Asperger Syndrome vs. Borderline Personality Disorder

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I'm another one who was first diagnosed BPD. I think it had to do with the theory of mind - thing.

A person with AS can certainly also have BPD, as I do not think they are neurologically exclusive, but a person with BPD alone does not have the inherent inability or deficit at picking up on non-verbal cues, it's just that their emotions factor largely into how they make executive decisions, while most people with AS rely on a system of logic to even determine how we should feel about a situation.

Paranoia is actually a disqualifer for AS under the DSM-IV (though that was a line that was drawn without knowing the neurological basis of either), and the reason for this is that juvenile onset schizophrenia can present in a similar fashion to AS, and schizoid personality types can as well.

I don't think people with AS are generally nearly as dramatic about things a people with BPD either....they are really entirely different things.

i have been thinking about this a lot and talking to someone else about it and i'm starting to see too how they could be confused with each other behaviorally. both people with AS and people with BPD have impaired theory of mind leading to misinterpreting other people and getting frustrated. yes, the reasons are really different, but the resulting behavior could look very similar, i think.

oh, and there was a discussion here recently about paranoid feelings, and a lot of people (diagnosed with asperger's) talked about similar experiences, but maybe there's a big difference between feeling paranoid and having clinical paranoia?

does anyone sometimes feel that they have interpersonal problems that cannot be entirely explained by asd?

most of mine can be explained by asd, yet i have certain social traits that are more emotionally based. for example, i often have little difficulty holding a conversation with a stranger, and i do not feel too uneasy around that person, yet i suddenly become terrified of people once i begin to know them better and begin avoiding them.

i also feel that i do not really have any personality and that while i could describe my thoughts, i cannot express my emotions. i feel the emotions but they are nothing but a stream of conciousness. in fact, i cannot even define the difference between thoughts and emotions other than saying that one cannot feel thoughts, while one can feel emotions.

also, do most aspies have a weak sense of self? i feel that many on here have a strong sense of self, which is the opposite of me. i tend to be a chamelion, since it seems to be the only way to survive, at least socially. psychologically, i do not have the luxury to have a strong sense of self. the most painful thing is writing cover letters because it forces me to talk about my personality. if cover letters asked for something else, such as my opinions or views, they would be so much easier. i could write a 12 page essay in one night, yet writing a one paged cover letter takes me a week, because cover letters ask you to "sell yourself".

i think another thing that aspies have in common with people with personality disorders is how both groups have pessimistic and misanthropic views of people. aspies learn not to trust people after being socially rejected and manipulated. people with personality disorders may have those opinions because of abuse.

I can definitely say that all of that is me. When I started secondary school, my English teacher wanted us to write a couple of pages about ourselves so she could get to know us (and probably so she could get her own idea about our level of writing ability, too). I refused to do it and went straight to my guidance teacher after class to say I couldn't do it.

Although, I would say my comprehension of my emotions is very poor. I can feel very strongly an emotion that I have no idea what is or why it is there. Sometimes, when people ask me how I am feeling today, all I can say is, "Bland. I have a bland mood today." That's the only word I can think of to describe the bit between happiness and depression.

I don't want to be spamming links, but this thread may have some relevant data on the relationship between AS and borderline personality:

http://www.wrongplanet.net/postt125383.html

If anyone has a problem with my posting the link, I'll be quite willing to take it down.

hrmpk, i have been following this thread because i am interested in how AS in women seems to sometimes elude diagnosis. i am wondering why, and so i was curious about why it sometimes is misdiagnosed as BPD or bipolar.

i don't want to rile her up, but it really looks to me like while sometimes AS is misdiagnosed as BPD, in the case of the woman on that thread, it is the other way around.

after reading both threads, i am still confused as to whether they can coexist (rather than one being a misdiagnosis), or whether borderline could actually be (caused by?) AS + severe PTSD.

Chronos earlier said AS and BPD are not neurologically exclusive, which might very well be the case, but i fail to understand how someone with AS could be unable to see (via logic) that their behavior had been as irrational as borderline behavior can be.

does anyone know what AS + severe PTSD (minus borderline) looks like??

I'm curious as well as to why women/girls seem to elude an AS diagnosis. I've heard people say it's because women tend to cluster into groups and those with AS tend to hide within these groups, however as someone with AS I find myself wondering how anyone with AS ends up in such a social group. Perhaps I'm an outlier among outliers but when I was younger, not only did I not really have any clue how to incorporate myself into one of these "girl groups" but I really had little, if any desire to, and generally spent my time at school off somewhere by myself.

If this grouping theory holds for the majority of women with AS though, I imagine the BPD diagnosis could come about because putting a girl with AS in a group of girls can be akin to putting a seal in a shark tank, as women use non-verbal communication far more than men, and relationships can deteriorate quickly if these gestures are not understood by someone in the group. A hallmark of BPD is high rates of failure of interpersonal relationships.

But I'm still at a loss as to how these girls end up in these groups in the first place.

I can only explain based on what I have experienced, which is that borderline personality disorder can be almost completely masked by AS, OCPD, dependent personality disorder, and avoidant personality disorder. The unfortunate effect I still have occasionally, is that when I become very close to someone and feel safe with them, eventually I anti-idealize them and go into the standard borderline rage, thus destroying the relationship. I end up hating myself more afterwards, and this happens over and over again. I completely shut myself off eventually, and suffered some nasty depression, and now I'm getting help. (The first experience I had with modern mental health care came from searching things like suicide on google...lol...this country needs more education....)

Oh my, I just found this thread. This is me! Sorry, I haven't read the thread, but I felt I should really post this anyway.

I was misdiagnosed with BPD in 2006. That was only shifted with my 2009 diagnosis of AS. I think I've become a real authority on this subject (AS vs BPD) because I didn't know it ever happened to anyone else. (I think we'll be seeing more emphasis on proper differential diagnoses between personality disorders and AS soon because both are still in their infancy as far as being diagnosable and understood.) I've been in treatment for BPD for 3 years (and become close to many people with BPD), and that treatment includes a large psycho-education component.

Make sure your therapist/psychiatrist/diagnostician is well versed in the differential diagnoses for these conditions. The clear majority are not.

The big differences: Stereotyped behaviors & obsessions, developmental domains*, time & circumstances of onset, & generalized social problems vs specifically volatile relationships.

These two lists are pretty much meant to be mutually exclusive. They obviously aren't exhaustive, nor are they likely to be a correct fit for everyone, but in my experience this is where the real differences are most evident.

Asperger's
Some of us actually like having it
Stereotyped behaviors (repetitive, not goal-directed, e.g. hand shaking)
Odd obsessions with encyclopedic knowledge
Developmental domains* chaotic and unrelated
Signs become evident before adolescence (some texts specify above age 7 for AS - below 7 would be autistic disorder)
Social problems in all aspects of life
Often no primary relationship
Specific sensitivities and emotional triggers
Problems with nonverbal language (expressive and receptive)
Can never be non-aspie if you have it

BPD
Always sucks ass to have it
Triggered by growing up in an invalidating environment (so-called stress/diathesis model)
Developmental domains* relatively even
Post-adolescent onset
Volatile relationships, especially primary relationships, but some social successes as well (e.g., coworker relationships)
Sometimes "relationship-hopping" (Imagine an aspie doing that! Anything's possible I suppose...)
Generally very sensitive to all emotional triggers
Few problems with receptive nonverbal language (can be prone to misinterpret), and no problems with expressive nonverbal language.
At least one treatment modality (long-term dialectical behavioral therapy) appears curative in ~60% of patients

*Developmental Domains
IMO, this is a VERY IMPORTANT POINT, perhaps the most important. Developmental domains of expressive language, receptive language, IQ, social, gross motor, fine motor, executive function, self-help, and emotional development are very even in NT's, including NT's with BPD & other personality disorders. In other words, if someone excels in one domain, they tend to excel by a similar amount in all domains. Non-autistic people with mental retardation have similar deficiencies in IQ as in all other domains. People on the spectrum tend to have wildly varied development among these domains. I have a high IQ and expressive language development, but terrible social and self-help development. My fine motor development is pretty good, but gross motor development is not. The nightmare this creates for people with ASD's is that people see the higher function in some domains and EXPECT it to be there in all. E.g., "anyone smart enough to finish college should be smart enough to keep his bedroom clean and shower once in a while." To the rest of the world, this is how everybody sees everybody. Almost none of them realize these domains can be different, and when we excel academically but fail at some basic life functions, we aspies & HFA's look as alien to them as they do to us.

Spread the word about this! It REALLY SUCKS to be misdiagnosed with BPD!

you know what i think it is? i'm a chronic puzzle-solver, so i tend to spout things out when they make sense to me, then revise my interpretation later ... so this might be short-sighted, but i'm thinking (in terms of misdiagnosis, at least) that women with AS, especially if they make it into adulthood without knowing they have it, can mistake confusion for their own emotional responses. women are told they are emotional and believe it. so when she can't grasp someone else's behavior and is frustrated to the point of meltdown, the aspie girl, unaware that she is totally out of touch with her emotions, would assume she is being overly emotional and thus would be interpreted that way.



it does seem unlikely, unless it's a social group comprised of misfits and outcasts.



so the aspie girl would be failing due to lack of understanding, but because she is in a group, it would be assumed she had the social skills to build the relationships up in the first place? could be. but mimicry of other women's social skills could initiate friendships just as easily (although they would be hard to maintain), and it's commonly theorized also that women with AS get by a lot by mimicking.

@hrmpk:
i don't mean to belittle you or disbelieve you, but the fact that you are able to reflect on your own behavior and know it is problematic makes me wonder if you aren't actually borderline. whatever it is you're dealing with may be something you can work through.

@dcs002:
that bit about developmental domains clarifies things quite a bit.

so far i remain unconvinced one way or the other as to whether AS and BPD can coexist.

katzefrau,

you said earlier:

and more recently:



The truth is probably a mixture of those perspectives, as would be my actual mental state. The primary thing I see that separates me from most borderlines is that I have no choice other than to be alone. As a result, I have time to reflect on my problems. Most borderlines frantically scramble to be with someone; you can watch them weep for hours and hours on youtube. Without social skills, and while logically seeing the effect I have on people I get close to, I logically choose solitude, even with the hell of bpd loneliness and paranoia.

Currently, I am preoccupying my self with an obsession, thus not feeling any emotion but the excitement of data flowing through my brain. And sleep deprivation does temporarily alleviate deression for me as well. XD


Going through diagnostic checklists is more of a professional approach to diagnosis, as I see it. It's better to simply describe ourselves and our problems without labeling them. The problem I have then, is being able to recognize the problems. So what I tried to do was to go through those lists of symptoms and descriptions in order to remember and recognize problems from my past. Then, eventually, hopefully, the nature of the problems can become somewhat clear.

This thread is so interesting. I thought that I'd drop this link for discussion, too. http://behavioralhealth.typepad.com/markhams_behavioral_healt/2007/06/when-the-bord-1.html

It talk about the different types of borderlines. The link in particular talks about the Hermit Borderline in particular. I think that's the one that can be confused with AS the most. I feel that my mother is the Hermit type BPD. While I most definitely may have some undesirable learned behaviors from my mother (what therapists call fleas) I can clearly see that there is a big difference between her, and I. The biggest two that I can think of off the top of my head is that 1. I'm actually able to listen to constructive criticism from a loved one, then think about what I can do (if anything) to make the situation better, and lastly take my thoughts to the other person for a rational discussion about the situation. My mother cannot do that. 2. Make a plan that is well thought out, and stick to it without changing it at all. My mother can't make decisions, and stick to them. Even a trip to the store requires her to re-plan over and over again, making a big drama, and often times taking several days. It wasn't uncommon for us to be grocery shopping, for example at 10 PM when we sat around all day long, just because my mother has no organizational skills, or routine.

Okay, quoting what would probably seem to be the obvious... but it's painfully TRUE, lol.

Was in a behavioral ward for 3 days once, because bf at the time was extremely abusive and I wound up severely depressed due to it.

Crap-I was abused... that just set me up right there for the BPD diagnosis.

If someone who doesn't know much about the differences, or focuses a lot on BPD anyway, then it just plain won't matter what you say after that.

Meltdowns you say? Oh, that's just an overemotional reaction... reasons, we don't need those.

Not liking people too close to you? (when meant in a very LITERAL sense, lol) You probably push people away a lot.

Don't know what you'll be doing 10 years from now? You are disconnected from yourself.

Point being... when you run into these docs, it happens... a LOT. They go on observation-asking very vague/basic questions, and not seeking out anything deeper than that. While I was there, they switched my medications several times... yes, in just a period of 3 days they did it. When I questioned how they even know whether or not it was working, it was written down that I was being difficult and trying to control the situation. When I argued that, then I was in denial of my actions and was trying to manipulate to gain control of the situation.

It didn't matter what I did after the doc decided this... everything was pinned down straight to BPD, and they didn't ask any questions that weren't related to it in any way. They would ask things like "do you lash out at people?" ...and... well, at that time, yes, because I would get overwhelmed and they would not leave me alone for anything! But that didn't matter... it wasn't taken very literally in the sense that they were in my personal space and I needed time to calm down.... it was taken in a sense that I lash out at people because I wanted to control them.

They asked if I watch the clock when someone leaves or is supposed to come over. "Yes. I do." -another mark towards diagnosis. But their interpretation was that I watch the clock because I'm afraid that the person will not come back, or is abandoning me. No... I watch the clock because if they say they are going to be here at 5:00, it irks me if they are not. I am not afraid of them leaving me, or never coming back, or abandoning me... I just want them to actually do what they say they are gonna do, lol, because it disrupts my routine.

But... denial, manipulation... things like that are also associated with BPD. As well as emotionally driven responses.... so... say you try to explain the clock thing. If they have it in their head that you have BPD already, it is seen as manipulation. If you try to explain that it's just a matter of fact thing? It's denial. If you get frustrated that they are not listening to you and taking it seriously, then you are lashing out irrationally.

The thing is... once they decide this, it's a lose/lose situation until you can find someone new, lol.... and it SUCKS.

So... after that diagnosis, I went to a forum... and got reamed day in and day out for trying to explain things objectively to people if they had a problem with something. I got cussed out and booted off of other forums because I just couldn't understand why they would get so mad about things, and would ask.

I finally wound up going to a new therapist who worked with me for about a week, then LAUGHED at the idea that I would be BPD. He said he was testing me all week... would do things like say he'd be back in 5 minutes, but would wind up back in 10 instead... would analyze the heck out of me to see if I was offended by anything he said. Instead, what he got was a "cool, you're back, now we can talk about ____", and "yes, I've noticed I do that too..." But if he moved furniture around in the room we were usually in, or switched rooms altogether, I would stand in the doorway staring for 5 minutes like a deer in the headlights.

He said the problem is... not enough of these docs look for the "why" to things. One person could lash out at everyone and claim she hates them, then in the same breath, state that she doesn't want them to leave. Another lashes out because they need space to calm down and are being overwhelmed. In appearance, they both look very much alike without a reason for doing it.

Thank you for telling us about hermit borderlines; that's new information to me. I definitely can relate to that kind of personality, though the differences from ordinary bpd are mostly superficial, and something is probably suppressing it in me, even more than in the hermit type.

I can listen to constructive criticism, but it really makes me cry inside sometimes.

My mother also probably has bpd, but she seems slightly more in control than in many cases, which is attributable to various causes. In my own case, I definitely have no organization. I've almost never kept a calendar, often don't know what day it is, default back to my obsessions all day long, sleeping when my eyes cant focus and lying in bed depressed for hours before I wake up.

I seriously have to fix my brain before I even think about getting into a relationship.

And at the moment, I need someone who specializes in four different personality disorders and autism, so I can't really expect that....and no matter how good the doctor is, they have some severe time constraints. That's a lot of why I'm doing this crazy hypochondriac stuff, so I don't get an incorrect diagnosis and go, "what's that?" and just blindly accept it.

But really....this is becoming a special interest....xD

I'm thinking there's two types of misdiagnosis.

There's being given a diagnosis that's incorrect, that shouldn't have been given.

And there's being given a diagnosis that's correct, that's accurate, but missing another important diagnosis.