Differences and Similarities: Bipolar Disorder and Borderline Personality Disorder

hi it's dr fox licensed psychologist in the state of texas and in this video we're going to talk about is it bipolar or bpd and this specifically goes to complex bpd and is this a component of your complex bpd and we're going to break down bpd in this video we're going to look at those different components overlapping components separating components we're going to get into a lot of components so hang on tight here we go stick around and let's get started please like share and subscribe that would be great and let's get started with is it bipolar or bpd here we go so we first want to help identify if it's bipolar or bpd symptoms so what we're going to do is we're going to talk about how common is it what is the age of the first symptom and are what are the similar symptoms those overlapping symptoms and making that bipolar disorder and bpd distinction so we're going to build some insight here all right we're going to try to help you separate it as well so here we go all right so how common is this well bipolar disorder and bpd are comorbid in approximately 27.6 percent of cases that means approximately 20 percent of bipolar 2 patients were diagnosed with vpd only 10 percent of bipolar 1 patients were diagnosed with dpd now the big difference between bipolar 1 and bipolar 2 is that bipolar 2 is a hypomanic episode which means that you have high highs but they're not as destructive and impairing to your socio-economic status and functioning some folks with bipolar 2 when they're in that hypomanic phase they're actually still able to go to work yeah they're cleaning they're cleaning a lot and they may be gambling somewhat and they may be a little more irritable but they're able to function to a greater degree compared to those with a manic episode or a manic phase and that's your bipolar one and that manic phase is very very destructive of an individual socioeconomic dysfunction that's their ability to go to school or go to work as well as maintain social relationships and they're having really high highs right and they have gambling spree spending spree promiscuity they can go on drug binges things like that so that can all be the manic phase as well so just to give that idea as you can see on the screen right twenty percent bipolar two ten percent bipolar one now bpd overall with bipolar disorder so we see that there's this separation of bpd and then there's separation of bipolar disorder but there is overlap and that's where this confusion comes into play now bipolar 2 and bipolar 1 right the percentages and you see it kind of write it backwards so we'll flip it right so bipolar 1 and 2 percentages in those bpd right just like we mentioned a moment ago bipolar 2 disorder 20 bipolar 1 10 okay so when we look at it this helps to graphically capture that that bipolar 2 is somewhat bigger and takes up more of that space because there's more overlap whereas that that bipolar 1 is not as much you can see there isn't as much overlap into that bpd symptomatology into that bpd sort of overlooking topology what's the age of first symptoms and this is really really important to be aware of now even though stuff i'm going to talk about everything isn't isn't you know absolute right with human beings very little is absolute we know that so we have to consider just because it's occurring with one or even a proponent of individuals that doesn't mean it's a hundred percent okay so age of first symptoms now the initial manic or hypomanic episode is typically around 18 years old and bpd symptoms are likely to occur in early adulthood which begins at like 18. so you've got that time and age overlap in there as well now in some cases what will happen is you'll see some bpd symptoms as early as 16. we got to be really really careful in any type of situation where you would diagnose a personality disorder in someone under 18. that's because a lot of our personality characteristics although they're present and our prolonged and habitual behaviors have solidified to a degree but there's still a lot of development between 16 and 18. there's still a lot of changes it's also a very tumultuous time for everybody 16-18 is tumultuous right there's all this stuff going on you're growing and developing your body's a little weird and you're you know another weird and negative way it's weird for all of us that's 16 to 18 you know and it's developing in a very different way and you're trying to get used to it you're trying to move into adulthood leaving childhood and adolescence behind so it's that it's that awkward position and situation so it can be very very challenging so we see that these symptoms start to show which is why for individuals that are around 16 between 16 and 18 we want to make sure that those bpd symptoms that they've been there for at least one year and consistent because if it is in reaction to an identifiable stressor it could be a maladaptive reaction to that identifiable stressor which is not a personality disorder it's a maladaptive response to a stressor and once that stressor goes away presumably so would the maladaptive behavior or it would at least attenuate to a pretty large degree so that's a little bit about age or for symptoms and what about those similar symptoms what the overlap right here's the confusion so the symptom overlap with the manic phase and bpd behaviors all right so we see the individual bpd and those that are in the manic phase have irritable mood racing thoughts and ideas right all these things get floating through your mind and stuff when individuals with ppd when they get excited they get all these neat ideas and all these things are running through their mind and things like that and they have rapid speech because they want to tell you all about it and they're super super excited well people in the manic phase do the same and a lot of times they'll also engage in risk-taking behaviors too that could be promiscuity substance abuse it could be reckless driving drinking and driving things like that so though that's risk-taking behaviors in the manic phase also sometimes in folks with with bpd as well because sometimes they're like heck with it and they don't say heck with it they just say you know the other one i'm not going to say it but and they just said i'm just going to do it because i want them to throw caution out there i don't even care and what happens is sometimes that bpd becomes so overwhelming and that voice in their head it's not a psychotic voice somebody's an inner critic sometimes it's family in the head that are talking to them and telling them you know hey just forget it just do it just do it just do it and that that volume becomes so loud and intense that they just do it and then also goes to that impulsivity and that that inner voice that we're talking about is also adding to that impulsivity but we also see that in that manic phase right that that's that symptom overlap now let's differentiate bipolar 1 in bipolar 2. and we have that manic episode now this is an individual can't successfully participate in required daily activities right i alluded to that earlier they may even need hospitalization in a manic episode due to delusions or hallucinations which are at a higher probability to occur in a manic episode now there's also that high probability of impaired insight into behavioral emotions which means right they're engaging in behaviors without slowing down looking at those behaviors and the destruction that they could cause on their life take a look at that hypomanic episode so hypomanic episode we see family and friends are noticing a little difference in behavior and mood they're kind of like what's going on with jerry i don't know what jerry that's just an example right they may have impaired insight the individual what this means is the individual may recognize that they have this increase in energy this increase in low frustration tolerance they recognize there's something different about them hey and they may be able to fulfill some of their daily activities talked about that earlier right it's not as destructive on your socioeconomic functioning but it certainly can be and then also that last component for a hypomanic episode that we're going to talk about is its impairment is present right but task completion is still possible and even in some cases again it's likely so really how how are you able to complete your task are you able to go to work are you able to get your kids ready for school are you able to you know take a shower have good hygiene continue it you know keep it up are you able to go to sleep are you able to slow down think through components as well that's your hypomanic aspect now bipolar 1 bipolar 2 that big difference generally they're differentiated by the severity right which i talked about earlier and the length of time the symptoms are present typically a hypomanic episode is going to be about four days and earlier a manic episode is going to be about a week or more okay it could be four days or more you got that gray area in there as well so the difference in bipolar one bipolar ii is certainly timing right as i just mentioned but for a manic episode symptoms must last for one week or longer whereas that hypomanic episode the symptoms are there and present for four consecutive days or more so you notice that or more is that overlap and that's why these are really complex disorders and we're not even into the into the bpd stuff just yet so it is confusing and it is hard to discern it but the episodic and the time component is really really important so let's talk about the depressive phase right and the confusing overlap so individuals with bpd they experience these depressive spirals and that's low energy prolonged sadness decreases in activity poor concentration difficulty with decision making excessive worry and anxiety feelings of guilt and possible suicidal ideation intent or gestures and these are all components associated with a major depressive episode so what we're looking at we're looking for severity how severe and intense and disruptive are these feelings of guilt in a depressive spiral it's not as severe as a major depressive episode however is that they're still there they're still issues but they're not necessarily to the extent where they're so disruptive in your life now they may be and a lot of individuals with bpd do also experience comorbid major depressive disorder and for some folks that's their complex bpd but now since we're talking about bipolar disorder we'll kind of stay in our current vein even though we're talking about the depressive aspect is those depressive spirals just aren't as intense they're there and they're disruptive and they're hard to manage but they're not to the point where they're incapacitating where there is a severe adverse impact on that socio-economic dysfunction right your your ability to go to school go to work take care of your family you know do your chores and follow up on your responsibility as well as maintain relationships so let's separate it out we did the overlap we're gonna separate it out so here we go all right so let's talk about symptom distinction timing and severity of symptoms is critical look it's even it's even written in red critical okay and we want to know is there a trigger emotional button or core content activation what drove these symptoms what are the drivers was it an activation of or an issue of abandonment is it a rejection sensitivity i'm afraid you're going to leave me i'm afraid i'm not going to see you again or is it a trigger is there something negative that happened right you texted somebody and they didn't text you back or they texted you something that was really rude and very judgmental and that triggered your emotions your memories your past which that's what the emotional buttons are is instances that occur that bring up all these negative memories that are really painful and it triggers all these emotions and then you know course core content and typically for those with bpd their core content tends to be and it's not the same for everybody everybody has different ones certainly abandonment and emptiness are kind of the two common ones that that i see but everyone has different ones as well so you can have those two and then you could also have some that are more specific to you and the issues that you're experiencing and the past and experiences that you've had now we also want to look at is this behavior outside of the usual for you and what happens is those with bpd is that they tend to respond in a particular way right it's this prolonged series and utilization of maladaptive beliefs behaviors and patterns so we see these patterns keep coming up keep coming up keep coming up that are certainly due to triggers emotional buttons right and core content activation or is it episodic are we seeing lows are we seeing highs and during the highs is when we see all of those adverse you know acting out behaviors intensity that we talked about during those manic and hypomanic phase just earlier the depressive phase is more severe than that depressive spiral so is it outside of the usual that's important as well now bipolar disorder there are periods of stable mood and behavior when they're not in a manic and depressive fade however those with bpd they have periods of instability that are frequently peppered right throughout their history right throughout your history you have these periods of instability right where you just kind of you know you just decompensated you're on this destructive streak so to speak and you know you're engaging in those maladaptive beliefs behaviors and patterns they're very disruptive to how you're living your life and what you're doing so it becomes very very complex and hard to manage and we see those moments okay however they're much more common and we don't see that ebb and flow what we see is a very erratic kind of actions and reactions to situations issues perceived issues in your life that's bpd with your bipolar disorder right you see more of those high highs and low lows bipolar disorder is at an increased likelihood to have long lasting and less turbulent relationships now bpd we know that they're likely to have relationship disruptions and that can often be due to angry impulsive outbursts paranoia and idealization and they tend to devalue their partner and that devaluation also tends to go with that idealization right is that their heroes and then something happens they don't tax they don't come home on time whatever it may be and then there's zeros and you don't see that with those individuals with bipolar disorder so that's one of those big distinguishing factors as well now bipolar disorder they're more responsive to medication than those with bpd and that's really important to be aware is because there's no medication for personality and that's why i think identifying core content and surface content is so so important and you see that surface content is typically responsive to medication medication can really help to treat and lessen surface content surface content can be bipolar disorder right manic phases depression phases or episodes as well as anxiety ptsd issues and symptoms things psychosis things like that whereas there's really no medication for abandonment fears rejection sensitivity feelings of emptiness and so that's really where that confusion lies okay so the next slide here we go the distinction is based upon the effectiveness of medication on bipolar as it significantly reduces not only severity of manic and depressive episodes but also lengthens the period of stability when taken as directed see the little y there i already gave you the little y isn't that great because that's why we have that core content in service content because medication treats surface content right now here it is reiterated right there on the screen so you have it so sometimes i get ahead of myself i get a little excited with this topic i'm very fascinated by it it really energizes me and i think this is so important to put out there so people have a greater sense of understanding in which we already talked about this right medication surface content not bpd core content so i hope that you enjoyed the video you can learn more about this by reading my book on complex borderline personality disorder and you know in the book we talk about early warning signs mood tracking cognitive biases that come into play you know and how to restructure your your cognition so i hope you enjoyed the video please like share and subscribe you like that and thank you all so much for your time and attention please be well bye-bye

Channel: Dr. Daniel Fox

Views: 19,288

Keywords: bpd and bipolar, bipolar disorder, borderline personality disorder, bpd, dr fox bpd, dr fox borderline personality disorder, dr fox bpd relationship, dr fox covert narcissist, manic episode, depression, bpd depression, dr ramani, what bpd is not, major depressive disorder, manic depression, bipolar 2 disorder, bipolar disorder symptoms, what is bipolar disorder, bipolar depression, bipolar or bpd, how to know if you have bipolar disorder, signs of bipolar disorder

Id: XviCEkdz1i8

Length: 17min 44sec (1064 seconds)

Published: Wed Aug 24 2022