Could EUPD come under the neuro diverse umbrella?

[UndertheCedartree]

I have been to a neuro diversity conference today. One thing that came up was that Emotionally Unstable Personality Disorder (BPD) should be categorised as a neuro developmental disorder like Autism. I found this so interesting as I've often thought the same. There is so much cross over between EUPD and other disorders like ASD and ADHD, for example many of the differences in the brain are the same, impulsiveness and black and white thinking can happen in EUPD and ADHD/Autism.

I would love to hear from anyone who has experience of these disorders what you think?

But officially we use the ICD? Is that right?

Clinicians have discretion, I believe.

What you've never heard that many autistic people have rigid thinking?

No I’ve never heard that splitting is common in ASCs.

It's an interesting question. I do think diagnosis is a bit of a crap shoot with a lot depending on background/circumstances as well as sex. My brother has a diagnosis of BPD, I have one of CPTSD. We both experienced a very traumatic childhood, and are both almost certainly autistic as well, though I didn't realise this until my own child was diagnosed.

My son is nearly 20 now and is a very confident "political" autistic person who frequently floors me with observations about my own life and behaviour. He would certainly argue that there is massive cross-fertilisation between autism - especially in women - and unsatisfactory catch-all diagnoses like EUPD, and also that because the DSM is written with males in mind, there is a whole generation of autistic women who have picked up MH co-morbidities due to the trauma of not having their needs met, and not understanding why they have difficulties. He has a theory that a great many anorexic women are also undiagnosed autistic, struggling to manage social messaging around bodies, thinnness and self-denial, and essentially "saying the quiet part out loud".

I have two friends with this diagnosis (well the older BPD). Both experienced unspeakably awful trauma as children. They have both said in different ways how the diagnosis was stigmatising and one didnt tell me for over a decade. It’s very hard because they don’t want to be open so people aren’t aware, which then leads to harder relationships.

I think the name should be complex PTSD or something similar

@Thoosa

Some do think EUPD is cPTSD

Why throw that in after insisting trauma doesn’t cause EUPD/BPD for three pages? The “t” in PTSD is “traumatic”.

I haven't insisted trauma doesn't cause EUPD! I'm just exploring some ideas. I'm well aware what the 't' stands for, thank you!! I've been talking about current thinking, that's all! No need to be snarky!

Yes, some people think that. I don't. Doesn't mean I'm right, though. But personally I don't feel trauma alone causes my symptoms. I also know that trauma treatment alone wouldn't have helped me

It’s easy to say that EUPD is a neurotype when the researchers are unknowingly looking at undiagnosed autistic people.

That's a very acute observation @amusedbush. Of course if they're not looking at what they think they're looking at in the first place then they will just pile error upon error.

I’m not being snarky OP, just confused.

Where’s your evidence for saying that EUPD is caused by innate structural brain differences? I just don’t think there’s any evidence whatsoever for that.

Trauma CAUSES developmental differences in the brain. You can’t separate the two because brains develop differently due to experiences? It’s impossible to separate nature and nurture in that way.

Personally I think EUPD is cPTSD which is a far more helpful label.

Most neurodivergent people have trauma from growing up in a world that doesn’t cater for their neurological wiring, from being forced to mask etc.

@amusedbush

I know four women who were diagnosed with EUPD/BPD as young adults and then much later told they were either autistic or had ADHD. As others have said, women are so commonly misdiagnosed and fobbed off.

I was told by an NHS autism specialist that I just had an attachment disorder and ‘probably’ dyspraxia. A while later I spoke with an independent specialist who convinced me to get another opinion, and I was diagnosed with autism by a much more holistic, understanding psychiatrist. I also found out I have ADHD, as an aside.

I 100% believe that EUPD exists but I think there needs to be a lot more work put into separating which is which. It’s easy to say that EUPD is a neurotype when the researchers are unknowingly looking at undiagnosed autistic people.

Thank you - all interesting points. The speaker who raised the idea of EUPD being ND was an autistic lady with ND children. She had written some books on parenting ND children. I'm not sure if one of her DC had EUPD.

Ive worked with more males than females with EUPD and virtually no males with ASPD.

Im concerned that a lot of ASD diagnoses could also be attachment and trauma based behavioural issues, not all but some can but pediatricians simply dont know enough about attachment disorders.

@TwistofFate

Personality Disorders are made, not born. As others have said, they usually develop as a result of trauma, and if the individual receives appropriate care and treatment, they can recover (and some people I've worked with who were diagnosed with EUPD mellow with age) so it's not necessarily a lifetime diagnosis.

But what part of being autistic is made and which is born. After all we also experience trauma due to our autism, like those with EUPD experience trauma due to their symptoms. And yes someone with EUPD can be 'cured' with DBT but many would not with just trauma therapy.

It can result from trauma whereas you are born autistic. My dd was different from her younger sister from birth

Your born autistic - you are simply an autistic person. most females with EUPD have been abused as a child whether that be physical, sexual or emotional but from my own experience its sexual.

An autistic person is born autistic....you dont become autistic following trauma

@hairymorag

The last thing we need to do is confuse autistic female diagnosis by adding in EUPD. I have been arguing about this situation in my current work as many females with a childhood diagnosis of Autism are then being rediagnosed as having an EUPD diagnosis when they become an adult, This is due to a lack of understanding around females with autism in maintream psychiatry. EUPD is a label that is not positive, it then gets excused as the person is EUPD rather than understanding that females with autism are different to men, they may have traits similar to EUPD but they require a very different intervention.

We need to support females to get the right support but an appropriate diagnosis should guide that...someone with EUPD would required DBT whereas a female with autism would require a full sensory assessment, SALT assessment and functional behavioural analysis to assist in next steps....they are very different

I think DBT would help those with ASD lots and a sensory assessment and functional behavioural analysis would help those with EUPD. Not that most people get any of those ASD or EUPD. I do agree with your point, though that correct diagnosis is important. But I think if EUPD came under the umbrella it would be like ADHD different to ASD but still ND.

This article is about Asperger's and splitting.

Thanks for posting that. I had never heard of 'splitting before but I recognise a lot of it in both my dh and ds.

But I do agree ASD and EUPD are different!

I think DBT would help those with ASD

I have never heard of DBT, what is it and how will it help me?

There are differences between EUPD and CPSTD and there's been a huge amount of research on these (ie Cloitre etc).

I don't actually believe in the EUPD diagnosis - it often is diagnosed as "traits" rather than a disorder and it's all very batshit in my opinion. I do however think that a trauma diagnosis or a major depressive diagnosis plus a neurodivergent diagnosis does fit with many people who have a diagnosis of EUPD.

I think DBT would help those with ASD lots

I don’t. Too close to ABA for comfort.

Trauma also causes difference in brain structure...

And of course CPTSD is going to influence and person's personality - but there is no such thing as a disordered personality. There's just different ways to react to situations due to previous learned behaviour and experiences.

@Thoosa

Not to be gratuitously nosey, I hope, but I’m intrigued. Why are you so attached to the specific wording of “structural brain changes and invalidating childhood” (which seems to be proposed rather than proven and a very narrow wording) and so opposed to the role of trauma (widely agreed and accepted)?

Is there someone about the traditional concept of EUPD or PDs generally that you’re uncomfortable with? I’m not quite catching your motivation.

I already said. Because that was what I was told caused EUPD by my psychologist and it absolutely slotted into place. Yes there is a role of trauma. But trauma as central to EUPD in all cases or that EUPD is cPTSD is not widely accepted and agreed in my experience atall. If I was treated for trauma, it would have been the incorrect treatment. And I'm not alone. Some may be misdiagnosed with EUPD when it is actually cPTSD but I personally don't believe all EUPD is cPTSD. Some people haven't even experienced significant trauma for a start.

The traditional concept of EUPD - well yes obviously I have a problem with that in that it is completely outdated and doesn't provide women with the help and need they deserve.

www.reddit.com/r/CPTSD/comments/bzjkwt/the_overlap_between_ptsd_cptsd_bpd_and_mdd/

This is quite a helpful image I've found (not that i agree with all of it)

@Soontobe60 - I'm going to be honest. I don't think all my reactions are 'normal'. I needed help with changing my thinking, my feelings and my reactions.

[quote Svadhyaya]@UndertheCedartree not unless they were looking for cause and effect in the scans. So in order to say that an EUPD brain is born different they would need to be able to have scans of both non-EUPD and EUPD brains at birth and then those same brains in adulthood post-diagnosis. Which obv is impossible. And of course there's no way of studying the same brain raised in a traumatic vs non-traumatic environment without a parallel universe.
Whereas to determine whether an autistic brain is different from an NT brain they just need scans of both types of brain at any given point in time. Although I guess if they were trying to posit that autism is caused by differences at birth which are then triggered by external stimuli (which as you'll know isn't the case) then yes the same dilemma would apply.

Thanks for the tip on DBT![/quote]
Thank you, it's very interesting. So I suppose they have looked at EUPD brains Vs. Non EUPD brains and seen differences? But whether it is caused by trauma or just born that way is the question?

When my DS was going through his ASD assessments, they had to rule out trauma as they said the same traits could be caused by trauma.

@amusedbush

Umm...I find this post just full of myths!

...but @User135644 said "in a lot of cases", not that not a single autistic person on earth want a relationship. User's post resonates a lot with me - I only have one friend (I had two but one moved to a different continent) and I'm perfectly happy with that. I'm married but my need for solitude has caused arguments in the past and I need to remind myself to make sure I spend enough time with my husband. Of course I love him but a lot of the time I want to be left completely alone and just the presence of another person in the house agitates me. I moved away from my family years ago and when my mum texts me saying how much she misses me, I say it back out of politeness rather than actually missing her. Day to day, it doesn't occur to me to nurture my relationships and suddenly weeks have passed since I saw anyone.

So, it's not a myth, it's just not your experience. I don't seek out human company and I don't feel lonely - I don't care.

Yes, she said in 'a lot of cases' in my experience that is untrue. However, many non-ASD people think we all have no friends. The same with the comments on EUPD - they are common myths but not actually part of current thinking on EUPD.