This article is published in the book:

"Psych 101 -
What you didn't learn in nursing school."


by Kathi Stringer
Paperback: 320 pages
ISBN-13: 978-0615193137
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Questions About Diagnosing
Borderline Personality Disorder

by Kathi Stringer

Question

I have been diagnosed with BPD for years, but never had a moment of manic behavior. I have only recently been re-diagnosed with an anxiety disorder and PTSD from a trauma that happened when I was three (there was an auto accident in which my maternal grandparents were killed and I was the sole survivor, but very injured with concussion, broken bones, etc...) and another at age 5 when I was repeatedly sexually molested by a teenage neighbor. I am feeling so much better on the regime that he has me on, which doesn't include mood stabilizers. I am taking Effexor XR 150mg, Alprazalom 0.5mg tid, and Seroquel 50 mg. for sleep. It has really decreased the nightmares and increased my energy. It has also helped me focus and interact more socially. I had almost gone agoraphobic before I found this psychiatrist. What do you think has changed the diagnosis? I'm just glad to be feeling half myself again. :-) It just proves my point...keep searching for the right therapist or psychiatrist.

Answer

I would think your energy has increased due to sleeping better at night with the help of Seroquel. Not getting a good night’s rest can make a person feels as if a zombie, or I say, the living undead.

As far as your diagnosis changing, that is not the exception in psychiatry but the rule. As most any psychiatrist will admit, the practicing of psychiatry is not an exact science, but rather through guessing and observation. In addition, PTSD and BPD are close cousins. Many respectable professionals stipulate that most, if not all, individuals with BPD really have PTSD. If you think about it, PTSD is the ‘power-up’ model and BPD is the ‘power-down’ model. The symptoms have many common dominators. Yet, a vet in a hospital with PTSD is a hero, while a person with BPD is a pain-in-the-ass. It’s another way to discriminate against the patient when the professional fails in treatment.

Looking at another example, consider the individual (guy in this case) looking for therapy because he is struggling with some issue that is interfering with their marriage. His wife demands he gets help because she is tired of him looking at nude girls on the Internet. He calls several treaters and profiles them according to their answers. He could approach the his selection of a treater in two different ways. (1) he is looking for support for his problem so he can tell his wife that she has the problem and she needs to work on accepting him as he is, or (2) he is looking for support to change his behavior and please his wife. Either way, shopping for a treater is like shopping for most anything. You get many times what you are profiling for. The point is, the symptoms did not change, only how the treater interpreters the symptoms or diagnosis.

For further reference, review this article for similarities between PTSD and BPD

http://www.toddlertime.com/borderline/counterwill.htm