Help :( Conflicting diagnoses

[Elad]

I received a letter from my Psychiatrist. It was basically to be considered as my current care plan, however the Diagnosis written in the report confuses me;

Paranoid Schizophrenia
Borderline Personality Disorder

My Psychiatrist has a lot of explaining to do... since when have I shown symptoms of Borderline Personality Disorder? But if anyone can answer the following questions I'd appreciate it.

How are these related?
How can you have both at the same time?

Much love.

[PanchoGoz]

Hi Elad - I'm sure we've spoken before but your posts have gone sadly. BPD (not to be confused with Bipolar Disorder!) can be a rather overused term if someone shows eccentric characteristics and I wouldn't worry about it too much. There's no reason why you can't have both at the same time and they don't have to be related. I wouldn't give it much further thought but you could mention it next time you see them. Best wishes.

[Elad]

Thanks for your reply PanchoGoz.

My Psychiatrist told me that they were diagnosing me with Borderline Personality Disorder in my last outpatients, when I asked "why?" he said that it is something they have observed during my last admissions and said something along the lines of "you also complain of low self-esteem, you repeatedly self harm feeling better afterwards, feel bored and empty and act impulsively without thinking of the consequences". How is this not depression?

How is this enough for a diagnosis of a severe life long personality disorder? How can they slap this on my head? It seems totally unfair.

Do you think I should go to Mind?

And yeah, we have spoken before, I just have a tendency to delete a lot of my posts, not entirely sure why.

:)

[Rennie1989]

Paranoid Schizophrenia and BPD are two completely different illnesses. I know about BPD but not on PS so can't really explain it, but looking at articles online I have seen these diagnoses together.

I can talk to people about anxiety, phobias, depression and the such until the sun comes down, but those two illnesses are quite out of our ranges so it would be best to either speak to your psychiatrist about it or seek a second opinion. I'm not sure what help MIND or the other mental health charities could do in this situation because, whilst they could offer you some light on what the diagnosis means, they wouldn't know your case well enough to explain why you have the two diagnoses.

[PanchoGoz]

The impulsive actions aren't to do with depression. It's not severe at all, it's borderline and shouldn't affect you much. Loads of people would be diagnosed with it if everyone was assessed enough, honestly you might as well not give it a second thought.
I mean it's just semantics at the end of the day, so what if they say you have this or that, it won't affect your life now they've given it a name. If anything it's just something else they can address and help you with using a set pattern of treatment.
In the same way, I was diagnosed with chronic fatigue and hypermobility...both potentially affecting for me, but something I don't even think about normally and just something else not to bother about.

[Rennie1989]

I agree that sometimes a condition is just given a 'label' but it can be comforting to the person to know what is exactly wrong with them and it can help when it comes to treatment. I know that treatment for anxiety and depression is vastly different to treatment for BPD, which the latter is often confused with the former, and can be detrimental to the person who may struggle to live a normal day-to-day life.

[Elad]

Good point Pancho.

Can I ask what exactly IS the treatment for borderline personality disorder? My Psychiatrist told me there's no medication for it.

[Rennie1989]

There is no medication for it but only to alleviate symptoms. I did see psychoanalysis as treatment, other then that I can't remember. I just remember it being vastly different.

[inCOGnito]

Good point Pancho.

Can I ask what exactly IS the treatment for borderline personality disorder? My Psychiatrist told me there's no medication for it.

As far as I know borderline personality disorder isn't treated with medication. It describes a set of behaviours, that's all. Treatment is usually behaviour management, counselling, psychotherapy, talk therapies. Things like depression are treated with medication because they are "believed" to be caused by or partly caused by a chemical imbalance. Whereas BPD is not seen in the same context.

[anthrokid]

Borderline Personality Disorder gets a pretty tough reputation from people who don't really understand it, but it isn't actually a bad thing. Firstly, it is a personality disorder, which pretty much means that aspects of your personality are different from the majority of people, and your way of thinking and behaving is a little different from others. A personality disorder can only be diagnosed if behaviours related to it are chronic (have been ongoing for a long time) and occur across different situations. For this reason, you can be diagnosed with a personality disorder at the same time as any other disorder.

Schizophrenia can be treated and managed with medication because there are biological factors that contribute to Schizophrenia, and medication helps to eliminate the symptoms. Borderline Personality Disorder isn't treated with medication, because a medication doesn't change a person's long-term views about the world and experiences. People usually develop Borderline Personality Disorder as a coping mechanism for stressful experiences. There are services available though that can help you manage Borderline though. DBT is often used to help people with Borderline understand their behaviours and responses to stress, and to build self-esteem and manage self-harm and impulsive behaviours.

I think it's really important to discuss this further with your psychiatrist and say that you'd like to understand more about what your diagnoses mean and how you can work together to treat them.

---------- Post added at 12:14 ---------- Previous post was at 12:05 ----------

I'm from Australia, so I had to 'google' MIND. We have a similar service in Australia who specialise in personality disorders, and they are fantastic. I work in mental health, and in my experience it sounds to me like MIND is an extremely helpful service that you may benefit from :) They have a lot of relevant information to help you understand Borderline Personality Disorder a bit more, and heaps of information on services and therapies that can help you gain more control over your diagnosis and develop good coping skills.

[MyNameIsTerry]

I agree with inCOGnito and anthrokid.

I have done a little bit of reading on PD's because my therapist thought I may be suffering from Obsessive Compulsive Personality Disorder (OCPD) and I have the minimum 4 traits so I thought this was the case for a while until I did some more reading to discover that I would also have a very narrow view and be resistant to treating it - which I am not.

If any of us look at the personality traits of PD's I bet we will see we have some from various forms. I know from reading them myself that I've seen people on here mention them but its broad, not specific to a singular one.

http://www.nhs.uk/Conditions/personality-disorder/Pages/Definition.aspx

As has already been said, its a behavioural hence treatment reflects changing your beliefs but is this so different to anxiety & depression? Not really, its just that PD's are a stronger form of beliefs and you may not believe it to be a problem until it is explained to you.

Medication may not be used specifically for a PD but some PD's, Cluster C, are associated with anxiety so maybe its possible that anti depressants would be used for elements? Maybe anthrokid can explain this.

MIND cover everything don't they? They cover more than anxiety & depression by having a broader scope of mood disorders and other things such as paranoia.

http://www.mind.org.uk/information-support/types-of-mental-health-problems/personality-disorders/