(Mis)Diagnosed with BPD. Need Opinions!

Hey everyone,

I'm 28 years old and I was recently diagnosed with Borderline Personality Disorder. I also have ADHD-PI. The thing is, I'm not convinced I have BPD. I could really use your opinions, and would greatly appreciate your input!

Diagnostic criteria for 301.83
Borderline Personality Disorder

DSM IV - TR

A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

(1) frantic efforts to avoid real or imagined abandonment.
Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.

(2) a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation

(3) identity disturbance: markedly and persistently unstable self-image or sense of self

(4) impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, Substance Abuse, reckless driving, binge eating).
Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.

(5) recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior

(6) affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)

(7) chronic feelings of emptiness

(8) inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)

(9) transient, stress-related paranoid ideation or severe dissociative symptoms

I have impulsivity in one area that is potentially self-damaging (i.e., alcohol abuse), as well as recurrent suicidal and self-mutilating behavior. I have a history of alcohol abuse, mostly binge drinking. I tried to kill myself twice while I was extremely intoxicated. I'm an entirely different person when I drink alcohol, especially hard liquor. I have trouble stopping once I start drinking, and I usually end up blacking out. I was hospitalized twice for drinking nearly fatal amounts of alcohol. For this reason, I don't drink anymore. I still self-injure, or self-mutilate, maybe once or twice a year when I either feel out of control or I want to punish myself.

So, yes, the above does seem BPD-ish, but could also seem ADHD-ish. Furthermore, I've only hit one and a half out of the nine BPD criteria as defined by the DSM.

My interpersonal relationships are typically stable. I have a very close relationship with my family. I'm an introverted homebody, so I only have a few close friends. I'm engaged to a wonderful man and we have a very healthy relationship. We've been together for over three years. Also, I've never been promiscuous--actually, I've been quite the opposite. I lost my virginity to the man I'm currently engaged to after dating him for nearly seven months. I was 26 at the time. I've never cheated and I'm extremely faithful. I don't alternate between extremes of idealization and devaluation. I'm able to see the good and the bad simultaneously, though I prefer to see the good in people. If my fiance does something upsetting or disappointing, I don't see him as "all bad." I see him as a loving, caring man who most likely just made a mistake. No one is perfect.

I've never made frantic efforts to avoid real or imagined abandonment. I've been dumped in the past, and for the most part, I've coped rather well. I would grieve, sure, but I was still able to move on with my life. I've never begged or threatened an ex. Also, I'm a fairly trusting person, and I tend to give people the benefit of the doubt.

Furthermore, I would say I have a markedly and persistently stable self-image or sense of self. I'm not a chameleon. I have a very big personality that is all my own. I'm able to be alone, to be single, and I still have a sense of self.

My moods and feelings are predominantly stable as well. I don't experience a variety of rapidly changing feelings, nor do I feel like I am on an "emotional roller coaster." I do have a history of recurrent major depression and anxiety; however, I'm usually depressed and anxious for months at a time, not just a few hours or a few days.

Also, I do not experience chronic feelings of emptiness. There are times when I feel my life lacks real meaning or purpose, or instances where I feel stuck or ambivalent, but that's not the same as feeling empty.

Generally speaking, I'm not an angry person either. If I happen to experience intense anger, my reaction is typically appropriate in relation to the situation. I don't rage inappropriately over trivial matters or when my needs are not met. When I do experience anger, I don't remain angry for very long. Alcohol, especially hard liquor, does have the potential to turn me into an inappropriately angry, explosive person. Angry drunks are not all that uncommon though.

Lastly, I've never experienced paranoia or dissociative symptoms.

Thoughts?

Anyone?

BPD, like most disorders, is on a spectrum. So, it's not a thing of either "you have it or you don't", but more of "a little borderline, not at all borderline, a lot borderline, extremely borderline" etc,.

My sense of Self doesn't change either depending on whom I'm with, I don't think. My behavior may change, but not who I am at the core. My sense of self does change though, depending on my own moods, not what other people are doing, or what they value. So for me if I'm in a sad, dejected mood, I'm "worthless", if I'm happy, I'm "a great person", if I'm angry, I'm a righteous avenger...stuff like that. At baseline mood, I feel inferior (low self-esteem) but not necessarily worthless. Does this resonate with you at all?

I have ADHD too, along with BPD (and OCD/PTSD) and my moods aren't constantly labile, either. I have many periods of baseline mood. When something triggers me though, I can feel a lot of anger/anxiety, and it can switch very easily, BUT normally I'm at baseline.

Some of what you're saying sounds BPDish to me tbh, but, some of it could be ADHD as well. Honestly though, I haven't heard of self-harm with ADHD. It could be a thing, not sure. But we can't diagnose you here. If you doubt your diagnosis, stick around and see if it fits, or get a second opinion.

Good luck.

Ok, maybe I'm a little borderline, or perhaps I have borderline tendencies. I will admit I used to be able to relate more to the posts on this forum when I was younger. I was more sensitive and moody. I was possibly a lot borderline. I was also in a toxic relationship though.

What you're saying resonates with me for sure. My sense of self does change depending on my own moods. When I'm depressed, I hate myself, and when I'm happy, I'm an ok person. At baseline mood, I feel inferior and I have low self-esteem, too. Killing myself always remains an option for me, which I feel is more BPD than ADHD. Actually, sometimes I'm able to handle breakups, and sometimes I'm not. I completely forgot I tried to hang myself with a belt when my fiance periodically broke up with me several months ago. When that didn't work, I downed a bottle of Klonopin to knock myself out and I remember truly hoping I would never wake up again. He doesn't know, though. I don't use suicide attempts to threaten people because I know I would look crazy if I did something like that. Does that sound like BPD?

I'm normally baseline, too, but yeah, I do have triggers as well.

I don't really have a history of major abuse or neglect though. My parents may have been verbally or emotionally abusive. They would call me names and they yelled a lot. Their love was definitely conditional. If I made a mistake, I was automatically a screw up and a moron. They fought a lot when I was younger, too.

Well, thank you so much for responding! Your input was really helpful!

Excuses wrote:What you're saying resonates with me for sure. My sense of self does change depending on my own moods. When I'm depressed, I hate myself, and when I'm happy, I'm an ok person. At baseline mood, I feel inferior and I have low self-esteem, too.

Sounds like me. My (soon to be ex) therapist told me that with BPD, we have a "fluid" personality that changes according to who we are with but that never made sense to me. I do mirror others but only to an extent; my values and opinions don't change at all if I'm interacting with someone I disagree with, you know what I mean? But I've heard that other people with BPD, they do have a complete shift depending on which group they are with, almost charleton like. It might be a different type of BPD, I know there was something called the "as-if" personality that is on the borderline spectrum.

Excuses wrote:When that didn't work, I downed a bottle of Klonopin to knock myself out and I remember truly hoping I would never wake up again. He doesn't know, though. I don't use suicide attempts to threaten people because I know I would look crazy if I did something like that. Does that sound like BPD?

Kind of, I know some people with BPD can get suicidal following abandonment, but it's usually a plea to get the other person back. Is that what you were hoping to do, deep down?

Excuses wrote:I don't really have a history of major abuse or neglect though. My parents may have been verbally or emotionally abusive. They would call me names and they yelled a lot. Their love was definitely conditional. If I made a mistake, I was automatically a screw up and a moron. They fought a lot when I was younger, too.

Invalidation is supposed to be the cause of BPD. Emotional/verbal abuse would fall under that, for sure.

The diagnose usually just represents a mental health professional's frustrated response to challenging patients. But if you say you're an easy patient, then they just aplied they stereotype that is, if you self-harm, you're borderline. They are usually right, but studies say 40% of patients fit another diagnosis. What i'm saying is that, it is possible to be misdiagnosed.

NimplyDinply wrote:Sounds like me. My (soon to be ex) therapist told me that with BPD, we have a "fluid" personality that changes according to who we are with but that never made sense to me. I do mirror others but only to an extent; my values and opinions don't change at all if I'm interacting with someone I disagree with, you know what I mean?

See, that doesn't make sense to me either. I definitely don't have a "fluid" personality and I don't really mirror others. My values and opinions remain the same regardless of who I am around. I just act like myself around other people, and if they don't like me, I really don't care.

NimplyDinply wrote:Kind of, I know some people with BPD can get suicidal following abandonment, but it's usually a plea to get the other person back. Is that what you were hoping to do, deep down?

No, if he had found out I was acting crazy, that would have just pushed him away. Threatening to kill yourself in an attempt to get the other person to feel sorry for you and come back seems nonsensical to me. I have self-respect and I'm not manipulative. I really just didn't want to live anymore.

I also don't have the same type of abandonment issues others are talking about on here. If my fiance leaves the house or the room, I don't feel abandoned. If he goes away for the weekend on a business trip, I actually really enjoy the solitude and alone time.

NimplyDinply wrote:Invalidation is supposed to be the cause of BPD. Emotional/verbal abuse would fall under that, for sure.

How interesting. My current therapist thinks my mother has BPD. She recommended the book Understanding the Borderline Mother. My mother seems to fit the queen character profile perfectly. I'm nothing like my mother. She loves aruging and picking fights, she holds grudges, and she's manipulative. I don't think she has the capacity for empathy, and she cannot relate to another's feelings, inner experiences or needs. I'm a school counselor, so I'm actually very empathetic and I'm able to read people fairly well. Is that uncommon for people with BPD?

-- Sun Oct 18, 2015 12:07 pm --

Chris Altman wrote:The diagnose usually just represents a mental health professional's frustrated response to challenging patients. But if you say you're an easy patient, then they just aplied they stereotype that is, if you self-harm, you're borderline. They are usually right, but studies say 40% of patients fit another diagnosis. What i'm saying is that, it is possible to be misdiagnosed.

I guess I am challenging case, but I'm an easy patient. I've been misdiagnosed with Bipolar II, Dependent Personality Disorder, and Adjustment Disorder.

Based on what you have shared it does seem like you've been misdiagnosed. But I think what's most important is the fact that *you* feel it doesn't fit. You don't sound like you're in denial, your arguments as to why BPD doesn't seem right are quite clear and level-headed. I mean, everyone has borderline tendencies to some degree - everyone - it doesn't mean that everyone is borderline.

It can't hurt to get a second opinion or to express to the person who diagnosed you (if you want to) that you don't think it fits. I was diagnosed with MDD some years ago (major depressive disorder) but it really did not seem to fit me and that was frustrating because I didn't get the appropriate care. BPD, on the other hand, does fit me. So I think it's worthwhile to express your views on this and see if perhaps there was a misunderstanding when they diagnosed you.

Well, if BPD runs in your family, that is an indicator that you may have it. Of course, a statistical probability means nothing when you can observe the actual data. Diagnostic criteria can be pretty vague, but if you don't seem to even vaguely fit most of it, and you don't relate to what other people are saying about their experiences with the condition, then it sounds unlikely to be your own personality type/condition.

Your moods... I think a constantly shifting mood - having profound emotional reactions to things that happen which are hard to get over - is very characteristic of BPD, whereas having long periods of a consistent mood are more characteristic of Bipolar (but can occur in BPD as well, though usually when there is a concurrent mood disorder). Also, BPD and Bipolar are very similar disorders. I would guess Bipolar fits you better. Substance abuse and self-harm could come under Bipolar, and a lack of the changeability of emotional state, sense of self and beliefs etc. do provide argument against BPD.

Of course, I have very limited knowledge of the whole thing and diagnoses aren't supposed to be made on here, so I don't intend for my words to carry much weight, but that is my assessment.

Excuses wrote:Anyone?

(1)

I have impulsivity in one area that is potentially self-damaging (i.e., alcohol abuse), as well as recurrent suicidal and self-mutilating behavior. I have a history of alcohol abuse, mostly binge drinking. I tried to kill myself twice while I was extremely intoxicated. I'm an entirely different person when I drink alcohol, especially hard liquor. I have trouble stopping once I start drinking, and I usually end up blacking out. I was hospitalized twice for drinking nearly fatal amounts of alcohol. For this reason, I don't drink anymore. I still self-injure, or self-mutilate, maybe once or twice a year when I either feel out of control or I want to punish myself.

(4) & (5)

What you're saying resonates with me for sure. My sense of self does change depending on my own moods. When I'm depressed, I hate myself, and when I'm happy, I'm an ok person. At baseline mood, I feel inferior and I have low self-esteem, too. Killing myself always remains an option for me, which I feel is more BPD than ADHD. Actually, sometimes I'm able to handle breakups, and sometimes I'm not. I completely forgot I tried to hang myself with a belt when my fiance periodically broke up with me several months ago. When that didn't work, I downed a bottle of Klonopin to knock myself out and I remember truly hoping I would never wake up again. He doesn't know, though. I don't use suicide attempts to threaten people because I know I would look crazy if I did something like that. Does that sound like BPD?

(1), (2), (3), (4) & (5)

Also, I do not experience chronic feelings of emptiness. There are times when I feel my life lacks real meaning or purpose, or instances where I feel stuck or ambivalent, but that's not the same as feeling empty.

(7) & (3)

Generally speaking, I'm not an angry person either. If I happen to experience intense anger, my reaction is typically appropriate in relation to the situation. I don't rage inappropriately over trivial matters or when my needs are not met. When I do experience anger, I don't remain angry for very long. Alcohol, especially hard liquor, does have the potential to turn me into an inappropriately angry, explosive person. Angry drunks are not all that uncommon though.

(3), (4), (6) & (8)

Diagnostic criteria for 301.83
Borderline Personality Disorder

DSM IV - TR

A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

(1) frantic efforts to avoid real or imagined abandonment.
Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.

(2) a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation

(3) identity disturbance: markedly and persistently unstable self-image or sense of self

(4) impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, Substance Abuse, reckless driving, binge eating).
Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.

(5) recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior

(6) affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)

(7) chronic feelings of emptiness

(8) inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)

(9) transient, stress-related paranoid ideation or severe dissociative symptoms