Many netizens left messages: "Marginal personality disorder" and "bipolar affective disorder" are silly and indistinguishable.
In our popular science about "borderline personality disorder", some netizens commented: "All in, but I was diagnosed as" bipolar ".
So, how to distinguish between "borderline personality disorder" and "bipolar affective disorder"?
The symptoms of irritability, impulsivity, and emotional fluctuations, bipolar (especially manic) and borderline symptoms are very similar.
Some bipolar patients were diagnosed as bipolar after experiencing manic episode, but when they saw the introduction of borderline personality disorder (BPD), they also felt that they seemed to be more in line with borderline personality. Both had severe emotional fluctuations, and it was difficult to distinguish between them.
According to the survey, 10%~40% of patients with bipolar disorder also meet the diagnostic criteria of borderline personality disorder.
In fact, borderline personality disorder and bipolar disorder, especially bipolar disorder of rapid circulation type, have many common characteristics, but they also exist Discriminable differences.
01. Time
According to DSM-5, manic episode of bipolar patients lasts at least 1 week; The onset of hypomania lasts at least 4 days; Severe depressive episode lasts at least 2 weeks.
If there are four different episodes in a given year (continuous hypomania and manic symptoms are counted as one episode), patients with bipolar disorder will show a "fast cycle" (mania, hypomania or severe depression).
Biphasic mood fluctuations have relatively long and stable cycles, and there is a high probability that mood changes will It happens suddenly without any reason.
The emotional fluctuations on the edge can be instantaneous and occur many times in a short time, and there will be induced events, usually with The rejection in the relationship is related.
BPD often swings back and forth between two levels of emotion. It can be angry because of a word from another person, but it can also calm down quickly and even show friendliness.
A BPD patient shared:
Maybe now I'm in a good mood because I have an appointment with my friends for lunch.
Suddenly she sent a message: "Sorry, I am temporarily busy, and may have to reschedule."
In an instant, I felt like I wanted to collapse: what does this mean? Hate me? Did I offend her? She doesn't regard me as a good friend anymore? She was like this once before! She must not like me! Make excuses to keep your appointment! I really failed. No one even wanted to eat with me. Pull black! All pull black! What's the meaning of living like this? It's better to die.
And then if she sends another message: "I put the matter off, see you at the same place!"
I was happy again in an instant: she rushed to work for me! She still loves me! We are best friends! I am so happy.
It can go back and forth between love and hate in a short time, making BPD patients always look uncertain.
02. Etiology
Although there is no clear cause of bipolar disorder at present, in clinical practice, it is more inclined to neural dysfunction, the level of hormones and neurotransmitters is unstable, leading to the mainstream explanation of emotional state fluctuations.
Biphasic disorder is currently considered a Highly related to genes Hereditary mood disorder is caused by changes in some brain chemicals.
The formation of borderline personality disorder Not only related to genetic factors It is also related to such environmental factors as people's temperament type, living environment, early development, relationship establishment, parental rearing patterns, etc.
The emotional instability shown on the edge is more related to the chaos of their inner self core. The fragility and instability of their self-image, the incoherence of their self-identity cognition, are extremely vulnerable to external influences, and can often experience the ups and downs of two-level emotions in a short period of time, and are very easy to change with the trend.
At the same time, because of the fear and avoidance of abandoned traumatic experience, I will be very sensitive to capture any details that have the meaning of rejection in communication with people, For example, heavy door closing, messages that are not answered in time, and the rising tone of voice when speaking, etc Once any sign is found, it is "sky collapse" for them, and then a series of anger, aggression, self denial, emotional collapse, and high emotional instability will follow.
03. Category
Bipolar disorder is a Emotional disorders , which is characterized by extreme mood fluctuations, falling from the peak of mania to the trough of severe depression, affecting a person's emotional experience and "emotion".
In different periods, the emotional experience and external performance of bipolar patients will be different. For example, in the case of mixed manic episode, the patient will feel extremely pessimistic, desperate, tired, unable to concentrate, but still feel excited, anxious, impatient, anxious, lack of sleep, and rapid thinking.
In contrast to bipolar disorder, borderline personality disorder is a personality disorder , is a continuous entanglement and confusion of interpersonal relationships and self-image.
Marginal patients often have some distinctive personality traits: "polarized thinking", impulsive behavior, strong fear of being abandoned, doing everything possible to avoid being abandoned, vague self-awareness, strong sense of emptiness, and so on.
04. Intimacy
Biphasic patients are entering Stable period , or after systematic treatment convalescence In terms of intimacy, there will be no particularly tense relationship problems.
For the bipolar patients who choose the combination of medication and psychological counseling, psychological counseling can help them and the people around them very well.
Because of the extreme fluctuation of mood, the intimate relationship model of bipolar patients will show unpredictable, impulsive and changeable characteristics. In different periods, their opposite behaviors often make their partners feel headache and tired.
But if you have mastered the skills to get along with them, you can understand the symptoms behind their various moods that are difficult to control, and it is not impossible to manage this intimate relationship well.
For patients themselves, learning to record, pay attention to and understand their own emotional change rules, learning some stress coping strategies, and maintaining positive and timely communication with their partners, reaching good consensus and setting clear rules can also largely avoid unnecessary conflicts and disputes, and help improve the quality of family relationships or marriage and love relationships.
In contrast, borderline patients are often Chaotic and bad It is often impossible to maintain a close relationship for a long time.
BPD is a black or white way of thinking. One day, it idealizes others and thinks that the other person is the best person, but the other day, it devalues the other person to be worthless and repeatedly jumps between love and hate. The unstable relationship model will lead to frequent conflicts, distrust, and strong fear of abandonment, which will allow them to show great control in the relationship.
This will also lead to their complex and changeable relationship with consultants even in psychological counseling. Sometimes they feel hurt, sometimes they attack consultants, but sometimes they idealize consultants as "saviors". It is not easy for BPD to find the right consultants.
Whether it is borderline personality disorder or bipolar affective disorder, the most important thing for us is to know ourselves better and be able to Master more initiative 。
If he finds that his treatment effect is not good, he will return to the doctor in time to adjust the treatment plan.
In our daily life, we can also observe our own emotional changes and what happens in our inner world.
If you can, you can also find a professional psychological consultant for consultation and evaluation, and establish a trust relationship with the consultant. From an objective and professional third-party perspective, we can understand our inner world, understand the thoughts or needs behind our emotions, and provide ideas and methods to solve problems, so as to reduce our emotional loss of control and make ourselves better.
Both biphasic and BPD need long-term treatment and self-development, Only in this way can the symptoms be alleviated and the normal life state be restored. It is important to keep a positive attitude. You should believe that you will get better and better. No disease can define who you are.
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