at sites all over the web the problem of treating BPD as an axis one problem causes shrinks to lose money so they typically list you as bi_polar (catch-all garbage bag) or they list you with clinical depression and medicare and insurance companies pay up. there is a national petition. they are similar but borderline has a couple of fairly important differences that affect my situation. one is the underlying "abandonment" issue and the second is meds. anyone out there conversant on this matter?
2006-12-13 20:23:13 · 6 answers · asked by Anonymous in Health ➔ Mental Health
You may have a point. My understanding is that it's an Axis 2 disorder, rather than Axis 1 (like Bipolar), but whatever. I think the issue for insurers is that treatment is open ended, and is all talk therapy rather than drugs, so their costs are unpredictable.
It may also be that the diagnosing psychiatrist stands to make money on follow-up appointments for Bipolar, whereas they would refer BPD to a psychotherapist or psychoanalyst and make no money...
2006-12-13 21:38:34 · answer #1 · answered by Random Bloke 4 · 2⤊ 1⤋
Borderline Personality Disorder is often co-morbid with another disorder, such as bipolar.
I see a psychopharmacologist and a clinical CBT psychologist and neither accept insurance - however, they will generalize the diagnosis and treatment to a vague description code on the bill so I won't run into any red tape when it comes to getting reimbursed and so that there's nothing to gawk at if my employer should have a look for some reason. Just because the bill reads one thing - doesn't mean that I'm not being treated properly.
The medication management approach is similar to both disorders. Anticonvulsants (aka mood stabilizers) are used as front line medication treatment, with an adjunct antidepressant and possibly anti-anxiety medication as well.
In addition to med-management therapy, it's strongly suggested that you participate in DBT (dialectical behavioral therapy). Which is modern approach which has been proven the most effective treatment for BPD patients.
I'm not sure what your questions are specifically - but there should be no logical reason why you can't get the treatment you need - unless your health plan doesn't cover mental illnesses.
2006-12-14 13:29:32 · answer #2 · answered by Altruist 3 · 0⤊ 0⤋
My understanding about borderline personality disorder, besides the impulivity is the black and white thinking and abandonment issues. This creates a paient that is very likely to leave treatment very prematurly, constantly switch between viewing the therapist as pure good or pure evil, tends to over step the doctor patient boundary, want to feel like the therapists only patient and constantly need reasuring that they will not be abandoned by the therapist. Oh, I almost forgot, while there are not complete splits in personality as there would be in a multiple personality disorder, borderlines do have different personas that can be displayed. One day the patient can act like management material and the next seem no more mature than a child. I'm sure there are other reasons that many don't want to treat borderline personality disorders, but these were the ones that I was most familiar with.
2006-12-14 12:19:42 · answer #3 · answered by ragtad 2 · 0⤊ 0⤋
According to articles online: The mainstay of treatment for BPD has always been, and continues to be psychotherapy. However, because of their impulsivity, about two thirds of borderline patients drop out of treatment within a few months. Those patients who stay in therapy will usually improve slowly over time - In my opinion and that of the "shrink" community, you need therapy, not drugs and therapy is available to people at little or no cost, you just have to be persistant. For the record, Bipolar disorder is not a catch-all garbage bag. The symptoms are very specific and require specific meds for life.
2006-12-14 06:43:37 · answer #4 · answered by Debra D 7 · 1⤊ 0⤋
The problem is that Borderline is a personality disorder this would go on axis two which according to the powers that be is incurrable and therefore cannot be billed for so in order to be able to treat a client many mental health professionals will put a Dx of bi-polar on axis one for which they can bill is this ethical that is open to debate but the alternative is to have a client who you turn away because you can not bill for them it is a ethical delimia oh and for those of you who say treat the client for nothing that to is done but even non profit orginizations have to make about 10% profit or go out of excistance sorry state of affairs but that is the truth
2006-12-14 09:29:09 · answer #5 · answered by needtoknow 3 · 0⤊ 0⤋
The ones I know would rather treat 10 schizophrenics than one borderline. Usually the borderline doesn't WANT to be helped (or rather, admit they have a problem).
But I don't see how classifying the disease would be the deal. Saying they're bipolar or borderline still means classifiying them with an label and they hate that.
2006-12-14 06:06:52 · answer #6 · answered by T J 6 · 1⤊ 0⤋