On the face of it, determining the difference between Bipolar 1, Bipolar 2, the more obscure Bipolar Mixed State versions and Borderline Personality Disorder looks tricky.
From the inside, for myself this is not at all tricky. Having Bipolar 1 is the Classic old school expression of the condition, around since time in memoria, Manic Depression that charts a very clear course if not managed & thwarted in some way, (heavy duty pharmaceuticals being historically the most common form of management) worsening over the span of a life due to what is called the kindling effect of previous episodes.
The other variants, somewhat more modern descriptors but I think useful *are* more confusable with BPD but the over arching distinguishing factor is the inter-personal destruction. That is *first*, that is the most primary hallmark in BPD, plus excessive rage & self destructive frustration. Having overwhelming, difficult to control anger, emotional toxicity & awful behaviour such as burning relationship bridges is 90% a BPD thing in my opinion.
Bipolar episodes in my life have been triggered when my BPD emotional dysregulation drives loved ones to reject me, leave me, react in an unloving way due to my difficult behaviour.
For me, a Bipolar swing from neutral takes a lot of externals to set in motion. A major relationship breakdown, a relentless series of smaller scale disappointments, the cumulative affect of feeling that I’m endlessly failing at something important, the frustration of that, endlessly feeling misunderstood or thwarted.
These things have sent me to either pole, High & Low, in the past, sometimes fast, sometime took a while. If you remember that I was told there was essentially *nothing wrong* with me by a Psychiatrist in 2007 when I was anorexic & believed I had an entity! People with big qualifications seem so trustworthy, but I had gone in there 95% sure that I had Bipolar (plus an entity) to be floored when he laughed at my descriptions. Having enough insight to communicate accurately to another person what’s really really happening is the hardest thing of all with mental health dysfunction.
Throughout my 20’s/30’s GP’s repeatedly said similar when I presented with the endless yawning chasm of depression & suicidal ideation. On a hyper manic (this is a limited mania) I was having a great time, having a ton of amazing sex, usually trying to get a band together, binge drinking alcohol to blow myself up & bring myself down a bit, until the real world chaos I was creating came back & bit me on the bum. Also, the physical neglect of a Hypermania inevitably results in a crash to a low. How serious a low depended, for me, on external support & circumstances, ie how much had survived my behaviour.
Self Insight is literally god in mental health awareness, we have to grow our insight into our states, behaviours, triggers, habits of thought etc. Having the incredible benefit of my twin diagnosis since 2019 to overview my life is like been handed the owners manual to my brain, mind & nervous system.
BPD is a daily struggle with oversized emotional reactivity to triggers, especially interpersonal but identity stuff can trip me up too & completely mysteriously, just walking into a room can make me disassociate in the most baffling way & which can take all day to recover from. I have days when I’m tired & my eyes just stream like I’m dumping neurotransmitter waste materials, I have days when everything is so vulnerable & tender that I burst into tears at the slightest thing.
Sleep problems are for me mainly on the Bipolar side, Bipolar for me is a lot, if not entirely about Dopamine & I guard my Dopamine receptors with a small army of Elves. 🧝♀️
Dopamine is the motivational reward neurotransmitter, so sex, hot music, exercise, sugar, carbs etc all increase Dopamine in the brain which gives you the energy, direction, enthusiasm to persue stuff. The absence of Dopamine is truly horrible, nothing has value, attraction, interest, there is *no* physical energy to push with, it’s a very believably incapacitated state & other people, perhaps bringing a little Oxytocin, are often necessary to help break out of this.
With a true Bipolar 1 Low, the longevity of the thing, in my own experience, grew to such monolithic proportions, 9 months out of 12 every year at age 30. My stomach sinks to remember losing whole summers to being bed bound & toxic, alone & apparently unacceptable, unloved, unwanted. Bipolar 1 Low causes significant brain damage, as does Bipolar 1 High.
I have not had a Low like that since I got my dogs. The last decade I’ve used dog power to shift my ass up that hill. It was a gamble & I think it worked. There were costs, but overall it worked. BPD low is not the same. In my experience, BPD low is a lower case low, it has light still entering through beautiful but sad stained glass windows, it is not destroyed to the ground, some structures still remain standing with which to rebuild from. It’s fucking lonely yes, it’s a bit hopeless, it has a core sense of despair attendant with it, like fuck I’m never ever going to be able to get my needs met, but there’s some acceptance of attempting to live with that rather than to escape from this life entirely as with Bipolar 1 Low, which has already walked, wants out & does not really give a fuck about that either.
BPD high, too, is a lower case, shorter duration Dopamine play date. They are quite nice to be honest compared to the personal demolition of a full classic Bipolar 1 High, they are really nice, they are a lot of fun perhaps a bit over the top but the place isn’t trashed & you can still find your car keys afterwards. Post high in 2016 I could not cognitize hardly any written information at all & my short term memory was shot, making very much ordinary life things extremely difficult. Imagine filling in a benefits claim form in that state. Surprisingly, & so welcome, I was still able to read sheet music to piano which was my best friend & healer.
Phew. I’m gonna edit this in situ but I think I’ve said what I wanted to say.
So this is just the distinction, as I see & feel it between two commonly confused severe mental health conditions that are now known pretty conclusively to be very distinct from each other & have a very very different cause, basis, expression & most importantly treatment.
Lots of Love
Feel free to comment won’t you, I don’t bite ♥️💜💕💕💕🧝♀️
