DSM 5 debate
 

so the DSM 5 has been rumored to be coming out for 2 years and they've just said they now hope it will be out in 2013..there are lots of debates that are stopping the publication but one big one interests me and my psychiatrist and i talked about it and i thought other people might be interested..

as it is in the DSM 4 BPD (borderline personality disorder) is under the section of personality disorders however there are some people who want it to be changed..
the idea is that BPD will be removed from the DSM and entered as CPTSD (complex post traumatic stress disorder)..which already exists on its own..however 99.9% of people diagnosed with BPD are also diagnosed with PTSD (post traumatic stress disorder) so they want to combine the diagnosis as CPTSD..

this would make a huge change in treatment most psychs agree that as a personality disorder you can not recover from BPD..you simply learn to live with it but by changing the title to CPTSD it puts it in a different section of the DSM and it becomes a disorder that people can recover from with the right treatments..

what do others think? should it be changed or stay they same? should treatment be changed so it can become a treatable disorder and give hope to sufferers instead of just being something that they have to learn to live with?

It should stay the same because of that .1 percent. I technically have BPD but I do not have PTSD.
I'm sure that this is the case with quite a few of us here as well...

agree with Flem.

what would happen to the treatment for the remaining .1%?

Agree with the above.

I'm another one of this supposed tiny minority who have BPD and not PTSD.

& the symptoms of BPD fit me really well so I don't think I've been misdiagnosed.

This thing is going to be a mess. Its had drug companies and political interests stretching it in 100 different directions

I don't really believe the statistic would be up at 99.9%.

I think the integration of a new self-injury based disorder might make the classification of borderline more accurate. But I don't know enough about it co-occurring with PTSD, but it seems to me that if you have both then to diagnose both makes sense and instead challenge the notion that it cannot be treated. Really we're just changing names here and if it can be treated as a CPTSD why not have it treatable as a PD?

I just wish they'd stop trying to label any consistent self harmer with BPD, the amount of times without even sitting down and talking to me someone has brought up the suggestion of BPD, then having met me realised oh wait, that doesn't quite add up is unreal, so much time has been wasted on a diagnosis that all have eventually agreed that I don't have.

This.

There're those of us who totally meet the C-PTSD criteria, but because it isn't in the DSM, and because we are sub-threshold for Borderline, we just get this Depression with sprinklies business.
Yeah.

You can recover from BPD so the psychs that say you cannot are rubbish. It has been know for a while that PDs are recover-able but they take a long time to get better from.

I kind of agree because I think what they mean is thoes who have had a poor upbringing or difficulties at home during their development could be classed as a form of PTSD. There does not have to be a specific event for post traumatic stresses to occur and the theory is: where did the fears of abandonment and the unstable interpersonal relationships come from if not during a disturbed upbringing, at home or school or whatever? Hence everyone that fits the criteria for bpd has some PTSD symptoms, technically.


I think it is valid and I agree with it.
I think the argument is that they change the criteria slightly for CPTSD meaning more people with BPD symptoms will fit it.

^ See that's where I'm confused with my diagnosis, because I had a really happy childhood and upbringing, with nothing that could really be described as enducing any form of PTSD.

I would no longer fit into it if it were changed.

late teens/early twenties, female, self harms = BPD

seems to be how it goes at the moment

i also don't have any PTSD symptoms, that i know of.

This.
Can i ask for a source from the OP for this statistic, as it seems ludicrous to me.

I've heard that BPD and several other PD's are being clustered together and labelled Emotionally unstable personality disorder.

I don't know how that is relevant but just wanted to add it as I found it interesting when I was told it by the manager of a NHS Personality disorders support group.

That seems reasonable, as for example histrionic and borderline personality disorder may have slightly different presentation, but are both quite well-explained under the umbrella of emotionally-unstable.

Also, Katie, wouldn't you just get diagnosed with PTSD then, given that C-PTSD isn't in the DSM?

i've always been diagnosed with emotionally unstable pd, just use bpd because it's less to type out...

i thought it was the same thing?

Furthermore, in response to what Kate [Ballerina123] said, I would disagree with the fact that a lot of the BPD symptoms are related to PTSD. I wouldn't say a difficult upbringing, abandonment issues from an absent parent or poor interpersonal relationships due to turbulent friendships would count as 'trauma' as such. I see a danger in expanding the definition of trauma and PTSD as it may well fall into the bracket of medicalising 'normal' life.

e.g. I grew up in what other relatives have described as being a very strict household, and have had some difficult experiences which are 'traumatic' to me, but so does every other Tom Dick and Harry and to medicalise that seems unwise. Fair enough, I have a personality disorder which is a combination of biological factor and environmental factors and the way I personally adapted to them, but to take any one of those factors and say I have PTSD from it makes them into something they're not.

I'm unsure if I make ANY of the sense here.

That said, I have a diagnosis of BPD and therapists/professional folks always say I don't seem Borderline in person. There is a stereotypical presentation, and then there are people like me who fit the criteria technically, but the presentation may also be caused by other things such as PTSD and OCD and Psychosis. I'm not saying you have BPD, I'm saying you may fit the criteria an potentially benefit from that kind of treatment due to other factors.

Really, it doesn't matter what your diagnosed with as long as you get help that works. So if DBT would be helpful to a person who fits the criteria for BPD but that is due to the criteria being fulfilled by other conditions, then it would be beneficial to diagnose BPD to gain access to treatment.

I *think* BPD is DSM, and EUPD is ICD?

They clearly have not spent a lot of time with you...
:p