This was a question that a person on Quora asked which goes to the whole issue of how one is diagnosed with a particular mental illness in the first place, and then how misdiagnoses are made. Here is how I answered this question: 

There are some very clear differences between the two diagnoses so let’s take a gander and see what is really going on with you as mental health pros misdiagnose all the time.

Bipolar: One is going to have much longer periods between the moods they experience. A rapid cycle is considered 3 weeks – though many go months before going from one extreme to the other.

Borderline Personality Disorder: the moods are labile meaning that in a split second when triggered a person can go from happy to throwing things and cursing.

Both illnesses have a lot of anger involved – however, the BPD person will be enraged when they don’t get their way. It is a personality disorder which means the person though as intelligent as anyone is acting at the emotional age of a very young person – it is always about the ‘id’ wanting what it wants NOW and when it doesn’t get it, has a tantrum such as a 2-year-old would.

Both are master manipulators of themselves and others but go about it differently

Bipolar people will manipulate to get what they want usually by creating their fantastical ideas in business exaggerating what they can do and what they have to work with.

BPDs will manipulate to get the hole in their soul-filled usually through buying things they do not need, always asking for favors from others, and usually glomming on to one particular person more than anyone else – when that person does or says something that the BPD person finds hurtful, the BPD will drop them in a second and talk shit about them to the next person they glom onto. This is called ‘splitting’ between two people and is something that only BPDs do.

BPDs will self-harm – usually superficially while in a very depressed state.

Bipolars – 85% will self-medicate themselves with drugs – so while up they will take depressives, while down they will take amphetamines.

BPDs have a great fear of abandonment – they will do anything to stop others from abandoning even to the degree that they will abandon others before others have the chance to abandon them.

Bipolars do not have a fear of abandonment.

There are more differences between the 2 diagnoses, however, this gives you enough to better understand where you fall. DO NOTE THAT A PERSON CAN INDEED HAVE BOTH AT THE SAME TIME as we found out was true with my mother from the psychiatric staff at the nursing home where she lived the last 7 years of her life.

If you think you have BPD the best thing that you can do is to learn how to stop the impulses you have to be overly emotional, and instead use logic to make your decisions. It is also very helpful to just be more mindful of how you are coming across to others. It isn’t an easy thing to do at all, but it can be done if one wishes to stop pushing people away with what would be considered infantile behavior.

If you have Bipolar the best thing you can do is deal with feelings of unworthiness by figuring out what your best attributes are and owning them, dealing with your anger and your issues of sadness. I was diagnosed with bipolar 2 back in 1990 and was lucky enough to turn it around so that it is no longer a part of my life on any level back in 2004. Unfortunately, those with personality disorders are unable to truly overcome them, however, if you do those things that I suggested above and maybe get some Dialectical Behavior Training by a person who specializes in working with BPDs, you will be able to gain much control over the almost instantaneous shifts in mood and learn how to reduce the impulses to act out to get your way if you are indeed a BPD.

Thank you for asking this question because these 2 diagnoses are mixed up all the time as are those with schizophrenia and bipolar with psychotic features and many other types of diagnoses because the Diagnostic Statistical Manual has so many symptoms that overlap from one diagnosis to the next, especially in the 5th revision which basically notes that every normal human emotion receives its own diagnosis so the pharmaceutical companies can make even more money on their poison – NOTE: the only people that I believe ought to be placed on psychotropic medications are those who have psychotic features and at the most minimal dose to minimize their hallucinations. I have come to this conclusion after 30 years in the business both in conventional psychiatry and in complementary mental health in the form of hypnotism and neuro-linguistic programming (for 20 years now so plenty of time to have lots of case histories to prove the point that the mind is the best asset anyone has to make transformational change. However, I am unable to help those with psychotic features or those with personality disorders. Though I am able to help those with anxiety, major depression, bipolar, OCD, eating disorders, and sex addictions as I have been successfully doing this since 2002.

This was a question asked by a person on Quora which is a forum for anyone to ask questions and for others to answer. Here is how I answered this interesting question:

As a practicing hypnotist for the past 20 years, I believe I am qualified to answer this question.

As one of my first teachers of hypnotism explained, ‘Hypnosis is nothing but meditation with a purpose.” Her name is Julie Griffin – give credit where it is due, right?

The state of hypnosis is a very relaxed state, where your attention is highly focused on what you are doing as this is how the hypnotic state works – given that you are the ‘suggester’ in this situation.

So, you are only telling yourself those things, those ‘suggestions’ which are mere ‘affirmations’ given in the hypnotic state that you would like to achieve. Why ignorant people feel that one can harm oneself by doing this is beyond my understanding. It is no more dangerous than telling yourself anything really – in fact most people are telling their minds crap about how horrible a person they are for doing whatever, or not doing whatever, most of it in their UNconscious mind anyway, so few people even realize they are doing it. People are more damaged listening to the negative and untrue garbage on the ‘news’ channels that are merely giving you editorials as the news organizations no longer have reporters on location (unless it is very local) to get the ‘facts’ which make real news, news. They are merely giving their politically slanted opinions = editorials.

So, you put yourself into a relaxed state, and then you tell yourself those things that you would like to accomplish with deep feeling as if it is happening now, and see yourself doing that thing, and play it over a few times in your imagination, and whammo! You have achieved what is known as ‘auto-hypnosis’ otherwise known as self-hypnosis, which people have been doing for centuries.

Thanks for the question for those who want to learn about hypnotism from an actual professionally trained and practicing hypnotist instead of people who think they know what they are speaking about but don’t because they do not use it in their own practices. because they weren’t trained and haven’t practiced it enough to have any idea what one can do with this most magical of states in the world of healing and achieving pretty much anything a human being would like to accomplish in life.

One of the most frustrating situations that I find myself in is when a parent is in distress their kid having major mental health problems causing all sorts of mayhem in the family, yet refuse to spend the money to get them the help they require.

I had this situation over the last couple of weeks with a mother who was overwhelmed with her 20-year-old son’s anorexia and the obsessive-compulsive behaviors that come with it. However, overwhelming his behavior is to her, she stated that she did not have the money to invest in his treatment.

While doing the Detailed Personal History with her son while his mother was present, the son was unable to recall any memories without her prompting him. He has a flat affect, meaning there was zero emotion in anything that he said, even those events that would have been very distressing in a person with normal emotional responses. He had shut down his emotions a long time ago. For him, all that mattered was to get what he wanted which was workout equipment so he could go back to his desire to drop fat and go for those wonderfully formed muscles he envisions as perfection for the male form. This is in fact what is called in the psych world “muscle dysphoria” and how males express their anorexia. No matter how large their muscles are or how great their 6-pack abs are, the anorexic male will not be able to see it, much as a female who has starved herself with only the skeletal form looking back at her in the mirror, she still perceives herself as fat, which is known as ‘body dysmorphia.’

I gave the mother the cost of a program that will run for 1 year given how stuck in this obsessive thinking and behavior or son is, the anorexia having progressed fairly far. He noted that he had never stopped his anorexic thinking or behavior much to the shock of his mother who thought he had stopped for a couple of years. Even so, her response was that she was overwhelmed with the bills to rehab the house she bought so that her son could have a gym set up given his obsession with the idea that this is all he needed to be happy and healthy again but this time he was going to drop the weight in a healthy manner instead of many pounds in a short amount of time as he did the last time he dropped a massive amount of weight. What his mom fails to understand is that if she gets the workout equipment her son will be back into the anorexic mode over working out stressing out his body to create a perfect male form that he will never acknowledge he attained given the muscle dysphoria.

One thing that I want to make clear is that during the taking of the Detailed Personal History she made it clear that her son really needed to get the help and begged him to move forward. Then after he did a piece of homework I gave him to help him figure out if this was the correct thing for him to do for himself, he answered that it was. So to have his mother beg him to get the help and then pull it out from under him was at the very least another emotional harm that he has suffered on top of a childhood of trauma full of losses starting when he was 4 years old. This was most likely the main reason he developed this illness in the first place. To find some method of feeling in control of his life.

Parents: You need to understand that so long as you are the legal guardian for your children, it is your responsibility to get whatever help they need in this life as they are unable to do it for themselves. To sit there and realize that there is a terrible situation going on as is indeed the case with any person who is suffering from anorexia, the #1 killer of kids between the ages of 12 and 24, the amount of money paid is negligible in the face of what will happen if the body of your child breaks down because of malnutrition, and could ultimately die. This is not being sensational in the least – it is a fact of how this illness progresses.

But, even if the son didn’t have an illness with such a high mortality rate, a child in distress deserves to receive the help to deal with whatever the underlying issues are that are causing them distress in that child.

I have had many teenagers on Quora (a forum where anyone can ask a question and then others answer them) in particular ask how they can go about asking their parents to get them a therapist, feeling that their parents will not take them seriously, or worse downplay the very negative thoughts and feelings that brought the kid to the understanding that they were in emotional difficulty and need help. I always advise them to be direct with their parents and explain what they are thinking and feeling that brought them to the conclusion that they could use therapy. However, there are those parents who don’t believe in it or don’t believe their kids are in that bad a situation where therapy is necessary.

Understand that if your child is telling you that they need therapy they aren’t doing so because they are happy with the situation. They are asking you for the help because they are feeling miserable and in the case of eating disorders are physically damaging their bodies with malnutrition and in many cases other forms of self-harm as well including purging food eaten which harms the esophagus, throat, and teeth from the acid in the stomach, cutting themselves with razors, using laxatives sometimes to the point where the anal sphincters no longer keep the fecal material inside the body, over-exercising which stresses out the body even more because of the lack of calories being eaten by the anorexic, etc. Many anorexics die of heart attacks from that stress and others die from infections their malnourished bodies are incapable of fighting off.

However, even a child who is feeling anxious all the time is running too much cortisol in their body and that is damaging as well, as the body can’t be in flight or fight mode without it causing other problems physical health problems.

If a child is depressed and lonely, well this accounts for many of the suicidal attempts in females as they are more likely to use less deadly ways such as taking many pills or superficially cutting themselves than males who will use a gun or hang themselves.

We, adults, need to be much more sensitive and understanding to the pain that our children are going through especially in this time of lockdowns, masks wearing which is not only uncomfortable but isolating as we can’t see the facial expressions of others and of course the fear of those graduating high school and college of ever being able to find a job that will pay enough to pay for living on their own. Our kids are in deep trouble these days, more so than adults because they have no control over their own lives not having the resources necessary.

So, do your best to be present with your child. Recognize if their habits have changed – sleeping more, or having insomnia as the negative thoughts and fears run through their brains. Eating much more or playing with the food instead of eating it. No longer do those things that they once loved to do. Isolating instead of spending time with their friends. Grades sliding in school. And, any signs that they are using drugs or alcohol to self-medicate their emotional problems. Our kids deserve that much from us as their guardians and protectors.