Female Aspergers confused with BPD or other mood disorder...

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Hello!

I am new to the board and I am in need of a little guidance and/or if anyone has experience anything similar. I will try not to be too long winded!

Basically growing up I always felt a little odd and didn't seem to fit in like other children. I was typically on the outside of things and was always having random episodes of crying over little things. I am highly sensitive to various sounds i.e loud eating and I would break down if someone used a nail file near me. My family found me difficult to be around and my sister spent years in my shadow because I was so demanding and difficult about minor things. As I got older I became more depressed and suffered with moodiness and just frustrated because I felt like something wasn't quite right. I developed anorexia in my later teen years and still suffer just now. I am rigid with control, routine and doing the same things every single day. I don't really tire of doing the exact same things over and over again in the same order (for the past 3 years I have struggled with over exercise mainly). I have tried to break my routine and have had complete meltdowns and really struggle with change.

Now I understand that a lot of the traits may be from anorexia but there is definitely an underlying cause which is where I have been diagnosed with borderline personality disorder. I can understand why a doctor may think that with my crying meltdowns and mood fluctuations but I haven't had a traumatic childhood, I don't self harm, I am more than happy to be alone in fact I prefer it!, I don't go to desperate attempts to stop people leaving and don't have delusions. It just seems like a bit of a cop out on behalf of my pysch and have suggested psychotherapy which thus far hasn't helped one bit.

I went for a screening and had a score of 42 for the test but the people seeing me had never dealt with someone with an eating disorder and had mainly met men with aspergers. They had a think and called me back for another interview where they decided I did not have aspergers. This was a year ago and still feel my diagnosis of BPD is wrong and have since been referred back to the autism team for another screening. I'm basically just frustrated because I feel the treatment I am receiving and way I am being treated is unfair because of this BPD label. I feel if I could identify the underlying cause then I could move past my eating disorder and it would just explain a lot.

So! Has anyone else encountered similar diagnostic problems? Have you challenged it? What was the outcome? Has a AS diagnosis helped you move on with your life?

I was misdiagnosed with BPD last winter and had it altered to AS and ADHD last month. The diagnosis was done during a screening, and pretty much no one who interacted with me believed it.

I've heard this happens fairly frequently, although I don't understand how they can confuse AS for BPD.

I've had a fairly long mental heatlh history, with three different shrinks and different mood disorder diagnoses since the age of 12. I'm now 24.

Since I was 17 I saw the same psychiatrist. They also diagnosed me with BPD, but freely admitted to my parents that I was a mystery. The BPD diagnosis did not quite fit me, they said, and I agreed. The things that fit me were the mood swings, depression, and suicidal thoughts. That was it. I also had problems with insomnia. And I always felt different, like a member of a different species or something. It caused me a lot of distress and I was very withdrawn, with no friends. I never had intense, unstable relationships or a fear of abandonment. I had a very hard time getting close to people and I was always sad and very much in my own little world all the time.

I tried several different types of medications through the years, antidepressants, anti-psychotics, mood stabilizers. Nothing helped much.

I lost my insurance at the age of 22, so I had to quit getting treatment. I got my insurance back at the beginning of this year, and called my old doc back and got an appointment. She consulted with another psychiatrist about my files before I came in and they both suspected Aspergers. She talked to me, had me take an assessment, and said that the results for it indicated that I had it.

I wasn't sure at first, but as I hang out here more, I identify with a lot of the Aspies here. I never identified that much with the sufferers of BPD that I sought out on the internet.

I'm confident that I have the right diagnosis now, so are the doctor and my parents, and we all feel relieved. I still have depression problems, but now I know where they came from and I'm trying to work on socializing and making friends so that I can feel a little better and function.

You do sound somewhat like me, so I think it's worth looking into further. Good luck.

I have a bpd diagnosis, among others. I disagree with it, although I can see why they gave it to me. There are a few diagnostic criteria I fit, but others I am the complete opposite to. I've had several other diagnoses in the past, and it just highlights to me that psychiatrists have their favourite labels, that they frequently get things wrong, and that they often lack enough knowledge of ASD in adults to see it, or even consider it, in their patients. I feel that one problem is misinterpretation of behaviour, not understanding the motivations or causes of a person's behaviour, not having an understanding of the patient's inner life and experiences.

I found a post on another autism forum a few months ago about this issue that helped me a bit. This post is part way down the first page of this thread, in reply to a question about confusion between ASD and BPD. The poster is using the term ASP to refer to Asperger's.

http://asdgestalt.com/viewtopic.php?f=3&t=316




Re: Asperger's Syndrome vs. Borderline Personality Disorder
"Hello,
I hate to say it but there could be a whole lot in common between ASP and a least certain subtypes of "Borderline Personality Disorder".

Before I get into this subject though, first of all, I feel there's a real need here to point out that "manipulative" is not part of a diagnosis for BPD. Anyone who has worked with this population will find that it is precisely their lack of communicative skills, their inability to clearly express their intense, overwhelmingly inner emotional pain, that has made them seem "manipulative" in the past. However those who suffer from pure BPD generally lack the foresight and planning that true manipulation would entail. That said, very often those with BPD who are not autistic have an astonishing capacity for empathy whereas those with ASP generally have great difficulty in "putting themselves in someone else's shoes" - as hard as they try. (Which would also mean that they are not capable of "true manipulation" any more than someone with BPD, albeit for other reasons). Many BPD sufferers cannot shut out the suffering of others. One could say that they have no skin - they are constantly assailed by the emotions of others and cannot filter out other people's pain from their own. This alone drives many of them to isolate themselves over the years.

The DSM description of this disorder mixes all kinds of states with traits and does not achieve a coherent description of one kind of personality. It is becoming more and more clear that there are many subtypes finding their way to this diagnosis. Perhaps the most important subtype for this conversation is the "internalizing dysregulated borderline". These are people in intense emotional pain, mired in negative feelings, most often dysthymic, who do not think in black and white, but who spiral down into prolonged periods of anguish, fear, guilt, shame, etc. (intense dysphoric states), tend towards major (melancholic) depressions, are mostly introverted and are very far from the stereotypes of this disorder as reflected in these posts. They are almost invisible, as they had great difficulty in expressing any feelings of anger whatsoever - turning anger against themselves repeatedly - they may be masochistic and very SELF-destructive, undermining all their chances for real achievement.

This subtype is most likely to be classified "fearful-avoidant" as far as attachment goes. They are the most likely to spend years of their life "dissociated" - i.e. numbed out, feeling little or nothing, barely "alive" emotionally. They often have the similar stories of peri-natal traumas found in many bios of those more clearly in the "autistic spectrum". They often present with speech difficulties and feel cut off from contact with others just like those with ASP. It is very likely that many people with very difficult childhoods and adolescences suffering from ASP are unfortunate enough to also fall into this subtype of BPD.

Over half of those suffering from BPD are not related to the impulsive-histrionic spectrum of this disorder, but rather to the "emotional dysregulation"- dysphoric spectrum. There is more and more speculation as to the possibility that these are even two separate disorders.
Emotional dysregulation also includes the lack of nuanced emotions - one can swing from feeling nothing at all to writhing under intense feelings of self-loathing, guilt, shame, etc. in a flash, but hardly with anything in between. It is thought that the HPA axis is damaged - their nervous system in on red alert, and insomnia is rampant among these people.

It is quite possible that in these individuals BPD is a kind of childhood PTSD, possibly with roots in the first days/weeks of one's life, which would make it a developmental disorder, and link it to other developmental disorders such as found in the entire autistic spectrum. BPD and ASP are both disorders of the SELF. It is this sense of self that is so hard to obtain for individuals on the autistic spectrum and so hard to maintain for those who we call "borderline" (for lack of a better word). One can say that without a firm sense of self, one cannot have more than a vacillating sense of others...

It's time to stop thinking of BPD as a kind of personality, all the research points to problems with emotional processing in some, with impulse problems in others, with both in still others and as BPD makes it's way slowly and surely to AXis I (as did autistic disorders before it), it will become more and more evident that even those with ASP can also suffer the hell of being "borderline". Once we stop using BPD as a lame adjective for difficult or unlikable people, we will finally realize to what a degree all kinds of (good, caring, sensitive) souls may have this disorder, even those with ASP. The "quiet" ASP who also struggles with the nightmare of this inner pain merits the same compassion and attention as that of more "extroverted borderlines".

The problem is, as far as I've been told, that practically no one with BPD thinks they have it... so if you try to convince them you don't, they'll probably push back harder saying you do. I have autism and definitely have some traits of BPD. I deal with them, try to work around them, and try to grow from the trouble they've caused me. Neither my autism nor my borderline traits define me, though.

I have known people with a BPD diagnosis who agree with it. But it is true that if you have a personality disorder diagnosis, certainly in the UK, any form of protestation of that diagnosis just adds to their conviction that you have it. People with a PD are perceived as manipulative, and maybe some are, but because of this it is very difficult to get rid of a PD diagnosis once you have it.

I don't really care that much about my diagnosis, as it will undoubtedly change again, or be added to, when I next have a new psychiatrist. As I always see locums, I get a new one every 6 months to a year. But I believe that Asperger's is the right one for me, possibly with other ones such as depression, Bipolar Disorder or Generalised Anxiety Disorder.

It was suggested I could have a personality disorder along with everything else but Asperger's. In my case I quite simply do not have some of the core components that are supposed to be present for a BPD dx.

Risky, impulsive behavior
suicidal thoughts
addiction or substance abuse
angry outbursts that can turn physical

The emotional issues are extremely subjective. A second opinion is always an option. Finding someone more experienced in adult autism dx would be more helpful. If you do not feel the dx fits, letting it follow you through life will not help you and, if drug interventions are employed could be very very wrong.

When I was diagnosed with it, I tried to find out if it was true - I asked pretty much everyone I knew if I came across as borderline at all, and none agreed with it. I've tried to talk to my therapist about the diagnosis but she brushes it off because, as she says, she hasn't seen any signs.

I have had people decide I must really have it because I was diagnosed with it and don't believe I have it. While I agree that defense mechanisms such as denial make it hard for people to admit they have these things, I think having a history of borderline behavior or at least matching more than 1-2 of the symptoms, would be required to confirm having it.

I've done a lot of research on it, though, and I think what Henbane posted above is pretty accurate from what I've read. Also, the characterization of BPD patients as manipulative, often for behaviors that are acceptable from other clients, is a huge disservice.

I have bipolar disorder, and once when I sought hospitalization because things were that bad, the hospital personnel decided I was being manipulative and decided I had BPD. They stuck me in a DBT group, which I don't regret because DBT is useful whether you have BPD or not. After the group ended, they sent me to a psychologist to continue therapy with, and she tested me and determined that I didn't have BPD and therefore she couldn't treat me, and everyone dropped me like a hot potato.

I'm glad to not have the BPD diagnosis, and I found a psychiatrist that helps with the bipolar, which was the problem all along.

AS is suspected, but I'd have to seek out a specialist to diagnose it, as my psychiatrist says my case is too complicated.

And I guess just to clarify, I was born female but am transgender. I was presenting as female through all of this.

On the relationship between AS and personality disorders
http://www.wrongplanet.net/postx156230-0-0.html

I think emotional dysregulation can be a co-morbid from being on the autism spectrum. I definitely suffer from it along with chronic depression.

The whole psychoanalytic theory of BPD kind of falls short though in my case. A personality test I took for my pdoc put me in the BPD category (along with depression and dysthymia) but he and I didn't think that diagnosis really fit. A lot of the symptoms fit me but there are a couple basic ones that just don't fit at all (if I even really understand them). BPD is far too specific and the theory behind it doesn't really apply to me.

Thank you kindly for all your responses. It helps to hear from other people that have had similar experiences.

I am now waiting for my second referral from the autism team but I'm fairly anxious because if it isn't aspergers which I feel would explain a LOT then I am back to wondering what the hey is wrong and just feeling completely lost.

There is no reason you should be lost. These are general diagnoses that you may or may not fit the profile of depending on which doctor you talk to. Obviously your situation is significant enough for you to speculate that you might lie somewhere on the more serious "spectrums" in the DSM. The point now is not to worry about labels but to simply start figuring out what's going to help you, because you can't derive that from arbitrary diagnoses--not these ones, at least. If you are in the ballpark of Asperger's or severe personality disorder, it's whatever works, period.

I wonder as well if it is possible to have both Asperger's and BPD. A person born with an ASD can still experience childhood sexual abuse and other traumatic events that could lead to the development of BPD. It must be very hard to be a psychiatrist sometimes, trying to translate symptoms into a disorder.

I was told I had BPD which confused me because I didn't fit enough of the symptoms. Plus I felt the diagnosis was too 'broad' and covered too many other conditions. I have now been told I definitely don't have BPD, and I am 'cured' but I don't think I had it at all. I have got Aspergers and Tourettes with possible ADHD and I think that pretty much covers all the issues I had!

And Yes, In the uk I think BPD is the 'one size fits all oddballs' diagnosis

Yes, it's possible to have both. There are threads on WP in which members here talk about having both, as well as being misdiagnosed with BPD before (if ever) getting an ASD diagnosis.