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?

@Junction5aOnTheM4

It's a type of PTSD. It's not a neurodivergence.

What makes you say that? What about those with EUPD that haven't suffered trauma?

@sadpapercourtesan

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 absolutely agree with your son!

As a late diagnosed autistic woman (late 30s) with a side order of ADHD I can completely relate to that. I am so grateful that my own daughter was diagnosed at 3 (despite having no learning difficulties, being verbal and advanced academically) which is unusual. It was only possible because we went private. I am hopeful that her early diagnosis means she won't suffer the trauma of not having her needs met throughout her life, or at least if we can't meet them all, we will meet most of them.

Ditto with anorexic woman. Of course not all of them will be autistic but I personally know of one woman, who I know very very well and have for a very long time (birds of a feather?). Her child is diagnosed with ASD, I have known her for all of her life and knowing what I know now about autism, she has so many traits, albeit like me, not being particularly visible. What's she been diagnosed with? Anorexia.

I don't think putting BPD in with autism or general neurodivergence works actually. People are born autistic, or doesn't get activated at some point because of something traumatic. Autistic people suffer trauma because their base needs remain unmet.

@TuscanApothecary

You can't state that for a fact OP. There are two sides to this debate with people better educated on this than us. Personally I believe there will be a huge shift in personality disorders and trauma in the future.

And it was old white men who made the diagnostic criteria.

I know there are 2 sides and I'm interested to hear both. But I'd like to hear reasons not just 'EUPD is a type of PTSD'. with nothing to back it up. Personally, my psychologist and psych (well more than one) did not believe that and believed brain structure changes/invalidating environment were the cause. The speaker at the conference who was very educated believed it is neurodevelopmental. Some believe it is cPTSD. So actually maybe there are 3 sides!

Op your trying to squeeze EUPD into ASD and I completely disagree with you. DBT would have zero impact on someone with ASD. You need to educate yourself on the difference as it is very upsetting to see your posts as you clearly do not understand the difference.

I have been diagnosed with EUPD and although I welcomed the diagnosis as it meant I could access treatment. I work within paediatric mental health and special needs education and autism and I really identify with some autism traits and definitely thrives in that environment. I often wonder if I am neuro diverse and also suffered trauma as a child which in combination has caused difficulties in interpersonal relationships. Perhaps my personality traits were exacerbated by the trauma? It’s an interesting question OP

I think DBT would help those with ASD lots

I think DBT would help anyone. It’s nothing like ABA. It’s not only used for BPD either.

The CAMHS clinical psychologist often use DBT techniques to work with young people with autism

I've got the speaker's book, by the way so I'll update if I read anything interesting!

What about those with EUPD that haven't suffered trauma?

I don’t think there are any.

Autism is something you are born with. No matter the environment you will always be autistic.

@Thoosa

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.

Thank you.

DBT would have zero impact on someone with ASD

Disagree strongly, as an autistic person helped a lot by DBT. I think it would help anyone and should be taught in schools.

Except the differences in the brain people with EUPD are born with are really similar.

How can you say this? They would need to have brain scans to verify and compare? Trauma changes the brain.

How would DBT help someone with ASD it’s a huge spectrum. I don’t think you are coming at this objectively.

Yes people are misdiagnosed but you are not born with a personality disorder, unlike ASD.

It would be helpful if you said what you think are the similarities. I suspect there are more differences.

OP who was the speaker I’d be interested in the book

@sadpapercourtesan

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've been familiar about the idea around anorexia for a long time. It is often called 'female autism'. And of course there is a massive crossover with EUPD and Anorexia. I can see so many links. I feel like Shaun in the good doctor! Maybe it is only us ND that can see these links

Well I am suprised at the DBT focus and would question that as it has never been a 'treatment' for anyone with autism...as autism is who you are and doesnt require treatment....very odd comments on this thread ...the most effective focus is FBA, sensory assessments, SALT, social stories and PBS...

@WhenZoomWasJustAnIceLolly

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.

So is autism also cPTSD?

Re:the innate structural brain differences I was told this by a number of psychologists/psychiatrists on acutes and also specialist EUPD units. I guess they saw enough evidence to assert this.

The problem with changing EUPD to cPTSD is that what then happens to treatment? Do you now just get trauma therapy?

@bellac11

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.

Ah, really that's interesting. It has been the opposite for me.

When my son was being assessed for ASD, the mental health team did assess him for trauma.

@gogohm

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

Some believe that those with EUPD are born with differences in their brain structure. Hence why it could be seen as neuro developmental.

I’m autistic. I was born with an autistic spectrum condition. I am not disordered, I do not have a disorder.
Before I retired I was part of an autism diagnostic team.

The only evidence around brain abnomality for PD is for psychopaths where they found a difference in the amygdala and there was a family in hollland where they were all psychopaths and found to have this abnormality.....however most with EUPD/BPD is due to trauma due to events post birth,,,,there is no research to suggest there is an abnormality in the brain

@hairymorag

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

It is true most of us have been abused but not all. I would say most of us with ASD have also been abused but not all.

Many specialists believe those with EUPD are born with structural differences to the brain.

What makes you think trauma is central to the behaviour of most women with EUPD?

I'm genuinely interested by the way! Lots of posters just piling on to tell me EUPD is caused by trauma. I've heard the theory but what makes people think it is true?

@RoastedFerret

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.

You're welcome.

I had DBT (for a different diagnosis) it completely changed my life but whenever I tell a Dr that I can see their brains jump to BPD and the tone of the conversation changes.

I have been diagnosed with the new name for Hysteria (did not appreciate them putting that in the letter!). It's mostly trauma based as I believe most of the disorders in the ICD are. Trauma is not just PTSD. I have a trauma based disorder but not EUPD, PTSD or CPTSD.

I've seen mental health included under neurodiversity before not sure how accurate it is and who decides what belongs. We probably need a new category and a greater understanding that the mind and brain can't be separated.

I guess there's a fear that calling a MH condition neurodiverse that it might discourage people from treatment where it exists.

It's incredibly hard to unpick neurodiversity and the damage done by the trauma of not having your needs met, especially in women who are very probably underdiagnosed with ASCs. I see this in my work daily.