Lecture Notes: Understanding Bipolar Disorder and Borderline Personality Disorder

Bipolar Disorder (BPD)

Overview

• Type: Mood disorder
• Characteristics: Mood swings lasting weeks to months
  • Depression: Persistent low mood, low self-attitude, low energy (described as walking through molasses)
  • Mania/Hypomania: High energy, need less sleep, elevated mood, grandiose ideas (e.g., solving global issues)
• Timeframe: Diagnosis requires symptoms lasting at least two weeks for depression and one week for mania
• Normalcy Phases: Periods without mood disturbances where individuals feel completely normal
• Diagnosis Caution: Avoid self-diagnosis due to potential interference from substance use like marijuana

Examples of Symptoms

• Depression: Persistent sadness, low self-worth, thoughts of being a burden, low energy, difficulty in daily activities
• Hypomania/Mania: High productivity, reduced need for sleep, grandiose plans, feelings of invincibility, risky behavior

Borderline Personality Disorder (BPD)

Overview

• Type: Personality disorder
• Characteristics: Patterns of unstable relationships, self-image, and emotions
  • Core Issue: Weak or non-existent sense of self
• Response Dependency: Emotional state highly dependent on others' treatment
• Behavioral Patterns: Erratic behavior to seek validation and support (e.g., suicidal gestures)
• Long-Term Impact: Relationships affected due to dependence on external validation

Examples of Symptoms

• Unstable Relationships: Intense but short-lived relationships, fear of abandonment, manipulation to garner attention
• Self-Harm: Suicidal threats, self-harm behaviors to elicit response from others
• Emotional Swings: Over-interpretation of small events (e.g., non-response to a text) as major rejections

Treatment Approaches

• Long-Term Change: Requires stable, consistent, and non-reactive support
• Learning and Modification: Patients learn to engage in healthier behaviors over time
• Professional Help: Essential for dealing with complex symptoms; laypersons should encourage seeking psychiatric help
• Behavioral Reinforcement: Avoid reinforcing harmful behaviors by providing support in structured, non-reactive ways

Special Considerations for Helpers

• Boundaries: Helpers must set boundaries while showing care and ensuring their own well-being
• Behavioral Techniques: Similar to training, focus on reinforcing positive behaviors without giving in to harmful patterns

Comparison of Disorders

Bipolar Disorder

• Mood-Based: Persistent mood states detached from interpersonal relationships
• Periods of Normalcy: Clear periods without mood disruptions
• Diagnosis: Involves specific durations of mood states
• Medication: Can be effective in managing symptoms

Borderline Personality Disorder

• Self-Identity-Based: Sense of self reliant on external validation
• Constant Influence: Persistent, long-term impact on personality and relationships
• Behavioral Focus: Management through behavioral therapies, less reliant on medication

Audience Questions & Answers

Mood Swings vs. Emotional Lability

• Bipolar Mood Swings: Last weeks/months; not hour-by-hour variability
• Emotional Lability: Quick shifts in emotions, often seen in stressful situations or unprocessed emotions

Reinforcement of Suicidal Behavior

• Focus on Changes: Reinforcing healthy coping mechanisms without reacting to crises states directly
• Professional Intervention: Encouraging professional psychiatric help is crucial.

Relationship Dynamics

• Low Self-Esteem Impact: Continuous fear of abandonment can lead to erratic behavior
• Controlling Behavior: Usually stems from insecurity and fear, exacerbating relational issues
• Cycle Reinforcement: Negative cycles in behavior leading to further relationship instability