Borderline or Bipolar?

By Kristina Randle, Ph.D., LCSW

Q. Could I be Borderline? I had an ‘episode’ about 2 years ago, a few weeks after I started on anti-depressants for the first time in my life. I was very impulsive, spending a lot of money, binging a lot on food, making risky decisions, and worst of all…sexual indiscretions. Since this all happened right after I started on anti-depressants, the first thought is that I am Bipolar. But I really don’t fit the bill for Bipolar. Even in that incident that was medication-induced…I was not moving any faster. I have never had racing thoughts, or inflated self-esteem (my self-esteem is constantly very low!). I have never had any issues with sleep — either too little or too much, not even during that episode 2 years ago. I have never been really “high” or agitated or anything like that. I have read the symptoms of Borderline Personality Disorder, and that seems to fit me a lot more than Bipolar. It also includes impulsivity…which explains the binging, sex, etc. I have had some periods of impulsivity that were not related to any medication — in fact, one was very recent, last month. I have not been in therapy or on medication for almost 2 years. However, since that one episode 2 years ago did occur right after I started the anti-depressants, does that automatically mean I’m Bipolar? I am somewhat confused.

A. “What is my diagnosis?” is one of the most frequently asked questions. Unfortunately, it is extremely difficult to know what a person’s diagnosis is without meeting with them in person or getting to know them. To identify your diagnosis over the Internet is almost impossible. You may meet some of the criteria for each diagnosis; bipolar and borderline personality disorder but to know for sure which one is correct, or if you suffer from both I cannot tell you.

Although many may disagree with my sentiment, I am not sure how much you would be helped by knowing your exact diagnosis. I am not even sure it’s possible to get a definitive diagnosis. Even though mental health professionals have a guidebook to assist in diagnosing (Diagnostic and Statistical Manual of Mental Disorders (DSM), often times, clinicians, when assessing the same client will come to very different conclusions about what he or she may be suffering from. Ten different diagnosticians may give you 10 dissimilar diagnoses; this is not all that uncommon.

What is most important is that you get help. If you are having psychological problems in which you cannot control your behavior, and you are being harmed by your inability to control yourself then it is imperative that you get help for these issues. It’s been almost two years since you engaged in treatment. What’s the delay? If you are able to find a competent therapist there may come a time when your “episodes” are a thing of the past. Your effort is better spent on trying to find good help rather than trying to pin down your specific diagnosis.

Photo

 

 

Last reviewed: By John M. Grohol, Psy.D. on 29 Mar 2008

APA Reference
Randle, K. (2008). Borderline or Bipolar?. Psych Central. Retrieved on December 22, 2014, from http://psychcentral.com/ask-the-therapist/2008/03/29/borderline-or-bipolar/