BPD is a very different diagnosis than schizophrenia, though the two can co-exist. While BPD is characterized by a pattern of instability in interpersonal relationships; schizophrenia is characterized by a range of cognitive, behavioral, and emotional dysfunctions.
Adult patients with BPD experience a wide range of other psychotic symptoms in addition to AVH, including hallucinations (11% visual hallucinations, 8% gustatory hallucinations, 17% olfactory hallucinations, 15% tactile hallucinations [19]), thought insertion (100%), thought blocking (90%), being influenced by another ...
Borderline personality disorder (BPD) is one of the most frequently used clinical diagnoses in both US and Europe. According to DSM-5 [1], the prevalence of BPD among inpatients is 20% and thus approaching the level of schizophrenia [2].
Cluster A personality disorders and avoidant personality disorder seem most commonly to antedate schizophrenia.
Schizotypal personality disorder can easily be confused with schizophrenia, a severe mental illness in which people lose contact with reality (psychosis).
Schizophrenia and Borderline Personality Disorder (BPD)
One study found that both patients with schizophrenia and patients with BPD experience hearing voices. The difference between the two being that paranoid delusions occurred in less than one-third of patients with BPD, compared with two-thirds in schizophrenia.
Between 50% and 90% of patients with BPD report hearing voices that other people do not hear (Yee et al., 2005; Kingdon et al., 2010). Importantly, such auditory verbal hallucinations (AVH) are a risk factor for suicide plans, attempts, and hospitalization (Miller et al., 1993; Zonnenberg et al., 2016).
Factors suggesting BPD include a pattern of worsening psychotic symptoms during stress, long-term symptom instability, lack of delusions, presence of dissociation, and nonresponse to antipsychotics.
You could have: Hallucinations: Seeing or hearing things that aren't there. Delusions: Mistaken but firmly held beliefs that are easy to prove wrong, like thinking you have superpowers, are a famous person, or people are out to get you. Disorganized speech: Using words and sentences that don't make sense to others.
What is Known About BPD Today. Today, the term “neurosis” isn't used as a diagnosis, and BPD is not considered a disorder falling under the category of psychosis. BPD officially became a personality disorder in 1980 in the Diagnostic and Statistical Manual of Mental Disorders III (DSM III).
Paranoia as a Symptom of BPD
Under the influence of non-delusional paranoia, people with BPD may see signs and symbols of hostile intent everywhere. They may detect hidden meanings in speech, body language, casual glances, and other behaviors that would seem non-threatening or perfectly benign to anyone else.
Residual Schizophrenia
This specific type is characterized by when an individual doesn't display positive symptoms of paranoid schizophrenia (hallucinations, delusional thinking), although they still have the negative symptoms or more mild schizophrenia symptoms (no expression of emotions, strange speech).
Recent findings: Both auditory hallucinations and delusional ideation (especially paranoid delusions) are relatively common in individuals with BPD.
It is called 'borderline' because doctors previously thought that it was on the border between two different disorders: neurosis and psychosis. But these terms are no longer used to describe mental illness. It is sometimes called emotionally unstable personality disorder (EUPD).
Hallucinations, Childhood Trauma and Dissociation
Hallucinations in BPD are also associated with posttraumatic stress disorder and a history of childhood trauma, especially emotional abuse,17 but sexual and physical.
Schizoaffective disorder.
People with schizoaffective disorder have the same symptoms as people with schizophrenia. But they also have episodes of depression and times when they feel extremely happy or have lots of energy (mania). For more information, see the topics Depression and Bipolar Disorder.
Intense outburst of anger. Repeated involvement in risky, impulsive behaviors. Lack of a stable or clear self-image. Intense, often unreasonable fear of being abandoned.
Rapid changes in self-identity and self-image that include shifting goals and values, and seeing yourself as bad or as if you don't exist at all. Periods of stress-related paranoia and loss of contact with reality, lasting from a few minutes to a few hours.
For example, a person with borderline personality disorder also may be more likely to experience symptoms of major depression, PTSD, bipolar disorder, anxiety disorders, substance use disorder, or eating disorders.
Suppressing Emotions
Many with quiet BPD, especially those who experienced childhood trauma, hide their feelings because that is what they learned to do to survive when they were younger. You might believe your emotions are only acceptable if you appear in good spirits.
Many people who live with borderline personality disorder don't know they have it and may not realize there's a healthier way to behave and relate to others.
Quiet BPD looks different from 'typical' BPD. Having Quiet BPD means you 'act in', rather than act out. You may not have stereotypical BPD symptoms such as frequent anger outbursts – instead you suffer in silence. You may appear calm and high functioning, instead of 'exploding', you implode and collapse from within.
In the general population, it is estimated that approximately 20% of men with BPD also present ASPD [5].