Posted by Blue Cheer 1 on January 23, 2002, at 19:22:07
In reply to Re: bipolar vs. borderline , posted by Dinah on January 23, 2002, at 17:43:35
> Well, here's my take on it. A borderline personality disorder diagnosis is made based on actions. It represents a pervasive way of relating (note - an action word). For example, I have a lot of the mood dysregulation that would characterize borderline personality disorder but no one would ever diagnose me with it because I don't exhibit the behaviors. I am a rather reserved and, on the surface, unemotional person. My relationships are very long-lasting and stable. I'm not at all sure it is a fair diagnosis, because there is almost definitely a biological component to borderline "personality disorder" and the actions are that person's habitual and dysfunctional way of dealing with the underlying mood disorder. A person with a different habitual and dysfunctional way of dealing with the mood disorder would be diagnosed with a different personality disorder. A person with a functional way of dealing with the mood disorder wouldn't be diagnosed with a personality disorder at all. But all three hypothetical people would be suffering from the same mood disorder and medication treatment should be the same although psychotherapy treatment should be tailored more to the overt actions of the individual.
> On the other hand, bipolar II refers to underlying mood cycles. So many people who are bipolar II may also have borderline characteristics, but many may not. And many people who are borderline may have bipolar II but many may not.
> Bipolar II mood cycles would probably be less dependent on life circumstances than borderline mood cycles. Bipolar mood cycles just happen in many cases (although of course stress and sleep disturbances can trigger cycle changes.) In other words, people with bipolar II cycle without regard to rejection, loss, etc. Borderline mood cycles would be more tied into relationships, boredom, etc. But it can be very hard to tell the difference sometimes, because bipolar II people in a depressive cycle or especially an agitated depression can see rejection and loss where there is none due to distorted thinking and can create huge crises over things that they would take in stride in any other mood.
> So, in my apparently not so humble opinion (forgive me, I'm in an up phase of my own cycling) borderline personality disorder is probably a useless diagnosis for medication management since it could be the result of a number of underlying biological causes. And bipolar II is probably a useless diagnosis for psychotherapy purposes because it does not address dysfunctional behavior, although it is useful for understanding that the individual will probably have mood swings that have no cause based in life circumstances.
That was a scintillating exposition -- thanks!Blue
poster:Blue Cheer 1
thread:91257
URL: http://www.dr-bob.org/babble/20020116/msgs/91319.html