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Raziel
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18 Oct 2012, 12:56 pm

Bio_Info_Seeker wrote:
Raziel, I would think BPD and ultrarapid cycling would overlap but doesn't mean they are linked together. Actually, most of the psychiatric disorders overlap in some way. Most of the diagnosis are poorly defined and they are just terms that has been made up in order to describe different conditions. They are rarely based on scientific studies, only on "how it looks like".


I'm not sure about it.
It's not like I would have one opinion about it I'm 100% shure of.
I just read studies about it and know ppl. dx with those disorders and out of my own experience, that's all. :)

I found here a study about it: Differential diagnosis of bipolar affective disorder type II and borderline personality disorder: analysis of the affective dimension.

and here: Bipolar and Borderline Personality Disorder
Are Bipolar and Borderline Personality Disorder Related?


I think that that those disorders are mostly different, but still even to a higher degreee overlapping than research thought in the past.


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18 Oct 2012, 1:47 pm

It also depends how you diagnose them. I would trust only scientific studies that show concrete signs of these conditions.

E.g. You may have bipolar disorder with hypomania and you experience an episode once a year ---> condition A
E.g. You may have bipolar disorder with hypomania and you experience an episode 4 times a year ---> condition B
Are there any biological differencies in these two conditions? Probably not. The frequency is just different.

Compare with BPD. Is the neurobiological cause identical, similar or different? That should be the main question. Observations and meta-analysis are not always accurate. There are not enough scientific studies to show the truth.
(My opinion would be: they are different. But I cannot refer to any study. Too lazy and busy to do any research...)


To the OP, BPD sounds more likely than bipolar in my opinion. The traditional bipolar disorder is often serious and leads to noticeable changes in the everyday life. It's caused by a certain pattern in the brain activity in most cases and may be nicely described by using pseudo-mathemical methods. :)

But I would suggest that a general mood dysregulation disorder is the best option. This is however not an official condition at the moment. I believe there are mood disorders that are unknown. Bipolar and BPD are only the classic ones. I'm not sure how valid those conditions actually are.



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18 Oct 2012, 2:20 pm

StevieC wrote:
someone else has suggested it may be BPD, which really scares me

Why is this scaring you? BPD is not a horrible condition. It's only as bad as you experience it.



Raziel
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18 Oct 2012, 3:45 pm

Bio_Info_Seeker wrote:
To the OP, BPD sounds more likely than bipolar in my opinion. The traditional bipolar disorder is often serious and leads to noticeable changes in the everyday life. It's caused by a certain pattern in the brain activity in most cases and may be nicely described by using pseudo-mathemical methods. :)


BPD first also sound to me like a very scary condition, because it has a lot of negative clichée to it, but when I started reading about it from experts in this area, I understood it better what it really is.
Bipolar is a lot more scary, becaus it's more of a lifelong condition and can't be treated with behavioural therapy like BPD.


Bio_Info_Seeker wrote:
But I would suggest that a general mood dysregulation disorder is the best option.


I also have the feeling that the emotional dysregulation who often goes along with autism has some points that others mood disorders don't really have. For example when I stayed in the traumatic environment I totally freaked out, much more extreme than most NTs I guess. I totally freaked out. I stayed in this environment for nearly two years and was totally messed up there, but then when I left was was mostly calm within weeks and now just 7 weekts later most of my symptoms are gone, most of them even right after. This is not a "normal" way to deal with trauma, so it was very easy to missdx me in this time I guess, because I didn't really show the classical PTSD-symptoms, but I also didn't reeeeaily fit in another diagnosis and that was the mainproblem. And I guess that's because of my autism and I also made this experience in other situations and even shrinks who are not specialiced in ASD can confuse this a lot.

Bio_Info_Seeker wrote:
This is however not an official condition at the moment. I believe there are mood disorders that are unknown. Bipolar and BPD are only the classic ones. I'm not sure how valid those conditions actually are.


Well, it's possible, but I guess we'll propably first now when there will be a new era of diagnosis who also include PET-scans, EEGs and so on, who can also tell something about the psyche, but we are not that far now. So we have to live with the system we have right now and I think it's always good to remind oneself that this diagnostic system we have right now is far from being perfect and propably not even complete but it's the best we have right now and especially the PDs are more or less just concepts.


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Raziel
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18 Oct 2012, 4:03 pm

I forgot that part:

Bio_Info_Seeker wrote:
Compare with BPD. Is the neurobiological cause identical, similar or different? That should be the main question. Observations and meta-analysis are not always accurate. There are not enough scientific studies to show the truth.
(My opinion would be: they are different. But I cannot refer to any study. Too lazy and busy to do any research...)


I'm not sure about the exact brain pattern, I just know that BPD, Bipolar, ADHD (and also some other conditions acutually) go along with too less activity in the fronal lobe. But than it's still the question what the exact differences are and so on.
So there seem to be some neurological connections, but BPD also has some neurological simmilarities with PTSD how it seems and Bipolar some simmilarities with schizophrenia. So there seem to be neurological differences, but also a lot of overlapping how I understand it.


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18 Oct 2012, 4:24 pm

Raziel wrote:
Bipolar is a lot more scary, becaus it's more of a lifelong condition and can't be treated with behavioural therapy like BPD.


Shouldn't BPD be a life-long condition too? I don't think it can be cured, the persons are only able to overcome their symptoms and problems. (Which in a way seems like the same thing as a cure...But you said "treat", not "cure", which means it's still life-long according to your definition.)


Raziel wrote:
Bio_Info_Seeker wrote:
But I would suggest that a general mood dysregulation disorder is the best option.


I also have the feeling that the emotional dysregulation who often goes along with autism has some points that others mood disorders don't really have.


You could have autistic emotional dysregulation + some other emotional dysregulation disorder. Autistic person may have the same disorders as neurotypicals but their "+ autism" trait makes the condition look different (or worse).

My conclusion was that the OP, StevieC, most likely has some general emotional dysregulation/mood disorder that isn't really an official diagnosis yet. I didn't want to use bipolar disorder because it's too extreme to fit this case. BPD is a shady diagnosis and hard to diagnose, especially among autistic people who seem to be similar to BPD. Thus the rational conclusion is emotional dysregulation/mood disorder Not Otherwise Specified.



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18 Oct 2012, 4:36 pm

Raziel wrote:
I'm not sure about the exact brain pattern, I just know that BPD, Bipolar, ADHD (and also some other conditions acutually) go along with too less activity in the fronal lobe. But than it's still the question what the exact differences are and so on.
So there seem to be some neurological connections, but BPD also has some neurological simmilarities with PTSD how it seems and Bipolar some simmilarities with schizophrenia. So there seem to be neurological differences, but also a lot of overlapping how I understand it.


If you look at the neurobiology, then there will be lots of overlapping between the most of the disorders. Especially if you look only at certain regions. But to identify the "true" condition you need to consider every part of the brain and how the activity changes over time.

PTSD most likely shares many mechanism with BPD. Sometimes BPD is even called complex post-traumatic stress disorder instead of emotional dysregulation disorder.



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18 Oct 2012, 5:22 pm

Bio_Info_Seeker wrote:
Shouldn't BPD be a life-long condition too? I don't think it can be cured, the persons are only able to overcome their symptoms and problems. (Which in a way seems like the same thing as a cure...But you said "treat", not "cure", which means it's still life-long according to your definition.)


Well there are high chances that ppl don't fit in the diagnostic criteria of BPD after right treatment anymore (most of the time years). Especially DBT has huge succes in a lot of ppl with BPD. Of course they still remain sensitive in a way, but BPD once you fall out of the diagnostic criteria usually doesn't cause relapses.

Bio_Info_Seeker wrote:
PTSD most likely shares many mechanism with BPD. Sometimes BPD is even called complex post-traumatic stress disorder instead of emotional dysregulation disorder.


I consider complex PTSD as something different than BPD, especially because not all ppl dx with BPD had a trauma. Some even come from loving families. So there seems some overlapping, but also differences. There are even trauma experts, claiming that you could clearly distinguish between BPD and PTSD. I wouldn't go that far, but I also know ppl dx with BPD who didn't have a trauma.

It actually makes more sence to me, seeing BPD as an emotional disregulation disorder and PTSD as a condition that can lead for short term or even in the long run to problems with the emotion regulation.


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Last edited by Raziel on 18 Oct 2012, 5:57 pm, edited 1 time in total.

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18 Oct 2012, 5:55 pm

Raziel wrote:

I consider complex PTSD as something different than BPD, especially because not all ppl dx with BPD had a trauma. Some even come from loving families. So there seems some overlapping, but also differences. There are even trauma experts, claiming that you could clearly distinguish between BPD and PTSD. I wouldn't go that far, but I also know ppl dx with BPD who didn't have a trauma.

It actually makes more sence to me, seeing BPD as an emotional disregulation disorder and PTSD as a condition that can lead for short term or even in the long run to problems with the emotion regulation.


I agree with your view. I wouldn't consider complex PTSD the same thing as BPD neither, but I didn't invent that term. I also prefer emotional dysregulation disorder.



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20 Oct 2012, 1:08 am

Bio_Info_Seeker wrote:
About rapid cycling. Last time I checked rapid cycling was defined as 4 or more episodes per year. So, I don't really see how this would be called "rapid" in any way. And then what is the even more extreme form, "ultrarapid"? I don't really like these conditions, they are poorly defined.


It's called "ultradian" or ultra ultra rapid cycling, and it's real because I've been diagnosed with it. You can have up to several episodes in one day.


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20 Oct 2012, 9:57 am

sunshower wrote:
It's called "ultradian" or ultra ultra rapid cycling, and it's real because I've been diagnosed with it. You can have up to several episodes in one day.


Did you get a "real scientific" diagnosis for this or did your psychiatrist just look at your symptoms? (No, I don't mean to offend you.)

Those episodes, are they actually real bipolar episodes? Not just mood swing, but real bipolar episodes that last for few hours? I have a hard time to understand how that would work. Sure, the brain activity pattern could match bipolar disorder but have a lot higher frequency, but I have a hard time to believe how that could be clinically diagnosed. If you compare to regular mood instability (e.g. in BPD), how is ultraradian different?



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20 Oct 2012, 8:37 pm

Bio_Info_Seeker wrote:

Did you get a "real scientific" diagnosis for this or did your psychiatrist just look at your symptoms? (No, I don't mean to offend you.)



Every diagnosis is done by the psychiatrist looking at symptoms. There is no other way and I guess you know it. Other causes for the symptoms need to be excluded by running lab tests. Are you one of those people who like to say that human applications of science aren't "real science"? What do you consider to be "real science"? Do you think it necessarily involves a microscope? Because the people looking through the microscopes are using similar science-based protocols for making their decisions, as the psychiatrists are.



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21 Oct 2012, 3:12 am

i don't know - that's the thing.... it's probably all the same thing - ie the aspieness, but as i say, i don't know. having BPD or anything else for that matter scares me....

thinking about it, it seems more likely that it is due to stress or overload - but i can't say for sure. maybe it's where i cycle from hopelessness to ultra self-confidence or whatever it was worded from that aspie test i took....


there's the usual 2 year wait (that's how long it took to get a dx of asp from initial GP visit to psy referral) until i'll know for sure....




ellipses .... :D


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21 Oct 2012, 3:27 am

Bio_Info_Seeker wrote:
sunshower wrote:
It's called "ultradian" or ultra ultra rapid cycling, and it's real because I've been diagnosed with it. You can have up to several episodes in one day.


Did you get a "real scientific" diagnosis for this or did your psychiatrist just look at your symptoms? (No, I don't mean to offend you.)

Those episodes, are they actually real bipolar episodes? Not just mood swing, but real bipolar episodes that last for few hours? I have a hard time to understand how that would work. Sure, the brain activity pattern could match bipolar disorder but have a lot higher frequency, but I have a hard time to believe how that could be clinically diagnosed. If you compare to regular mood instability (e.g. in BPD), how is ultraradian different?


Clinical diagnosis by a bipolar specialist - however, he currently tends to refer to it as ultra rapid since I've been on medication (as the cycles slowed somewhat). Yes, each "swing" fully met the criteria for a major depressive, hypomanic, or mixed episode. Before medication I was having strongly distinct fairly extreme swings each lasting approx 3 hours - switching from one swing to the other took about 5-10 minutes.

For example - I would be experiencing a hypomanic episode where I would be moving constantly, dancing about (unable to sit still) and coming up with lots of ideas or wanting to go running somewhere then I would start to slow down, my facial muscles would slacken, my speech would dramatically slow sometimes to the point where I would become unable to speak at all, I would basically come to a complete halt and have to lie down wherever I was, then I would be unable to move, get up, speak, or do anything, and I would have suicidal thoughts running through my head. Sometimes it would feel like oblivion. Then after a few hours I would suddenly feel like I had energy again, bounce out of bed, then be dancing about.

The above happened every day for months, and as you can tell I was completely unable to look after myself so I lived at my parents place and they took care of me.

There are recent scientific studies confirming the existence of ultradian and ultra rapid cycling even though it's not listed in the old DSM. My psychiatrist told me as much and I also looked them up for myself, those who specialize in bipolar are aware of cases such as mine. They do count as episodes due to the extremity of the symptoms - they do not fit the profile of cyclothymia, and bipolar episodes are completely different from BPD - if you look at the diagnostic criteria the two don't have very much in common (if I haven't made it clear before, I definitely don't have BPD, don't fit any of the criteria for that).

Although when I was diagnosed I was in my most severe state, since being medicated and in earlier years my cycles were more varied in length - they could last anything from hours to three weeks.


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21 Oct 2012, 3:29 am

^ fully met all criteria except in length, but as I discussed the length requirements for bipolar episodes have been reevaluated in recent years.


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