Q:  Can a BPD Person Recover & Become BP II?

I have had Borderline Personality disorder and have had 15 years of therapy. I am in therapy with another therapist for about a year. She diagnosed me with Bipolar II. Can a BPD person recover and become Bipolar II? Is this an improvement? She said she does not see BPD only traces of it.

Thanks,
Chris
 

Hello Chris -- 
Now that's an interesting one.  Of course we might hope that your therapy was actually accomplishing something, especially something that might make you have fewer symptoms.  And if you had fewer symptoms, perhaps you wouldn't merit the diagnosis anymore?  Certainly we hope that in treating bipolar disorder, we're shooting for zero symptoms -- and at that point, other than the known risk of relapse without medications, the person doesn't really "have" bipolar disorder in the same way anymore (remission, though not cure).  So, you're asking if in the case of a personality disorder, treated without medications, there could be a remission that amounts to something more like a cure, right?  I think the answer there is a definite yes. 

But, it sounds as though you've then been considered for a different, subsequent diagnosis: Bipolar II.  Is this an improvement?  Well, not exactly.  It carries less stigma, that's sure.  I presume that the new therapist sees more than "traces" of Bipolar, and thus the suggested dx.  

All in all, after all that is said, I rather suspect that the two diagnoses are being confused together; and that the symptoms which used to be prominent and appear "borderline" may well have responded well to treatment.  Now the symptoms which are more like "bipolar II", which I would guess were there in the past but perhaps obscured by the more "borderline" symptoms, are the remaining target.  

The two conditions are so similar, and overlap so much, it's not clear in many cases if it's one, or the other, or some combination of the two.  How this affects treatment options (especially for folks who haven't already responded to treatment as you appear to have done) is reviewed in my little essay on Borderline and Bipolar, if you haven't been there yet.  Good luck from here. 

Dr. Phelps

Published August, 2003