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Re: BPD/antisocial/bipolar/Jamison/stimulants....

Posted by margaretmarburg on July 28, 2001, at 5:10:08

In reply to Re: questions-borderline personality disorder » MM, posted by Elizabeth on July 27, 2001, at 20:37:53

nobody's mentioned the comparison between antisocial personality (in men) and borderline (in women). I had to bring it up, since there's a lot more literature suggesting that borderline is the female antisocial personality disorder, than that borderline is the female ADHD.

I've always thought it's a stupid association, because antisocial and borderline are fundamentally different in their core traits (one is self-destructive attention-seeking, the other aggressive). The only serious similarity to me is impulsiveness. And if that's so important, then why not group mania and ADHD with borderline and antisocial personality?

I was particularly annoyed that in Kay Jamison's book "night falls fast" she overtly equates antisocial and borderline. Especially since she positions herself as a spokesperson for bipolar disorder, and doesn't bother to acknowledge (in any of her books) that there's a possible relationship between borderline and the mood disorders (especially bipolar).

IMO borderline is just dysphoria (which could be related to any mood disorder) + disinhibition. Most people with depression will relate to the URGE to do what borderlines are diagnosed by doing: self-injury, self-destructive acts, needy and desperate cries for attention, fear of abandonment, seeing everything as evil and black, etc. An inhibitied depressive doesn't follow through. A borderline does, and doesn't see why that's a problem.

If it's disinhibition (or impulsivity) that's key - then that would explain the overlap between ADHD and borderline. Also bipolarity and borderline.

Which brings me to stimulants. I see how stimulants would help with focus even in normals, but I don't see how they help with the impulsivity/disinhibition. But they seem to in ADHD - I've seen it in a friend of mine. If they ahve that effect in normals too, then I could see how they would be useful for borderline. But in normals, I thought stimulants tended to be disinhibiting. Not true?


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