Bipolar I with Borderline Personality Disorder

by A.W.
(Michigan)

Symptoms of Bipolar Disorder are anything but subtle. Manic episodes are marked by grandiose thinking, increase of energy and racing thoughts. The low of depression is the exact opposite. Feelings of hopelessness and feeling worthless are the pitfall of depression. These symptoms are sometimes hard to diagnose as Bipolar Disorder I if there is psychosis present during the manic episode and is diagnosed as having schizophrenia. If a client is in a hospital showing signs of depression, like being suicidal at the moment a doctor makes a diagnosis it will be major depression.

Being Bipolar I, symptoms must be managed by medication. But what if the symptoms are being caused by something else? Bipolar Disorder I can be misdiagnosed when it is actually Borderline Personality Disorder or ADHD. Psychiatrists are going by trial and error. There is no test to prove one is Bipolar. I have the therapist's worst nightmare diagnosis, Bipolar Disorder I AND Borderline Personality Disorder. With these diagnosis what causes what is always a question. Medication for Bipolar I is readily available, but non-compliance is always an issue with medication. Being labeled contributes to non-compliance, but many people with diabetes don't take their medication as prescribed either.

Dialectical Behavior Therapy, though it is a treatment for Borderline Personality, can also help those with Bipolar Disorder I. Thoughts that plague one's mind must be dealt with because medication cannot do it all. When negative thoughts bombard one's mind, they must be stopped on the spot and be reframed. This means if I have a thought that says, "I can't write at all", I would reframe it by saying "I have written many things before, and they were good". Thought stopping is actually first. First you stop the thought, then you reframe it.

Thoughts run through people's minds constantly, but for those in a manic state, they are racing and make a person think they are unstoppable. That is why people like Robin Williams stop taking medication when they want to be outrageously funny. I am funny with medication and would not like to risk mania to act funny because my mania has had me playing frogger, a game where you are on a highway stepping out of the way of a car before it hits you. I won't take that chance again.

Depression is often the symptom that is noticed first. Suicidal ideations, feeling helpless, hopeless and having no worth are a daily existence for many with Bipolar Disorder I. The lows of depression are often the symptoms that drive people to go get professional help. Then they are diagnosed with major depression, given an anti-depressant and then the monster of mania is set up to come to light. It may not be immediate, but eventually a person who is Bipolar I will have a manic episode. It feels good at first to not be depressed, have energy, and do impulsive things. But untreated, it can have devastating effects on one's relationships, money, and one's life.

Symptoms need to be addressed and explained to someone who is diagnosed with Bipolar Disorder I. Medicine can help manage depression and mania, but talk therapy, whatever type a therapist chooses to use, is also quite beneficial. It helps a person deal with the train wreak a person might have experienced to get them in the chair across from a doctor or therapist and symptoms need to be dealt with and tracked. Some use mood tracking and that is helpful for the therapist to know what the client is facing during a week or month. Now with budget cuts, therapy is more likely if through state aid, once a month or even less. That means a mood tracker can help pinpoint times of depression and mania and also stable times.

Whatever mode is used, medication, talk therapy, Bipolar Disorder I can be managed and the diagnosis does not mean that the client cannot live a normal life. I am going to school to be a social worker, so I can help people realize their potential and not concentrate on the illness but the dreams and desires each person has and deserves to pursue.