My sister (27) is diagnosed with schizophrenia but I don’t find her symptoms matching. In my view, she is more likely to have borderline personality disorder (or possibly antisocial personality disorder) which possibly goes with bipolar disorder. I would be very grateful to get your opinion.

She has:

– deviation from the norm of the individual’s culture

– impulsivity and self-injurious tendencies (risky sexual behaviors, drinking alcohol, smoking, eating much despite putting on a lot of weight)

– inappropriate, intense anger that can lead to physical violence (sometimes to the point of severely hurting others)

– a recurring pattern of instability in relationships (with alternating between love and hate)

– refuses to accept blame, has difficulty accepting corrections, doesn’t learn from mistakes

– selfish most of the times, needy and bothersome

– inappropriate reactions (for ex. clapping hands when mum brings home food she likes)

emotional instability

– identity disturbance (there were times she wished to be a boy)

She doesn’t have:
delusions

– hallucinations

– disorganized speech

– catatonic behavior

Her way of thinking deviates from normal. She doesn’t understand the appropriate ways of behaving even after being told multiple times. At the same time she isn’t intellectually delayed. She is not self-reliant, she has many demands and they must be met at once. If it doesn’t happen, she turns angry and may become violent till she gets what she wants. She constantly wants many things but she doesn’t understand that the budget is limited. For example, she wants X, Y, Z. We tell her that we can afford only two of the items but she wants all of them. She doesn’t get that we cannot conjure money out of thin air. Most of the time she won’t leave my mum and aunt in peace, she engages them into conversations even when they are occupied or tired and they try to teach her sense but of course she doesn’t like their answers (because they don’t tell her what she wants to hear) and gets angry. To continue the conversation is pointless but she carries on. Also she can grab their hands and hold it despite being told that it’s not a way to behave and it hurts. She does it cause she believes it will make them agree on her point of view or just because she feels like to.

A. Providing a diagnosis over the Internet is impossible. Diagnosing involves interviewing an individual, in person, and gathering a great deal of information about their symptoms, personal life, and so forth. Therefore, I can only provide a general opinion and not confirm nor dispute a diagnosis.

The fact that your sister has been diagnosed with a disorder would suggest that she has been assessed (in person) by mental health professionals. They likely thoroughly evaluated and observed her symptoms, and subsequently arrived at a diagnosis of schizophrenia. Diagnosing mental illness is not an exact science and thus, if she were interviewed by multiple clinicians, she may receive different diagnoses.

Nevertheless, schizophrenia is the disorder that they thought most matched her symptoms.

Bipolar disorder and schizophrenia share common symptoms but they are different disorders. The main difference between the two is the mood component and mania. If an individual is experiencing both symptoms of schizophrenia and bipolar disorder, they might receive the diagnosis of schizoaffective disorder.

You also wrote that she doesn’t have delusions, hallucinations, disorganized speech or catatonic behavior. Maybe she is not currently experiencing them but perhaps had them previously. To be diagnosed with schizophrenia, she would have needed to display at least one of those symptoms.

I would encourage you to contact your sister’s treatment providers, about your concerns, if possible. They might be able to explain why they thought that she has schizophrenia and not bipolar disorder. Arguably, what’s most important is whether or not her treatment is working and if her symptoms have improved. If so, that is encouraging and evidenced that she is on the right track. If not, then she might need to return to her treatment providers to discuss a modification or seek out different providers for a second or third opinion. Best of luck to both you and your sister. Please take care.