Is My Depression Actually Borderline Personality Disorder? When Misdiagnosis Hinders Healing

Borderline personality disorder was only recognized as a diagnosable disorder in 1980, and given the numerous similarities that it shares with depression, many people are misdiagnosed, preventing them from receiving the specific treatment that they need. Determining if you have been misdiagnosed can help you unravel the real root of your mental health issues and restore the stability and control that you need to live with your disorder.

For as long as I’ve known Austin, his unpredictable, unstable emotions always gave him difficulties in his personal life. Between maintaining a job and keeping a relationship, his fluctuations between depression and anxiety seemed to have a negative impact on every facet of his life. After months of expressing his pervasive feelings of instability and loneliness to me, he decided to get treatment and was diagnosed with depression.

For a short while, his life seemed to be improving, but as time passed I noticed him falling back into the same patterns. It was only after seeing another psychiatrist that it was clear he had been misdiagnosed—he actually suffered from Borderline Personality Disorder (BPD).


Similarities Between Borderline Personality Disorder and Depression

The Diagnostic and Statistical Manual of Mental Disorders V (DSM-V) defines BPD as “a pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity.” Individuals suffering from this disorder have difficulty regulating their emotions, often causing them to experience feelings such as anger, happiness, and sadness to degrees that are far past the point of healthy functioning. The end result is a life of unstable relationships, impulsiveness and a self-image that becomes distorted due to an inability to maintain a stable perception of who you are. However, being misdiagnosed with depression can make you feel as if all of these feelings and experiences are just byproducts of your depression, when in reality they are signs of a much different problem.

Individuals suffering from BPD often describe chronic feelings of emptiness, can find themselves fluctuating between extreme depression and anxiety, and might either threaten to or engage in suicidal or self-harming behavior. All of these symptoms can also present themselves in those suffering from Major Depressive Disorder (MDD), the most common type of mental illness—and given the relatively recent recognition of BPD as a diagnosable disorder (back in 1980), many people are incorrectly diagnosed with depression when they actually have BPD. In addition, some individuals that suffer from BPD have other co-occurring mental disorders with overlapping symptoms, ultimately making the diagnosis process even more complex and preventing many people from getting the proper treatment that they need to heal and grow.

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Why BPD Requires Specific Treatment

BPD stems from an inability to properly regulate emotions, especially in situations where you’re dealing with family members or those that you’re close with. BPD creates waves of intense anger, depression, and anxiety, all on a daily or weekly basis—and for many individuals suffering from this disorder, their reaction is to distance themselves from their emotions. However, when you distance yourself from what you feel, you unintentionally exacerbate feelings of emptiness and depression, sometimes so much so that they seem to be indicative of depression as opposed to BPD. In order to properly treat BPD, you must recognize and acknowledge your irrational emotions, patterns of impulsiveness, and the toll that they are taking on your life and relationships.

The biggest problem with treating BPD as depression is the fact that there is no acknowledgment that the problem stems from increased levels of emotional arousal. In fact, depressed patients often have the opposite problem—they feel only one emotion all the time. While living with BPD is like constantly riding a roller coaster of emotion and turmoil, depression is like living in a painting with only one color. Although individuals with BPD at times do feel intensely depressed and down, this is just one of the many fluctuating emotions that dominate their life.

Medication-based treatments for BPD typically utilize selective serotonin reuptake inhibitors (SSRIs), a class of antidepressants that are also used to treat depression. However, depression is also treated with the numerous other classes of antidepressants such as serotonin-norepinephrine reuptake inhibitors (SNRIs) and tricyclic antidepressants, all of which are not preferred medications for treating BPD. In fact, many antidepressants can cause mood swings as a side effect, which can amplify the flurry of emotions that you are already feeling due to BPD, highlighting the necessity of proper diagnosis and receiving the appropriate antidepressant medication. Furthermore, people that suffer from anxiety along with their depression are typically treated with benzodiazepines such as Xanax, which can actually reduce inhibitions and increase impulsivity, exacerbating symptoms of BPD.

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Restoring Stability and Control Through Understanding

The similarity between BPD symptoms and depression, as well as the possibility of other co-occurring mental disorders, makes misdiagnosis a reality for many. Receiving treatment for a mental illness that you don’t have will only prolong the healing process and prevent you from learning how to take control of your emotions and deal with them in a way that positively impacts your life and relationships. Ask yourself if the treatment that you are receiving is really helping you take positive steps forward, or if you still feel stuck in the same pattern.

Through residential treatment, you will have access to comprehensive diagnostic testing that will reveal the real root of your mental health issues that have been affecting your life. With access to treatments such as Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), and mindfulness, you will begin to cope with the fluctuating emotions that dominate your mind and restore balance to your life. Living with BPD can make you feel like you are constantly out of control, but with the proper coping skills and an understanding of how and why you feel the way that you do, you can take back control of your life and mend the relationships that you have lost.

Contact us to learn more about our renowned Los Angeles programs. We can help you or your loved one start on the path to healing.