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Gizalba
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24 Jun 2014, 5:37 pm

Hi, does anyone here have experience of having/having witnessed both of these disorders?

If anyone does have a diagnosis of both, I wondered if you could answer the following:

1. What are your main ASD symptoms?
2. What are your main BPD symptoms?
3. How do you tell the difference between an autistic meltdown, and a borderline meltdown?

Why I am asking this:

After asking my GP for a referral to an autism specialist, it turns out he had referred me back to a psychiatrist, who seemed to have no knowledge about autism. When I tried to show him the detailed document I'd written with my symptoms that appear to indicate an investigation into autism, he just shrugged, refused to look at it and said I'd already been diagnosed with borderline personality disorder by a past psychiatrist. I hadn't been told about this diagnosis so I feel confused that it wasn't explained to me, as to what it is, what it means in relation to me, or what the prognosis is etc. I have asked him to send me the notes concerning the diagnosis but it hasn't come as of yet (it was about 2 weeks ago but in the past it has taken months for psychiatrists to send me documents I have requested).

I have since done some research and instead of feeling like I finally have an answer as to why I am the way I am, I feel even more confused because I'm not sure how I match the description of BPD or how I am meeting 5 criteria. Looking at my behaviour from an ASD perspective, reading the books, I felt like so many things made sense. But all the accounts of borderline I have read so far, I can't seem to relate to most of it. I am aware that it could appear pretty differently in different people, but I really want to figure out whether my diagnosis is probably accurate and/or whether it is still worth pushing to see an autism specialist or go private.

I am questioning my diagnosis of borderline for the following reasons:

I don't have a fear of abandonment, I don't have love/hate relationships, I don't have unstable relationships, I don't dissociate, I don't have identity confusion. I am guessing the main symptoms in me indicating borderline are my history of severe cutting, and my still quite frequent head banging rages/panic-attacks. I am a very cautious non-risk taking person in general, however arguably I become impulsive when I start head banging, so whether I meet the 'impulsive' criterion for borderline overall, I'm not sure.



AardvarkGoodSwimmer
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24 Jun 2014, 11:32 pm

I'm self-diagnosed as being on the Autism Spectrum, although I'm really pretty sure I am. And I'll be happy to tell you about that.

My energy slumps, at times rather dramatically, both socially and on intellectual projects.

A lot of loneliness, a lot of social nonacceptance. It's like I'm slightly different and because of that, I'm hugely excluded. It's a social justice issue. Almost the exclusion causes more harm than being Spectrum.

I have anger flashes. A small injustice might remind me of a larger injustice from the past. I rapidly rub the back of my head in a kind of stim as I engage in different revenge fantasies. It never works. I mean, it doesn't get me the person admitting they were wrong.

Now, 15 years ago if someone had asked me if I have sensory issues, I probably would have said no. But things like a malfunctioning repetitive machine or a computer screen saver in my peripheral vision bother me MUCH more thant most people. Itch can bother me more than pain. I'm highly motivated to avoid strong chemical smells. And my mother toe-walks and is also highly motivated to avoid chemical smells, she says it's to avoid allergies.

I stim. Sometimes squeezing or twisting a towel or soft T-shirt. This helps me unwind, almost like a nap. And as I do this, I sometimes envision sports or movie scenes and sometimes I grunt or make fighing sounds or explosions. I still think this is functional, although something I very much like to keep private.

I need long walks and alone time to emotionally process. And I sometimes mumble to myself when walking.



alexi
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25 Jun 2014, 4:37 pm

Gizalba, I am in a very similar situation to you. I have never officially been diagnosed with borderline personality disorder, but the suspicion of it has followed me around with health professionals for the last 15 years. It is extremelly frustrating. Psychologists tell me that there is no way that I have borderline and that issues with impulse control (specifically the kind of self harm that you describe) and emotional regulation are a part of aspergers. Like you say, they are not related to borderline issues of abandonment, relationships, etc. and I too am generally a VERY controlled and non-risk taking person.

But despite being diagnosed with aspergers, as soon as I see a psychiatrist (who generally seem to know VERY little about ASDs), as soon as they hear about the self harm (and being female) they straight away jump to borderline again!

I recently spent 4 weeks as an inpatient where I was viewed as being manipulative and eventually refused care because I was struggling to control self harm from overstimulation in such a busy setting. It was a terrible situation, not having anything that I said taken seriously, and very dangerous.

I have my 2nd appointment with a new psychiatrist today. It is really hard work to keep looking for the right help and finding that there is so many walls in the way. My first appointment went terribly and so my psychologist has agreed to call to speak with her before my appointment today to try to clarify with her that borderline is not the issue, that aspergers is the root of my self harm and emotional regulation issues) and that I need to be assessed for bipolar (I had a manic reaction to an SSRI - why I was in hospital - that no one picked up on because they were too busy looking at my behaviour as borderline!).

Anyway, I'll message again after my appointment today to let you know my progress.



Minionkitty
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25 Jun 2014, 7:08 pm

I have a psychiatrist that thinks I have either Borderline and Bipolar disorder, or Schizoaffective disorder. I need to know for school if I have an ASD, as when I was younger I was diagnosed with Nonverbal Learning Disorder. My psychiatrist probably won't do that testing, so I have found a private psychologist to do the testing. I don't personally think I meet the criteria for BPD anymore, but I don't know if I meet criteria for ASD either. Sorry I couldn't be of more help, but if your health coverage will cover it, maybe you can get a psychologist to do an ASD test? Personally, I just asked to be tested for Asperger's/ASD and the psychologist set up a day to do it. I go next Wednesday. Good luck to you!


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AardvarkGoodSwimmer
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25 Jun 2014, 7:17 pm

Wow, it seems like they're just calling the patient 'bad,' and the label borderline is nothing but a high falutin way to do this. Even if a person does have abandonment issues, relationship issues, self harm, they are still a human being and should still be treated with respect.

I've seen three different mental health professionals on an extended basis, and I'm not all that impressed. And I've seen others on a more limited basis. All too many, I don't know, maybe a third, maybe more, seem to be big egoists, big ideologues, and "be righters." And that is the kind of so-called professional (cough, cough) who is more concerned about "being right" about the diagnosis or whatever else than they are about the rights and welfare of human being who is sitting right there in front of them.

You know, I worked for H&R Block for a couple of tax seasons, and I decided "The hard clients are the good clients." And I don't mean just the hard tax problems, but the clients who are hard to work with and somewhat unreasonable. This is one of the things which convinced me I might have been a good doctor, and I hoped I would have adopted the motto, the hard patients are the good patients and are exactly why I went to medical in the first. But alas, I'm not enough of an abstract thinker to handle that kind of heavy science load.

I myself struggle with bouts of depression. I have not yet tried antidepressants, but I personally kind of look at them as my Ace in the hole. And alexi, wow, I am sorry you had a manic reaction to an SSRI [something like prosac or zoloft], and it sounds like a serious shortcoming on the part of a medical professional not to pick up on this. I've read that it's trial and error in a respectful sense, and thanks for emphasizing just how much trial and error. I've also read that it can be important to come down from the medication in a series of steps even if it doesn't seem to be having an effect, just that your body may have gotten used to it and adjusted to it.

For myself, I think I'd rather get medication from a general practitioner like an internist, I really would.

And for counseling, I might almost prefer a minister, even though I'm a good agnostic! The minister is likely to be less dogmatic than some psychiatrist who is wedded to some damn theoretical orientation, I mean really. For example, the long shadow of Sigmund Freud.



mental
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26 Jun 2014, 1:13 pm

I 'only' have an ASD, with cluster C treats avoidant behaviour/coping) combined with GAD and social phobia.

no borderline: I tend to go into hiding to the extreme. unfamilair with anger and external ventilations of emotions. Tend to internalise..



rhodedendron
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18 Jul 2014, 1:16 am

it's possible you might not be borderline. i am and i dissociate a whole lot and have extremely unstable mood and relationships. autistic stuff makes it more difficult for me to maintain relationships but it is not the source of instability. also, an overwhelming amount of people with borderline are trauma survivors and many of us also have ptsd. some people (like me) see it as a trauma reaction, like ptsd



nuttyjoy
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18 Jul 2014, 10:15 am

Yep borderline is just crazy.. You have such unstable feelings and relationships. I try hard to keep it stable but it sucks that I have to go thru such sucky moods! I've never suffered trauma - but I'm bipolar. But I know I'm borderline too. I'm diagnosed borderline. I have a feeling its from having lived in too many places as a child and never having had proper relationships.



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18 Jul 2014, 9:35 pm

I have both.

There are two AS symptoms
1) persistent social deficits
2) restricted activities (rituals, routines, special interests)

Borderline Personality Disorder is my inability to have intimate relationships. I automatically push people away when they get too close. I can't help it. I deeply regret it afterwards. It feels terrifying to have someone close. My BPD is smoldering anger that I always have, which sometimes intensifies to become rage. It is my inability to trust anyone. It is my near continuous addictive behavior for as long as I can remember (age 3). It is the unbearable feelings that I feel when I get flashbacks (emotional triggers from childhood drive me to suicidal depression on a near daily basis). BPD is (according to the book my psychologist gave me) most of the time a form of PTSD from severe childhood abuse and neglect. It is the natural emotional reaction (hypervigilance and numbing) that a person develops when exposed to extreme and prolonged stress. The lack of identity thing, I am becoming aware of now that I am older. I have worn many disguises (mostly just fooling myself about who I am, adopting the values, dress, and behaviors of people I admire). I used to self-harm by burning or hitting myself or hitting my head against the wall. I stopped doing that a long time ago, although I think about doing it a lot. People are either all good or all evil to me. I ex-communicate people from my life if I let them get close to me and they disappoint me.

AS is easy to deal with compared to BPD. I work on it and work on it for years and still feel miserable most of the time, having extreme emotional reactions that I cannot control.



marshall
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16 Dec 2014, 6:36 am

I suspect I have some elements of both. I have chronic depression though and it's hard to see where that illness ends and other personality traits begin. It's also hard to tell since I'm asexual and haven't really had experience with intimate relationships. Turns out I'm asexual but not aromantic. It's so ridiculous that now that I'm trying I'm running into problems I didn't experience before. I crave something so deeply it feels like i'm pulled apart from the inside, yet I don't really know what it is I want. I always feel disappointed. Disappointment is pretty much a constant, but I don't just get despondent, I get frustrated and full of undirected rage.



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16 Dec 2014, 4:34 pm

I am officially diagnosed with both.

ASD - need for routine, cannot make eye contact well, cannot read peoples' intentions, sensitivity to sounds, meltdowns, social overload if with people too much, need for alone time a lot, struggle to verbalise emotions in a way people understand, cannot put myself in others' shoes.

BPD - clashes with the Asperger's need for solitude very badly, as when I have solitude, I panic, feel very alone. I struggle to get close to anyone as it is too high a risk of me getting too attached, and not coping when they are not there. I have immense anger outbursts, appalling self esteem/self hatred and my abandonment fears are very painful, although these days I tend to try and keep distance from people to avoid them kicking in. I have never been one for being violent to others, however, and do my best to avoid any sort of that manipulation that those with Bpd seem to be stereotyped for.


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17 Dec 2014, 8:08 am

My father is probably both although BPD is more visible in his case.

He is very social compared to me(he got a lot of superficial friends, he knows nearly everyone in 25kms round) and hates being alone - especially when my mom is not around. He doesn't talk much and spends most of his days working with photos but he must know mom is home, preferably cleaning or cooking. If she is not there he becomes uneasy, walks around the house as if he lost something and gets really irritable. He can get furious when she is late. He often asks her "Where have you been again?". He is paranoid about her having a lover (she doesn't) and when she meets her family he says "they made you think bad of me again, didn't they?".

He is a good guy deep inside. He cares about us. We never had to hire any builder or hydraulic - he does everything, he is skilled. He also often cooks for us out of blue, gives us gifts and tells my mom to sit down and stop cleaning. He also nags me when I don't help my mom enough or keep lights on at night when she is trying to sleep.

But then something ticks. A mere moment is enough to change the mood 180*. My mom says a wrong word or he sees a spiderweb in corner (that was there from a long time but he just happened to see it at the moment) and the lovey-dovey mood disappears, replaced by a living hell within a second. He yells his mouth off, saying we are worthless and we can't do anything without him, he gets paranoid by thinking we treat him as a slave and he says we will see how it is when he is gone. Then after a few hours of swears and insults he goes to his room and stays there for few days, refusing to do anything (unless it is urgent and dangerous such as boiler breaking down and covering basement with water) and treating us like air or pests when we try to say "sorry". Whats funny - at the same time he still talks and is nice to his superficial friends. He is a devil only to me and my mom - the people most close to him.

And when he was younger he used to fight a lot (to a degree he had a "hanging" prison punishment once), he was an alcoholic and he was really impulsive (for example he simply didn't feel like showing up to work so he didn't and when they fired him he didn't care). Fortunately my mom was able to make "a responsible human being" of him.

His AS traits seem to be his special interest (photography), inability to properly use and read non-verbal cues (although it might be just me - he ofter assumes something I don't mean and I never understand his tone of voice although I am already able to get it most of the time with other peoples. He is totally unpredictable for me. I'm not sure how good he is with other people but he does argue a lot... perhaps he is just impulsive), inability to "think what others think" (he often misunderstoods what others say to him, he gets everything too personally and seems to have one route thinking), sensitive hearing (he can hear a whisper from 2 floors away and the sound of kid or woman crying makes him furious and totally out of control), need for routine and limited food choice (dinner must be at 13:00 and there must be meat and potatoes, any other food - such as dumplings, pancakes, spaghetti - is not considered a dinner but a just snack) and of course his "shutting down" after an argue.
The fact he was spending most of childhood time spinning a bike wheel (whole hours without a break) also seems pretty autistic.



kraftiekortie
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17 Dec 2014, 11:32 am

Yep....your dad sounds like he's a real trip. Seems to have many autistic traits.

Too bad you can't reason with him when he's mad.



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27 Dec 2014, 1:40 am

Where I live...

The cutting is what gives you the BPD diagnosis, and especially if it is severe. It is considered manipulative behavior, which is a trait of BPD. The person creates a real crisis (severe cutting) because of poor coping skills.

Around here BPD is the diagnosis of last resort. It means the therapist has had it with you. My friend's daughter was diagnosed with BPD and it is hell trying to find anyone to take her case. Shrinks will take substance abusers over BPD patients. Blows my mind.


The difference between an autism meltdown and BPD meltdown, is one is a sensory overload (too many people, noise, odors whatever). The BPD meltdown is almost always relationship driven with overriding anxiety. When my husband finally meltdowns, he has no clue of his surroundings, and you have to ride it out. The BPD patients I saw while in the psych ward, believe me they stopped the screaming and carrying on when security showed up and the leather restraint were out. Or they were very aware, but wanted to prove a point by not quieting down or following orders. They were still engaged with whoever was pissing them off.

It would be interesting to find out what exactly the first psychiatrist wrote. Did you come in just for cutting and the head banging, or was it for anxiety and depression? When did the shrink first decide to slap you with that label?

Whether or not you have ASD, I don't know. For that you have to have the developmental delays. Speech, movement issues, etc. And that goes back to birth. The head banging does not automatically scream autism, and it sounds like your current shrink views it in the same camp as cutting-manipulative behavior.

For grins and giggles, I looked for the ICD code for cutting/self mulitation.

Almost everyone uses the code for BPD. There is one for unspecified nonpsychotic mental disorder. That gets used by pediatricians and GPs to 1) not make a psychiatric diagnosis which supposedly they aren't trained to do. 2) They want insurance to pay for the office visit and CYA incase you decide to do something else. The kid was messed up, but I don't know what.

IF you see a psychiatrist and cut/self multilate it is always coded under BPD. There are really only three codes, and everyone seems to use BPD for billing. If you have depression, anxiety and cut, that is where you will be put.

It seems cutting is in a separate camp from biting, picking, scratching and head banging for coding. The previous four are listed under Autism, the cutting is not. Anything that you do and need an object to inflicted damaged is not under autism. Burning..piercing..stabbing..cutting all listed under BPD. I wonder why?

HTH

Tawaki



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27 Dec 2014, 7:18 am

I don't see cutting as always a manipulative behavior. I mean there is a certain rush you get from cutting and I know many people who do whatever they can to hide their scars. I think the BPD diagnoses is BS in most cases. I was diagnosed with it when I was at the peak of my drug use. Drug users tend to meet the criteria for personality disorders until they go off the drugs and they start to return to normal. Most doctors I've seen agree that I have AS. BPD was only made by one doctor at a group home where no one liked me. The staff absolutely hated me but I don't blame them.


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