Deciphering Bipolar and Borderline Personality Disorders

This video explores Bipolar Disorder and Borderline Personality Disorder symptoms and is designed to lessening the confusion.  It is my hope that this video clears up some of this confusion.

BPD is characterized by transient mood shifts that occur in response to interpersonal stressors, whereas bipolar disorder is associated with sustained mood changes.
What’s the research saying and why is research important:

Individuals with BPD tend to be dominated by heightened instability and interpersonal reactivity of negative emotion. 

BPD tends to be characterized by the dynamics of guilt and shame—high instability, interpersonal reactivity, and persistence of emotion over time.

Differentiating BPD from BD and MDD. Specifically, research findings suggest that differential diagnosis would be most effectively informed by asking people about the following: 
(a) The frequency and severity of specific emotional responses to interpersonal challenges, particularly guilt and shame; 
(b) The frequency and severity of persistent shame; 
(c) The extent to which these dynamics are problematic in their lives. 

BPD would be most distinguishable by problems with heightened interpersonal reactivity of guilt and shame and shame persistence of emotion over time. 

Treatment approaches:
Medications. 
Continued treatment. 
Day treatment programs. 
Substance abuse treatment. 
Hospitalization. 

Medications may include:
Mood stabilizers, anti-psychotics, antidepressants, antidepressant-anti-psychotic, anti-anxiety medications. 

Psychotherapy
Psychotherapy is a vital part of bipolar disorder and BPD treatment and can be provided in individual, family or group settings. Several types of therapy may be helpful. These include:
Interpersonal and social rhythm therapy (IPSRT). 
Cognitive behavioral therapy (CBT). 
Psychoeducation. 
Family-focused therapy. 

Daniel J. Fox, Ph.D., is a licensed psychologist in Texas, international speaker, and award winning author. He has been specializing in the treatment and assessment of individuals with personality disorders for over 15 years in the state and federal prison system, universities, and in private practice. His specialty areas include personality disorders, ethics, burnout prevention, and emotional intelligence.

He has published several articles in these areas and is the author of:

The Borderline Personality Disorder Workbook: An Integrative Program to Understand and Manage Your BPD --COMING SOON--

Thank you for your attention and I hope you enjoy my videos and find them helpful and subscribe. I always welcome topic suggestions and comments.

Citations:
Lish JD, Dime-Meenan S, Whybrow PC, et al. The National Depressive and Manic-Depressive Association (DMDA) survey of bipolar members. J Affect Disord. 1994, 31:281–94.

Mneimne, Malek & Fleeson, William & Mayfield Arnold, Elizabeth & Furr, R. (2017). Differentiating the Everyday Emotion Dynamics of Borderline Personality Disorder From Major Depressive Disorder and Bipolar Disorder. Personality Disorders: Theory, Research, and Treatment, 9: 192-196.
00:00 Introduction
05:45 Misconceptions
09:50 Research
11:32 Emotional imbalance
18:44 Treatment approaches
20:51 Ongoing treatment
23:38 Psychotherapy
26:07 Cognitive Behavioral Therapy
27:42 Family Focused Therapy

[hads]

I feel so bad for my partner. He didn’t sign up for this and he feels like he’s on a constant rollercoaster ride. Sometimes I feel like I should just go at it alone so I don’t burden anyone.

[sandradibiaso]

I think I have both. I have triggers like being disrespected, insulted or rejected.

[c.b.]

You should have a podcast so that it’s easier to listen to you when I’m on the go. Although I appreciate seeing your face.

[Nathalie.]

Thank you Dr Fox. I watched all your videos on BPD as i have in the past year been diagnosed and everything makes so much more sense now. But it is still a scary thing to live with. I watch your videos about BPD to calm down because they make me feel like I'm not crazy and there are reasons for the ways i feel and act. Your videos help me a lot!!!

[SaturnianTenshi]

Diagnosed Bipolar II & BPD. I often have a hard time identifying if they're "working together" or if one triggered the other.
Basic backdrop is decent, btw. I'm glad you talked about this.

[angiejustice]

I have been suffering in silence with BPD since I was diagnosed at 19. I am now 39 and am finally ready to accept that this is my personal battle within myself - the fear of abandonment shows up almost every day- I feel scared and emptiness all the time- I am not good at anything because I cannot be in the moment long enough to focus my attention on any sort of mindful task . I feel so lost and broken and scared all the time . I get triggered and although I stopped self harming years and years ago, I still feel that way- I want to so desperately . I have clawed at my own face in the mirror in such disgust and shame at myself. The self hatred the self loathing the humiliation .

[Shortkonner]

Hey Dr. Fox, I have BPD and I'm Bipolar. I've seen about 6 of your videos. You are truly well educated on how I feel and what to do about it. I'm finding you are helpful to me and I'm understanding more and more as I strive to be better. I'm in therapy and medicated. I have a 2.5 year old. I'm using your worksheets and I just want to to know that you did this to help people... You're helping me. Thank you very much. You makeb more videos, I'll watch them, take notes, print extra materials, watch them 5x each and recommend you to others. You are the fucking best, thanks for spending your personal time doing this. You the best.

[helenachase]

I have unfortunately zero positive others to help me when I get triggered. But, I do have the internet and I do rely heavily on the YouTube community and you, Dr. Fox ! Lol. Fortunately, I do not drink, or drug, engage in promiscuity etc.... I just suffer the paranoia, and pathological loneliness of the bpd whilst trying to reparent myself.... An interesting side note ... I host people who bicycle across Canada and they often are raising awareness for a cause. This summer a young couple came who were raising awareness for mental health issues. I had another cyclist at the same time who shared his battle with depression. It was so refreshing to discuss these issues in casual conversation I am baffled as to why there is such incredible stigma around mental illness....I haven't had a soul to talk to since... Thanks again for your efforts Dr. Fox

[tracieday]

So many people suffer from mental illness it's unbelievable. I have BPD, GAD, panic disorder, and agoraphobia. Imagine me out here trying to hold down a job lol. I was turned down for disability and my husband of 16 years passed away last year unexpectedly. I'm currently living with my daughter and trying very hard to keep myself together. Mental illness is so stigmatized and so many people are suffering. Coming to channels like this and reading the comments help me to realize at least I'm not alone. Another major issue is trying to get and keep health care in the United States is another cross we have to bear. Stay strong people and thanks for listening.

[michaelcraig]

My wife and I have just begun dealing with an adult daughter whom we believe is a "legacy" that was afflicted with the disorder, consistent with behaviors manifested by my mother and brother. Your video has enlightened me by connecting research to the observations and conclusions I have had to deal with w/o insider-understanding. I now realize that BPD, which we only heard about a few years ago, is a very complex onion to peel. Accepting the fact that it is a true disorder should lend patience to this process sustain me in supporting her on a path of improvement. I will resort to your videos, often, to learn more and to refresh what have already learned. Your videos are empowering to us and we will have our daughter watch them as an informational and coaching-tool. Thank you.

[rjrnj]

Just diagnosed. I'm fearful of lamotrigine. I had been on a cocktail of anti depressants for more than 30 years before I discovered that I WASN'T depressed, (dysthymia), but instead have BPD, am OCD & ADHD, and suffer from PTSD (child of holocaust survivors). I eliminated all the meds I'd been placed on, using Prozac (20mg) to finally and safely eliminate the Cymbalta without the nasty withdrawal symptoms.
On top of all of that, I'm also now off all my former health medicines because i drastically changed my WOL (am now a carnivore). No diabetes, no inflammation, no cravings, and weight loss to boot!
I've never felt better so imagine my surprise when I thought to myself recently, "Hmm, I'm feeling manic." Can't sit still. Spending money. Don't want to and can't sleep. Thank heavens for both CBT and DBT.
After a discussion with my psychiatric meds doctor, he recommended I keep a journal for the next couple of weeks.
I'm looking into behavioral therapies to deal with it because I love feeling again and don't like the potential side effects listed for the lamotrigine. 🤞🤞

[amAfterlife]

I'd like if you could discuss that feeling of emptiness in Borderline Disorder more. I don't understand where it comes from or why it's so persistent. If you could shed some light on that, I and other folks here would be interested. Thank you Dr. Fox for all your helpful videos thus far :)

[FindingoutWhoIam]

Ive had the opposite happen to me..
I was diagnosed originally with bpd
And then was inpatient treatment and the drs realized i had Bipolar 1
This had made me distrust the whole mental health world.. bc of all the mean and nasty things said to me. My favorite is when a hospital staff told me if i was serious about killing myself he would give me his gun.. thats the last time i asked for help from all inpatient.
It made me for years to be okay to really talk to my mental health clinicians..

[julssilver]

Thank you for this very educational video. I have been diagnosed with Bipolar 2 and Borderline Personality Disorder. When you mentioned hospitalization, I wondered if a lot of other Borderline pd sufferers like hospital stays. I feel more safe in the hospital than anywhere on Earth. I have tried to keep my visits to a minimum because of this. I think part of it is the routine, which I have never had or been able to create. Even during my career and raising my son. I enjoy all of your videos and very much appreciate any advocate for those of us with these specific mental health issues. ✌️💙

[juliettailor]

This man is incredible. I used this information to advocate for my bpd husband who was diagnosed as bipolar. Thank you Dr Fox 🙏

[mandywilson]

I was 15 and diagnosed with PTSD. I started mutilating myself at the age of 10 years old. At 19 diagnosed with bi polar disorder. The mental health providers put me on all kinds of meds that rarely worked or made me worse. I went in at 35 or 36 to another doctor and I said I've tried all the meds for depression and bipolar disorder, went down the list, and I said they didn't work. She said because yes she believed I have a mood disorder, PTSD, anxiety disorder but not bi polar disorder and I had been misdiagnosed for all these years and actually have borderline personality disorder so that's why the meds didn't work. I wonder how much harm was done to my brain and body from meds that I never should have been on for something that I was misdiagnosed with... I went into an angry fit when she told me that. I left her office and had a few choice words for her before I left. She said would you prefer me to lie to you? My follow up appointment a month later I went in and thanked her. During that month I educated myself on bpd and it all clicked and I knew that she was absolutely correct. I always knew something was off because bi polar meds didn't work. Wish I had met her sooner. I'm 45 now and it's still a struggle but I feel blessed because I don't have addictions on top of my mental health disorders. I maybe worse now though because my kids are grown and gone and I shut myself off from the world, and rarely go anywhere and push everyone away. I love people but hate being around too many people. I get triggered easily. I enjoy your shows Dr. Fox. Thank you for doing what you do. I don't have health insurance and you help me a lot. God bless you.

[jeanwillis]

Thank you Dr Fox, now that I’m aware of my BPD I’ve found it possible to not feel abandonment issues
as painfully as I once did..I do struggle with shame and guilt but not frequently, however I find depression to be a constant and I do struggle with motivation. However I will start an exercise program as you recommend and balance my diet that’s my goal anyway!!!

[ennvee]

Every time I try to make my comment shorter I end up going on and on, I guess it’s because I feel as though someone Finally understands, and I feel the relief, and there I go I’ll stop here, Thanks 🤗🤗🙏🏼🌈👏🏽.

[zunyldajones]

Thank you for making these videos. Not only do i relate to all these bpd criteria but your voice is very relaxing and makes me feel like i dont have to be so hopeless

[delphinium]

He comes across as such a caring man with a huge understanding of his subject. Thank you.