Aspergers + BPD

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Greetings community! (I will intorduce myself properly another time ) I forget where, but I have read several times that emotionally abused aspies have a tendency to develop borderline personality disorder. I think it makes sense to me, If I was more eloquenmt I could communicate my good guess as to why. I would also guess that it is more transitory and easily treatable (perhaps just wishful thinking!) comparibly to an NT with BPD. Hope some others might have some information, cheers!

There's been discussions on here before about BPD and Autism/Asperger's. Always with some people who only know the stereotype of BPD and say they are total opposites. But others who think they can overlap, and/or, who can see similarities. And, having also participated at a messageboard for people with BPD, I can definitely see similarities.

I haven't read any literature on BPD and autism.

Your post, though, inspired me to do some looking, and I found a very fascinating post on another messageboard. Yeah, a messageboard post, but one where the poster really seems to know what he's talking about. He knows his stuff, as far as BPD. (The board is an autism board.)

http://asdgestalt.com/viewtopic.php?p=4 ... 6d8#p43169

That link should go direct to the particular post I refer to, if not, it should be easy enough to figure out which one, or, look for: phin on Thu Jul 17, 2008 12:46 pm

That was amazing to read. It's like, that's me, pretty much.

Actually there is an article in Scientific American about Borderline Personality Disorder and it actually is the opposite of AS.

People with Borderline Personality Disorder apparently are hypersensitive to facial expressions. They detect facial expressions before the average individual and have overly emotional responses to them.

This can and does lead to misinterpretation but a person with AS generally mis-interprets because they don't detect that something particular is trying to be communicated.

But I certainly don't think having AS excludes one from Borderline Personality Disorder like tendencies and behaviors.

First, that's ONE trait, not the whole of either disorder.

Second, that's a generalization of what's true, not what's true for every individual. Difficulty in reading facial expressions is NOT required for AS diagnosis, and for BPD how well one reads facial expressions is not a diagnostic criteria at all. (Actually, I'm not sure it's part of the Asperger's diagnostic criteria... it's says "use of", not ability to read.)

Third, that's one study.

BPD and AS are not opposites.

Heck, you even admit it yourself in your last line. That wouldn't be possible if they were truly opposites.

I was dx with BPD and PTSD among many other things 20 years ago. I was dx with AS 6 months ago.

According to my wonderful mental health professionals it can co-exist and it is like living your life in a combine harvester. The internal conflict and processing issues are horrendous.

But there is always light at the end of the tunnel.

Take care.

Mics

This article intrigued me:

Borderline Personality Disorder, Asperger's and Robust Individuals
http://matrixpsychology.blogspot.com/20 ... order.html

I don't agree with it. But it brings up the question... is there maybe gender related bias in diagnosis? Are people with traits of both either having one diagnosis missed (where they could get both) or getting the wrong diagnosis, with a gender bias as to who gets which diagnosis?

Added to that is the idea I've read various places that sometimes the BPD label is used for difficult patients, without really doing a proper diagnostic process. If that's so, I can easily see some people with AS wrongly getting a BPD diagnosis.

They can exist together.. i say that as i clearly have both and have been offically diagnosed with both.

My borderline personality disorder has been diagnosed as severe, Ive seen several BPD therapists, (i think having Asperger's has actually made what may of been just minor BPD into severe BPD).

My Asperger's diagnoses recently came from a proper assessment at the Autism Society... the Asperger's was missed by everyone else as everyone had been focused on the BPD.. but then wondering why therapy wasnt working at all for me and why they couldnt understand me and why i couldnt understand them.

I've seen about 6 psychriastrists and about 7 psychologists.. and none of them had been able to help me. They all had my full diagnoses wrong and hence expected things of me that i just couldnt do or even understand). At least now they have my diagnoses right and hopefully things can move forward from here.

Ive had Asperger's of cause (thou undiagnosed) all my life .. and BPD for past several years of my life so that has brought in much more things. They are completely different but at the same time have many very similar things... so in a way im confusing for those trying to treat me to work with. Its truely hell for me trying to deal with both things.

eg Both BPD and Asperger's suffer from emotional meltdowns. BPD people have extreme emotions.. it has been said their emotions are 7 times stronger than a normal person hence they get meltdowns. cause a BPD person is so emotional, BPD people like to be in control of things. Asperger's get meltdowns too from things too (but from a different things from a BPD person eg overstimuli). With my BPD i can dissociate during a meltdown.. completely blank out.. Asperger's people can do that to.

BPD people self harm in their attempts to control their emotions (i cut and scratch myself due to the BPD).... so can Asperger's (thou an Asperger's person may bang his head.. but its to try to deal with emotions or cause cant deal).

Cause of my BPD ..i get an eating disorder if stressed.. start going picky with my foods, follow food rules etc.. to feel in control as BPD people feel way out of control. Autistic people also may have food processes or rules they follow (thou for a different reason to a BPD person).

A BPD person cause they have been hurt so much in life emotionally, may end up keeping away from all people. Ive come across BPD people who are living as hermits (so this can look a bit like an Asperger's person).

They both have relationship issues. (with BPD relationship issues are severe.. so i have a hard time having the Asperger's too)

I cant think right now but there is a heap of other things they do the same.. and from a person looking from the outiside.. it is easy not to see Asperger's in a BPD person esp if that person is an adult female so harder to diagnose as far as Asperger's go.
.........

Ones here probably wonder how someone finally worked out i had Asperger's. It was cause cause i couldnt cope with daily life stuff, i moved in with a doctor who's son, husband and her family members had Asperger's. If it wasnt for her, my case would of NEVER been picked up.. she told me i had Asperger's and got me to go for a proper assessment.

Things which distinguish my Asperger's from my BPD are..
my childhood (before i got the BPD) my friend situation or lack of cause i couldnt make friends, i went about it all very very wrong when i tried. I want friends.. but i drift from them.. cant keep on track to keep them.
i dont understand a lot of stuff still as an adult to which a normal person would (and a BPD person would).. im naive about a lot of things in life. People have to help me out in this area a lot still (even thou im almost 40yrs old)
My "special interests.. both as child and adult .. (so many collections of things as a child, i collected)
I rock when upset (and arent even aware i rock)
I pull faces and grimises I dont even know I do
My facial expressions are all wrong for situations (the experts told me that)
I cant read the expressions on peoples faces (but yes i also over react to them thou i read them wrong due to the Asperger's, the over reaction thou may be the BPD)
I dont see peoples body language and miss a lot of others communication about me (apparently that was happening during my assessment.. as they commented on it)
i hate small talk
I dont get jokes
I dont understand many sayings
I run weirdly
I have never learnt to hold a pen or pencil properly, i just cant
(and my list go on)

There is no doubt in my Asperger's assessment.

I meet everyone of the BPD assessment requirements too.. eg fear of abandonment (due to the asperger's i cling to only one person). I freak out completely if i think im being abandoned.
Im Impulsive and engage in impulsive behaviour eg reckless driving, binge eating
I dont have a clear sense of self so try to formulate myself out of another
I mood swing into suicidal behaviour and actualy carry it out at times (which isnt depression but caused by the BPD)

Due to having both issues.. i shift back and forth between "emptiness" of BPD and being afraid to be alone... to wanting to be alone due to the Asperger's. It's sooo confusing. Im often in both emotional states AT ONCE, needing the closeness but also needing to be far far away from everyone and have my own space (this all then just causes a melt down).

Ive had one psychologist who was dealing with me for a while say to me if she believed in multiple personality disorder, she'd say i had it. I dont know if that is cause of the two opposing parts of myself happening. Who i are.. The Aspie.. with the very different personality (BPD) completely in conflict. Ive no real idea who i really are.

What really sucks is that Im rejected from the Asperger's groups held by the Autism society.. due to having the coexisting disorder (do they believe i will take advantage of others with Asperger's and lie like a BPD person manipulates and lies, in order to get their NEEDS met??, Im thou fully Asperger's there.. and so truthful it gets me into trouble all the time) ... so arent getting a change to meet others with Asperger's in which i could communicate better (i dont realy even like most NTs, they are so unlike me, i cant stand their small talk and lies)

Im really curious why you would think that an Aspie with BPD would be easier to treat than a NT with BPD?

Being Aspie.. i think it would be a ton harder to treat in an Aspie.. as after all, being Aspie, i DETEST CHANGE (ive found myself having a melt down just on someone suddenly changing on me what we are having for dinner!!). and in BPD to fix it.. one has to work very very hard to change, so much in the way you do things, the one you react, the way you think. I think a NT person would find that all far easier. (Note BPD is very hard even to fix in the NTs, with many, it isnt that treatable)

Not only that, the effort of it and all the thinking that many Aspies do compared to NTs, makes it all the harder as we tire far more easily than a NT does, i know my thoughts completely wear me out at times, i tire myself out with all my constant analysing, my Aspie mind never stops. (ive had to do that to survive in the NT world as i survived basically alone, unhelped)

To make it harder still.. all the focus which would have to go into correcting BPD.. i know in myself, my mind is constantly going to my special interests. When i was having therapy for BPD, i couldnt even organise myself to get my homework done.. id forget it, or it just wouldnt get done... i didnt mean not to do it..but that is just what happened. (i was the same at school, never seemed to manage to get my homework done and was always in trouble). With BPD there is constant homework. i had a therapist quit on me as i just couldnt get my act together (thou i was trying).

During my BPD therapy appointments.. sometimes i couldnt concentrate on the therapy as i was wanting to flee the room just cause the therapist was looking at me (I found that very very confronting and made me extremely uncomfortable. i cant always handle someone looking at me).

Just to get to the therapy sessions was hard.. if someone wasnt organising me to make sure i got there on time i would of been being late for most of them. (i struggle to organise myself to get ready for things)

Anyway.. im wanting to see what makes you think it would be easier for us to get heal the BPD?

I don't think it's easier for us to get BPD. We are far more likely to wind up with schizoid personality disorder.

But it's certainly not impossible. Let's look at the traits--Five or more of the following required to diagnose:

Not incompatible with AS. The abandonment can be real--so you don't have to be overreacting; you just have to be making "frantic efforts to avoid" it. (That would be going further than most people would to keep a relationship.) It has to be distinguished from poor social skills causing you to cling too tightly or work too hard at a relationship.
No conflict here, but has to be distinguished from any general tendency toward binary thinking in the autistic. If he thinks of everything in yes-or-no terms, then it's not particularly diagnostic of BPD if people are included on that list.
May be more common among autistics; some do lose the idea of "self" at times. (I do, when I am very involved in a special interest. The self-awareness subroutine gets shut down to save processing space. But this is an autistic trait, not a Borderline trait, and must be distinguished from the unstable self-image that leads to the constant redefining of self and poor ability to describe one's own personality and traits.)
Must be distinguished from impulsivity related to poor executive function and overload.
Must be distinguished from normal autistic tendency toward self-injurious behavior. Even "traditional" superficial self-injury can be related to autism, especially in those who have learned to use SI to delay meltdowns. (Yes, it works; no, it's not a good idea.)
Must be distinguished from meltdowns.
No conflict here. Autistics and NTs can both have this trait.
Again, must be distinguished from meltdowns. Inability to control anger is a different thing from inability to process information or sensory input (leading to anger or shutdown).
Can happen to anyone, NT or autistic. Has to be distinguished from realistic fear of bullying or abuse, which can create paranoia as a survival strategy or due to PTSD.

So you can see there's no reason why you couldn't be both autistic and Borderline; but some of these traits can have superficial similarities, and care must be taken not to misdiagnose one as the other. If self-injury and meltdowns are the only traits present in an autistic individual, it makes no sense to diagnose Borderline as well, even if paranoia and clumsy relationships are also present. With the gender stereotypes involved with Borderline, there are probably a great many females misdiagnosed Borderline Personality Disorder who are actually autistic, and males diagnosed autistic who are actually Borderline.

It's probably a difficult differential diagnosis to make when the traits are present in just the right (wrong?) combination to make it hard to tell what their source is, and whether to diagnose autism and BPD, or just autism alone. Some things, however, are useful for both groups and can probably be used to help people in ambiguous situations: Social skills training, stress management, and impulse-control strategies.

ohh that was such a good post. So good you've made me doubt my BPD diagnoses.

But are *all* autistic meldowns due to inability to process information? I've seen a pattern in myself and others on the spectrum where we are more likely than NTs to go nuts from stress alone, stress that's not always sensory related. I think autistic meltdowns can happen because we are at a disadvantage compared to NT's in terms of being able to communicate our issues in a way that gains a sympathetic understanding from others.

Also, in an argument - being autistic = less ability to manipulate your 'opponent' due to lack of communication skills = feeling a loss of control in the situation = more tendency to become violent or filled with rage. I think anger can become a learned defense mechanism in autistic people for this reason. We simply aren't equipped with a better way of dealing with conflicts.

Again. I see how all of this can become confused with BPD as people with BPD have the same issues but with slightly different causes/reasons.

Thanks for the great info. I posted something earlier about this subject then did a search for it, found this post.

Most of the issues stated here I have thought myself in relation to AS and BPD.

I also had to look up NT... Still not certain what NT is... Seems like that thread erupted into some intellectual conversation over its true meaning lol

NT = neurotypical, in other words someone with no neurodevelopmental disabilities.

Probably.

I know there's good evidence for a gender bias in distinguishing borderline from antisocial personality - many borderline men and antisocial women are misdiagnosed. (Both conditions share rages, and borderline can lead someone to commit crimes due to things like self-destructive impulsivity, but antisocial people don't tend to have internalizing issues like depression and anxiety.)



I figured that was because we're under more stress to begin with, trying to live in an NT society. NTs can have meltdowns too, if you stress them out enough.

I have BPD traits, but fall short of enough for a diagnosis. I have frantic efforts to avoid abandonment, self-injury and mood swings. I think it's all caused by the sexual abuse I suffered when I was little (from two foster siblings).

I have both overload and emotional reactions as potential causes of my meltdowns. I can have pure overload without any emotional distress, which I call 'shutdown' because it mostly shows up in skill loss. I feel disconnected and my senses get weird, and I can't do things as well as I usually do. In this state I'm extremely irritable, but if nothing sets me off I won't have a meltdown.

Meltdowns can be a mix of sensory overload and emotional upset, or purely emotional. I don't have as bad of skill loss as in shutdown, due to adrenaline, but I have some skill loss. I also have a pile of rules about what I can and can't say that generally force me to act really angry even though I'm actually scared and sad. And I have this drive to do something drastic, now, so that if I don't do anything to express my emotions I start getting suicidal thoughts. I'm incapable of calming myself during a meltdown, if left alone I tend to self-injure while getting more and more upset. The only thing that calms me down is managing to get through to my parents and get them to reassure me about whatever's upsetting me (typically takes the form of them convincing me they still love me). Typically what sets off a meltdown is something that reminds me of the abuse and makes me feel like a loved one is going to abuse me.

I have....

a....

(wait for it)


THEORY!

I'm just gonna share it, then run, not because I think it'll start any arguments (though it could I suppose), but mostly because the last one I posted started a long and interesting discussion, and I need to get my butt to bed! So here it is. Hit and run:

I'm very cautious discussing ASD/BPD co-morbidity. The reason is as follows:

I've had a strong suspicion that my mother may have been Autistic, never recognized by any of her doctors, was diagnosed as "Clinically Depressed," "Major Depression," "Manic Depression," and finally, "Bipolar Disorder." She was also told she probably had a mild form of Multiple Personality Disorder, though she never blacked out, but I do remember a period of time when she acted like a totally different person, with a weird accent too, but that could have been caused by certain medications. I think she was on Lithium at the time. She took all sorts of different meds over the decades.

Unfortunately, she died before I could ever talk to her about her possibly being Autistic, so we'll never know now.

But, it was that thought, that suspicion that got me thinking, "What if the real problem had been Autism all along?" (She never displayed any Depressive behaviors until she was in her late twenties)

What if it were really mild Autism, like Asperger Syndrome, and the depression was really just caused by "snapping" from so many years of conforming and faking who she really was?

I remember clearly that once the "Depression" surfaced, we all started seeing sides of her we'd never seen before. She started becoming more outspoken, refused to dress and act the way she used to. Nothing bizarre really, just different from what we all were used to. I tossed about the question, "What if someone who is really Autistic, is treated for depression, but the only reason they're depressed is from years of stress caused by faking their way through life, pretending to be something or someone they are not?"

What would happen to someone like that if the Autism wasn't recognized, and they were treated for being depressed, but that wasn't what the real problem was? Could it actually CAUSE further depression to worsen, thus perpetuation the cycle? Make their Autism even more pronounced, causing even more treatment for depression, possibly degenerating in a dangerous downward spiral that could destroy the individual?

I will say this. If my mother was actually Autistic, that's what happened to her, eventually causing her death.

BUT...

I don't know that that is the case. It's just conjecture right now. I have though, spoken to her therapist of the last twenty years of her life about this thought. He was, to say the least, VERY intrigued.

Well, off to bed!

Crap! I almost forgot. At one point, decades ago, she was evaluated for Schizophrenia. They found she didn't have it, but that makes me wonder. Why were they looking at that? What was it about her that made them think it might be possible. And now I know that Schizophrenia has to be ruled out before Autism can be diagnosed. So whatever made them think she might have Schizophrenia, could have been explained by Autism!

Anyway, so I'm always wondering now, when I hear this particular co-morbidity, "Is it really co-morbid, or is the one possibly being caused by treatment for it, when it's really just a side effect of being Autistic?

I hope I didn't confuse the conversation too much.

I'm exhausted.

Diagnosed with AS a couple of years ago - really knew before but nice to have the rubber stamp thing.

Been depressed and extremely anxious forever - started having personalization/derealization when I was 5 (utter hell, still).

Always alone. Years before I even heard of Asperger's, I boiled it down to this: I am afraid of being abandoned or overwhelmed by people. They'll either cut your heart to ribbons or they'll pester you to death. Fell out with people so often. All this is classic BPD.

Could never believe my ex wanted to be with me. Always felt I had to fight to keep him there. We broke up and reunited countless times - again, BPD (he is BPD I am sure of it - he even has a PD diagnosis, which he ignores).

See it clearly. Autistic little girl, hounded by bullies, unable to make friends. Lonely Aspie dad used me as the confidante Mum would never be to him. Grew up lonely, sure I was ugly, too close to Dad, despising Mum. Then (oh my!) she tried to kill herself. Then I became so close to her, I was sewed to her side. Then I left home and was solidly, solidly ALONE.

What I see is that there's a kind of PTSD involved in growing up Aspie. Also an Aspie kid will get as shattered inside by family mess as any NT, who'd wind up BPD.

What I mean is: All roads lead to Rome. You put any kid under pressures like that, there are only so many ways the mind can shatter. The way mine did compares to how BPD people do. Maybe theirs is the same.

If you look up BPD online you will get pages and pages of how "these people will ruin your life, they are satanic, run!" which made it hard at first to see myself reflected there, except as a tragic victim of my evil ex. They have no real emotions, they are manipulative, they come back and "hoover" you back to their side - all this. Well it helps at that "angry" stage of grieving a dead relationship.

Truly Aspie, I am analysing this to the point where my brain just freezes. So; a personality disorder - what they call it now is Emotional Regulation Disorder, which makes more sense. And I see it in myself. Not sure where I'm going with this. Anyway...

I read a lot about personality disorders while I was trying to work out what my problems were, what struck me about them is that they do not seem to be very well understood yet. But it seems they all have their roots in defence mechanisms that people use to protect themselves, that grow out of trauma, it seems logical to me that autistic people would be vulnerable to developing personality disorders due to over sensitivity and constant set backs in early life. The gender thing is interesting as I do think there is a lot of overlap between BPD and how aspergers manifests in some women, similarly I think there is a lot of overlap between the covert form (but only the covert) of NPD and aspergers in some men, and schizoid personality disorder overlaps with either (all this is based on reading I have very little experience of others with aspergers in real life). It makes me wonder how much misdiagnosis goes on, how much overlap there is, and whether there is possibly some unknown connection between autism and personality disorders.