Am I showing signs of Borderline personality disorder?

Age 22 female I was diagnosed with depression/anxiety as a teen now I have low moments and super high moments I feel detached from myself and have explosive moments
Asked by Onlykye
Answered
10/12/2021

Hello,

So of course I wouldn't be able to give you a diagnosis based on the information you provided or without meeting with you in person, but I'll give you some of my thoughts. There are a number of features often seen in Borderline Personality Disorder, and "explosive" moments can be one, as well as rapid mood shifts. However, there are several other mental health disorders that also would fit with these as well. 

If I were to assess you for a mental health disorder, I would want to take a look at your life history first of all. The most common "ruleout" I would make before looking at a Borderline diagnosis is Posttraumatic Stress Disorder. It is very common for those who present with "explosive" behaviors to have a history of trauma. When this trauma has not been addressed in therapy, there can be a wide range of unhealthy behaviors that result. In fact, the majority of the clients that I meet with who have previously been diagnosed with Borderline Personality Disorder I end up giving a diagnosis to of Posttraumatic Stress Disorder. There are also mood disorder, such as Bipolar Disorder, that could apply, although I find that this is often also overdiagnosed. There is also Intermittent Explosive Disorder which involves, as the name implies, occassional violent, aggressive behaviors. I woudl also want to look at any substance use history (even if it is not occurring presently). 

Above all else, I'd want to look at what your life looks like in general. For example, if you are dealing with a lot of stress and a lack of self-care, that could certainly explain those feelings of detachment and some explosive episodes. If you're feeling trapped, dealing with a lot of guilt, having difficulty coping with grief, etc., these are all potential explanations for what is occurring. There can even be medical factors that could be playing a role, such as some vitamin deficiencies.

Borderline Personality Disorder tends to be fairly inflexible. You can work on the symptoms, and it is possible for them to go away, but as a personality disorder it tends to be more inflexible than some other mental health disorders. From personal experience I've seen many clients who are convinced they have Borderline Personality Disorder or another personality disorder work on issues that are resulting in their maladaptive behaviors and by doing so no cope much more effectively. In other words, they probably never had Borderline Personality Disorder in the first place.

So, here are the two most important points I want to make: One is that the diagnosis really doesn't matter. Even if you did receive the Borderline Personality Diagnosis (which I would perhaps ignore unless it was done very carefully and by collecting a considerable amount of information, as it is often misdiagnosed), the problem isn't the diganosis--the concern is your well-being and your behaviors. Getting a diagnosis really doesn't fix anything, and if it's an incorrect diagnosis, it can definitely do more harm than good. I secondly want to strongly encourage you to give mental health treatment a try, whether you choose to participate in therapy on this platform or reach out for help elsewhere. The symptoms you're experiencing can be addressed, but we would want to dig deeper into what is causing them. If you would like to participate in therapy, or even if you just have further questions for me, please don't hestitate to ask. No matter what the diagnosis is, it's very likely that with some help your mental health can improve. Take care.

Nick 

(MRC, LPCC-S, LICDC)