Is borderline personality disorder any more volitional than bipolar disorder?!

Is borderline personality disorder any more volitional than bipolar disorder?

I was diagnosed with bipolar disorder years ago, and have been hospitalized many times. During a recent hospitalization, the staff began throwing around the word “borderline.” This terrified me, as I am aware of the stigma surrounding BPD.

Ever since my initial diagnosis of bipolar, I have taken some consolation in knowing that it’s “not my fault;” that my symptoms and inappropriate (and humiliating) behavior were the result of a chemical imbalance in my brain, not an act of the will.

With the borderline diagnosis (and I have not been formally diagnosis, but I admit I fit a lot of the criteria), I feel as if I don’t have that luxury; I feel like it’s my fault. While genetics and biology play a role in BPD, from all the literature I have read, it is usually a response to some kind of trauma, and therefore not organic. Further, unlike bipolar, therapy is usually the most effective way to treat it. So, all this makes me feel like the old cliché “Mental illness is not you’re fault because it’s a chemical imbalance” does not apply to BPD – and that, even from a professional standpoint, many people treat borderlines as if they can “help” their maladaptive behavior.

Thoughts?

1 week ago
Wow, sorry that was so long!

The interrater reliability of any of the personality disorder diagnoses, barring antisocial personality disorder, is very poor. Meaning that the diagnosis of BPD has no scientific merit.

This is not to say that the people who are lumped into this category do not have persistent psychiatric problems. It's just that as a group psychiatristy cannot agree on what the problem is. Current thinking is that BPD may just be extreme bipolar disorder.

My own thought is that some people lumped into this category may have a mood disorder as well as post traumatic stress symptoms that are unresolved.