How to get diagnoses for BPD or Bipolar

[Coconuttree]

My dc was first hospitalised with psychosis 4 years ago. We (family) from our daily experience believe dc has either bpd or bipolar or at least more than autism. While dc was in hospital last time they said they need more observation to be able to diagnose so they wouldn’t be able to do it during dc’s staying. But this s very much affecting dc’s daily life. Dc will go through a period of a few weeks not sleeping much then a few weeks sleeping all days. Also dc’s extremely moody between high and low. Dc gets aggressive very easily and is very difficult to put up with at home. I don’t feel I can handle dc much longer.
How can our dc get a diagnose? How did others got their diagnosis?

Sorry that your adult child is having such a tough time. I don't think the poster you quote was voicing a hostile opinion of people with BPD/EUPD. She was simply stating the fact that people with this diagnosis do suffer from the stigma that this conditions falls prey to.
I think the point of the post was to suggest that label-seeking just isn't the best way forward.
It is a question of getting the NHS to respond to needs. Labels/diagnoses aren't always the key part of this process, and can actually be harmful (though it is understandable that parents and patients have a hunger for them, given that they have to surf so many uncertainties))

I don't think anyone is manipulative. I'm saying that's how people are treated by services. And I personally believe no individual (except perhaps true sociopaths) has a disordered personality. People experience trauma or attachment difficulties that significantly impact their ability to function, but their personalities are not disordered.

There are numerous patient led movements against this label. See #traumanotpd and recovery in the bin. Also research stop sim, which was in protest of the criminalisation of 'frequent users of emergency services' who are chronically suicidal. The label is also misogynistic and often slapped on traumatised young women, and also queer and undiagnosed autistic people.

I stand firmly with the vast majority of patients on this. This isn't to erase suffering. There is a massive push to have this relabelled as complex PTSD. The label may help some, but by and large it ends up excluding people from care. I see this daily. There are numerous studies backing this up. People with the bpd label often have negative experiences in places like A&E, and crisis care is a nightmare for those with this diagnosis. There have been multiple deaths of people whose suicidality has not been believed due to this label.

I advocate for better treatment for these people and the area is a passion for me. I care deeply about these individuals and want better for them from services. Again, I repeat I stand with patients and survivors on this.

From personal experience, I'm a woman with a trauma background with a history of chronic suicidality and self-harm. When I went through services, I was in an abusive relationship. The first time I ever disclosed this was to a male mental health nurse, and I disclosed my partner had thrown something at me and kicked a door in in a rage. The nurse told me I'm sensitive, and 'probably just have a personality disorder'. I already doubted my reality, and it took years after to unpick this and let go of self blame. I am well now and have been for several years thanks to truly trauma informed private therapy. But honestly that should tell you what you need to know about how BPD is seen by professionals.

I urge you to do more research into survivor led movements, and I hope one day you child will find some peace.

It took me several years from my first manic episode to get a "maybe bipolar"diagnosis and another 3 years to get a bipolar diagnosis
I should have been diagnosed in 2010 when I had a manic episode. I had just enough insight to be able to decline an admission without being sectioned. I was working and studying full time and despite my mania getting me into trouble at work my consultant didn't believe I could work with my symptoms so put that I was only sympathetic in the evenings so it couldn't be bipolar
A few years later I went manic again after my GP put me on antidepressants for depression. On the basis of the previous drs comments about me not having bipolar they didn't include any mood stabilisers to mitigate the risk of high mood. This resulted in a referral to the early intervention team and my "maybe bipolar" diagnosis. From this point my treatment plan was in line with bipolar. There were bits of my history consistent with bipolar but also bits consistent with something like bpd. My care team at the time wanted to observe what triggered and helped episodes before finalising my diagnosis. In particular they wanted to see if I had episodes of high mood when not on antidepressants. I was under this team for 3 years and it was on discharge that my diagnosis was changed to bipolar.

For me the biggest improvement didn't come from the diagnosis but from the change in mindset from me just having depression to something else going on and the prescribing of antidepressants with caution

You used stigma yourself which is really not helpful to call ppl abnormal.

This! The diagnostic criteria for BPD is the exact same as wandering womb which was used as a tool to silence abuse victims. Guess who gets the most labels for this now? I think that trauma informed movement is much better than using stigma and a system built on misogyny, homophobia, racism and classism amongst other things. I do not support a system that is built on this and uses this as its foundation.

I wholeheartedly agree with all you say. Thank you.

PsychiatryUK will assess them for bipolar via an online assessment so you don't have to go anywhere. Get the bipolar assessed first and either diagnosed or ruled out because that's the most treatable one and the one that is most urgent to treat. Then consider other possibilities if that's ruled out.

I have never had any problems getting my bipolar diagnosis from PsychiatryUK accepted. I have had nothing but problems getting my ADHD diagnosis from the same place accepted. I think it comes down to what the NHS community mental health want to treat and want to believe is a "real" illness worth treating or not.

Once diagnosed, bipolar disorder is usually taken very seriously regardless of how it was diagnosed IME. My GP and NHS community mental health teams (I have moved a few times in my life) have always taken it seriously since it was diagnosed, it's just a bugger getting any help without a diagnosis.

It's also not true that you're then necessarily stuck paying for psychiatry and psychology privately. I've never found psychological treatments particularly useful, sometimes my brain throws a spark and doesn't work properly and medication is the only thing that helps, and the right medication sorts out my sleep and underlying mood (elevated/depressed/mixed). I was offered psychology on the NHS but didn't take it as I knew it wouldn't help, having done all sorts of therapy privately.

There's a misconception that bipolar makes you happy one minute and sad the next, or angry a minute later, when actually it's the underlying "mood" (in psychiatric terms) that it affects, i.e. elevation, depression, or a combination of both at the same time. In a crisis or mixed episode, bipolar and BPD are virtually indistinguishable for a lot of people which is why it can be hard to get the right diagnosis from the NHS when services only see you in a crisis.

Good luck OP.

I don’t think you thought about this at the time of writing but just be aware of writing/saying things like ‘just having depression’

Plenty of people with Severe and recurrent Depression are every bit as crippled by their illness as those with Bipolar. It hits a bit close to home when you are one of them.

Sorry yes clumsy wording, I meant that once the GP recognised that my high moods were a problem too and not just the low moods the treatment plan changed. The "just" referred to the episodes I experienced and not "just" depression. So high and low moods not just low moods rather than bipolar and not just depression if that makes sense. Bipolar depression needs slightly different treatment plans to unipolar depression and it was this distinction that made the difference in my treatment as antidepressants send me manic in hours. I once went to bed suicidal and woke up manic cartwheeling down the street having been bed bound the day before.

My depressions cause me way more issues than the high moods and I know that depression is awful whether it is bipolar or unipolar depression. The biggest problem with bipolar diagnosis is getting none depression episodes recognised and that is what I was referring to although completely see your point and that it was poorly worded. I hope this makes clearer sense and I apologise for any hurt my phrasing caused I wasn't meaning to pit bipolar Vs depression