Zimmerman says, bipolar disorder shares some symptoms with borderline personality disorder, a condition marked by impulsive behavior and problems relating to other people — and because of this, people who have borderline personality disorder are often misdiagnosed as bipolar.
Why Bipolar Disorder Is Often Misdiagnosed
By Jennifer Acosta Scott
Reviewed by Farrokh Sohrabi, MD
Bipolar disorder is missed in some people and mistakenly diagnosed in others. Find out why.
About four percent of people in the United States are diagnosed with bipolar disorder at some point in their lives, according to the Centers for Disease Control and Prevention. In recent years, however, some researchers have called some of those diagnoses into question, while others have maintained that the number of people with bipolar disorder is actually greater.
In 2008, the Journal of Clinical Psychiatry published a study that suggested bipolar disorder is often diagnosed in people who don’t actually have the condition. The researchers determined that fewer than half the people in the study who said they had been diagnosed with bipolar disorder met the clinical criteria for the illness, which causes severe swings in energy levels and mood.
Mark Zimmerman, MD, the lead researcher on that study and a professor of psychiatry and human behavior at Brown University in Providence, Rhode Island, says the study also revealed that some people who met the criteria for bipolar disorder had never been diagnosed with it. But far more people had been given the bipolar label by mistake, he says. Dr. Zimmerman believes part of the reason for this overdiagnosis trend is aggressive marketing to doctors by companies that produce the drugs used to treat bipolar disorder.
Borderline folks are at the mercy of their own pain, and have little energy left over to offer care for others. They are capable of both guilt and empathy, but often cannot access either.
Narcissist or Sociopath in Your Life? Four Essential Answers
By Jonice Webb PhD
As a blogger on PsychCentral, I regularly read the most popular blog posts. I’ve noticed that articles that contain the words “narcissist, borderline or sociopath,” three types of personality disorders (PDs), are often the most read, liked and shared.
I also notice that the folks who comment on those posts very often express a mixture of strong emotions like confusion, hurt, anger and helplessness. Clearly a great many of you, our readers, are hungry for information and guidance on how to handle your relationships with these complex people in your lives.
The world is full of people who struggle with personality issues. In truth, the numbers are staggering. 6% of the U.S. population has narcissistic personality disorder. 5.6% has borderline personality, and 1% has antisocial personality (according to the National Institute of Health).
With these numbers, there’s a reasonable chance that you’ve met, befriended, been related to, or fallen in love with at least one of these personality types.
These three personality disorder types are all different. Narcissists are known for being self-centered. Those with borderline personality are known for being unpredictable and highly emotional. And antisocial personalities (or sociopaths) are famous for their brutality. Generally, these three PD’s can best be understood by their ability or inability to feel two very important emotions: guilt and empathy.
Before her patients could or would change, she saw, they needed to accept themselves, and to be accepted, exactly as they were in the present.
No Longer Wanting to Die
By WILL LIPPINCOTT
MAY 16, 2015 2:30 PM
In January 2012, two weeks after my discharge from a psychiatric hospital in Connecticut, I made a plan to die. My week in an acute care unit that had me on a suicide watch had not diminished my pain.
Back in New York, I stormed out of my therapist’s office and declared I wouldn’t return to the treatment I’d dutifully followed for three decades. Nothing was working, so what was the point?
I fit the demographic profile of the American suicide — white, male and entering middle age with a history of depression. Suicide runs in families, research tells us, and it ran in mine. My father killed himself at age 49 in April 1990. A generation before, an aunt of his took her life; before her, there were others.
Shame runs in families, too, and no one in mine talked much about mental illness.
The first time I was hospitalized for wanting to kill myself, as a teenager, my dad visited me a few days in. I made an effort to greet him with a firm handshake; he shared a few jokes with me. Dad was visibly concerned and told me he loved me. Only after his suicide a few years later did I learn that he, too, had been hospitalized, for depression, when he was in his early 20s.
Myths about BPD abound. Part of fighting the stigma is to know the facts.
Bon: From one of my favorite sources – Karen Hall’s Emotionally Sensitive Person blog.
Fight Stigma: Facts about Borderline Personality Disorder
By Karyn Hall, PhD
May is Borderline Personality Awareness Month. To fight the stigma that is so difficult for individuals with mental illness and particularly for individuals with borderline personality disorder (BPD), I encourage you to learn more about the disorder. Stigma can be devastating to individuals who are already struggling with intensely painful emotions and a fear of not belonging or fitting in. Stigma also can stop individuals from getting the help that is available or in continuing in treatment.
Myths about BPD abound. Part of fighting the stigma is to know the facts.
Myth: Individuals with BPD Are Dangerous.
Individuals with BPD are some of the most caring individuals you could meet. They have intense emotions that arise quickly. They can anger quickly and be most expressive with their anger. These intense emotions, including anger, typically pose a danger for the individual with BPD rather than for others. By far the majority of individuals with BPD are dangerous only to themselves. Their intense emotions may lead to self-harm and/or suicide attempts.
Because individuals with BPD have intense emotions and may act impulsively without thinking through the consequences, that can be unsettling to others. This impulsivity may also contribute to the view that individuals with BPD have no self-control. The fact is that individuals with BPD do have self-control. They often go to great lengths to manage their emotions. When they are overwhelmed they may act in ways that are not helpful or effective, but rarely in a way that is dangerous to others.
Myth: Only Women have BPD
For many years borderline personality disorder was believed to be more prevalent in women than men, with about a 3 to 1 ratio. The Diagnostic and Statistical Manual of Mental Disorders, a guide to diagnoses used by clinicians and created by the American Psychiatric Association, has consistently reported that the diagnosis is more prevalent in women
A lot of psychological issues — like PTSD and borderline personality disorder — cause sufferers to have frequent vivid nightmares.
How To Stop Bad Dreams In 7 Steps, Because Nightmares Are No Fun
Most of us grapple with nightmares as kids — but becoming an adult doesn’t automatically make us stop having bad dreams. In fact, researchers estimate that three-quarters of all of our dreams are nightmares, even if we don’t live anywhere near Elm Street — we just usually don’t remember our dreams after we wake up. And if you’re one of the five to 10 percent of adults who have at least more than one nightmare a month, our human tendency to dream something horrible is more than just a quirky fact — it’s a real and practical problem that can leave us sleepless, irritable, unproductive, and worst of all, afraid of naps.
When we were toddlers, nightmares were a fact of life — some studies estimate that up to 50 percent of children aged three to six have regular nightmares. Those stats tend to lower as we age, but in times of great stress, or when something about our lives changes, we can sometimes start having regular nightmares again as adults.
The easiest choice is to focus on pharmacologic therapy for target symptoms rather than the personality disorder as a whole.
Personality Disorders Largely Being Treated Inappropriately by Psychiatrists
May 6, 2015
Psychiatrists are giving drugs to most people with emotionally unstable personality disorders outside of the best-practice clinical guidelines, according to a study in the Journal of Clinical Psychiatry. And an accompanying editorial stated that the reason is because “therapy takes time.”
The researchers performed a cross-sectional survey of self-selected psychiatric services, and found that of 2,600 patients with a diagnosis of personality disorder, more than two-thirds (68%) had a diagnosis of emotionally unstable personality disorder (EUPD). Nearly all of these (92%) were being treated with antidepressants or antipsychotics. “The use of psychotropic medication in EUPD in the United Kingdom is largely outside the licensed indications,” concluded the researchers. This was a particular concern, they added, because the practices aren’t often systematically reviewed and monitored, “so opportunities for learning may be lost. Treatment may be continued long term by default.”
“(I)t is now known that specialized treatments such as dialectical behavior therapy and mentalization-based treatment can be helpful for most cases,” stated the accompanying editorial. “Although these more specific psychological treatments are known to be efficacious, they are not readily available. The reason is that therapy takes time and is expensive in human resources. This leaves harried clinicians with an inadequate set of options. The easiest choice is to focus on pharmacologic therapy for target symptoms rather than the personality disorder as a whole.”
The editorial argued that the problem may be even more widespread than found in the study, and stated, “Clearly, psychiatrists need to receive better education about evidence-based treatments for severe personality disorders. However, much of what they think they know is filtered through a climate of opinion shaped by neurobiological models and psychopharmacologic options.”