Q:  Affective Instability

Dear Dr Phelps,

I was dx with bipolar disorder with a history of severe depression, hypomania and I am currently in a mixed episode.

I was told that I had affective instability but as part of my bipolar disorder and not as a part of a cluster B personality traits.

I know affective instability is a feature in both disorders but does the symptom manifest istelf differently in people with bipolar II and borderline personality disorder (eg is affective instability is part of having rapid cycling bipolar or mixed mania whereas in borderline personality disorder the affective instability occurs as a direct reaction to an event and the mood shifts are much quicker than what is experienced in bipolar disorder)?

Or does affective instability present itself/mean the same thing under both disorders?

Thanks so much in advance for your response.

Dear S’ --
Well that is a sophisticated question! You are right at the very edge of research on this issue. 

There is a lovely article on this topic by two well-known mood experts, which is the source you’ll want to go to for a thorough answer (if you have read it already, then I’m sure that I have little else to add).  Because their paper is so important, I have “translated” it into plain English on my website, in the essay entitled Mixed States and Rapid Cycling. But if you can, I would encourage you to get hold of the original article.  The full title of their review is Affective instability as rapid cycling: theoretical and clinical implications for borderline personality and bipolar spectrum disorders.. Here is the abstract.

I hope that article will help; when you are done, you will have an up-to-date review of the literature on this subject.

Dr. Phelps


 

Published February, 2009