Category Archives: Borderline Personality Disorder

The Difference Between Bipolar Disorder, Borderline Personality Disorder and Adult ADHD


The Difference Between Bipolar Disorder, Borderline Personality Disorder and Adult ADHD
By Scott Shapiro

It can be very challenging for even the most experienced clinician to distinguish the differences between Bipolar Disorder, Type II, Borderline Personality Disorder and Adult ADHD. Symptoms often overlap and these disorders frequently co-occur; however, there can be clues from the history and presentation that often help determine the diagnosis and the appropriate types of treatments. Below, is a case of a patient with a challenging diagnosis followed by tips on differentiating Bipolar Disorder, Type II, Borderline Personality Disorder, and Adult ADHD.

Case:

Anna* is a 46 year-old, married nurse with three children. She presented with persistent low-grade depression, anxiety, and irritability. She was on probation at work for poor performance. She also had a long-standing history of difficulty with friendships.

She complained of life-long depression with intermittent episodes of more severe symptoms. During the more extreme episodes, she overslept, felt more irritable and anxious. She reported chronic racing thoughts and difficulty concentrating.

She had a chaotic childhood. Her father was a successful, workaholic attorney who was also an alcoholic. There were frequent, explosive fights between her parents. Anna was the oldest of 3 children and at the age of 10, her parents divorced. She became ensnarled in their long, drawn-out divorce process. In pre-school and elementary school, she had been quite precocious, according to school reports. She listened well, followed instructions, and had many close friends.

However, as the fighting intensified at home around third and fourth grades her grades dropped and she began to exhibit behavioral problems at school.

The above case represents a challenging diagnosis. Below are tips to help determine the diagnosis and whether there is the possibility of more than one diagnosis.

Mood Swings

Mood swings in Bipolar Disorder, Type II last for one to four days and include the person feeling “hyper”, “on top of the world”, irritable, invincible, elated, or even depressed despite being in a hypomanic episode.

People with Borderline Personality Disorder also have mood swings but they have feelings of sadness, anger, rage, or depression that is more chronically present and triggered by criticism, disappointment or stress. Also, people with Borderline Personality Disorder rarely feel elation.

People with Adult ADHD also describe mood swings and difficulty with managing moods; however, the duration is usually brief and due to low frustration tolerance. Also, in Adult ADHD there are feelings of shame, irritability, frustration, and sadness secondary to difficulty with school, work and relationships.

Impulsivity

Similarly, the symptoms of impulsivity are present in all the disorders but with different histories. Impulsivity may manifest as sexual promiscuity, excessive shopping binges, poor decision-making, automobile accidents or speeding tickets, and careless mistakes. With Bipolar Disorder, Type II, the impulsivity is present only during the periods of hypomania compared to Borderline Personality Disorder and Adult ADHD, when the impulsivity occurs chronically or due to an emotional trigger.

Concentration

All three disorders present with difficulty concentrating or focusing. This creates challenges with completing tasks, jumping from task to task, and starting projects without completing them. These symptoms occur in Bipolar Disorder, Type II only during the hypomanic phase but can be chronic with the other two disorders.

History

In Borderline Personality Disorder, there is more frequently a history of feeling empty and lonely, chaotic relationships, self-injury, and an extreme fear of abandonment. There is often a history of significant physical or sexual abuse during childhood or severe emotional neglect.

In Bipolar Disorder, Type II, there is frequently a family history of depression or Bipolar Disorder, and the symptoms of depression start at an earlier age. Also, depression is the more frequent complaint than hypomania.

In Adult ADHD, the person has persistent challenges with sustained attention, focus, executive functioning, distractibility, time management, procrastination, and significant difficulty with organization.

These symptoms may appear in the other two disorders; however, in Adult ADHD, the symptoms must have existed since childhood. In addition, ADHD has the highest genetic component of all three disorders and is estimated to have a concordance rate ranging from 60-80%. Thus, eliciting a history of other family members with ADHD increases the likelihood that the person may be dealing with Adult ADHD.

All three disorders can manifest “racing thoughts”. In Adult ADHD, these thoughts are intermittently present and are exacerbated when there is greater stress or challenge in the environment.

With Bipolar Disorder, Type II, the symptom of racing thoughts occurs only during the hypomanic phase. The racing thoughts are often described as “crowded thoughts” and thinking of new and creative projects.

In Borderline Personality Disorder, the racing thoughts are usually precipitated by an emotionally laden experience such as a fight with or criticism from a friend or colleague.

Case Continued:

Upon further discussion with Anna, she denied having hypomanic episodes. However, she described feeling empty, lonely and having low self-esteem. Under severe stress, she would become acutely agitated, suicidal, have feelings of worthlessness, and be absent from work.

Over her life, she has gone to the psychiatric emergency room 6 times for suicidal thoughts, but has never made an attempt. She has also had a partial hospitalization. In addition, she has a long history of self-injuring behaviors including anorexia, cutting, and unprotected sex with casual contacts.

Anna has Borderline Personality Disorder as well as dysthymia. My recommendation was to start schema therapy twice a week as well as start on an MAOI and to start treatment in an intensive Dialectical Behavioral Treatment Program (CBT). Even though a MAOI is not FDA approved for Borderline Personality Disorder or dysthymia, there research shows its efficacy.

Two years later, Anna’s mood has stabilized and she feels much less anxious. In addition, she has been able to enjoy more pleasure in her personal life and career. She has currently been in a relationship for 14 months, and although the direction of the relationship is unclear, she feels more comfortable tolerating the unknown.

This case presents the diagnostic challenges distinguishing Bipolar Disorder, Type II, Borderline Personality Disorder, and Adult ADHD. Using the above distinguishing features and taking a thorough assessment improves the accuracy of the diagnosis and helps in the determination of an effective treatment plan.

References:

Hirschfeld RM,Cass AR, Hot DC, Carlson CA. Screening for bipolar disorder in patients treated for depression in a family medicine clinic. J Am Board Family Practice. 2005:18: 233-239

McIntyre, Roger. Differential Diagnosis of Bipolar Disorder. Supplement to Current Psychiatry. Bipolar Disorder. 2011: 3-22.

* To Maintain confidentiality

Scott Shapiro, MD is an Assistant Professor at New York Medical College and specializes in Adult ADHD. He has a private private in New York City. For more information contact him at 212-631-8010 or visit his website at http://www.scottshapiromd.com.

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Link between drinking soda and depression?

I Found This very Interesting. Fortunately I hardly drink pop or soda anymore since I quit smoking 2 years ago.

The Huffington Post had an article (as redOrbit also reported) on the relationship between depression and soda or high-sugar fruit drinks. The article explained that a new study found an association between drinking four cups/cans of soda or fruit punch daily. The study showed that those who drank four cups or cans of soda had an associated thirty percent higher risk of depression while those who drank four cups or cans of fruit punch had a thirty-eight percent associated higher risk of depression.

And drinking diet did not help; there was an even more pronounced association between those who drank four cups or cans of diet soda or diet fruit punch than those who drank regular soda. The study could not determine an exact cause/effect relationship, but it definitely showed an association between sugary soda and fruit drinks and depression.

There are many reasons to limit our soda intake, namely calories, sodium, and unnatural ingredients. This is just another reason to at least consider minimizing soda drinking. Depression is incredibly serious. It is not just feeling down or punky; depression can be debilitating. If watching what we eat or drink minimizes our chances of depression, then so be it. I’m in for that.

A nice soda pop on occasion is not bad. The problem comes when all we drink is soda. Diet soda may have less calories, but it often has artificial sweeteners and sodium that make it dangerous. Soda has been known to contribute to heart attacks, metabolic syndrome, fatty liver disease, weight gain, osteoporosis, and type 2 diabetes. And now there may even be a connection between soda—diet and regular—and depression. All of these deserve much attention and consideration.

I know that limiting soda drinking will be very hard for many individuals. For some people, sodas are the only hydration they get on any given day. The sugary sweetness is addicting. But it is also hurting our health. Though the study on the Huffington Post does not provide absolute proof that soda contributes to depression, there is enough data out there to make us rethink how much soda we drink. Complete abstinence is not necessarily what I am advocating here, but we should at least minimize how much soda we drink.

On the plus side, the study also found that drinking four cups of black coffee daily had an association with a ten percent lower risk of depression. This is more good news for all of us coffee drinkers. As if coffee was not good enough already, apparently it may also help us avoid the seriousness of depression.

Coffee has also been found to help lower the risk of oral cancer, stroke, and diabetes. Where four cups of soda hurt heart health and is associated with depression, coffee may help heart health and lower the risk of depression. Those two alone are pretty awesome. Plus, it is so delicious!

For those who drink coffee with cream and sugar, they may want to just drink it black. Not only would they be lowering their calorie and fat intake, but they would possibly lower their risk of depression. Coffee has some serious goodness in all its antioxidants.

Borderline Personality Disorder Test

Author: NarcisusBerdimo

Borderline Personality Disorder recognized as BPD is a kind of mental illness that is known to be really serious. It is characterized by inconsistency in behavior, moods, interpersonal relations and self-image. Personal and social life, long term planning and cognizance of one’s individual identity is most often distressed by this unsteadiness. People with Borderline Personality commonly have difficult time stabilizing their emotions. Even if the indicated disorder isn’t as famous as bipolar disorder or schizophrenia, it does affect 2 percent of the adult population, largely younger section of female sex. The amount of self-injury lacking the aim of suicide is high in such cases. In some cases people who have Borderline Disorder also mean to commit suicide. Among patients hospitalized for psychiatric problems, patients that have BPD amount to 20%. Over time many feel better with help and are able to lead useful lives eventually.

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Borderline Personality Disorder Test

Borderline Personality Disorder recognized as BPD is a kind of mental illness that is known to be really serious. It is characterized by inconsistency in behavior, moods, interpersonal relations and self-image. Personal and social life, long term planning and cognizance of one’s individual identity is most often distressed by this unsteadiness. People with Borderline Personality commonly have difficult time stabilizing their emotions. Even if the indicated disorder isn’t as famous as bipolar disorder or schizophrenia, it does affect 2 percent of the adult population, largely younger section of female sex. The amount of self-injury lacking the aim of suicide is high in such cases. In some cases people who have Borderline Disorder also mean to commit suicide. Among patients hospitalized for psychiatric problems, patients that have BPD amount to 20%. Over time many feel better with help and are able to lead useful lives eventually.

While persons who live with bipolar disorder or depression generally show continued state of mood for a longer period, persons suffering from BPD may have fierce outbreaks of anger, anxiety and depression lasting for a few hours or maximum a day. These may involve series of aggression which is impulsive, such as alcohol or drug abuse and injury to self. Weak self esteem is too common among patients suffering from Borderline Personality. They may believe to be mistreated unfairly, feel empty, or even bored at times. These symptoms are more severe when individuals with this disorder feel that they do not have social support and are isolated.

Intimate relationships of persons having borderline personality have really unstable patterns. There is a shift in their outlook towards their friends, family and loved ones, from love and great admiration to dislike and flaming rage. Borderline personality often appears with other mental problems like bipolar disorder, anxiety disorders, depression, substance abuse, etc. Borderline personality is originated by the uncommon functioning of the Lymbic region of the brain which controls emotions. It may be associated with neurotransmitters such as dopamine, acetylcholine, serotonin, and norepinephrine.

A borderline personality disorder test is a questionnaire used for diagnosing borderline personality disorder. A mental health professional administers the borderline personality disorder test. The test ordinarily consists of a series of questions or statements which the subject should answer. If five or more symptoms are spotted through the patient’s answers then the diagnosis follow accordingly.

A part of the questions included in the test are checking for responses to abandonment, relationship issues, instability, questions related to self confidence and self vision, questions that try to find more about the self destructive behavior of the patient, questions about suicidal thoughts and attitude towards life, or self injurious act, questions related to feelings, especially feelings of void and trouble in getting hold of emotions, more so anger and ones revolving around paranoia and disconnection to reality.

There are abundance of websites with borderline personality disorder test that can help you figure out if you or your loved ones may have the symptoms of borderline personality disorder. Once you have finished the test, you can after analyze the results with a mental health professional to help with diagnosis and therapy of borderline personality disorder. The causes, syndromes, signs are generally surveyed by the borderline personality disorder test. Therapy along with the steps you can take by yourself to fight such condition must be prescribed by qualified specialists only.

There has been progress in the treatment for Borderline Disorder in recent past. One on one and group counseling have created positive impact on many patients. A common treatment labeled dialectical behavior therapy also known as DBT, is a psychosocial therapy which is usually recommended for borderline disorder and appears to be likely to help. Depending on certain symptoms the person has, meds may be prescribed.

Article Source: http://www.articlesbase.com/health-articles/borderline-personality-disorder-test-3919434.html

What People Need to Know About Borderline Personality Disorder

Author: Wendy Lau

Do you think you might have borderline personality disorder or BPD? Well, you might have personality traits commonly exhibited by people with the disorder, but it doesn’t necessarily mean that you have it. BPD, just like other personality disorders, involves a consistent pattern of thought and interaction between the person with the disorder and with his environment. This pattern usually causes several problems and can impair the sufferer’s ability take of himself or cope with life. The pattern for borderline personality disorder is usually characterized by unstable views about one’s self, behaviour, feelings and ability to interact with others, all of which can interfere with the person’s ability to function normally.

In the past, BPD has been regarded as a set of signs and symptoms that include both psychosis (reality distortion) and neuroses (mood problems). People saw it as a condition that sits borderline between schizophrenia and mood problems. However, it has now been established that the condition is more similar to personality disorders, especially with the way it develops and occurs within families.

Do you think you might have borderline personality disorder or BPD? Well, you might have personality traits commonly exhibited by people with the disorder, but it doesn’t necessarily mean that you have it. BPD, just like other personality disorders, involves a consistent pattern of thought and interaction between the person with the disorder and with his environment. This pattern usually causes several problems and can impair the sufferer’s ability take of himself or cope with life. The pattern for borderline personality disorder is usually characterized by unstable views about one’s self, behaviour, feelings and ability to interact with others, all of which can interfere with the person’s ability to function normally.

In the past, BPD has been regarded as a set of signs and symptoms that include both psychosis (reality distortion) and neuroses (mood problems). People saw it as a condition that sits borderline between schizophrenia and mood problems. However, it has now been established that the condition is more similar to personality disorders, especially with the way it develops and occurs within families.

The actual causes of borderline personality disorder are still unknown, but there are family, genetic and social factors that are associated with its incidence. The risk factors for the disorder are: 1. disrupted family life, 2. poor family communication, 3. abandonment during childhood and/or adolescence, and 4. sexual abuse. It occurs both in men and women, but mostly in women who are also receiving mental-health treatment. It affects about 6% of adults, and that is why it helps to know about the condition.

Borderline personality disorder has different symptoms. Most people with the disorder are unsure about themselves and their identity, thus their values and interests often rapidly change. They also frequently experience frequent changes in feelings or mood, and these often lead to unstable and intense relationships. They also tend to view things in extremes, as if the world is in black and white. For example, if one thing isn’t all good, then it must be all bad. Other symptoms include an irrational fear of abandonment and unwillingness to be alone. They often feel empty or bored when they are alone and are impulsive with their money and sexual relationships. This impulsiveness can even lead to substance abuse, binge eating and shoplifting. They may also have frequent bouts of inappropriate anger and episodes of self-injury. If you exhibit some of these symptoms, you should consider a check up, especially if the symptoms are starting to or are already interfering with your daily life.

Like all the other personality disorders, borderline personality disorder is diagnosed based on a psychological examination. The history and severity of the symptoms are also being evaluated. The good news is that BPD can be managed and treated. Many form of talk therapy are successful. These include dialectical behavioral therapy (DBT) and group therapy. Medications can also help with the person’s mood swing and to treat other conditions that can occur with BPD. Generally, the outlook will depend on the severity of the symptoms and on the person’s willingness to accept help.

Article Source: http://www.articlesbase.com/mental-health-articles/what-people-need-to-know-about-borderline-personality-disorder-5253679.html

Symptoms of Borderline Personality Disorder (DSM-IV)

Author: Brian John

Borderline personality disorder also known as DSM – IV in medical terms is a mental illness in which one feels erratic mood swings and emotions, impulsive behavior, unstable relationship with others including the loved ones and extreme feelings of low self worth even one has done something sufficient. People who suffer from this disorder also become victims of severe depression, substance abuse and eating disorders such as binge eating. In most of the cases pertaining to DSM-IV the symptoms become apparent in the early childhood while in some cases the symptoms may not appear apparent until adulthood. Being human beings we all suffer from range of mood swings and behavioral problems but people who specifically suffer from borderline personality disorder feel the negative emotions in extremities where they must seek professional help to remain in control of their lives. These people may also have disruptive lives as the symptoms when severe may restrict their daily activities and force them to live unproductive life. Some of the apparent symptoms of DSM-IV are as following:

Borderline personality disorder also known as DSM – IV in medical terms is a mental illness in which one feels erratic mood swings and emotions, impulsive behavior, unstable relationship with others including the loved ones and extreme feelings of low self worth even one has done something sufficient. People who suffer from this disorder also become victims of severe depression, substance abuse and eating disorders such as binge eating. In most of the cases pertaining to DSM-IV the symptoms become apparent in the early childhood while in some cases the symptoms may not appear apparent until adulthood. Being human beings we all suffer from range of mood swings and behavioral problems but people who specifically suffer from borderline personality disorder feel the negative emotions in extremities where they must seek professional help to remain in control of their lives. These people may also have disruptive lives as the symptoms when severe may restrict their daily activities and force them to live unproductive life. Some of the apparent symptoms of DSM-IV are as following:

Extremely impulsive behavior
Self harm or self destructive behavior
Unstable relationships with family members and friends
Very low self esteem
Fear of abandonment by others
Suicidal thoughts
Lack of anger control
Feelings of paranoia and losing sense of reality

According to studies two in hundred people suffer from this disorder (Helium). The exact causes of this disease are still not known but it is believed that certain genetic makeup can cause the disease and the disease is said to run within families. Certain imbalance of essential chemicals in brain can also cause the disease.

If you are studying abnormal psychology and are having problems writing academic papers on such topics as borderline personality disorder you can seek our custom writing services as we comprise of the professional writers who can deliver you academic papers on abnormal psychology according to your desired specifications.

Article Source: http://www.articlesbase.com/college-and-university-articles/symptoms-of-borderline-personality-disorder-dsm-iv-3633475.html

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