Victims of violence may in some cases be diagnosed with post-traumatic stress personality disorder. But its symptoms sometimes resemble those of another mental illness—borderline disorder. What is their similarity and how to distinguish them, we explain on the example of one case from the practice of a psychiatrist.
When Anna started working with a psychotherapist, the first two sessions were somewhat like a roller coaster. A minute ago, she was talking with joyful anticipation about a new job and new opportunities, and suddenly she was overcome with anxiety – it seemed to the woman that she could not cope with caring for her sick mother. At the second session, she was very worried that the partner with whom she had lived for a long time might leave her, and by the third session she had completely forgotten about it.
The psychiatrist repeatedly tried to help Anna better manage her emotions, but she continued to have severe mood swings, the cause of which she could not explain. Initially, the doctor suggested that the patient suffers from borderline personality disorder. But a more detailed questioning revealed that Anna’s case did not meet some of the criteria for this diagnosis.
- She was not afraid to be abandoned – before, a woman lived alone for more than 10 years, without a partner, and was successful and happy.
- She never attempted suicide or engaged in self-harm.
- She occasionally drank, but it never reached the level of addiction.
Without these criteria, a diagnosis of borderline personality disorder is not made.
What else could cause such violent emotional reactions? The psychiatrist was able to answer this question when he learned that Anna had been abused – both by her parents in childhood and by one of her former partners. In addition, her father died relatively recently.
Anna considered her emotional outbursts to be panic attacks, but when one of these attacks occurred during a therapy session, the specialist immediately realized that it was actually a symptom of post-traumatic stress disorder (PTSD).
Knowing the true cause of the problem, he helped her work through the traumas she experienced, learn to relax and calm down. As a result of therapy, Anna’s behavior quickly stabilized.
Symptoms of PTSD often “mask” as manifestations of borderline disorder. Here are some similarities and differences between the two diseases.
Experienced mental trauma
Similarities
In some countries, the diagnosis of PTSD may also be made in cases of prolonged abuse.
A prime example is child abuse in the family. For example, if a person was locked in a closet as a punishment as a child, as an adult they may show symptoms of PTSD when riding an elevator. The consequences of such events continue to affect our lives many years later if we are not treated.
Similarly, the borderline patient feels past psychic traumas very acutely, as if reliving them again. In “borderline” patients, in general, any emotions are extremely strong and vivid.
Differences
In PTSD sufferers, after healing from the effects of trauma, emotional reactions usually become much less violent.
But patients with borderline disorder are unable to detach from their feelings, even when the trauma is fully worked through. They have such a developed emotional memory that memories of the experience are perceived as sharply as what is happening right now.
Mood swings
Similarities
To the layman, a PTSD attack is like a panic attack, like overreacting to some minor event.
People with borderline disorder may react in the same way if they feel threatened or afraid of being abandoned. Such violent emotional reactions may seem like just mood swings, although in fact their cause is different.
Differences
A frequent PTSD sufferer can quickly stop an attack by turning their attention to their surroundings or simply going outside. Sometimes it is enough for him to be reassured, assuring that he is safe.
All these methods will not help a person with borderline disorder, on the contrary, they can only aggravate his condition. To help such a patient at the moment of exacerbation, it is important to assure him that you understand his pain and experiences, to show sincere sympathy.
People unwittingly push others away from themselves
Similarities
Neither PTSD sufferers nor those with BPD want to ruin relationships with others, but unfortunately this often happens. People around them are often not ready to enter into their situation and help them cope with problems, but simply begin to avoid them. This only exacerbates the anxiety of patients with PTSD and borderline disorder.
Differences
PTSD sufferers react violently to external triggers that somehow remind them of the trauma they experienced. In the absence of these stimuli, they usually behave much calmer and more adequately. There can be a lot of triggers, but if you work them out in the course of therapy, the patient will stop reacting so sharply to them.
People with borderline disorder are more provoked not by external stimuli, but by their own experiences and fears. It is very important for them to learn how to regulate the intensity of their emotions.