Borderline personality disorder is often misconstrued.Credit:Stocksy
Those with borderline personality disorder have difficulties regulating their emotions. This contributes to angry outbursts,anxiety and depression,and relationships fraught with difficulties. It’s also commonly associated with trauma (such as childhood abuse or neglect).
Many actions of a person with borderline personality disorder (such as self-harm and overdose) are done out of desperation in an attempt to manage difficult and intense emotions.
Bipolar disorder
While borderline personality disorder and bipolar disorder can look similar (mood problems,impulsive behaviour and suicidal thinking),there areseveral key differences.
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Bipolar disorder is characterised by extreme mood swings – from severe lows (depression) to periods of high activity,energy and euphoria. The different mood states can seem like a personality change,but a return to the “usual self” occurs once mood stabilises.
While depression is part of borderline personality disorder and bipolar disorder,those with bipolar disorder experience significant “up” mood swings. This is known as mania in bipolar I disorder and hypomania (less intense mania) in bipolar II disorder.
Bipolar mood episodes last longer (four days or longer for “ups” and two weeks or longer for “downs”),with periods of wellness in between,and are less likely to be triggered by external events. And bipolar disorder is more likely to run in families,disrupt sleep patterns,and psychotic symptoms (delusions,hallucinations) can occur during mood episodes.
We all have ups and downs,but bipolar disorder is much more than that with extreme,recurrent mood episodes that are not only distressing,but have a significant long-term impact on key areas of a persons’s life. Positively,with the right treatment,good quality of life is entirely possible despite ongoing symptoms.
Schizophrenia
Schizophrenia,meaning “split mind” in Greek,is often confused with dissociative identity disorder. However,the “split” refers not to multiple personalities,but to a “split” from reality. People with schizophrenia may find it difficult to discern whether their perceptions,thoughts,and emotions are based in reality or not.
Hearing voices (auditory hallucinations) is a common symptom,along with seeing,smelling,feeling,or tasting things others can’t. Unusual beliefs (delusions),including some that cannot possibly be true (such as a belief that one has special powers) are also common. So too is disordered thinking,where the person jumps from one topic to another at random,or makes strange associations to things that don’t make sense. They may also exhibit bizarre behaviour including socially inappropriate outbursts or wearing odd clothing that is inappropriate to the circumstances.
Other symptoms of schizophrenia look a lot like depression,such as an inability to experience pleasure,social withdrawal and low motivation. Depressive symptoms are also present in schizophrenia,but are slightly different in that emotion is diminished altogether,rather than a depressed mood per se.
Mental health conditions don’t come in neat packages
Unlike physical conditions,we don’t have a biological test that can magically tell us what mental condition we’re dealing with. Mental health practitioners are carefully trained to observe symptom patterns:the right diagnosis guides the appropriate treatment.
For example,first-line treatment of schizophrenia and bipolar disorder often focuses on medication. While dissociative identity disorder and borderline personality disorders are treated primarily with psychological therapy.