- How do you know if you have
borderline personality disorder versus depression?
That's what I'm gonna talk about in this video today.
I'm also gonna give you some techniques
to regulate your emotions.
I'm Dr. Tracey Marks, a psychiatrist,
and I make videos on mental health education
and self-improvement.
This video is based on a viewer question
from I Hayden Designs,
and I'm gonna read excerpts of the question.
I'd love to see a video about the differences
between depression and BPD.
I feel they get mixed up so often,
and I haven't come across a video or an article
where it's explained or talked about.
I'm currently undergoing assessments for re-diagnosis,
but feel not only would I benefit
but so many other people.
Thank you I Hayden Designs.
The short answer to this question
is you can have both disorders at the same time.
Borderline personality disorder
is part of your makeup that's always present.
I defined borderline personality disorder
and go through the criteria for it in this video.
There's a link in the corner as well as in the description.
So if you don't know
what borderline personality disorder is, watch that video.
But suffice it to say that
with borderline personality disorder
you get an unstable mood that can go up and down.
And with the ups and downs, they can be very dramatic.
So it's more about a dramatic expression of your emotions
rather than the experience of a depressive episode
that lasts for two weeks.
With borderline personality disorder,
your mood or emotions can fluctuate quickly
within hours or even minutes.
And if you become very upset and even tearful,
or feel like you wanna self-harm,
it doesn't have to mean you're depressed.
Upset is not the same as depression.
Depression is much more than a low mood.
You get changes in your energy level, your ability to sleep,
your appetite, and your thinking process can even change
when you're in a depressed state.
Now you may say, I have borderline personality disorder
and I can feel all of those things you just said.
Well yes you can have borderline personality disorder
and depression on top of it.
But what this will look like
is you will go through a period of depression
that lasts at least two weeks and once that resolves,
you still can have these dramatic expressions of emotion
that are more transient.
In other words the highs and lows can just come and go,
either triggered by something,
or without an identifiable trigger.
The main treatment for borderline personality disorder
is dialectical behavior therapy, or DBT.
Since borderline personality disorder
greatly impacts your emotions and your relationships,
DBT is mostly about teaching you skills
to manage your emotions and your relationships.
There are four modalities to DBT.
There is mindfulness, interpersonal effectiveness,
distress tolerance and emotion regulation.
The full DBT program is best learned
in a therapy environment.
And usually it's a combination of individual sessions
and group sessions.
However there are some self-help resources
that can get you started if you don't have access
to a DBT therapy program.
And I've included two self-help books in the description.
This one is more of a general overview of DBT,
whereas this one is more focused on helping your anxiety.
DBT uses many ways to develop coping skills.
And two techniques for regulating emotions
are checking the facts and accumulating positive experiences
that you can fall back on to counter your negative emotions.
Let's look at checking the facts.
When something happens that causes you
to have an unpleasant emotion like frustration,
upset or anger, you can review the facts of the situation
to see if you overreacted to this.
Ask yourself these questions.
What event triggered your emotion?
What assumptions did you make about the situation?
Or how did you interpret the situation?
Did the intensity of your emotions
match the facts of the situation?
Or did your emotions match
the assumptions you made about the situation?
Here's an example.
Your partner has spent the whole weekend
inside the house, and says.
- I feel like I need some fresh air.
I need to go outside and do something.
I think I'm gonna go to the gym.
- You wanted to cuddle on the couch and watch a movie,
but you never told him this.
This was just something
you were thinking about in your head.
So when he tells you that he wants to go to the gym,
you say, I can't believe you don't wanna spend time with me.
Are you saying you're sick of me
because you've been with me all weekend?
Your partner says.
- I just want to get some exercise and go outside.
You're not my mom, I'm tired of you getting mad at me
whenever I try to do something without you.
- The argument continues,
and you end up with your partner leaving the house angry,
and you feel rejected and hurt.
Now, let's check the facts of this interaction.
Your partner said he wants to go to the gym
because he's been inactive all weekend.
You assumed your partner wants to leave
because he's sick of you.
You made wrong assumptions
about what your partner was thinking.
He didn't say that he was sick of you.
He said that he was sick of being in the house.
You felt intensely hurt and rejected
from him wanting to leave the house.
That reaction doesn't match the fact
that he said he wanted to get some exercise.
So your reaction came from a wrong assumption
rather than reacting to what he actually said.
You read his mind but you read it wrong.
With borderline personality disorder,
you tend to fear abandonment from people.
And that fear can make you misinterpret people's actions
and see their actions as threatening to you.
So this exercise analyzes your emotions in a way
that help you react differently in the future.
You want to write this down this process
of checking the facts and keep a journal of this
so that you can go back and look at these examples.
If you try to keep this all in your head,
you're going to forget the specifics
because your mind is very good
at selectively leaving out the details
that expose your negative assumptions.
Let me repeat that.
Your mind is not going to want to remember
how you messed this up.
So you're going to have to write it down
at the time that it happens
so you can remind yourself of actually how it played out.
Another technique is accumulating positive experiences.
It's only natural to pay more attention
to the negative things than the positive things.
If a group of people gave you five compliments,
and one person criticizes you,
what comment do you think you're more likely to remember?
If you notice that you seem to be very focused
on negative experiences,
turn your attention to something positive
that you experienced that day.
This is different from simply thinking positively
about butterflies and ponies.
(playful music)
(horse neighing)
You wanna draw from a positive experience
and reflect on how that thing made you feel.
To make sure that you have something to reflect on,
you need to build into your day
one small positive experience.
You can do more than that,
but you wanna at least fit in one positive activity
that will allow you to divert your attention
to that experience rather than ruminating
over your negative experiences.
And it doesn't have to be something huge.
Here are some examples of some positive experiences
that you can fit into your day.
Watching a fun movie with or without your partner,
trying a new hobby, going for a walk in the sunshine,
visiting a friend, having an un-rushed meal
where you reflect on and enjoy
everything that you're eating.
This would be in contrast
to multitasking while you're eating.
I'll have some follow-up videos on other aspects
of dialectical behavior therapy and managing your emotions.
If you haven't already seen it, check out this video
where I compare borderline personality to bipolar disorder.
See you next time.