Borderline Personality Disorder Often Overlaps With Other Mental Illnesses

Borderline Personality Disorder Often Overlaps With Other Mental IllnessesPeople with borderline personality disorder (BPD) have a range of symptoms that significantly damage their ability to maintain stable relationships, control their emotions and control their impulsive tendencies. Anyone affected by this condition may also have symptoms of other mental illnesses. In a study published in December 2014 in the Journal of Affective Disorders, a team of Swiss researchers sought to determine how often people diagnosed with BPD also qualify for a diagnosis of one of two other conditions: bipolar disorder and attention-deficit hyperactivity disorder (ADHD). 

Borderline Personality Disorder

A person diagnosed with borderline personality disorder has at least five symptoms contributing to an ongoing, dysfunctional behavioral pattern that substantially damages his or her sense of well-being or ability to lead a functional lifestyle. Prominent examples of the disorder’s symptoms include highly volatile intimate and family relationships, repeated involvement in reckless and potentially hazardous conduct, the emergence of paranoid thinking while under stress and the onset of suicidal thoughts, suicidal behaviors or non-suicide-oriented self-harming activities such as skin “cutting.” Suicide is the most severe outcome associated with BPD; the National Institute of Mental Health estimates that 4 percent to 9 percent of all people with the disorder will ultimately kill themselves.

Researchers and mental health professionals are well aware that people affected by BPD have increased risks for developing certain additional mental health problems. Specific illnesses known to occur with unusual frequency in individuals with borderline personality disorder include various forms of substance use disorder (substance abuse/addiction), major depression and other forms of depressive illness, eating disorders such as anorexia nervosa and binge eating disorder and anxiety disorders such as panic disorder, social phobia and generalized anxiety disorder.

Bipolar Disorder and ADHD

Bipolar disorder is the commonly used term for a group of related mental illnesses that include bipolar I disorder, bipolar II disorder and cyclothymic disorder. Bipolar I disorder is sometimes known as manic depression, since affected individuals experience prominent episodes of mania, as well as prominent episodes of major depression. People with bipolar II disorder experience prominent episodes of depression and a less severe form of mania known as hypomania. People with cyclothymic disorder have long-lasting symptoms of hypomania and mild depression.

Attention-deficit hyperactivity disorder is the well-known childhood illness that centers on unusually hyperactive and/or impulsive behavior, an unusual inability to maintain focus or attention or a combination of hyperactive/impulsive behavior and a reduced ability to maintain focus/attention. Roughly 4 percent of all people in the U.S. continue to experience a diagnosable number of ADHD symptoms after reaching adulthood.

Overlap With BPD

In the study published in the Journal of Affective Disorders, researchers from Switzerland’s Psychiatric University Hospital used a small-scale project involving 74 adults to approximate how often people diagnosed with borderline personality disorder also have symptoms that would qualify them for a diagnosis of ADHD or some form of bipolar disorder. They undertook this project, in part, because the research community doesn’t have much information on the possible degree of overlap among the three conditions. All of the study participants were previously diagnosed with BPD, ADHD or bipolar disorder and received care for their condition in either an inpatient or outpatient setting. Each participant underwent an interview process designed to identify symptoms of the two illnesses for which he or she had not previously received a diagnosis. The researchers also gathered information on each participant’s demographic background (age, gender, etc.), general mood and level of exposure to the eating disorders, substance use disorder and anxiety disorders often associated with BPD.

After analyzing the interview results, the researchers concluded that, among the study participants, there was a 54 percent overlap among cases of borderline personality disorder, attention-deficit hyperactivity disorder and bipolar disorder. In other words, more than half of the participants had symptoms that would qualify them for a diagnosis of any of the three conditions. The researchers also concluded that symptoms of the mild form of bipolar disorder called cyclothymia accounted for much of this overlap and appeared in essentially the same form in the study participants previously diagnosed with BPD, ADHD or bipolar disorder.

The study’s authors believe their findings suggest that dysfunctional but relatively minor mood swings may be a unifying, underlying factor in borderline personality disorder, bipolar disorder and ADHD. However, they also note that future researchers will need to conduct larger, more comprehensive studies to confirm or disprove this conclusion.

On April 1st, 2015, posted in: Mental Health by Tags: