Charlotte Stephens – Intersection of Borderline Personality Disorder and Bipolar Disorder


Below is the transcription of this interview with Charlotte Stephens.

Transcript from Interview

Ashley Bruce: Hello everyone. I am Ashley Bruce, and I’m one of the six attorneys here at Bruce Law Firm. We’re a law firm that solely practices divorce and family law here that’s located in Palm Beach County. We often consult with people, however, throughout the state of Florida. If you want some more information on our law firm, please go to www.brucepa.com, and you can get some more information there. And today we have a very special guest. Her name is Charlotte Stephens. She’s going to be talking about the differences between bipolar disorder and borderline personality disorder, and what are the characteristics of each, and how really somebody that’s a lay person, maybe a spouse, a family member, or a friend can identify the particular disorder and try to get help to the person. So first before we dive in, I’d like to know a little bit more about Charlotte. So Charlotte, if you could please just tell us about yourself.

Charlotte Stephens: Yeah, absolutely. So I am currently a grad student at Florida State University. I’m getting my Master of Science in a Mental Health Counseling. I got my bachelor’s degree in Psychology from UCF. And after this, I plan on either going into a private practice setting or obtaining my PhD in Counseling Psychology. And so, yeah, I basically am currently just researching many fields, but I have a lot of interest in researching borderline personality disorder, and other personality disorders.

Ashley Bruce: That’s fantastic. I mean, and we love FSU. My husband went there. And I love UCF, because I went there. So again, just as a little bit of background. Christopher and I met Charlotte at the Florida Mental Health Counselors Association meeting this year. Bruce Law Firm was a large sponsor of the event, and every year at the conference, students compete in a research competition, and they also present to the body at the conference, and they display what they call a poster. It’s a poster contest, but really, it’s their research, and they’re calling down the research into digestible information, for the people who were there. And Christopher and I were really amazed at Charlotte’s presentation, which she entered into the student poster contest. Charlotte’s presentation was judged alongside other presenters. Doctors were judging these different presenters, and Charlotte and her colleagues at FSU actually won first place. So congratulations Charlotte to you and your team on that.

Charlotte Stephens: Thank you.

Ashley Bruce: So Charlotte, can you please just tell us a little bit about your research and your presentation, and what prompted you to research the topic? And clarify for us what the topic was as well.

Charlotte Stephens: Yeah, sure. So, as you said, my poster was looking at the differences and similarities between borderline personality disorder and bipolar disorder. So basically, what I see a lot clinically is that the two can be confused, and oftentimes people come in with a misdiagnosis and it isn’t until years later that they’ll get the right diagnosis. So either they’re diagnosed falsely with borderline, falsely with bipolar. And also just in life, a lay person can very easily confuse the two. And so basically, my research was trying to determine strong points that they’re different. And so, we’re looking at how they’re similar, but we are also trying to pick out exact points where someone in any kind of situation can determine the difference between the two.

Ashley Bruce: And that’s fantastic. Why don’t you tell us some of the characteristics of each disorder, and give us some examples of someone maybe who has had borderline personality disorder, and someone who has had bipolar. So just give us some of the differences there.

Charlotte Stephens: Okay. So basically what is so confusing about the two, and why they get misdiagnosed so frequently is that they’ll actually look exactly the same to someone when they see them in one instance. So what’s really different is the root behind the behavior. So there’s a few examples of both of them that will act in the same way. So for example, someone with bipolar or borderline might be really impulsive or irritable. And so we know that in bipolar to be mania, but it’s not the same in borderline. So this is where you have to look at the root of everything.

Charlotte Stephens: For borderline, what specifically special is that their relationships are where their difficulty comes from. So basically someone with borderline will feel very rejected quite often, or they’ll feel like people are abandoning them. They have a big fear of abandonment. So they might act out impulsively or irritably, because they feel like they’re being left behind. And oftentimes a phrase that you hear in borderline is that they’ll leave you before you can leave them. And so, they’ll act out and do things impulsively in order to either leave you or keep you around. And so in bipolar, they’ll do the same kind of stuff, but examining that their history isn’t an interpersonal difficulty, you’ll realize that it’s just because they’re in a period of mania or hypomania. And then another example-

Ashley Bruce: That’s interesting, I mean the abandonment issue, especially in my practice, it plays in a lot in the divorce and family law practice. So I’m sorry, go right ahead.

Charlotte Stephens: Oh no, no worries. Yeah, and so another kind of example of that is they both have a suicide behaviors, suicidal ideation, suicide attempts, and self-harm behaviors. And so, if you look at borderline versus bipolar, so in bipolar a lot of the times that’s coming from a period of extreme depression. And so in borderline, conversely, it could be depression because a lot of people with borderline suffer from comorbid disorders, but it could also be that fear of abandonment again. And so, when they feel they’re being left, they want to do anything they can to keep people around. So through no fault of their own, they’ll use a little bit of manipulation in order to keep people around.

Ashley Bruce: Interesting. So if you could just give us quickly, just the bullet points for borderline personality disorder. Just run those down in the summary form for our listeners.

Charlotte Stephens: Yeah, sure. So in some of borderline, you’re going to see abrupt mood swings, so very erratic, very different quite often. You’re going to see a big fear of abandonment, and you’re going to see impulsive behaviors on both sides, and doing what you can to keep people around. You’re going to see a little bit of manipulation, and that’s a characteristic of borderline. That’s not necessarily their fault, but they will do a lot of things to get people to act the way they need them to, basically.

Ashley Bruce: Interesting. And tell us why really it’s important to highlight the difference, and to isolate one behavior, one disorder as opposed to the other disorder. Why is that important to really diagnose the right disorder here?

Charlotte Stephens: Yeah, so the importance really is that there are two different diagnoses completely. If you look at the DSM, one is a mood disorder, and one is a personality disorder. So, they’re going to require completely different treatments. So bipolar, we know it to be mania, or hypomania, and depression. And so, what’s really going on is the chemical imbalance in the brain. And so, if you’re going to treat that, then you’re going to need drugs to do so. You’re going to need SSRIs, or mood stabilizers, or something of the sorts. You can use counseling to help with that, but you’re going to need something scientifically changing the brain chemicals.

Charlotte Stephens: And then in borderline personality disorder, it’s kind of the opposite. So the therapy side is way more important, basically. And so borderline personality disorder, definitely a lifelong condition, and so you’re going to need specialized treatment methods. They use dialectical behavior therapy a lot for that. And so basically, both conditions are going to need different treatments. So, if someone is misdiagnosed, if they’re diagnosed with bipolar and are actually borderline, they’re going to be receiving medication they may not need, and converse, the opposite for that in borderline. So …

Ashley Bruce: And so, that would be a reason. It’s really important to get them to the right professional. What type of professionals should maybe a friend, a spouse, a colleague, maybe suggest to somebody who has some of these characteristics? Maybe you’re not sure, who should these people turn to for help?

Charlotte Stephens: The good news is most professionals are good at handling both disorders. And so really, your primary goal should be to get them to someone who can do assessments. And so, someone with a PhD can do a proper assessment and diagnosis of either of these conditions, someone with a PhD in the psychology field. And so, you’re going to want to get them there. The good news is you can use the information you’ve gathered on the individual in your life and what you know about them to help with the assessment process. And from there, they’re going to be able to determine what disorder they have. And then from there, actually mental health counselors, licensed social workers, psychiatrists, psychologists can all help treat the condition.

Ashley Bruce: Okay. So basically, you need to get a team of professionals to treat these two conditions, one of these two conditions, whoever has it. So that’s very interesting, Charlotte. Well, we thank you so much for appearing today with us on our webinar here, and we thank you for your research that you did, and for the lovely poster. I’m going to ask, maybe we can project a copy of it as part of the webinar, so people can really visualize the differences, and why it’s so important to identify what disorder here. So we, thank you so much, Charlotte, for your time.

Charlotte Stephens: Yeah. Thank you so much for having me.