KCI The Anti_Meth Site

Borderline personality or Meth addict?

samwitch	Borderline personality or Meth addict? Before I suspected meth use by my ex (my baby's father) I pretty much had myself convinced he was classic bpd. His father even read a book about it at my suggestion and he thought the same. Once I suspected meth and began to educate myself, the symptoms of the two are really similar! Maybe it's both...and who knows which came first.... Anyone else know of any connections between the two?
Replies...
Indiana shedevil	Re: borderline personality or Meth addict? My ex has the same traits and symptoms. It's like asking which came first, the chicken or the egg. I have little knowledge in that area. I'd ask Pen. She's really a valuable source of info.
vctry7	Re: borderline personality or Meth addict? My husband was diagnosed as bipolar with intermittent explosive disorder with social anxiety. Meaning he would have really good days and really bad days, mixed with violent outbursts during his really bad days. It made him nervous to be around people because he was always paranoid. After a while of the meth being gone, so were all his psychiatric problems.
Indiana shedevil	Re: borderline personality or Meth addict? That's really encouraging to hear. In my case, the mental stuff got worse. I think that maybe part of the reason Tommy was using, was to self medicate? I'm not a physician or mental health expert, that's just a theory... Besides, I guess that smoking an 8ball everyday for 2 years tends to cause brain damage. The verdict is still out on whether or not its permanent damage or not...
Sfj	Re: borderline personality or Meth addict? There are plenty of differences between Bi-polar and meth addiction. If you really want to become informed about this, there are plenty of free resources. Among them would be the DSM IV If you prefer the scientific professional explanations, that source is about as good as any and better than most.
Penel0pe	Re: borderline personality or Meth addict? Here's the reality (And this is a long one:) First of all, it has been said on this forum that "Addiction" is not in the DSM IV. That is inaccurate - the word "Addiction" is synonymous with the word "Dependence," which is how the DSM IV classifies addiction. Accurately diagnosing or treating a mental disorder in a person who is actively using meth or any other substance is just about impossible. The drug use has to stop before any accurate diagnosis can be made, period. The symptoms that are secondary to the drug use (Psychosis, depression, manic like symptoms, anxiety) can be treated on an acute basis in the hospital, but WILL return if the drug use resumes. And that is why the DSM IV has separate diagnostic categories for Drug Induced Disorders: I'll use meth as an example. Amphetamine (or Related Substance) Use Disorders: Amphetamine (or Related Substance) Dependence Amphetamine (or Related Substance) Abuse Amphetamine (or Related Substance) Intoxication Amphetamine (or Related Substance) Withdrawal Amphetamine (or Related Substance) Delirium Amphetamine (or Related Substance) Psychotic Disorder: Specifiers: With delusions With hallucinations Amphetamine (or Related Substance) Mood Disorder (Depressed type, manic type) Amphetamine (or Related Substance) Anxiety Disorder Amphetamine (or Related Substance) Sexual Dysfunction Amphetamine (or Related Substance) Sleep Disorder Amphetamine (or Related Substance) Use Disorder NOS (NOS = Not Otherwise Specified.) Borderline personality disorder has some very specific criteria - with substance abuse being one of them: Borderline Personality Disorder DSM IV Criteria A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following: 1. frantic efforts to avoid real or imagined abandonment. Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5. 2. a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation. 3. identity disturbance: markedly and persistently unstable self-image or sense of self. 4. impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating). Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5. 5. recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior 6. affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days). 7. chronic feelings of emptiness 8. inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights) 9. transient, stress-related paranoid ideation or severe dissociative symptoms For more details re: Borderline PD, click Here Substance abuse can cause a person to exhibit symptoms of just about any disorder you can find in the DSM IV - particularly the mood, psychotic, and Cluster B personality disorders. Your Question about borderline personality disorder is almost a "which came first, chicken or egg" scenario. The only way to make an accurate determination is to remove the drug use from the equation. A competent psychiatrist would not make a definitive diagnosis of any mental disorder in a patient who is actively using. I have to add that, from personal experience as both an addict and a psych nurse of MANY years, METH AND ALCOHOL are probably the WORST substances in regard to creating confusion re: Primary mental disorder vs substance induced mental disorder. In hindsight, looking at my own behavior as an active addict, ANTISOCIAL PERSONALITY DISORDER (What used to be known as psychopathology) would have been MY primary diagnosis.... Finally, one of the BIGGEST problems with diagnosing addicts is this: ADDICTS LIE. Unless the psychiatrist is aware of the drug use, a misdiagnosis could easily be made, and what amounts to drug induced pathology could be treated as a primary mental illness... and then guess what happens? The patient doesn't get better! (PS: Personality Disorders are in the same category - Axis II disorders - as mental retardation because neither can be successfully treated via medical intervention... Axis II means that this is who the person is - you can't medicate it away.) Both are treatable via behavioral interventions; the secondary symptoms (depression, anxiety, agitation) are treatable with meds, but meds won't change the primary problem.
Loraura	Re: borderline personality or Meth addict? *Quote:* There are plenty of differences between Bi-polar and meth addiction. Hey SFJ -- she was talking about borderline personality disorder, not bi-polar.
Imgetin rite	Re: borderline personality or Meth addict? Pen...thanks for the list....now a few things I have noticed about myself...I have a explanation for.
Sfj	Re: borderline personality or Meth addict? OOOps, me bad. I erred. But the same statement applies. There are differences between the two. There are also similarities, but the main difference that I see constantly is that meth users routinely go for days and days without sleep. Without an external stimulant, that is virtually impossible.
Penel0pe	Re: borderline personality or Meth addict? Going days without sleep is one of the main criteria for a manic episode. They get to tweak with no dope at all.
Sfj	Re: borderline personality or Meth addict? But it really isn't the same. The notion of "get to tweak" seems quite awkward to me. It is not a condition to be desired. BPD and Bi-Polar are not something to be desired like a rush from a hit of meth. Addiction (dependency) and days without sleep are not desirable either. Regardless, I doubt if you've ever seen BPD or "manic" patients stay awake as long as a meth user. Not even close.?
Penel0pe	Re: borderline personality or Meth addict? *Quote:* Regardless, I doubt if you've ever seen BPD or "manic" patients stay awake as long as a meth user. Not even close. My dear friend, you have no idea. Quite the contrary. I love you, but I have to tell you that on this one, you are dead wrong. Manic people can go DAYS AND DAYS AND DAYS without sleep - and they look like tweekers, they talk like tweekers, they are disorganized like tweekers, and they have as much if not MORE energy on no sleep as a tweeker with a limitless supply of meth. One difference is this; a tweeker can be medicated to sleep with relative ease. We can give a person in an acute meth psychosis a "hot shot" (Haldol 5mg, cogentin 1mg, and Ativan 2mg IM) and it's all over for them. Sometimes we will use another medication called droperidal if the person is young enough and there is no risk of cardiac problems, but most often Haldol is used. Generally speaking, a person who is high on meth can be brought down with one injection, sometimes two. They will sleep for a long time, and in most cases are non - psychotic when they wake up. Some take a little more treatment before the psychosis resolves. On the other hand, a manic person most often CANNOT be medicated to sleep. What happens in those cases is the person just becomes ataxic (Unstable, drunken like gait,) falls down and ends up hurt in the course of the never ending activity of a manic episode. Mania can be treated over time with meds - but one or two shots isn't going to do it like it will and does with someone who is high on meth. Manics have meth addicts beat when it comes to going without sleep. There is nothing desirable about tweeking - of course not. I was making a comparison. But, having spent my entire career in the company of the mentally ill AND in the company of, or under the influence of meth, I ASSURE YOU, a manic person can out-run a meth addict any day of the week. Mania is supposedly the "Best high in the world" - and this is what THEY tell us, not something I read in a book or extrapolated from observing hundreds of manic patients since 1980 when I began my career in mental health. Mania is unmistakable and takes quite a bit of time to stabilize. Manic people EAT for one thing - that gives them an edge as far as stamina is concerned. A meth addict will deteriorate over time without sleep... a person who is having a manic episode can go and go and go... they need little or no sleep, their minds are racing, they are usually very irritable and difficult, but they do enjoy themselves in the process! The one thing they don't want is the mania to end. It can take weeks to stabilize a manic episode, and the stabilization is usually proportional to the amount of sleep the person gets over time. As the amount of sleep increases, the severity of the mania tends to decrease. Sleep is an indicator for resolution of a manic episode, among other things. Even a Bipolar II patient - one who is hypo manic, but does not lose judgment or insight, can go many days without sleep and feel perfectly fine. I'm not trying to be contrary or argumentative - I am just sharing many, many years of experience. And, for the record, Borderline Personality Disorder and Bipolar disorder are two very different conditions. About the only common feature between the two is irritability and reckless behavior. Bipolar manics are reckless in an uncontrolled, impulsive manner - a borderline generally knows EXACTLY what she is doing... and is doing it for a reason. Borderlines are impulsive and have very poor judgment, and often end up dead just trying to get some attention. There is little "reason" in the behavior of a person who is manic. Again - I'm not trying to argue - but I am sharing what I know via many, many years in the mental health profession.
kmb2006	Re: borderline personality or Meth addict? What an interesting and informative thread... My husband just returned home from inpatient rehab followed by a 5 day stay in a psychiatric hospital. He's finally been diagnosed with Bipolar I, though I can't recall the full official diagnosis. He resisted diagnosis and treatment for years, though he knew as well as everyone else what was going on. I've been asked by a few people how I didn't know that he was using back in 2002 when he first started. "How could you not notice that he was up for days?" Well, because that wasn't unusual for him. It wasn't until he started losing a lot of weight and developed the picking and the weird projects that I knew something was up. So, I can confirm that the awake and wired part of mania is very real. His episodes started cycling more intensely as he came into his late 20's, he started smoking more and more weed (a 1/4 a day), and then he found meth... His medication cocktail is a little scary, but I guess the docs know what they are doing: Klonopin (3mg a day) - Can somebody please explain why anyone would give this to an addict? At least my husband asked me to administer this one because as a former dealer of pleasure poisons he knows that this one can be easily abused. And it's not like he lied to the docs about his drug history. The psychiatrist is part of his new dual diagnosis IOP. Lamictal Lithobid Risperdal
Penel0pe	Re: borderline personality or Meth addict? It's not unusual for klonopin to be used. I guess at some point the doctor had an expectation that he would be responsible with it, and it sounds as if he has been if he gave it to you to dispense. The rest of the meds sound pretty typical. *Quote:* The psychiatrist is part of his new dual diagnosis IOP. That's great that he has a doctor who is trained in dealing with dually diagnosed patients. How is your husband doing now that he's been through rehab and is being treated for bipolar disorder?
vctry7	Re: borderline personality or Meth addict? ADDICTS LIE. Unless the psychiatrist is aware of the drug use, a misdiagnosis could easily be made, and what amounts to drug induced pathology could be treated as a primary mental illness... and then guess what happens? The patient doesn't get better! Exactly. Only my husband had either uneducated doctors or quacks that just didn't care as long as the got their $$$. He told all three that he used meth, pills, and pot. They still diagnosed him and gave him so many pills it would make a pharmacist's head spin. One pill being klonopin that he abused. Hence, the reason my husband doesn't trust psychiatrists. The last Dr. prescribed him depakote, lexapro, and risperadol. That was after my husband had quit, but he had only been clean two weeks. It took at least 6 months before I could tell a difference without the meth. They said the risperadol helps with nightmares and using dreams. Has anyone else heard that?