    Her diagnosis has freed her to realize that her feelings while she was growing up of being a freak and "crazy" have given way to understanding that she isn't 'crazy' and isn't a bad person. Her father and I no longer feel like we were bad parents. In fact in looking back we realize that we did many things right and have helped her to reach adulthood in a way that has prepared her to meet this challenge in her life with maturity and courage.

    Because symptoms have been present since birth I can say with confidence, at least in her case, that having bi-polar disorder has contributed to problems in her childhood that seemed like borderline personality disorders but that they did not co-exist.

  • Betsee

    An MD and previous MD's (psychiatrists) have diagnosed me with Bipolar but I don't understand why as I NEVER have manic phases. When I was in my teen years, I did experience "highs" for no reason but I have not since those years.

    I am 48 and just have terrible depression day after day. I get irritable and angry but never MANIC. How is a mood stabilizer going to make me less depressed if prescribed? And I refuse to take one that will make me gain weight, further increasing my depression. Any suggestions, thoughts? I definitely do believe I have borderline personality disorder. I also just found out that my thyroid functioning is low.

  • J.

    My problems started in my early teens with Truancy, temper & severe jealousy with boyfriends, but I was not diagnosed until I was about 43 years old. I had been married 3 times by the age of 27. I had no control over my temper or jealousy, which usually went together. I am a 'high functioning' Borderline, as I hold down jobs & I am regarded as reliable & good at the jobs I do. In 2006 I had a very bad year & was suffering a great deal of stress, which caused my borderline traits, which were usually well covered, to surface. A colleague pretended to be my friend & wanted to help me, I made the fatal mistake of telling her that I had this disorder, which she then repeated to a Manager. after 7 years service I was removed from the premises. Eventually I went back, & staff 'ganged up' & told lies about me & I was suspended & then Dismissed. Apparently, I was threatening the health & safety of other staff. I hadn't threatened them BEFORE she learned that I have a disorder. I was good at that job for over 8 years, now I seem to be viewed as a danger to society. I am now unemployed, unhappy & feel worthless. They were annoyed because I clean equipment, go over & over a problem, fear loss of control, For all this current Diversity training - it actually means nothing in reality.

  • Justin

    not sure if agree with MD's - Betsee - Feb 7th 2009

    An MD and previous MD's (psychiatrists) have diagnosed me with Bipolar but I don't understand why as I NEVER have manic phases. When I was in my teen years, I did experience "highs" for no reason but I have not since those years.

    I am 48 and just have terrible depression day after day. I get irritable and angry but never MANIC. How is a mood stabilizer going to make me less depressed if prescribed? And I refuse to take one that will make me gain weight, further increasing my depression. Any suggestions, thoughts? I definitely do believe I have borderline personality disorder. I also just found out that my thyroid functioning is low.

    Betsee-

    What you have to realize is there are three different types of bipolar mood disorders-Bipolar I, Bipolar II, and cyclothymia. Even if you have never experienced a full blown manic episode, you can still be diagnosed with a bipolar mood disorder. From what I can infer, you seem to experience something called hypomanic episodes which exhibit similar symptoms as manic episodes but differ in that they are less severe and have shorter duration. One of the symptoms of a hypomanic episode is irritability. The person is easily agitated and as a result often becomes angry for no apparent reason. You mentioned that you "get irritable and angry". The other qualification for a diagnosis of Bipolar II is at least one Major depressive episode which, from the sounds of it, you have experienced.

    A strong mood stabilizer, such as lithium, may not be needed to treat your hypomanic episodes but this is something that you and your psychiatrist should decide. Moreover, it would be extremely beneficial if you were to seek therapy for your bipolar and or depression. There is a type of therapy called interpersonal and social rhythm therapy specifically intented to treat people with Bipolar. Often there are certain social or environemntal stressors that precipitate a manic or hypomanic episode. This form of therapy attempts to identify these stressors and get the person in a daily routine. Often people with bipolar have poor eating and sleeping habitis which are believed to provoke or exacerbate their bipolar symptoms. Getting into a good routine, such as going to bed at a certain time every night and eating on a reugular basis, has prooven to be effective in preventing the onset of manic and hypomanic episodes. You have to be careful with taking antidepressants because they can trigger a hypomanic or manic episode.

  • skyler

    if you are molsted can that cause bipolar to???

    Editor's Note: Bipolar Disorder is not caused by events like molestation, although being molested is undoubtably often a stressful and depressive event which coudl make a pre-existing vulnerability worse.

  • lynda

    I would like to know how, in this day and age, with all the research and information available through training institutions etc, how do the professionals in the mental health field still get it so wrong?

    Sites like these are littered with people who have been misdiagnosed, misprescribed, or simply left to sort it out for them selves. Sometimes their lives and mental health issues have been hacked to the extent that where there may have been hope, the situation now seems hopeless.

    There is still so much stigma, predudice and misunderstanding about mental health in our communities. GPs are sometimes uncooperative, judgemental and underprepared to deal with issues of the psyche, prefering to pass the buck or put the problem in the too-hard-basket.

    I would like to know why it is so hard to get help. if I had a broken arm, or diabetes help would not be a problem. No one has an issue about taking meds for cancer, diabetes or heart problems. So why the attitude change when it comes to meds for brain function?

    It just goes to show that in so many ways we are still in the dark ages. Until the health professionals we rely on to help us start to change their thinking, the unnecessary suffering of victims of brain function problems and their families continues.

  • Georgiainkentucky

    I am from a small town that doesn't have alot of knowledge of mental issues. I was always very mischeivious in school. I had 4 children with my ex husband and I was always so very jealous. I was in and out of jail so many times for fighting, reckless driving and drinking. I went to the dr. the first time about 5 yrs. ago and they diagnosed me with deep depression, post tramatic stress syndrome and anxiety. Nothing ever really helped, so I moved out of town. I went to a different dr. in the town that I am in now. He diagnosed me 2 mos. ago with ADHD. I am paying $178 a month for Vyvanese and it is not even helping me. I started reading into the borderline personality disorder and I just know that is what I really have to have. I taken 3 different test and I have just about every symtom. I am going to let the dr. know next month on my next visit, because it is just hell living the way that I have been living all my life. I have had over 75 or more very good high paying jobs in the last 10 yrs. I can't cope being around people, not even my kids most of the time. If my relationship is not going good with my boyfriend that I have been with for the last 13 yrs. then I am misaerable. I go into bad panic attacks, cry and just want to die if he leaves me for one night. I have a bad fear of abandonment, angry, bad temper, don't have any friends and don't really want to make any because I know that I will do or say something to lose them, I am scared to say things because I know that I will say something stupid, I am so forgetful. My biggest problem is trying to work or go somewhere without my boyfriend. I fear even going out the door without him because I am afraid he will leave me for good. I am either sad, scared, worried, anxious, or angry everyday of my life. I just wished that I could live a normal life, but everything that I have read about borderline, there is not much help and if so it will take a very long time.

  • Vickie

    I have had chronic depression all of my life and 3 years ago I was diagnosed with Bipolar Disorder. I am curious to know if my bipolar has anything to do with the fact that every general observational thought comes out of my mouth? I can't seem to keep my mouth shut and it's driving not only my family crazy, but I'm exhausted as well. Is this just a personality trait or habit, or is it indeed a result of bipolar disorder? Is this something that can be controlled with meds?

    Thanks

  • peaches

    I feel the same way Vikki, I say whatever cometo mind. Say it. t get on my nerves and my family nerves too. Is it a trait of Bipolar. I have Bipolar and I take Seroquel, depakote, celex and another that begins with a B.

  • Kait M

    Hello,

    I was stunned when I read this article and information regarding the topic on, "Rapid-Cycling Bipolar and Borderline Personality Disorder." I am amaized and I feel like I just put the final piece in a JANGA game. My life has consisted of growing up nothing but TRAUMA and DRAMA. It began with my alcoholic father, whom left my mother an I when it was just past my first birthday. Then I was sexually abused by my first step-dad (my younger sister's biological father) from the ages 2-7. I had to testify in court right in front of him along with my step-brother who was also molested. Then it was decided that my step-father was guilty but he never recievd a jail sentence, just probation. We were still allowed to see him as a family, and did for the whole following summer after the court case. I was sexually abused by him again, nothing was done about it. My mother finally broke free from him as we were living in seperate communitys and she of course met a new man. On her forth husband now and my 3rd father.... I didn't take to him to nicely. My sister adored him and well of course, she never really knew her father, and it was the only Dad I knew-- I wanted him back... I figured he didn't do anything wrong if we were allowed to go back and the same thing happened. Well the NEW guy wasn't going anywhere and he made that quite clear to me! My mother let him disipline me right off the get go.... which I thought was terrible. Way too soon as he was living with us within 3 months of dating MY MUM and they married 3 moths after that. Being my NEW DAD... we had a NEW family too. He had a Mother (who was the culprit who sold AVON to my shopaholic mother and fixed her 6 month clean and sober son up with MY MUM) and a Step-father who was in the Navy.... he also had a Brother who was married with two kids a boy (year younger than me) and a daughter (my sisters age). So I guess we were all one big happy family for a while. Us cousins became close.... we got babysat by the GRAND parents when ever we needed sitting.... HE always offered to take us all the time. Well in a matter of time I realized something was going on when I was sick one day from school..... my sister was in kindergarten and she was taking, "NAPS" with our new Grandpa.... the he told me cause I was sick I had to go have a NAP too... well from there it started. Then he started taking us out to the gun range... teaching us about GUNS... (My new step-Dad had all ready taken me out a few times and I liked it... but the Grandpa had a lot of GUNS special ones he would show us. Then one day he pointed a gun right at me and said, "You never point a gun at someone unless you are going to kill them." He cocked back the pistol and quickly shot it in a different possision by me and told me that if I told anyone what was going on with me and my sister, (I guess he knew what had happened to me?? Or my age?) that next time he would shoot me and my sister. I was terrified!!! I didn't tell untill 2 years later. I couldn't out of fear and manilpulation. My poor sister, I didn't care that it was happening to me..... but my little sister was going through what I had to go through... I had to watch. So then from there my life went down hill after the court...... he only got 18 months!!! This was for abusing my sister, myself and his daughter -who was 34 at the time when she came foward about the sexual abuse she endurred her whole childhood and teen-years untill she left home from him. I ended up smoking and smoking pot after ..... running away.... hitch hiking all over BC..... I hung out with anyone that was, "bad." I got myself a froud charge by the time I was 15 for ripping off my GOOD grandfather (Mums Dad) while he was in Chile..... he left me with his VISA and Interact Card..... I took advantage.... I always just wanted to fit in and I guess with the finer things in life I thought I could. In anycase I grew up always going to councelors and them saying I was a real delite and a a wonderful person to know... and how strong of a perrson I am...... well I ended up going from man to man getting beaten by these guys that so called loved me.... then I got into serious drugs after I cought a wonderful job working as an ADVOCATE when I turned 20.... by 24 I was using needles.... I was 20 all ready with HIV from un-protected sex and now I deciede to get back into drugs (before I had only tried snorting cocaine a few times.... well I would have tried anything I think if it was put in front of me I was such a risk taker but... thank GOD I got a hold on things when I was young..... I was diagnosed at 20 3 days after my 20th b-day....... so then it was all this BI-polar stuff and dealing with the past and I was a mess so was it the illness and PTSD?? Did I just BANG! All of the sudden come out of the closet and have Bi-polar? I just went with the conclusion and all the meds and mix ups because of the HIV meds. I LOVED my job.... I was healthy and working and HELPING others that couldn't help themselves.... but I found out that I was really co-dependant..... I started to CARE too much for my clients and then being around the drugs I fell back into my bottom-less pit of self pitty and presumed yself into drugs..... this time was differnt though.... Opiate pills... then it was Heroin.... smoking then I--- me even got into needles... then it was loosing the great job- my studio appartment and everything else that belonged to me that I loved!! Like my Family. Now I am on Lamuvidine, Topirimate, for my moods and I wonder...... am I still not being treated properly? I have been clean now for well over two years now... going to school and have conquered the battlle of self worth.... but I have lived quite a tale to tell. (Sorry for any spell errors as I did this quite quickly)

  • shirin

    hi

    this is shirin i want know more about this scikness if any possible just tell meyes or sent for me some movie about that

    thanks

  • Syed ImtiazAli Shah

    My son has been diagnosed sufferring from Schizophrenia aged 23 yrs. I would like to know about this disease . Where does this disease fall? He is on medication . By the grace of god he is improving. What care should Itake for his early recovery and does not deteriorate again.

  • MCDrennan, LCSW-C

    One of the risks is that patients improve and stop taking their medications. It's like being prescribed an antibiotic for 10 days and on the 5th day you start to feel good, so you stop taking the meds and the infection comes back. Schizophrenia, of course is not an infection and he is not taking antibiotics for his condition. People with schizophrenia can lead independent, meaningful life, but if your son lives alone, and you notice a change in his behavior, it may be a sign that he thought the meds were no longer necessary. For your own support, you might want to connect with other families in your situation. Your therapist should be able to help you with that. I hope your son has continued improvement.

  • emma

    To Rob The most helpful comments Ihave read. What a concept! I am inspired to try your suggestions.

  • russocomedy

    I'm simply being supportive here, grateful we've come to an age where Bipolar and Borderline Personality Disorder is open to discussion. I've suffered from both since the death of my mother when I was three, an ingrained fear of abondonment, an impulse never satisfied, always on, attempted suicides, self destructive bi-polar swings, low cycles to manic highs, once a jump overboard into a river filled with barge traffic. What's worse is there was never any help. One just didn't talk about it or suffer personal and social rejection. That was a long time ago and I merely offer it as an example that manageing such pain can lead to a productive life with successful moments as it did with me. but to some of my acquaintences with the same symptoms it led to their death at their own hands. My point here in commenting is as I said: to congratulate this community for organizing itself and to say thanks for the sanity, community outreach and to shine a light into the ignorance of medeval thought that cannot accept the concept that a brain problem is as vital a problem as much as a broken arm or a splinter in the eye. I've been around since the ealy thirties so my time is mostly past but we've now generations struggling to find support in a too often confusing life. It is my humble wish the bright powers that be in America, governement, insurance powerbrokers, and educators, take in hand the fact that an issue like mental health belongs in the public square of our global village.

  • natasha dennis

    this is the main reason I am studying in this field I too have suffered from many disabilities all my life with no assistance .My goal is too become an advocate in the mental health field an open an non-profit organization

  • Anonymous-13

    My boyfriend and I have been together just a year now... slowly over time, Ive gone from being emotional (like crying and so forth) to getting so mad, I do whatever I have to to get a reaction out of him (while Im acting psychotic, Im fully aware of it, but at the time, I dont care, then once I have the reaction I wanted, I feel really bad). He brought up that he thinks Im obsessed, but I read into obsessive love, and Im not like that, if anything, I push him away more so than obsess. What could be wrong with me?

  • Anonymous-14

    The effects of cannabis addiction on the rate of cycling in bipolar disorder and how borderline personalities influence mixed episodes within those cycles.

  • Anonymous-15

    I have been seeing the same psychiatrist for the past 5 years. We have built up a good relationship with each other but I am very much wondering about her true ability to understand my circumstances and give advice. I am a big guy, 6'2" tall and my weight goes between 250 to 265. She has put me on all sorts of meds but Depakote has always been central. I have been on so many meds that my body shakes to now in which I wonder if I need more or something different. Moreover, I have had to ask her for so much advice about finding support groups, resources, etc, and she really did not know a lot of current info. She does sincerely try to help but just gets it wrong a lot of the time. I had expected to have my doctor help me find networking, job and social advocacy, etc. Instead, I have been repremanded at work twice and now am at risk of being kicked out of my martial arts group. Something is not working right. I understand my behavior is my responsibility, yet when I feel like the way Jack Nickolson looked in "As Good as it Gets" when he "screwed up" due to his illness then I just have to wonder about my treatment. My doctor is trying to run her own practice and, frankly, not doing a very good job of it. My insurance is pretty insufferable when it comes to mental health. I sure could use some help and soon. I am bi-polar II

  • Michael Matthews, PhD

    Your comment that it is generally assumed that personality disorders have no biological substrate is incorrect. It has been well documented in the last 15 to 20 years that antisocial personality disorder and borderline personality disorder in particular have underlying biological components that contribute to the problem. In the case of antisocial personality disorder, compromises exist in the prefrontal cortex involving judgment, remorse, and executive function. In the case of borderline personality disorder, the amygdala and other parts of the limbic system are compromised.

    Over time, the research will undoubtedly show that the distinction between personality disorders and other forms of mental illness is perhaps not clear or warranted.

  • chrissy

    over the past 4 years I have been diagnosed with bipolar,post traumatic stress disorder,borderline personality disorder all from different psychiatrist.My new psychiatrist is saying I have complex personality disorder,what ever tht is? now I'm more confused than ever.

    I have and still on occasions now self harm.I'm recently having flashbacks of childhood trauma and have had only 4 relationships each having children. I'm 45 and at the age of 16 attempted suicide I had about 4 to 5 addmision since then for depression the last time I was found walking in my pjs in the middle of the night heading for town and had cut my arms and legs to pieces yet I have no awareness to that night,and of cause i was sectioned for this.

    since then I have nothing but deep depression then excessive energy lack of sleep and my thoughts and speech race its hard for me and family to understand me. They switch from one to the other and I'm not sure when or how long these moods will occur only that several times a year is enough should I say.

    So getting to my point if my new psychiatrist diagnosis is complex personality disorder what is this? And why for over 3 years has bipolar never been discuss with me since 4 years ago on that night in my pjs I cant recall.

    So do I have both bipolar and complex personality disorder as i,m now very confuse. The quetipine helps me sleep at 800mg night but it does take time to work when im excessively energetic coupled with so many thoughts I cant keep up and talking so fast I barely hear anyone around me and somewhat detached. I'm not very good at talking with psychiatrist yet so I'm desparatly searching for helpful answers.

    sorry if this is long or not a very helpful in detail but it was as short as I could make it. many thanks

  • Tricia

    My daughter was first hospitalized at age 15 for threatening suicide. Later that year she was diagnosed with ADD and tried several different meds none of which she took regularly. Throughout high school we now know she tried just about every drug under the sun as well as having very unhealthy male relationships. She took off from home at age 18 and we had no idea wher she was for 2 days. Mind you although this behavior of drug use (moslty marijuana) and occassionally finding out disturbing information about sexual relationships she was/is a great daughter and person. We never could have known what she was doing- we now know she lied all the time to feed her sexual/drug habits. We have an older son and 2 younger sons. She is very artistic and loved baking. Before she snapped in October of 08 she had gotten very into yoga, organic eating, and was taking classes a community college. Our family has not been the same since she left. We were close and had no idea how serious the situation was. We had lunch once a week and she visited both granmothers often. ONe who had alzheimers and one having cancer. She has gone from living wiht her family in a warm home to the streets. She has been hospitalized 10 times and we even had guradianship for awhile. In September of 09 someone finally diagnosed her with bipolar/personality disorder with skytsotypal (SP?) features. She hooked up with a 44 year old black crimainal who robs drug dealers and has 6 kids. She is currently pregnant and living at salvation army. She has been working a part time job since November. We have tried everything to help. Can no longer get gurardianship due to fact she is holding done a job. Everyone says, including drs. that we need to wait till she wants help or hits rock bottom. This sorry case for a human being has threatened her life and we have heard he is very controlling. I go to where she works to be sure she is okay. We are in a living hell and are trying to be okay for our sons sake. They miss her terribly and its like she has become a different person. How does a sweet, caring girl do this? We feel so helpless - and pray every day she is kept safe. We do not know what will become of her or this baby. She has turned her back on all family, friend (which she had many of and nonone can give us any guidance. I have read Dr. Amen book Change your Brain Change Your Life which I highly recommend. If I could get her a spect scan i am sure something would be found. Please keep our daughter in your prayers and I pray every day that this Old man that has taken advantage of her suffers for what he has done. I know she is sick and apart of the equation but he was told when we found her that she was ill and know she is in a worse predicament. This made me feel better to write. The days are long and painful and we miss her soooo much. Doesn't matter if you are a great family or dysfunctional, rich or poor -these things can happen to any family without warning

  • Anonymous-16

    There needs to be more commen sense in society. You're completely right about the complexity and entanglement of the situation. That is when your inside of it but once the borderline can be managed, atleast to the extent of the absence of suicidal thoughts. Then its much easier to see how and if a bipolar disorder is occuring. Im only 16, but have spent the last two years smoking a lot of chronic herb. I'm not in any way proud of it but i have noticed that its excellerated my borderline to the point i have to deal with it. Because i can now recognize its influence on me. And how i form relationships. I do believe borderline disorders have to do something with the brains reward system because I got ten time higher when in the hellish depths of depression.(caused by borderline). I dont really know what im trying to conclude, but i truely believe that Bipolar disorder just gets worse as a patients bordeline is subsequently pushed aside and dealt with as they please. Bad diet, smoking, drug abuse, sex. Bad habits in general. As long as those feelings are maintainabe to an extent, Bipolar disorder's mania and depression stay reletively managed, until the person needs something more in there life. Maybe more drugs, more spending, more friends that really arn't friends. They will constantly lean towards abuse so they can feel the mania to keep them going, subconciously. But once you realize that everything you do, every choice you make effects Bipolar disorder, can you then fully surrender to your borderline. Even if it means believing in God, not allah, or buddah. who has saved my life more than once. The government may not know it but ripping 'God' out of society and pushing pills down our throats will not help. We need to learn to receive help in every simple way, before we let a governmental body who's not concerned with our health try to tell us whats in our heads. Except that its wrong.

  • Doris Bittar

    My mother, age 70, suffers greatly from a 24-hour manic-depressive cycle. They repeat each day and are as regular as the sunrise and sunset. She suffers greatly from them, but would never admit that she suffers from it. She would rather blame my father or the rest of us for her inability to get up in the morning because we upset her the night before, because she is so sensitive. She gives new meaning to the “not a morning person” saying. In the afternoon, she is even-tempered, perhaps a bit tired due to her heart condition, but basically normal and sane. As the veil of evening descends, she becomes quite aggressive. She zeros in on a theme or gripe and begins to create provocations. She spins her web, and God help you if you are ensnared in it. She is high at night, but not to the point of being delusional or thinking she can fly. She is highly motivated to be in control, to win an argument, to have her will with my father or me or anyone who is around, the neighbor, the mailman, etc. She is at times extremely creative at this time. As we get sleepy, she gains strength. At this point, it is like she is on a treadmill and tires herself out long after we are asleep…and then finally sleeps in the wee hours of the night, usually between 1- 3 AM. In the morning, she is once again on her death bed, looking like a consumptive out of an Edvard Munch painting mouth half opened and unable to lift a finger. She stays that way until about mid-day and then the whole upward mood toward anger or a high begins anew. It is nearly like clockwork with hardly any variations. I read that talk therapy may help with this particular pattern, but she is very closed to it, only wants to blame those around her for her death-like weakness and depression in the mornings. Recently, she has admitted that it's depression she feels, but again, it's our fault, we depress her, upset her, push her over the edge.

    I have observed my mother for many decades. It's like a vortex building every day. It's very hard on my father (he is 73 and has been diagnosed with Parkinsonism or MSA). He takes care of her for most of the morning and afternoons. They are strung out now in their old age. We have help for them each day but cannot afford more help. I wonder if it's worth trying to get my mother some kind of awareness about it and ultimately some form of therapy or treatment. I keep thinking it would give us al some relief. She is now a heart patient with congestive heart problems and a very bad arthritic back, which she blames on everyone. It is very sad and I wished I could have recognized this earlier in her life. I spent most of life feeling responsible for her saddness and anger. I am clear eyed about it now. I don't blame myself any more. But what to do, if anything?

    Thanks,
    Doris Bittar
    619 283-4647

  • Kim Miller

    I am an ultradian rapid cycler, whoo hoo....have been that way most of my life. Although everyone in my inner circle never looked beyond the surface, all assuming I was simply a moody out of control person and I was not formally diagnosed until the age of 41. I am now 43 and can find the path that began at a suicide attempt at the age of 11 which was followed by years of confusion, turmoil and more suicide attempts. I could run on a high for a year, complete 3 years of college in one year and quickly switch and get arrested, pregnant, etc.....There have been several periods of time where I was symptom free, which allowed me to at least raise my child, stay married and live a somewhat normal life for about 10 years, with some periodic depressions and hypomania intertwined, then bam when I was 39 the nightmare began all over again, the parasites had invaded my brain once again and were savage to say the least. They occupied my every moment, whether I was sleeping or awake. To lie awake for hours clenching your head begging for the mind invaders to go away is not fun.......and your family looks at you in disbelief, they think you are simply crazy...I try to explain to them and they dont understand. This went on for 2 years, by the time the little parasites decided they had consumed as much of my brain as possible they slowly went away but then the cycling began, one moment I would be writing a book and the next moment I would be lying on the floor crying or standing on my dock watching myself being submerged by the water, I wanted it all to end......it had become entirely too painful. So after 30+ years of living this way I finally went to a doctor and was diagnosed.......wow, after all this time I could finally make sense of what and who I am. I tried the meds but the side effects were horrible and I decided at that point to deal with what I was given, not to fight it but to embellish it and soar beyond the stars. I have now been mostly symptom free for about 6 months without the help of medication or support and it feels pretty good, but I know it will come back and when it does at least now I have the support of my family and my wonderful husband who has dealt with more than his share of trouble from me. He can tell when my moods are about to shift and he can tell which way they are shifting, will he have a depressive emotional wife or a nymphomaniac that can't sleep, cant eat and wants to shop, gamble, scream, stay out all night, drive like a mad women, listen to loud music, talks until she cant catch her breathe about things that make no sense.......wow, during my next manic mode I need to write a book about my life, problem is that I cant stay focused long enough on one thing. Nonetheless, heres to all of you who are dealing with this, and if you are able to take this as gift that was bestowed upon you and once you can grasp that and when the spinning slows a bit you can soar beyond the stars like I am doing........vision living life in a kaleidoscope and make it all yours.

  • Anonymous-17

    While your article showed some sensitiity to a complex situation, it is misinformed. There are deep seated organic brain differences in Borderline patients. Certain areas of the brain are dramatically smaller, others unable to access the "coping section" of the brain as readily. In other words, communication skills, emotional regulation, and emotional processing areas of the brain are all very different in bpd patients. This is important to note.

  • Ginger

    This is the best information, I have researched. Excellent. Thank You.

  • Anonymous-18

    so how am i suppose to manage. I cant help but blame either myself or the ones around me for who i am. When i blame myself i get very depressed for a few days, maybe even a just a few hours. And then i get way to much energy and direct it into anger, then blame everyone around me. I cant figure out how to find a balance because i honestly dont know what im looking for. Nothing seems good enough until im so depressed that anything seems better than depression. I'm only 16, can seeing a doctor really help?

  • Like No Other

    (sorry abut my black enghish)

    I'm not Ph.D. but difference between is I think clear to me. Maybe im somehow naive but i see in that way:

    All brains(bee brain too), especially the "abstract part" of brains are on natural drugs, not aware of this fact. In human brains "abstract part" is huge and conscious, but still on powerful drugs.

    In healthy (normal?) brains these drugs keep this abstract part in safe, healathy boundaries, giving some independent from actual thougts "mood bias" also what is maybe more important help stabilize, sustain, amplify, integrate some feels (maby create but this i'm not sure).

    I think BPD is lack of chemical stablization around "mood bias" or developed "skill" of ignoring it

    Without this "chemical" stabliziation, "abstract brain" will bounce like a ball in pinball. Every single thought, every external event can for example trun upside down any jugment. Also any jugment must bo strong (black or white) to sustain in mind. Some feels can't stand each other without "chemical" middle.

    Where Bipolar is the shift of the "chemical" boundaries

    When boundaries shift they pushing the abstract brain to mania range or depresion range. The mood internal(chemical) bias is shifted too, then additonal thouthgs inducted mood swing, won't return to "normal" but to shited "bias".

    If it's possible to thougs, life events to affect those chemicals giving "mood bias" and stablization, but the connection is many levels indirect.

    Why drugus used in treatment are simillar ? Because both functions are realized by the same group of neurohormones wich work differently in other parts of brain. Maybe in some people some parts are somehow "affected" and they have tendency to react in way of bipolar an others in BPD way ?

    I think both have strong biological component. But bipolar (even ultra fast (1h?) cycle) is more "hardware" problem even if it's symptoms may seems inducted externaly. BPD is more "software" but there is a huge underlying "hardware" problem wich creates possibilty to develeop this kind of "software".

    I think the good real life distinction in diagnosis maby a story from another article on this page:

    "...All of her symptoms of depression and anger cleared away and she felt wonderful. I became her hero, a man who was brilliant and capable of solving all problems. One day, I yawned during the session. She became fiercely angry at me. She experienced my yawn as my anger at and rejection of her..."

    I could not imagine that kind of effect on bipolar only patient (event 1h cycle).

  • Dr Andrew Kinsella

    I was diagnosed with ADHD at age 46. I am confident that diagnosis was right as it improved my life so profoundly and so rapidly. Three years later I meditate regularly and exercise a great deal and have been off medication for almost a year and a half.

    However what is clear is that I have unconsciously preferred ADHD people as my companions all my life- so I have seen a good few over the years. The mood state of the untreated ADHD sufferer is usually very labile. We are usually easily angered or made anxious, or distracted by something interesting.

    I have got to the point where I really doubt the intellectual validity of the idea of rapid cycling bipolar- and suspect most are missed diagnoses of ADHD.

    Equally, I daresay that many of the more mild end of the borderline specturm are just chronic untreated ADHD that has evolved into a personality style.

    Rather than attack the thought- hold it for a while and try road testing it. I know it is unconventional- but it has a good deal of careful thought and observatin behind it.

  • chris60

    This is an interesting article, and the difference between whether a brain has a chemical imbalance or thought imbalance that contributes to mood swings seems significant. what needs to be observed is that the brain is open to change: you can become justifiably upset by your environment and the way you are treated, and you can learn to calm yourself by such methods as reframing thoughts, deep breathing, physical activity, detachment and distraction. In violent or abusive situations it is normal to react with anger, upset or confusion. Sometimes a normal person can be driven over the edge or turn psychotic under extremely stressful situations such as rape, assault, torture, captivity and repeated abuse or exploitation. By suppressing our natural reactions to toxic influences we fail to recognise the way that our emotions serve as warning mechanisms to avoid pain or harm. Sometimes the best remedy is to remove yourself from a bad situation instead of popping pills or seeking methods to cope with highly conflictual or abusive interactions. The link between domestic violence and mental health problems has been well documented. Antisocial and narcissistic behaviour injures those on the receiving end, but the irony is that