BPD or misdiagnosed?

Post Reply New Topic

I am a 30 yr old female who was diagnosed as suffering from BPD and depression 10 yrs ago. I always felt like I didn't fit in at school but my problems really started at university where I became extremely isolated. I started to self-harm to cope with feeling dead inside and after quitting my part time job at the age of 22 I went downhill. I have been in a psychiatric unit 3 times now due to feeling so desperate and trapped in my head. I know that being female and self-harming immediately makes people think BPD but I'm not so sure. My mum has joked that my dad must have Aspergers and my brother ticks nearly every box except they have managed to make their way through life relatively unscathed and both hold down good jobs and enjoy themselves, in their own way. I feel like I am broken inside and incapable of having normal relationships with people. I don't connect with other females and often find them terrifyingly unpredictable. I am happiest on my own, listening to my music or out walking in the countryside, but I know you don't get very far in life being so isolated from others. I am hyper sensitive to noise and whenever I am in my flat I have to have certain appliances on to act as "noise blockers" or else I pretty much lose the plot. I find eye contact extremely invasive and people trying to hug me when they aren't family (or often even if they are) makes me shudder. I never normally post on the internet but I am getting so desperate for ideas on why I am like this and how I can feel happier that I am risking posting this message and I hope someone may be able to share some words of wisdom or even humour. I've never felt like I've fitted in more than when I've been browsing WrongPlanet and am grateful I stumbled across it when I did.

The newest information is Asperger's Syndrome presents differently in women and girls than it does in men and boys. Women are under different pressures and expectations and can often 'fake it' by being considered 'shy' and 'self effacing'.

Trying to cope will cause reactions like post tramatic stress disorder, BPD, depression and constant anxiety. When the root cause is not found, the co-morbids are not dealt with effectively. The autism spectrum condition was a native condition at birth - it could be the crux of the whole personality disorder matrix.

That's what I was wondering. My only friend who understands me is a girl with BPD. I think she's AS. She does well in social situations but after a while people start ignoring her.

I got the borderline misdiagnosis thanks to self-injury, too. It was a misdiagnosis, since there's no other good reason I should have that diagnosis.

In a female with SIBs, especially if tools are used (as opposed to banging limbs or head against something, biting, etc.), many doctors immediately think borderline, but that's not always the case. The doctor who diagnosed me borderline after five minutes' interview made that mistake; he didn't even consider that I have over the years had all sorts of SIBs, not just the classic "cutting"...

Where they can overlap:
Self-injury, obviously.
"Tantrums". With autism they will come from cognitive overload; with borderline they are a result of unstable emotions and poor impulse control.
Relationship problems. Asperger's tends to have more problems making friends; borderine, more problems with keeping them. BPD relationships will be extremely intense, dramatic, and often short-lived; Asperger's can be simply nonexistent, distant, or include poor communication.
Black-and-white thinking, or "splitting". Something or someone is either very good or very bad; no in-betweens. Thinking in absolutes. Asperger's tend to do this with concepts and the world around them; with borderline it is mostly seen with people and relationships.

If you see these, suspect Asperger's:
Difficulty with empathy.
Special interests.
Repetitive movements.
Odd speech.
Difficulty with reading non-verbal communication.
Being overly literal.
Face-blindness.
A preference for being alone.

If you see these, suspect Borderline:
An undefined or extremely vague sense of identity.
Impulsive, self-destructive behavior that can't be put down to self-medicating or lack of understanding.
Unstable, intense relationships.
Repeated, low-lethality suicide attempts.
Emotional instability, "moodiness", being very reactive emotionally.
Defining yourself based on who you are with--not just changing behavior, but changing identity/self-concept.
Fear of being left alone, either physically or left without a relationship.

Traits where they are almost mutually exclusive:
Introspection. Asperger's individuals are often very introspective, thinking a great deal about who they are and what life means; Borderline individuals may feel like there's not much "in there" to look at.
Empathy. While AS individuals can be hyper-empathic (a lack of emotional empathy is a lot more common), Borderlines almost always are--to the point that they have trouble figuring out where their emotions stop and the rest of the world begins. That can result in being very compassionate... or simply being overwhelmed by feelings.
Asperger's individuals, even the extroverts, tend to NEED to be alone. Borderlines often fear aloneness in all forms.

Of course all this is more confusing in that it is possible to have both, or have one and have a few traits of the other. They can overlap. It'll tend to be an atypical case of BPD if someone with Asperger's has it, but it can happen.

I have an eating disorder (anorexia nervosa), SIB, and was also diagnosed with BPD in the past. I have always thought that the BPD diagnosis is incorrect. I am not like others I know with BPD, who seem desperate to have relationships, but are too 'pushy'. I prefer to be alone and I am frightened of close relationships. I have always had anxiety, obsessions and compulsions, right from being a small child. I find people difficult to understand and do not like social situations. I have not been diagnosed with AS, but I do feel that it fits me more closely than BPD.

Obviously self-harm is not the only criterion for BPD. You have to have other things too, like impulsivity in other areas (binge eating, substance abuse, reckless driving, etc.), unstable relationships, intense mood swings, etc. Even ifyou meet enough of these to qualify for a diagnosis, of course it may be that you only meet criteria under certain circumstances (eg. after an important trasition in yoru life), and that makes no sense for a *personality* disorder (but then again I'm not a doctor, and doctors can do weird things).

Of course there is also the possibility tha tyou have both BPD and AS. They are not mutually exclusiv eunliek what some people here have suggested in another thread (some traits look contradictory, but that may also be misinterpretation).

I wonder how many AS women end up with dx of borderline just because they're more emotional and don't settle down until their hormones do? by my early 20s I'd stopped cutting, drinking, and doing drugs and was looking for a stable relationship (because I erroneously believed I should be in a relationship) so my behavior around age 19 would have probably earned me a BPD dx. however, the majority of my instability was a result of intense conflict and emotional and physical abuse at home and bad role modeling for relationships.

as I was searching for help for why I am the way I am and in the middle of dealing with pressure and abuse from my ex-husband, several times I resorted to digging my nails into my arms deeply enough to leaving bad bruises and scabs, for the sole purpose of preventing a melt-down in public. there was no difference between those situations and the ones involving knives when I was younger. I never realized that my methods of self-harm could stem from the same place as a need to head-bang or punch oneself, which is what my son does.

I really wonder about these:

because I had every one of them but "grew out" of them once I got away from my mother, who was controlling, abusive and probably BPD or NPD herself.

even through all that, I craved solitude. I've always craved solitude. that would make BPD unlikely, especially since most of the above were behaviors modeled for me and which I abandoned as self-defeating after years of experimentation.

I'm not sure it's possible for AS and BPD or NPD to be co-morbid, although I suppose it's possible to end up with some of the issues that would dx a NT with a personality disorder. it's just that while the behaviors might seem the same, the causes are different. for instance, unstable, intense relationships... an AS girl could easily fixate on someone and because of problems empathizing with her friend, the relationship would be volatile and stressful. being pushed to socialize would also cause a girl to end up in a situation where she allows others to define her in order to fit in. years of conditioning make it hard to break out of those survival patterns and the cost is high (I know from experience).

with all the sensory issues the OP describes, a visit to a neuropsychologist might be helpful in sorting it out.

(sorry for the long, rambling post. I'm kind of sick today and my brain isn't working as well as it could)

Personality disorders are not a particularly solid concept in psychiatry.

Autism is grounded in the notion of people with it having different neurology, with various candidates possible as causes for this neurological difference. By contrast, it does seem likely that BPD is based upon some common neurological difference. At best, it probably just means your behaviour is 'abnormal' and that it is causing you distress. But you probably already knew it before you walked into the psychiatrist's office…

The trick to diagnosing AS is looking for seemingly unrelated characteristics but yet regularly reappear in autistics people, hence there is something more fundamental causing them. For example, someone being shy merely means someone is shy. Equally, someone taking things literally means someone takes things literally. But since being shy does not then cause people to take things literally (and visa versa) yet these two traits are often seen together, we think something more fundamental is going on (different neurology, named AS). Other traits would be lack of eye contact, obsessive thinking, disliking change, liking doing things methodologically and others mentioned on this board. You don't have to have them all but having some seemingly unrelated traits that a subsection of humanity also share does suggest something more fundamental causing it.

By contrast, I'm not sure the same methodology would suggest something more fundamental is causing BPD as someone fitting one of those criteria you'd probably also expect to fit others. Of course, there still could be neurological differences for BPD, but if so establishing that scientifically would be much more difficult that with AS.

I, too, was misdiagnosed with having BPD. I thought for years that is what I had, but wondered why I didn't fit in so well on the BPD forums. I would offer some logical solution to what someone was talking about, and wind up being told off in 50 different ways. By the end of each one I tried, nearly everyone hated me.

Finally, someone on one of my forums messaged me and told me to check it out here and see whether or not I felt like I fit in better amongst those here. I really had no clue where she was headed, and was shocked, as before I learned more about autism, I had the same perception as a lot of people to be honest. I never thought of myself as autistic or could really see much of a relation, but came here anyway and wow... I was floored as to how much I could relate to.

Shortly after coming here, I started seeing a psychologist... he looked at my initial diagnosis and "experimented" with me by randomly saying things that would really set off someone who actually had BPD. But since I really didn't react to those things, but had major meltdowns with plan changes unless I was involved in them in some way, he laughed at the former diagnosis and agreed it was Asperger's.

I guess my feeling is that the way we all view the world and cope with life depends upon both nature and nurture.

The suggestion is that BPD has a neurological basis as well as a social basis. People with BPD are often said to have been raised in an invalidating environment where they fail to make essential attachments with parents or carers. However, it has been suggested that they are also vulnerable to developing BPD because of inherent anxiety or sensitivity. Thus, the BPD is a combination of inherent and social factors.

People with AS are born with AS, but they still have a distinct personality that has been shaped by their environment and social interactions.

Maybe I'm stating the obvious?

That, right there.
Obviously, I can't diagnose somebody based on one post, but a borderline would not have made that statement.

Like a bunch of other people just said.. if you're a female who self-injures, they figure you're borderline. If you don't know how to connect with people, they figure it even more, 'cause they mistake aspie inability to connect with the "I hate you" side of BPD.. especially if you get pissed that they're being nasty to you for not knowing how to connect.

You can't diagnose borderline in someone who has a mood disorder unless you get their history from when they didn't have the mood disorder. Any good psychiatrist should know that. You have to prove a life-long pattern, NOT just what somebody does when under stress, going through transitions, etc. Often times, they are too quick to diagnose borderline, when what they have is someone with simple depression, PTSD, or another common and not personality-related problem.

Thanks for the responses. It was quite a big deal for me to start the thread but I'd had a drink and decided the world probably wouldn't end if I did it. I definitely fit both BPD and AS in several ways but what has made me really question the BPD diagnosis is the fact that I am only ever truly at peace when I am on my own without having to analyse the behaviour of others and deal with all the other sensory input that's inevitably bombarding my brain. I have never understood how so many people can't stand being alone and actively seek out company regardless of whether they really feel comfortable with that person or really connect with them. People say they get bored sitting on their own "with nothing to do" but I don't see how you can ever get bored whilst you have an active mind. I have found myself watching hours and hours of tv to try and learn more about how people relate to one another, how they can ease into a conversation, relax and feel as if it's all pretty effortless. It doesn't seem to work for me though. I don't know what I'm expecting to happen by opening up about this because whether I have BPD, AS or something else it doesn't seem like it's going to be easy to get myself out of my self-made fortress (I moved out of my family home nearly four years ago and have become even more shut off than ever) and into the big wide world again.

sinsboldly,

Wondering if the part of your post I emphasized explains something that happened to me. I also have always craved solitude. But there was a 10 year period in my life where I used recreational drugs, and smoked pot nearly every day. During this time, I became a kind of charicature of myself. Although I was very popular, something was incredibly wrong. It appeared that while self-medicating with pot, I was coping beautifully and had virtually no social problems whatsoever. This, however, was a farce. Red flags should have been going up all around me. I've always had severe social problems----except for those 10 years. So what was up?

Well, I think self-medicating with pot, caused me to be a lot more outgoing than I really am. And there are some excellent reasons why I'm naturally not very outgoing (being wired differently). The pot couldn't address those underlying issues. It could cover them up, but it couldn't remedy or change the core neurology. In fact, it exacerbated my constitutional difficulties, by facilitating a coping reaction that I essentially couldn't process neurologically. Looking back on my obsession with recreational drugs, it seems like my personality was being split in two: Half was always laughing and happy. But the other half was hurting and neglected....that is the part that needed to be alone.

The result was that I began to exhibit BPD, which I now think may have been the result of traumatized (possibly damaged) autistic neurology. When I quit recreational drugs altogether, it actually got worse....as I went through years of withdrawal...and eventually returned to my natural state of isolation.

I'm inclined to think it was not the pot that caused a problem for me. Rather, it was my overdoing of the socializing that was the problem. My nervous system just isn't built for so much "popularity".

Last edited by alba on 15 Oct 2009, 7:32 pm, edited 1 time in total.

Perhaps you did have those problems, but the people around you were either stoned and didn't notice, or figured that the reason you were acting that was was because you were stoned? A lot of people here who don't smoke pot have commented that people think that they do.


Diagnostic criteria aside, I don't see how anybody could think that you have BPD. Borderlines need others to define them, they need others who they can idolize and blame.

Everything you're saying is the exact opposite of BPD, whether or not you meet the behavioral criteria that have nothing to do with the actual basis of the disorder. A lot of behaviors of AS look similar to behaviors of BPD.. but for completely different reasons.

man I can relate to that. a couple of years ago (before I got brave enough to leave the cult I was in) one of the women kept bugging me to call her. once she said "if you're ever bored, just give me a call." it struck me as so weird to need to call someone if I found myself bored, and it crossed my mind that I wished I had the luxury of some boredom because I have so many things I could do with that time!

being bored and wanting to go out are two separate and distinct things for me. I'm never bored. sometimes I want to go out and can't because it takes planning and I don't like to go out at night by myself, although I prefer to run errands, shop, and go to lunch by myself.