Originally Posted by bettermarriage View Post
A friend of mine who is a counselor herself brought that up.... He does seem to fit the [BPD] profile more than I do.... it would help to get a professional to weigh in, as he somehow doesn't think my therapist (who's been practicing for 15 years) knows what she's talking about. [Your 12/22/13 post.]
Back in 2013, both your therapist and John117
suggested that your H seems to exhibit strong BPD symptoms. In your response to John (above text), you indicated that you would be seeking a second opinion by getting another "professional to weigh in." If you did so, what did that professional tell you?
I am asking, Better, because BPD is sometimes mistakenly diagnosed as "adult ADHD" because -- in adults -- these two disorders share some similar clinical features (e. g. impulsivity, emotional dysregulation, and cognitive impairment). Indeed, some psychologists speculate that adult ADHD and BPD might be the same disorder, at least for some patients. A 2006 study, for example, concludes:
ADHD in childhood has been reported to be highly associated with the diagnosis of BPD in adulthood and adult ADHD often co-occurs with BPD. Treatment studies revealed an efficacy of dialectical behavioral therapy (DBT) and DBT-based psychotherapy, respectively, in BPD and adult ADHD as well as neuroimaging and psychopharmacological studies showed some evidence for a potential common neurobiological dysfunction suggesting the hypothesis that ADHD and BPD may not be two distinct disorders, but represent at least in a subgroup of patients two dimensions of one disorder. See 2006 Study.
Similarly, Dr. Robert Friedel (author of BPD Demystified
) states that adult ADHD occurs in at least 25% of BPDers -- five times what is seen in the general population. He cautions that, when BPD and ADHD co-occur, patients often do worse when treated for ADHD because the medication (i.e., the stimulants) can exacerbate the BPD traits -- causing an increase in emotionality, aggressive impulsivity and even paranoid thinking. He concludes, based on his clinical experience and anecdotal reports seen in the scientific literature, that this problem can be effectively managed in one of two ways:
When the symptoms of ADHD are mild, behavioral treatments alone may be effective, thereby avoiding the risk of increasing the symptoms of borderline disorder with a stimulant. However, if medications are required to bring the symptoms of ADHD under optimal control, it appears to be helpful to initiate treatment with a low dose of an antipsychotic agent for the symptoms of borderline disorder [Medications]. Doing so permits the use of a stimulant to produce a beneficial effect on the symptoms of ADHD with a minimal risk of worsening the core symptoms of borderline disorder. See Treatment of ADHD in Patients with BPD.