Borderline Personality: The Promiscuous Diagnosis

Probably more than any other psychiatric diagnosis, Borderline Personality Disorder is rarely a solitary one. There are several reasons why in doctors' notes and insurance forms there are usually other labels chaperoning the BPD diagnosis. Insurance companies often do not reimburse unless there is a primary (Axis I) psychiatric diagnosis, such as Major Depression, Bipolar Disorder, etc. Also, BPD continues to carry a stigma, distasteful not only to insurance companies but to the general public as well. Especially if you are a celebrity arrested in Southern California, it is probably more acceptable to claim Bipolar Disorder with addiction and proceed to rehab, then to cop to a diagnosis of BPD!

Perhaps the primary reason for additional diagnoses accompanying the BPD designation is the range of symptoms that infiltrate other labels. BPD mood swings may accompany or be confused with Bipolar symptoms. Suicidal threats may travel with Major Depression. Episodes of severe paranoia may look like Schizophrenia or Schizoaffective Disorder. Impulsivity and impatient anger may reflect Attention Deficit Disorder symptoms. Many patients with diagnoses of Anorexia, Bulimia, and Substance Abuse also fulfill criteria for BPD.

In the Hi-ho the Dairy-o Dell farmer's world, the Cheese stands alone. BPD does not!