Borderline Personality Disorder - diagnosis timeline?

[LongTermIssues]

I’m increasingly worried that my long term diagnosis of depression and anxiety isn’t actually that, and is borderline personality disorder or bipolar instead.

can I ask if you have BPD and if so what the diagnosis process involved? Over the last 15 years I’ve been under therapists, psych teams, couple of hospital admissions etc so I’m not unknown by mental health services but I don’t really think anyones ever known about my periods of mania because I obv don’t access the support needed in those moments because no one sees it as a problem but it clearly is.

EUPD and bipolar are quite different diagnoses - do you think you have one or both? They can be comorbid.

Bipolar type 2 can be more difficult to disgnose because you experience hypomania rather than mania and like you have said, it's less likely for people to seek support. I have been under mental health teams since I was a teenager and have only recently had a bipolar diagnosis (in my 30s).

What medication have you tried? It could also be worth keeping a mood diary to track changes in your mood over time.

During the course of the 15 years you have been engaged with MH professionals they would have diagnosed you as having BPD by now, especially during the two hospital admissions.

Have you not discussed your manic episodes with your healthcare team? Why were you admitted to hospital?

That’s the problem, I haven’t discussed the manic episodes until my most recent psychiatrist appt because up until recently I thought they were normal and thought everyone (family, friends etc) were overreacting when telling me to calm down and take time to relax. I thought it was normal to drive dangerously, binge eat and drink and want to spend money recklessly on my credit card. And because this wasn’t constant, I just thought it was perfectly ok. I only ever sought help for the depressive times when I was suicidal so hence the diagnosis of depression even though that’s not constant either.

I think that because you have gaps between episodes it is unlikely to be BPD. Experiencing distinct episodes of mania or depression is more likely with bipolar disorder.

Can you schedule another appointment with your psychiatrist to discuss things more fully?

And the problem is I’ve started self-harming too, cutting the skin on my arm

A bipolar diagnosis may take some time just because I think they will want to assess how your moods change over time. At this point, I would expect them to be working to treat the symptoms - has your doctor prescribed you medication?

Are you still under the care of a psychiatrist or do you need to be referred by a GP? In any event you need to make an appointment.

A family member of mine received a BPD diagnosis after a phone consultation of less than hour. I'm not sure how accurate or appropriate that was, though.

I’m so sorry that you’re going through this. Not me,but my husband. He was diagnosed as Bipolar 1 some years ago, this has often been reviewed too.

last year his lithium and orforil appeared to not be working properly. He has a wonderful psychiatrist who would often have appointments with me to get a fuller picture.

Due to his symptoms last year he was put under a full diagnostic pathway whilst he was recieving inpatient treatment. He has now been diagnosed as having bipolar as well as borderline personality disorder, evasive personality disorder and features of obsessive compulsive disorder.

To be honest the diagnosis of borderline personality disorder has in some ways answered many questions about his behaviour, but also has left an overwhelming feeling of hopelessness.

i hope you get the answers and treatment that you need.

Yes I’ve been on antidepressants for about 15 years now, various different SSRIs at different doses depending on the state of things at the time and those are prescribed by the GP

Unfortunately anti-depressants are unlikely to help if you have BPD.

You really need to see a psychiatrist to get a diagnosis in order to get the correct treatment.