BPD seems to fit, but not quite, gender bias?

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I'm just wondering because I don't meet some of the key characteristics but do seem to meet enough of the criteria for a DX. Is it worth getting one, and would it even be beneficial to getting the right type of treatment? I've found treatment geared towards Asperger's not to be helpful in my case, so I'm looking for a co-morbid that is a better fit and perhaps explains ASD as a misdiagnosis. I wonder if BPD is it.

I'm just wondering if the things that don't fit are because of gender bias. So is this the typical profile of a Borderline male?

(1) frantic efforts to avoid real or imagined abandonment.

Hard to say. I'm very avoidant, but not really; my tendency is more likely to preemptively remove myself from situations where I perceive negative reactions -- where my perceptions of negative are taken to an extreme.

I'll put this one as maybe.

(2) a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation. .

(3) identity disturbance: markedly and persistently unstable self-image or sense of self. Even the word "identify disturbance" matches so well.

(4) impulsivity in at least two areas that are potentially self-damaging (e.g., spending (?), sex, Substance Abuse, reckless driving, binge eating) (this one's questionable)

(5) recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior

Lots of suicidal ideation but few actual actions.

(6) affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)

(7) chronic feelings of emptiness

(8] inappropriate, intense anger or difficulty controlling anger

(9) transient, stress-related paranoid ideation or severe dissociative symptoms [Is stressing and assuming the worst of things included? I am not sure this is bad enough, but it might be).

At least 5 are strong, but some of the key indicators are not. Am I likely enough to be BPD to justify trying to get a DX, and how would this help me?

I'm not sure. Now you've gotten me thinking because I look at that list and I am almost certain I have every symptom except 1,2,8, and 9.

Several of the criteria could also be caused by depression though. Do you suffer from depression? My psychiatrist thinks I do but I notice my mood problems are more accurately described by symptom #6 on that list.

There is a need for differential diagnosis. One thing that you could look at is whether or not you have symptoms of AS that wouldn't be explained by BPD or vice versa. I don't see the harm in asking a doctor about it. You may think you're fooling yourself but I'm sure the doctor has had patients come in for much more frivolous things. He won't view your concern as pointless because of the perspective he has. It's a lot less pointless than many other things people go to the doctor about.

Is it AS or BPD? I don't know. Is it depressoin or BPD for me? An expert in differential diagnostics could sort it out and you'll never know for sure if you just go in circles asking yourself without ever asking anybody else.

I had never heard of this before - until two days ago when my neuropsychologist told me she believes I have aspergers/Borderline personality disorder with dissociative episodes co morbidly.

I don't see it as gender bias - there are more women/girls sexually abused in this world and to me that just leads to more women being afflicted with this disorder. As being sexually abused is one of it's causes.

Well, check...though not sure if childhood abuse counts...

I meant gender bias as in the "usual description" of the disorder is aimed primarily to describe women with it, similar to how the "typical aspie" characteristics are biased in favor of diagnosing men and under diagnosing women.

I'm not emotionally hysterical or visibly out of control really ever. But I wonder if BPD is a "hyper female brain" similar to how AS is a "hyper male brain." Thus, just as women are usually more successful at masking social deficits with AS, men are more skillful at masking emotional deficits with BPD. Am I wrong?

My reaction to emotional swings is usually just to become very social, cocky, sexual, and NT on the up and then completely shut down and manifest ASD, low self-esteem, asexual symptoms on the down.

This isn't bipolar. The switches are not predictable and usually caused by events. Also, they can last from a few hours to a few days but can sometimes last only a few minutes. I can switch from depressed to euphoric or vice versa within the scope of 10 minutes.

As I had a very long, very stressful day - I will quote what I read and post a link because my brain is just too tired to think how to answer you in any other way... sorry

There is also a list of male symptoms on this site.

Quoted:

"What was once thought of as a primarily female disorder, Borderline Personality Disorder is now recognized as something which affects males and females in equal numbers. Various factors, including gender bias, cultural stereotyping, and manifestation of symptoms have kept the male borderline hidden, or at the very least misdiagnosed. But research now suggests that this disorder is equally prevalent among men and is much more common among the population as a whole than previously believed. Whereas bpd was once thought to affect about 3% of the population with 75% of those being female, estimates are now as high as 6% with men and women affected in equal numbers."

Source: http://www.examiner.com/article/borderl ... rder-males

Thanks! This is really fascinating.

This describes me perfectly:

I am really attracted to women who are criminals, bipolar, borderline, or have other mood disorders. This would explain why. I do actually feel uncomfortable around women who have "greater resources" or whom I view as higher quality than me.

Then, I hit a euphoric mood and promptly dump them. I probably then regret it at some point.

I once lost $15,000 in a single day through reckless trading in penny stocks. And I'm not exactly rich. Also compulsively bought lots of "stuff" when I got diagnosed with Asperger's that was supposed to help, including an ipad, multiple books, a ps3 for visual-spatial, a tv, and a kindle, all in the course of a month. Bought virtually all the ipad apps in the Apple store having anything to do with autism. About half of them are crap. I had the money, but wtf?

I go on spending sprees and then when money gets low I shut down and don't even buy necessities like food till my bank account looks "full" again. This is how I avoid too much debt. I have no sort of systematic budget at all. I just panic when my bank balance looks "low" and then return or sell multiple things and go without necessities like food. And walk multiple miles to avoid paying for gas.

Last edited by Tyri0n on 07 Mar 2013, 12:39 am, edited 3 times in total.

Glad I could help

I was misdiagnosed with BPD. The standard treatment for it is mood stabilizers and DBT classes. DBT way developed by Marsha Linehan. She has a skills training workbook that outlines the program. I would suggest looking at that and seeing if it would be helpful before seeking a diagnosis.
Being diagnosed with BPD never did anything to help me. I just ran into a lot of discrimination with doctors because of it. Most doctors see borderline patients as being difficult or liars. I had series medical problems that weren't taken seriously. I was labeled as belligerent and was told I could not "direct my own care".

Skills Training Manual for DBT: http://www.amazon.com/Training-Treating ... DBT+skills

I once only had the suspicion (nothing more) in the past, from one shrink I didn't come along with.
And this was totally terrible because of the stigmatisation it caused me from doctors. It is also very difficult to get rit of the lable again, because everything you do is suddenly seen as "typical borderline".
It is a diagnosis who is easily given, because it is hard to proof that it's a missdiagnosis. In my opinion it is also very often used as a diagnostic waste can where all psychiatric symptoms and patients fall into there that can't explained otherwise and/or are just difficult.

In the meantime I figured that I had a trauma back than that wasn't taken serious and now that it's mostly gone you can see clearly the pattern of bipolar with moodcycles of weeks and months.

So, even if I would know I have tendencies, I wouldn't necesserily try to get a diagnosis for BPD because of the high stigma to it.
But especially diagnostic criteria 1 and 2 are very typical for borderline, what I heared, and not really for autism.

This is an interesting video about Borderline PD:

[youtube]http://www.youtube.com/watch?v=967Ckat7f98[/youtube]

I can see from this and other posts you have made that you are in the process of figuring out yourself in terms of your strengths, weaknesses and other characteristics. There are some areas that you have identified as problematic and others that are strengths. Going through all of this self-diagnosis using the DSM terminology can be a useful exercise in evaluating areas of difficulty and potentially finding ways of overcoming these difficulties and I hope you find some solutions which will get you what you want.

If there is one thing that differentiates a good psychiatrist from a great psychiatrist, it's his or her ability to see the patient as a human being - a complete human being.. So may I suggest that while you are doing all this diagnosing, don't forget that while all human beings are uniquely different from one another, we have a lot in common as well. Don't be hard on yourself, if you find that there is some aspect of yourself that warrants a diagnosis. Also, try to balance the 'deficits' you find with strengths. These are much harder to find within ourselves, but they are there. The strengths assessment is not just about boosting our egos. It is a way to identify exactly HOW we might be able to face the challenges presented to us.

Stigma? It can't be worse than the Ass Burger stigma, right?

Cluster B personality disorders have sadly the worst stigma in psychiatry.
Because those are very often patients who are difficult to handle and hard to treat. Of course not all, but above average.

They wanted to reduce the stigma of BPD to rename it to: "emotional disregulation disorder": EDD, but it didn't quite made it and still has it old name in the next DSM V. Most sientists in the field believe that BPD is an emotional disregulation disorder.
Also Marsha Linehan who invented DBT. She is very interesting, because she admitted some years ago that she had BPD herself as a teenager. I never read any of her books but I heard her talking about BPD on videos and she has a lot of inside into this disorder.
So far I know, it is very often a disorder between the age of 20 and 30. Most have grown out of it before the age of 40. Of course they will always keep a sensibility, but most don't meet the criteria for the BPD anymore by then.

But so far I know this is also a diagnosis with not a clear cut off and hard to diagnose. Very often it is diagnosed way too fast actually, so that it's used by many shrinks as a diagnostic waste can. Also because you can explain nearly everything in psychiatry with "emotional disregulation". So if I were you and you really want to know I would just go to a borderline expert and not to any random shrink, because there you can't be really sure afterwards.
But it is very typical to have many psychiatric comorbidities to it, but having many comorbidities also occours very often in autism.

I have a diagnosis of borderline personality disorder (though my psychiatrist prefers emotional dysregulation disorder).

I'm not 100% sure it applies to me, and definitely did not seek out the diagnosis (it was thrust on me) but I'm a bit more open to the idea since having read The Borderline Personality Survival Guide by Alexander Chapman & Kim Gratz. That's a suggestion for some more reading there, Tyri0n.

I am a little concerned because, if I'm remembering right, you sought out your ASD diagnosis and only received it relatively recently but now think it might be a misdiagnosis.

I'd be very wary of getting a BPD diagnosis, because yes, the stigma IS greater than that associated with ASDs. My experience is that in general people don't know about or don't understand ASDs. But that they have huge stereotypes about borderline personality disorder that paint people with the disorder as attention seeking master manipulators to be avoided at all costs so as not to be used by them.

I believe that attitudes towards those with BPD in psychiatric professional circles IS changing (previously BPD was thought to be untreatable, but they now know that is not the case ... though it is believed that treatment can help the behaviours but not necessarily the emotional dysregulation ... if the behaviours improve you no longer qualify for a BPD diagnosis), but I think there is a long way to go still.

Sorry it's late and I'm not thinking very coherently. I don't think I've said what I want to say very well.

Why would it concern you that I got my diagnosis last fall? I have spent more than two months in a social skills training group for Asperger's and even the instructors believe I don't belong there.

I definitely believe something is wrong with me that prevents me from having normal human interactions, but it doesn't seem like ASD is a good fit currently, though I clearly had some form of LFA as a child. Borderline just seems to describe me better in some ways. I can't really explain it. I really wonder if it's possible to be misdiagnosed as Asperger's/ASD as a male because clinicians won't even consider BPD as a possibility for males.

Yes, they found out (also because of the sucsess through DBT) that BPD is treatable and even has a good long term development in many cases. Also it has been shown that some steriotypes about BPD are not quite correct. That ppl with BPD usually don't plan to behave that way and so their actions are it's less due to manipulation, but more due high emotionality and not being able to deal with it.

Well, I don't have Borderline, but when I had my trauma I had the same problem and the same cliché with my old shrink. She believed that I behave like this on purpose, but I wasn't able to handle some situations. And I believe with ppl with BPD it's pretty much the same.




Okay, that's a very clear sign.



I have some similar problems, but with ASD and Bipolar in my case.
I was very typical autistic as a child growing up and especially under stress I still have some signs of autism left. But it mostly doesn't really apply to me anymore. When I got diagnosed the first time I fit in, the second time when I got screened again a fiew years ago I was right on the edge, so they wrote "possible" and now my social understanding is way too good. I still have a lot of autistic thinking patterns though, but with the old criteria I wouldn't really fall into the diagnosis anymore and with the new once I'll be more the "autism in residuum" when the diagnostic criteria once applyed, but not anymore.

But in puberty I developed mood swings and last month I started a mood chard, where I write down my mood every day and it looks a loot like Bipolar with mild depression in january and hypomania in february. I already had this suspicion about me since a while, but didn't wanted to admit it. Interrestingly my new shrink has this suspicion about me even since the first session there. Also because of the disorders that are typical in my family, that would fit in the picture (ADHD and schizophrenia, both are highly related to Bipolar - also to autism).

But the most astonishing thing is, that I'm still different from ppl with "pure Bipolar" and that I feel here a lot more confortable than in a bipolar forum. Maybe you'll have the same thing with borderline, I don't know.

Diagnostic lables CAN change, this is known under shrinks. The reasons are not very clear and there is not much research to it.
But if you once had typical behaviour, even if the diagnosis doesn't really apply to you anymore, you'll always keep some traits or at least thinking patterns.



That's highly possible, but you also wrote about having some form of LFA as a child, what also added to the fact and this propably even more than you gender I would suspect.

maybe this interests you:
"Men display externalized symptoms, expressing problematic emotions in outward behavior. Women tend to develop internalized symptoms, where problematic feelings are directed towards the self. In accordance with the internalized-externalized dichotomy, women are more commonly diagnosed with mental illnesses such as anxiety, depression, phobias, and borderline personality disorder. Men more commonly experience substance abuse, antisocial disorders, and violence.[2] Both men and women are more likely to be institutionalized if their diagnosis is not typical of their gender (Martha Lang, 2006)." - wikipedia

Actually, the idea of getting tested and treated for BPD gives me mixed feelings. I actually identify with and am proud of some of my BPD traits. This must be how some "anti-cure" aspies feel about Asperger's. I definitely would like to cure my ASD symptoms, but I have mixed feelings about getting rid of some of my BPD symptoms.

I think being ASD is very humiliating, but I actually like some of my BPD traits, even if others would consider them "negative," and maybe they help to cancel out some ASD. So I may actually wait to get assessed. A lot has been happening in my life lately, so this may not be a good time to definitively identify anything either. Maybe when things settle down.