Order The Borderline Personality Disorder Workbook by Dr. Fox: https://goo.gl/LQEgy1

Depression, specifically MDD is seen in 83% of those with BPD

There is significant symptoms overlap:

• Sullen presentation mimics depressive symptoms

• Suicide risk and self-harm

• Affective instability = Intense episodic dysphoria; Frequent temper outbursts, agitation, irritability mimic agitated depression

• Feelings of emptiness

• Stress-related paranoia severe dissociative symptoms mimic depression with psychotic features.

Depressive symptoms that occur in those with BPD are due to identifiable stressor (instance of rejection, perceived abandonment) and depression remits when stressor removed or relationship is restored.

Depressive symptoms may be expressed to communicate feelings, such as anger, frustration, helplessness, disappointment, etc. These tend to be due a difficulty in expressing those emotions. These states do not respond to medication and require building emotional identification and communication skills.

Treatment steps if you believe you may have depression comorbid with BPD:

1. Identify the symptoms related to BPD outside of depressive symptomatology.

a. Do they last even when trigger, emotional button, or occurrence has ended?

2. Find the underlying driving force for the BPD symptoms; this is the client’s “core content” (i.e., abandonment).

3. Determine how the core content is driving BPD symptoms? For example, if the client has abandonment issues, how do you think, feel, and behave when perceived abandonment occurs?

4. Can you recognize the connection between perceived abandonment and BPD and depressive symptom expression?

5. Learn adaptive coping strategies, such as mindfulness, relaxation, or healthy distraction, when core content is triggered.

6. Address the fear of letting go of old maladaptive patterns; “no one will love me if I’m not depressed or broken”.

7. Learn new ways to see them themselves and their world without their core content, fear, and maladaptive strategies.

Daniel J. Fox, Ph.D., is a licensed psychologist in Texas, international speaker, and award winning author. He has been specializing in the treatment and assessment of individuals with personality disorders for over 15 years in the state and federal prison system, universities, and in private practice. His specialty areas include personality disorders, ethics, burnout prevention, and emotional intelligence.

He has published several articles in these areas and is the author of:

The Borderline Personality Disorder Workbook: An Integrative Program to Understand and Manage Your BPD. Now Available, you can order it now at: https://goo.gl/LQEgy1

Antisocial, Borderline, Narcissistic and Histrionic Workbook: Treatment Strategies for Cluster B Personality Disorders (IPBA Benjamin Franklin Gold Award Winner): https://goo.gl/BLRkFy

Narcissistic Personality Disorder Toolbox: 55 Practical Treatment Techniques for Clients, Their Parents & Their Children: https://goo.gl/sZYhym

The Clinician’s Guide to Diagnosis and Treatment of Personality Disorders: https://goo.gl/ZAVe9v

Dr. Fox has given numerous workshops and seminars on ethics and personality disorders, personality disorders and crime, treatment solutions for treating clients along the antisocial, borderline, narcissistic, and histrionic personality spectrum, emotional intelligence, managing mental health within the prison system, and others. Dr. Fox maintains a website of various treatment interventions focused on working with and attenuating the symptomatology related to individuals along the antisocial, borderline, narcissistic, and histrionic personality spectrum (www.drdfox.com).

YouTube: https://www.youtube.com/c/DrDanielFox

Dr. Fox’s website: http://www.drdfox.com/

Facebook: https://www.facebook.com/appliedpsychservices/

Twitter: https://twitter.com/DrDanielJFox1

LinkedIn: https://www.linkedin.com/in/drdfox/

Instagram: https://www.instagram.com/drdfox

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