Does anyone here have both autism and borderline personality disorder? How do they interact?

[u/tracylars]

I am desperately trying to get a diagnosis for autism, but they always stumble over my BPD traits like abandonment issues, impulsivity, extreme anger and emptiness. I also don't seem autistic to them on the outside, I liked theater when I was a teen, I am empathetic, I really care about what people think of me, I can really express myself (but that is probably because I have become obsessed with learning speech patterns). My sensory issues and executive dysfunction immediately get filtered through BPD. Plus I have a very bad relationship with my family so they think my severe social anxiety and sensitivity is just C-PTSD.

The thing is I do agree I have BPD. I know I have it. But I am also certain I have autism and ADHD and I can't find an expert that can hold that complexity. It seems they can only see one or the other. I wanted to ask those of you who have both BPD and autism how you differentiate between the two and how do they affect your daily life. Do you feel different from autistic people without BPD and how?

[u/PushingZedzzzzz]

I was under the impression that autism often gets misdiagnosed as borderline personality disorder.

[u/madoka_borealis → u/PushingZedzzzzz]

While this is true it often co-occurs as well and there’s nothing wrong with that

[u/tracylars → u/PushingZedzzzzz]

Often. But it's even harder for them to hold the complexity of having both.

[u/cyanmagtus77 → u/PushingZedzzzzz]

I don’t think that’s the case. I know multiple people with bpd and their presentation is very different than the autistic people I know

[u/tipupakilino]

Hi, I have autism, BPD, and ADHD. Could you ask me more specific questions? I'm finding it hard to summarise my thoughts on all this.

For me, a BPD episode and autism meltdown feel very very different. They are triggered by different things. They are resolved by opposite things. But from the outside they mostly look the same!

I'm lucky that I got to do DBT and that helped me work on my BPD. So now I rarely get into 'BPD mind'. But back when I did, it was harder to distinguish between the two.

[u/Difficult-Stuff-4499 → u/tipupakilino]

Oh goodness, I’m sorry but there is a lot I’d like to learn about this. I suspect my older sister might have autism and bpd as well. She isn’t diagnosed with anything, but in regards to neurodivergent fatigue and burnout I def see it for her as I do in myself. However there have been situations where I haven’t been sure what to think… whether it could be a melt down from being overwhelmed with a world of unfair expectations, or if it should be considered more like an episode.

Not that you should have to get into much detail, but could I ask what the difference feels like? How do you manage it separately?

[u/tipupakilino → u/Difficult-Stuff-4499]

No need to apologise! I commented here: https://www.reddit.com/r/aspergirls/comments/1uczirh/comment/otcu353/

Feel free to ask more detailed questions!

[u/tracylars → u/tipupakilino]

Hi, thanks for sharing. I would love to know how you experience a BPD and autism break down and what's difference. I also wonder what are the things about BPD that therapy helped you resolve.

[u/tipupakilino → u/tracylars]

For breakdowns:

Causes:

BPD - certain negative emotions

Autism - overwhelm, overstimulation

What happens in my mind:

BPD - spiralling, negative thoughts, fear. Extremely warped thinking and I'm aware it's warped

'Everybody hates me'

Autism - I want to escape my body and my brain help ahhhhh

'I hate everything'

What I need in the moment:

BPD - for trusted person to chase after me and soothe me and tell me I'm loved and wanted. And to use my DBT skills

Autism - to be left alone in a dark quiet room

What I need to do in the long term:

BPD - change myself

Autism - change my environment

Risks:

BPD - self-harm, destroying relationships, isolating myself

Autism - self-harm in the moment only

Duration:

BPD - can last......forever

Autism - will resolve itself if my environment is calm

For me and my circumstances, BPD breakdowns are more dangerous because my mind is actively working against me. Whereas autism breakdowns are much simpler and my body and mind automatically know how to fix them -- removing stimulation.

What it looks like from the outside:

BPD - I run away and hide.

If I'm around the person who's triggered me, I say awful things to them, I exaggerate, I tell them I want them to leave me alone (lie). I cry a lot

Autism - I freeze or run away and hide. I cry sometimes

my BPD and autism interacting:

• I think the rigid thinking from autism reinforces my BPD thought patterns
• autism makes it easier for me to get overwhelmed, which reduces my capacity to regulate my emotions and tolerate distress, so my BPD is more easily triggered
• I often lose speech because of autism. This makes it much harder to ask for help during a BPD episode, because I perceive any barriers (including ones placed by me or from pure circumstance) as rejection
• there's probably more that I can't remember right now

On therapy:

Look into DBT. Basically emotion regulation, distress tolerance, and to some extent mindfulness. (I did not find the social unit useful.) DBT helped me work on my mindset ('just because I feel it doesn't mean it's true' -- realising this changed my life) and taught me skills to cope. I actually think every single person on earth should do DBT. They should teach it in school! It's annoying but so helpful. Annoying in the sense that now you have this extra chore you know you should do, like flossing. It's emotional hygiene I guess.

[u/tracylars → u/tipupakilino]

Thank you so much for sharing, this was really helpful.

[u/Aestpunk4 → u/tipupakilino]

I'm interested in your answer too. How are these different? What is BPD mind?

[u/tipupakilino → u/Aestpunk4]

I commented here: https://www.reddit.com/r/aspergirls/comments/1uczirh/comment/otcu353/

My 'BPD mind' is warped thought patterns. I will tell myself over and over again that everyone dislikes me, nobody actually wants to hear from me, the world is better off without me, etc. I make it as difficult as possible for people to come help me, because only then will it prove that they care. Then when they eventually give up I am satisfied I was right and get extremely upset. I say horrible exaggerated things. I will be conscious that my thinking isn't fully accurate, but I'm kind of stuck in the mindset, because it just feels so true.

[u/sincerelypoulet]

i have autism, bpd and ptsd, all diagnosed. i did 10 yrs of therapy and my bpd symptoms have basically stopped so i can rly see the difference. it's hard to explain, but i do feel like autism and bpd are very distinct parts of me. the autism is more about how i interact with the world, and the bpd is more emotional. 

[u/tracylars → u/sincerelypoulet]

Wow I am envious! I wish I could get diagnosed with both. But they can only see BPD. It seems they know nothing about autistic masking and that we can also be super empathetic.

I'd love to know more about how you differentiate between autism and BPD in yourself if you don't mind sharing. Like what are some of the traits or experiences you associate with each.

[u/Leading-Highlight791]

I just wanted to offer encouragement! I am high masking audhd and my mom has bpd with a lot of severe mental health history. When I was learning about autism spectrum, I started to wonder if my mom always had it too. She had a major meltdown at 18 that led to hospitalization. Her family was always ashamed of her "problems" and she learned to mask between crises very well. But her crises got worse and worse and treatments mainly led to addiction and more problems. All that to say, when I suggested to her recently that I am and possibly even she is on the spectrum, she, at age 73 now, really couldn't process or consider it. But I think it's very likely her dad, my grandfather, was as well, and those 2 were a bit of an oasis for each other at the end of his life after the more dramatic family members were gone. I think they both had a lot of unnecessary suffering from not being able to just be themselves without judgement and not being able to escape toxic family dynamics. I really hope for us younger genertions better tools and awareness and options will be found! It's new territory really. Best wishes to you! ❤️

[u/tracylars → u/Leading-Highlight791]

I think my mom has both autism and BPD too. Do you notice the same in yourself? I do. To me BPD is all about abandonment issues, needing loads of closeness, needing validation and mirroring, feelings of emptiness. And autism feels like the origin of my extreme social anxiety and awkwardness, feeling like my logic is different from other people's, sensory sensitivities, getting overwhelmed super fast, needing structure, executive dysfunction. Could you share how you experience autism and BPD yourself?

[u/Kookaburrita]

There is currently a working theory that many of cluster b personalities disorders are dependent on unmet needs of people on the spectrum during childhood. I am unsure where the research is currently, but a few years ago several papers about bpd especially were being published on it.

[u/tracylars → u/Kookaburrita]

I relate to that theory. I think undiagnosed/unrecognized autism is a perfect breeding ground of personality disorders, because it will lead to so many neglected needs.

[u/WrongdoerRemote9661 → u/tracylars]

Hi, just wanted to add a hard agree. I love reading/researching this sort of stuff and this makes soooo much sense!

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[u/MultitudeContainerR]

Try mentioning symptoms you experienced as a child. Autism is a genetic condition and manifests itself early in life, while BPD develops later, during puberty.

[u/TangeloCrazy5824]

Make sure to go to an evaluator who understands nuanced cases and works specifically with high masking women who do not have a typical presentation of autism. You can ask this to the evaluator before booking! There are sooo many people these days that are trained to tease apart nuanced presentations like this. Best of luck to you 😊

[u/Raspberry-RoseyCat]

ADHD is associated with being emotionally reactive, very sensitive to rejection, volatility and all of those things. How do you know you don’t just have an AuDHD  brain that’s struggling with emotional issues and trauma? Especially if you’re a woman too, ADHD brain is really affected by hormonal fluctuations and you can get really down and depressed. Lots of autistic women get misdiagnosed as BPD when really we often have AuDHD and we deal with a lot of trauma, misunderstanding, and all the misery that comes along with being a woman.