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TherapistMarryAnn, Therapist
Category: Mental Health
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Experience:  Over 20 years experience specializing in anxiety, depression, drug and alcohol, and relationship issues.
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Is it possible to be diagnosed with both Borderline Personality

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Is it possible to be diagnosed with both Borderline Personality Disorder AND Bipolar Disorder?


Hi, and thank you for requesting my help.


You can have both disorders, but because they overlap so much it is probably unlikely. It would take a very thorough evaluation to determine that you do indeed have two separate disorders or they are occurring at the same time.


Bipolar is considered what is called an Axis I disorder. That means it is considered a major disorder. Borderline is an Axis II disorder, which is considered a personality disorder. You can have both an Axis I and Axis II at the same time, but because you are not sure you even have Bipolar, it could be that you have one or the other instead of both at the same time.


Since the symptoms are so similar, it may be hard to determine which one you have. But Bipolar is marked by extreme highs and lows. Borderline is also marked by severe mood swings, but they tend to be other moods including depression and mania. Also, if you have Borderline, you may cycle faster. People with Borderline are more dependent in personality than people with Bipolar, either in a good way or bad. And finally, someone with Bipolar will become depressed and be very depressed, rather than someone who has Borderline who will go back and forth with anger, sadness (not depression), and other emotions. Bipolar is either depression or mania, not other emotions.


I hope this helps,


Customer: replied 4 years ago.

Sorry, I am so confused - not by your answer but about me!


I had my antidepressants withdrawn 2-3 months ago because the consultant said there was still a question mark over whether I have bipolar. I have since had an assessment with a psychotherapist who says I am showing traits of a personality disorder (not sure which one). I have spoken to my cpn today who doesn't understand why they don't just tell me what's wrong with me!


I tend to have a 'hyper' time, which lasts around 2-3 weeks at a time, which is accompanied by my head 'buzzing' and this is followed by a period of 2-3 months where I am in a deep depression, to the point that I feel suicidal and regularly self harm.


At the moment I seem to have a bit of a combination of both ... I have had high energy levels for the last 2-3 weeks, but the last week of this my mood has crashed through the floor. The energy levels are decreasing, but my mood can't get much lower.


All I want is for them to tell me what's wrong with me. They keep saying it's all about symptom control, but I NEED to know because I want to understand why I feel as bad as I do!


One doctor says I am describing bipolar and then another one says it's borderline. I understand that the symptoms are very similar but it's now been 18 months that I have been under the care of the mental health team and I feel no closer to having a diagnosis.


I can't carry on like this. This depression is slowly killing me ... I don't feel I can fight it much longer.


Sorry, that was a bit long-winded.


No, that is fine. I am glad you told me what you are experiencing.


Though it would be ideal for me to be able to meet with you to provide you with a diagnosis, I will do the best I can with what you told me.


It sounds to me like you have Bipolar. You are not describing any other emotions such as anger, rage or feeling abandoned by others. Self harm is a symptom of Borderline, which may be confusing to clinicians that you are seeing. But your main symptom is up and down moods, from deep depression to mania. This indicates Bipolar.


There are many cases in which a person has some symptoms of a disorder, but does not meet the criteria to actually be diagnosed with the disorder. That may be what is happening with you. You may have traits of Borderline, but not enough to actually have it.


I am going to provide you with links to websites that have reliable information on both disorders. Hopefully, they will help you figure out what you do have. At the very least, they could help you list your symptoms more clearly so next time you see someone, you can provide a detailed account of your symptoms. Here are the links:


The next time you see someone, let them know you want your diagnosis and a copy of your psychological evaluation. You have a right to that information. If you have any trouble getting the information, you can enlist the assistance of your doctor or you can contact the local mental health advocate or legal services.



TherapistMarryAnn and other Mental Health Specialists are ready to help you
Customer: replied 4 years ago.

Thank you for that.


I told the cpn today that I have had the 'buzzing' head again, but it can't be blamed on the antidepressants this time. I am due to see the consultant in 5 weeks time for a full medication review; however, she feels I need to be seen by someone next week, so I will look at the links you have provided and highlight the symptoms I feel I have in each disorder.


I don't particularly want to have either disorder, so it's not about wanting to be labelled ... I am just the sort of person that needs to understand something!


Thanks again.



Customer: replied 4 years ago.
One last question please ... is it normal to NOT be given antidepressants with bipolar or borderline? They took me off them last year, then decided I needed them again when my depression got bad and now they have removed them again, but are trying to decide whether I need them again because of my depression. What I don't want is to yo-yo on and off of them.

The typical medication for Bipolar is Lithium. That helps control the ups and downs and levels out the mood swings.


To take away the anti depressants is unusual, especially if you are feeling deeply depressed. You should be on something to help you cope. Sometimes the doctor will take you off medication to help see your symptoms more clearly if the diagnosis is hard to pinpoint, but you should not be off for a long period of time, only long enough to diagnose you. But it does not sound like that is what they are doing in your case.



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