“… Please explain how your doctors came to this second diag. of Borderline and how is it different of adding to your already Bipolar condition. I believe I am suffering from more than Bipolar because of my rage that has become very violent and I am NOT violent person ….?”
I was originally diagnosed as Bipolar I / Psychotic. Each diagnosis I received after that was “in addition to”, rather than “instead of” the Bipolar diagnosis. I am both Bipolar and BPD, as well as several other things. I was in therapy for years after my initial diagnosis – expanding the original is apparently a common part of the process.
I **COMPLETELY** understand what you mean about the rage. Man, when it gets going… it’s like a bloody force of nature. I never thought of myself as being a violent person either. Until, one day, I was. So here’s my understanding of how the two conditions work together. I must put the disclaimer here that I’m not a medical professional. I’m simply a patient who has observed this from the front lines for 20 years. With that being said…
For some conditions I really disagree with the phrase “mental illness”. It makes it too easy for the uninformed to conclude that it’s all in our heads. Bipolar is a physical illness – a chemical imbalance – that manifests via wild mood swings and (in the worst cases) irrational behavior. When I was manic I’d be extremely hyper. I’d be the life of the party! I’d have wild sex! I’d spend money like it was nothing! I’d sign up for a college degree!! Hell, I’d TEACH the class! Let’s move across the country and get MARRIED!!! I want a baby! NOW!!!!!!!!!! Everything seemed like a great idea, easily accomplished. The fury I’d feel if someone stood in my way was hair-trigger, irrational, immediate. Dangerous. Very dangerous. I still find it hard to believe I didn’t kill someone. Seriously.
As the manic phase passed I’d become somewhat lucid. Everyone I made all those promises to expected me to hold up my end of the deal . Which, six months ago, sounded like a grand idea! Only now my more lucid self is thinking… what the heck just happened?? What did I do? WHY??? My creditors were screaming at me, my phone would ring non-stop, my fiance was just confused… I’d burn bridges as fast as I made them. And that’s when I was lucid. The Depressive phase of Bipolar was still ahead.
Once into the Depressive phase I’d feel nothing but self contempt and loathing. How could I do that? How could I say those things, promise those things? I just let everyone down, how can I face them again? I can’t even explain why I did it! The anger turns inward. Homicide becomes suicide. I’ve made three serious suicide attempts, maybe half a dozen less serious. You should see the scars – they’re impressive! There were days I couldn’t move, much less get out of bed. And if, for some reason, I really did have to move, God help anyone who was close. The Beast would be roaring, screaming in pain, fear, confusion. And ultimately anger.
So if that’s Bipolar, where does Borderline come in? Unlike Bipolar, Borderline is a personality disorder. I love this definition:
“Personality Disorders are a class of mental disorders characterized by enduring maladaptive patterns of behavior, cognition, and inner experience, exhibited across many contexts and deviating from those accepted by the individual’s culture.”
Personality disorder – Wikipedia
The key phrase here, for me, is “maladaptive patterns of behavior”. “Maladaptive” is defined as “not providing adequate or appropriate adjustment to the environment or situation.”
So an adaptive pattern of behavior is an appropriate adjustment to the situation you find yourself in…. right? Right. Here’s the catch. Most people who are bipolar don’t know they’re bipolar until they’re diagnosed by someone outside of themselves. In my case, I was out of control with absolutely no idea why between the ages of 12–30. Eighteen very long, very confusing years. Or, roughly nine complete Bipolar cycles. That’s a lot of water under a lot of burned bridges. I couldn’t explain what I was doing or why. But the rational part of me was somehow held accountable for all the actions my irrational illness was performing. So I developed symptoms of Borderline in an attempt to make this wild merry-go-round of emotions somehow make some sort of sense. I didn’t deliberately set out to do it. I simply developed certain coping mechanisms that helped me endure the madness of the situation.
There are four types of personality disorders: Odd, Dramatic, Anxious and “other”. Borderline is part of the second group – “Dramatic”. They’re characterized by “dramatic, overly emotional or unpredictable thinking or behavior and manipulative, exploitative interactions with others. “
Cluster B personality disorders – Wikipedia
Personality disorders are “inflexible and pervasive” for a reason. Something within you thinks your survival depends on this behavior. The only problem is that situations change – personality orders do not. For me, once I received my initial diagnosis I was able to say “Oh, so THAT’S what’s going on! I get it!” My logical, rational side now had something to grab on to. Unfortunately, my emotions and behaviors were already set into that “inflexible and pervasive” pattern by default. It’s understandable damage from living with Bipolar so long. My poor brain had no tools to turn my reactions off, since 18 years of experience had taught it (beyond any doubt) that everything was about to blow up. Again. GET READY!
So that’s how I came to be both Bipolar (born with it) and Borderline (developed it due to the Bipolar). Someone with this diagnosis usually sees both a psychiatrist and a psychologist. The psychiatrist can prescribe medications to help level out the physical symptoms of Bipolar, while the psychologist can give the patient emotional tools needed to deal not only with the mood swings, but also with the fallout.