were you diagnosed with another PD before SPD?

Hi there,

I was diagnosed with BPD at eighteen, very textbook case. I spent a lot of time in therapy, participated in a research study, meds, etc. I am now thirty-one and have considered myself generally "recovered". I stopped exhibiting most signs of BPD several years back. I do notice thought patterns and some self-destructive tendencies still, but I keep everything very contained.

In fact, I started acting sort of opposite to my former BPD self - where I used to be oversensitive and hyperemotional, I became totally detached. At first this was a choice made because of trauma - simply too much pain and suffering, easier to feel nothing. But over the years, it seems to have "stuck" and for the last couple years, it's just kind of how I am. And I like this much better.

I had started to wonder whether I just traded one disorder for another - initially my traits seemed much more antisocial. After thinking and reading more thoroughly, it seems like schizoid is actually a far more accurate assessment. I meet almost all the diagnostic criteria for SPD. I was concerned I might be doing the whole "online self-diagnosis" business, so I've tried to look into whether there's any precedent for BPD and SPD being somehow intertwined - the jury seems to be pretty split. I did find one interesting study (poorly translated, sadly) that linked both BPD and SPD to early childhood neglect and disruption of attachment. The researchers claimed that BPD is the externalizing of that and SPD is the internalizing (summing it up poorly - if i can rustle up the link I'll post it later). This makes sense to me, as neglect in infancy is thought to be part of my BPD's cause.

I'm wondering if I have somehow "transformed" from one PD to another, or maybe just that healing one with very dramatic symptoms made it easier to see the subtler symptoms of another that was already there?

I guess I'd like to seek diagnosis not for treatment's sake so much as to get validation that this is real, that I'm not just making something up. Not just a jerk who doesn't want to have friends and relationships, you know? Because I think that's how some people see it, especially those who knew me in my youth when I was a very different person. Sad as it is to admit, I would rather be able to say "this is what's wrong with me so leave me alone". That, and the never-ending quest for understanding of wtf is my deal.

I see a therapist regularly and will be bringing this up, but I perused this forum at length and wanted to see if anyone had opinions or experiences to share. It is much appreciated.

I was diagnosed with ADHD before I was diagnosed with SPD (about two years earlier I think), but not with another PD. I was also diagnosed with schizotypal PD later by the same psych. I don't think I could be diagnosed with any other PD.

It was validation in the sense that it told me that "this isn't just psychiatric hypochondria", but I don't think it explained anything or even made it more definite. Someone other than me, who's supposed to be specialized in these things, saw the same as I did. But still, they could be wrong.

I do wonder (especially when I go through some kind of emotionally intense and troubled phase) if schizoid PD is essentially the same thing as when someone "gives up on social connection and embraces a tepid kind of existence" later in life for reasons that they're aware of, or if it's really a fundamentally different thing.

@OP You are definitely not the first person to be diagnosed with BPD and then later diagnosed with SPD.

Some people are also diagnosed with both at the same time or have one and traits of the other.

Personalities are complex and different features of your personality may come out in different scenarios, or as you age, you may develop new coping mechanisms and drop some other ones. You may become more functional in some areas and less functional in others.

There are some people who believe if you have BPD you can't have SPD, you just become an "isolated BPD" as an extreme defense mechanism against the trigger of relationships. T

What really matters is what are the symptoms you are displaying most prominently in the here and now and how they are affecting your life, rather than the precise label imo.

I guess I'd like to seek diagnosis not for treatment's sake so much as to get validation that this is real, that I'm not just making something up.

This part did stand out about your post though and sounds like a BPD feature to me, though. The desire for validation is a very BPD thing. Why do you need to know, or have it confirmed by a specialist? If you are not going to seek treatment? Is not knowing on your own enough? Do you believe you may be deluding yourself in some way? I'm just interested in your perspective on this.

To answer your question myself, I have been in therapy and been treated for disorders but was never told what was written in my medical chart. I'm actually glad I wasn't told because if I was I probably would have felt like I had to relegate myself to just one box, and wouldn't have the freedom to explore different facets of my personality. I prefer the ability to explore on my own and introspect and discover things about myself instead of have someone tell me "You are this." In reading the various forums here I feel like I fit in the SPD forum but I also relate to some of the other PDs, especially in the Cluster B. Personalities are complex and most people aren't a "pure" PD but can have traits from many.

zeno wrote:I do wonder (especially when I go through some kind of emotionally intense and troubled phase) if schizoid PD is essentially the same thing as when someone "gives up on social connection and embraces a tepid kind of existence" later in life for reasons that they're aware of, or if it's really a fundamentally different thing.

I've been pondering the same thing - if the end result is the same, but the path there is different, is it still the same disorder? or is it just the consequences of previous choices and experiences? etc etc

MotherRussia wrote:

I guess I'd like to seek diagnosis not for treatment's sake so much as to get validation that this is real, that I'm not just making something up.

This part did stand out about your post though and sounds like a BPD feature to me, though. The desire for validation is a very BPD thing. Why do you need to know, or have it confirmed by a specialist? If you are not going to seek treatment? Is not knowing on your own enough? Do you believe you may be deluding yourself in some way? I'm just interested in your perspective on this.

You're right - this is a very BPD thing, and I'm aware of that. There are several reasons for it. I have had a longstanding fear that people think I'm making things up or being dramatic - I've had a lot of uncommon experiences that, taken together, seem like too much to believe sometimes. Part of that fear is also from my mom's behavior toward me growing up. It used to be a much stronger paranoia and has greatly decreased, but I still tend to seek external confirmation for certain things, mental health being one of them. I've also lost touch with reality in times of extreme stress, so there's sometimes the fear that I'm not seeing things as they are.

I think the second (and still oh-so-borderline) reason is that I have an unstable inner sense of self, so I am always seeking more definite ways to identify myself. Ironic, since I hate being labeled or put in boxes by other people. I just do it to myself. But if you add in the afore-mentioned thought that people don't believe me, it sometimes leads to a desire for external confirmation of whatever I think is going on with me.

I keep asking myself the question you asked, "is not knowing on your own enough?" ..I can definitely look at my symptoms and observe my patterns and see clearly that I fit into this category, though still with some borderline traits mixed in. And I'm not unhappy with any of this, so why the desire to seek diagnosis? It's almost like a psychic itch that I need to scratch. I can't really describe it. The thoughts I have about it just go in circles: this is how you are - you should be trying to get better - i don't want to - why not? - because this is how i am - etc.

I appreciate the replies. I'm interested in what my therapist thinks, but i don't see her for another week or two. Guess I have more time to think about things.

vortexvoid wrote:I did find one interesting study (poorly translated, sadly) that linked both BPD and SPD to early childhood neglect and disruption of attachment. The researchers claimed that BPD is the externalizing of that and SPD is the internalizing (summing it up poorly - if i can rustle up the link I'll post it later). This makes sense to me, as neglect in infancy is thought to be part of my BPD's cause.

That's interesting. I was told both my my PDs were caused by childhood neglect, and that I had a "survivor" profile. I was dx'd with SPD and AsPD at the same time, though my childhood dx of ODD came earlier.

I'm not sure there are any PDs that can't be dx'd together. This forum seems to have a lot of "pure schizoids," but there are those with multiple PD dx's, too. And we can all relate to each other in some way.

I had AvPD traits for a good many years, probably due to ongoing trauma from being bullied in early childhood. I had a terrible self-image and low self-esteem, which is quite a heavy weight to carry on your shoulders.
As my self-esteem improved, the avoidant symptoms lessened. The memories of the bullying mean nothing to me now, although it took a good twenty years for me to get to that point.

I suppose I might have a few traits of some other PD's, but the way I look at it, who doesn't?