Orlando Counseling : Harmony Counseling Group

Many people have asked me, “What is the difference between Bipolar Disorder and Borderline Personality Disorder?” or have asked if they have Bipolar Disorder or Borderline Personality Disorder, when they could more accurately be struggling with Co-Dependency.

How does one tell the difference between each of these disorders?

Co-Dependency versus Borderline Personality Disorder (BPD):

Often times, individuals come to therapy thinking that they have Borderline Personality Disorder (BPD), when they are really dealing with Co-Dependency. Co-Dependency is not a recognized mental health diagnosis; it is not currently found in the Diagnostic and Statistical Manual for Mental Illness- IV, Third Revision (DSM-IV). To warrant a diagnosis for any mental illness, one would have to meet the specific criteria in the DSM-IV. Those with Co-Dependency:

• Often have only 2 or 3 of the 9 criteria of BPD: abandonment issues, intense relationships, and perhaps a little impulsivity to boot.
• Along with the aforementioned does come some mood swings, but the mood swings are usually directly related to having idealized or devalued an intense relationship (love addiction/love avoidance), rather than in response to general life stressors and situations as is the case with BPD and Bipolar Disorder.
• Those with Co-Dependency usually know who they are, but are focused on achieving the ideal relationship that will make them feel complete and whole, often pursuing it with reckless passion and abandon. Those with BPD do this as well, but their behavior and thought patterns affect more areas of their life: occupational, educational, intra personally, and of course interpersonally.
• Some therapists may tell these individuals with Co-Dependency that they have “borderline traits,” which is another way to say that he or she does not warrant the diagnosis for BPD, but has some of the criteria.
• To warrant a full-blown diagnosis of Borderline Personality, one’s life is marked with more than just fears of abandonment, desperate and drastic behaviors and anger, and momentary acts of passion.

For Borderline Personality Disorder, one would have to meet 5 of the 9 criteria. The life of a person with Borderline Personality Disorder (BPD) is, more often than not and depending on the severity, wracked with chaos, severe mood fluctuations marked with repeated suicidal gestures, and possibly self-destructive acts such as self-harm or self-hatred. Those with BPD often have trouble finishing things across their lifespan, have very low self-esteem to the point of self-hatred, and are chronically depressed and distrusting of others. A simpler way to describe the difference between BPD and Co-Dependency could be to say that those with BPD have very strong negative thought patterns that dictate how they live their lives, interact with others, and see themselves.

Bipolar Disorder versus Borderline Personality Disorder:

In general and simply stated, Bipolar Disorder is a mood disorder, while BPD is a personality disorder. Bipolar Disorder is characterized as having a couple of the criteria of BPD: mood swings and impulsivity. In Bipolar Disorder, the mood swings can be drastic, rapid, or long-lasting, but the difference usually is that in BPD, there is more baseline depression and dysphoria rather than mania, and the mood of a person with BPD slowly returns to its originally state (baseline) instead of shifts rapidly or quickly. In other words, Bipolar mood states can stabilize at a faster rate than BPD mood shifts, which slowly improve or decline. The impulsivity in Bipolar Disorder is usually within a manic phase, while those with BPD have impulsivity much of the time, independent of their mood.

Bipolar Disorder versus Co-Dependency:

Those with Bipolar Disorder are also, in general, more severely affected in many areas of their life than with Co-Dependency. Co-Dependency associated with addiction and dysfunctional families, and the problems usually occur within close relationships with problems in asserting boundaries or, on the other extreme, in being able to allow others in to get to know you. Those with Bipolar Disorder may have some relationship problems, but the defining characteristic is the mood swings which may or may not be a result of a tumultuous relationship.

The Sunny Side of Things:

It must be noted that having BPD, Co-Dependency, or Bipolar Disorder is not a death sentence. I have met some wonderful and inspiring individuals with BPD, who are wonderful and inspiring because it is who they are. Mood swings usually equal passion and intensity, drive and ambition, and creativity. Many people I have met with BPD and Bipolar Disorder are highly creative, and see a different side to life because of what they have been through. The dark side of things seems to have inspired in them a drive to survive and overcome, despite the internal turmoil they face. They developed a unique lens though which they see how things “ought” to be, and their idealizations are an effort to keep in touch with the hope for things to come. Some individuals with BPD lost their innocence very early on to some form of abuse, neglect, or major loss, and have found a way to survive in a world in which they know the difference between Good and Evil. They are the Survivors, Seekers, and Adapters.

To make an appointment for counseling in Orlando or Winter Park, contact us at 407.835.3673.

On DBT Skills: Being Effective with Effectiveness Skills

Life is, more often than not, very bipolar. Many people, places, things, situations, thoughts, feelings, desires, and fears occur within the context of polar opposites. Some conflicts are easy to resolve; water’s too cold? Just add hot water to make warm water. Paint colors too dark? Just add some light paint to it. But what happens when you want a sense of community, love, and belonging, but you don’t want people to get to know you, or if you have social anxiety? What do you do when you want to be happy in your own body, but don’t want to give up your eating rituals or can’t give up the binge foods, or if you want to get your college education, but don’t want to write those long essays or take those anxiety-provoking exams? What does one do in cases when you want two opposite things at the same time?

As everything has a flip side, so does The Effectiveness skill; Its polar opposite is Self-Satatoge. The Effectiveness skill, when practiced, is an answer to the balancing act of life. It is a method to reconcile the extremes that characterize our lives on a daily basis. It says that in every situation, the skillful way to be is to do the Effective thing.

What does the Effectiveness skill in action look like?

The Effectiveness skill is when, even though you are petrified of white coats, you go to the clinic or emergency room when you are ill. It is when, even though you feel like you have hit a wall and cannot possibly write one more word, you press on and finish the essay to get the grade because you’ve spent enough time and money on your education so far. The Effectiveness skill is when you hold your piercing words when your boss degrades you, because keeping the job is more Effective than walking out if you have no where else to work and have bills to pay. The Effectiveness skill is finishing what you started even though you feel discouraged, overwhelmed, bored, or distracted to another tempting path.

One obstacle to being Effective is today’s epidemic tendency for instant gratification, and if the going gets tough, we are used to just stopping. Default answer seems to be… just quit!  Many people buy into the trap of instant gratification, and buy into the lie that they are too old, there’s not enough time, or it won’t be worth in the long run.  But 10 years from now we will all be 10 years older… are you the person who will be able to say next month that you are one month closer to your goals, or will you be the person who, one month later, has something else to add to your list of unfinished projects?

The things we work hardest on and put the most energy in to, are the biggest payoffs. Doing the Effectiveness skill is a gaurantee that since energy cannot be created nor destroyed, the energy you put into your life will somehow benefit your life, whether through the building of your character, the breaking of your spirit and laying down of your will to achieve humility and peace, or through tangible rewards such as a degree or certification, financial stability, etc.

In sum, using the Effectiveness skill is a combination of knowing what your goal, objective, or desire is (How can you arrive safely at your destination when you have none?),  setting aside anger or self-righteousness, and doing what is right and beneficial for you in accordance with your pursuits and goals. It is also knowing when to throw in the towel in ineffective or fruitless situations, and when to keep pressing on toward your end result. 

For Counseling in the Orlando area, call Harmony Counseling Group at 407.835.3673.