Psychosis and Borderline Personality Disorder - Part 1

The term “borderline” was actually originally created as those with the condition appeared to be on the border of psychosis. Research has not supported this over the years but psychotic symptoms can and do occur in those with BPD and this causes the disorder to be even more complex than it already is. This is going to be a two-part video. In this video I’m going to discuss the types of psychotic disorders and the signs and symptoms and relate them to BPD, and in the second video we’ll talk in greater detail about BPD and psychosis and I’ll give you some management tips. Let’s get into it.

In the general public, psychotic experiences are reported by approximately 8–17% of children and adolescents and 5% of adults. One study found that 24% of those with BPD reported severe psychotic symptoms and approximately 75% had dissociative and paranoid ideation. Notice I am saying psychotic symptoms, not disorder or schizophrenia and that’s import to note here. Let’s break the psychotic disorders down:
Psychosis on a spectrum, like all disorders from absent to extreme (show severity scale).

Key symptoms of the various psychotic disorders are delusions, hallucinations, disorganized thinking or speech, grossly disorganized behavior, and negative symptoms.

Types of psychotic disorders include:

Schizotypal PD, Brief psychotic disorder, delusional disorder, schizophreniform, schizoaffective disorder, and schizophrenia.
Schizotypal personality disorder is a persistent pattern of social and interpersonal deficits, including reduced capacity for close relationships; cognitive or perceptual distortions; and eccentricities of behavior that usually begins in early adulthood but in some cases first becoming apparent in childhood and adolescence.

Time is critical here. Brief psychotic disorder lasts more than 1 day and remits by 1 month. Schizophreniform disorder looks just like schizophrenia except that it lasts for less than 6 months.
Schizophrenia lasts for at least 6 months and includes at least 1 month of active-phase symptoms. In schizoaffective disorder, a mood episode and the active-phase symptoms of schizophrenia occur together and were preceded or are followed by at least 2 weeks of delusions or hallucinations without prominent mood symptoms.

In the next video we will dive deeper into psychosis and BPD, check it out!

Daniel J. Fox, Ph.D., is a licensed psychologist in Texas, international speaker, and a multi-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.

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

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:
Kelleher I, Connor D, Clarke MC, Devlin N, Harley M, Cannon M. Prevalence of psychotic symptoms in childhood and adolescence: a systematic review and meta-analysis of population-based studies. Psychol Med 2012;42:1857–1863.

Linscott RJ, van Os J. An updated and conservative systematic review and meta-analysis of epidemiological evidence on psychotic experiences in children and adults: on the pathway from proneness to persistence to dimensional expression across mental disorders. Psychol Med 2013;43:1133–1149.

Niemantsverdriet, M.B.A., Slotema, C.W., Blom, J.D. et al. Hallucinations in borderline personality disorder: Prevalence, characteristics and associations with comorbid symptoms and disorders. Sci Rep 7, 13920 (2017) doi:10.1038/s41598-017-13108-6 .

Schroeder K, Fisher HL, Schäfer I. Psychotic symptoms in patients with borderline personality disorder: prevalence and clinical management. Curr Opin Psychiatry (2013) 26:113–9. doi:10.1097/YCO.0b013e32835a2ae7

[noordeepsingh]

Whoever is suffering from this, I just want you to know that you are not alone. Many people are going through your experience. Praying for each and everyone of you. May god bless you all, and may you manage to live with this problem in peace. Much love, Goro.

[cosmicfoxglove]

I have BPD and had an extremely frightening psychotic break in my twenties with delusions, hallucinations, and disorganized thinking for several weeks. Now, when very stressed I can get brief psychosis for a day or so. The psychotic episodes are mostly persecutory in nature. These videos help me feel better as they show me that psychosis with BPD is a recognised occurence, I'm not imagining it, I'm not evil or mad, and it's common. However, the bouts of psychotic thinking and my BPD have thoroughly ruined my life.

[gabrisage]

I have both persecutory delusions and referential delusions …. And they only come once in a while because of my stuff being taken in my childhood, invasion of privacy, people borrowing my stuff without asking, parents crossing my boundaries and maybe sexual abuse and my parents blurting out my business to other family members which really was top notch that set me off as emotional dysfunctional person and it’s taking me time to heal this.

[LustStarrr]

I'd like to see a video about the interaction between BPD, ASD, & ADHD - I'm beginning to notice a lot of crossover between them, particularly in women & girls.

[nicolecourtney]

Breaking down the dilusions is incredible because i can say i experience at least 3 of them regularly. The apocolypse one and the one where i think everyone has sexual or romantic feelings toward me, man sometimes its HARD to be me. Ive learned so much more from youtube psychologist than my own therapist EVER taught me.

[pegacorn]

As someone who suffers from BPD, I feel so blessed to have never experienced psychosis. I spent all day yesterday with a friend who is in a full-on paranoid delusional state and I have never in my life experienced something so otherworldly and terrifying.

[courtnryjk]

I’ve never been diagnosed with bpd but it’s so painfully clear I have it. I’ve never brought it up to my therapists because I didn’t want them to dismiss it and say I don’t

[idreamofjj]

I was diagnosed with BPD in 2009 and I've been on disability ever since. I'm 42 years old and it's an everyday struggle. Thank you for sharing this.

[thenerdgirl]

I wish I could have had a therapist like you. I've never had one lead session like you do. It's just very expensive small talk about my week and when I'm sick of paying & 150/visit to essentially recount my week to someone who took way too much education to have nothing insightful to offer, then I go home and look for a new therapist. I'm not kidding when I say these videos have helped me more than any in person therapy I've had.

[rachelwyatt]

I remember when my mom kept insisting she was talking to Ellen online and that they were telling her she was going on the show and that they were going to buy her a car and furniture. It was so bizarre and lasted for 3 weeks and I tried to explain that the emails and stuff were sent to everyone. When she figured out it was all wrong she got EXTREMELY depressed. It was awful

[ivy]

I wish more mental health clinicians brought this up. Thank you for speaking on it. I have BPD and suffered from a years-long psychotic episode on top of undiagnosed Schizoaffective Disorder. I had every symptom for BPD and nobody ever bothered to ask if I saw or heard things that weren't there.

[periperi]

Yoga, meditation, diet. Stay busy, laugh, socialize, self care, gratitude even prayer of some type. Think of others. Stay out of yr head. Anything everything to fight for a quality life. Don't self diagnose and be committed to implementing tools. Surely it's better than talking over and over and myelinating those neural pathways. Life's short, simplify and enjoy. Great vid thanks

[sophietaleb]

The problem is when BPD patients have high intelligence (neglected to mention) and their therapists come off as patronizing and condescending and want to compartmentalize the condition as one for all, when it isn't. How can therapy possibly work?

[Claire-mvtf]

I.ve been telling the Medics including psychiatrists and dbt practitioners that I get psychosis along with my bpd.. yet they just refuse to acknowledge it..
It absolutely infuriates me ..because the psychosis was the main thing I just could not get my head around.. what caused it..why it happened..
Thank God there are drs online who believe people like me .. ..

[dopeblacktherapist]

Dr. Fox and Dr. Grande are the most informed and professional psychologists on YouTube

[secretivescorpio]

I had to endure 10 years straight of psychosis everyday, it was hell. I really don't know how I survived it.

[devin]

Yess!!! I need this so bad!!!! It’s been a problem since I was a kid and I have been gaslit that i was doing it for attention. Whatever you present will at the very least validate and make me not feel like i’m losing my mind.

[Lidia.Bella.Italiana]

Thank you for finally touching on this... I been fighting for it to be spoken about more.

[nahttina]

This video couldn't have better timing. This lockdown has helped me calm down and has eased my bpd symptoms (less people on the streets, less FOMO, my narcissistic parents out of reach.) We've re-opened the society in Denmark and I have had horrible anxiety and psychotic symptoms ever since. Would love more videos on this topic. Take care

[itstorilynn]

seriously, thank you. this was the most helpful video i've ever watched. making the call today while i'm not in crisis. i didn't believe i was bpd i kept insisting i must be psychotic and they NEVER told me you can have these symptoms with bpd :(