Depression is Different in Those with Borderline Personality Disorder BPD

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Please watch: “How You Can Control Your Emotions with Dr. Fox – Affective Regulation” –~–

This is a complex issue, depression in those with BPD (borderline personality disorder). Depression is seen in 83% of those with BPD.

There is significant symptoms overlap between depressive symptoms and BPD:
• 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.

Topics discussed are:
Depression BPD but not a depressive disorder
Is BPD an affective disorder?
What about early experiences?
What about Medication?
Medication or therapy?

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.

Emotions exercise –

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 –COMING SOON–

Antisocial, Borderline, Narcissistic and Histrionic Workbook: Treatment Strategies for Cluster B Personality Disorders (IPBA Benjamin Franklin Gold Award Winner):

Narcissistic Personality Disorder Toolbox: 55 Practical Treatment Techniques for Clients, Their Parents & Their Children:

The Clinician’s Guide to Diagnosis and Treatment of Personality Disorders:

Dr. Fox has been teaching and supervising students for over 15 years at various universities across the United States, some of which include West Virginia University, Texas A&M University, University of Houston, Sam Houston State University, and Florida State University. He is currently a staff psychologist in the federal prison system, Adjunct Assistant Professor at University of Houston, as well as maintaining a private practice that specializes in the assessment and treatment of individuals with complex psychopathology and personality disorders.

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 (

Dr. Fox’s website:
Amazon Author’s Page:

Thank you for your attention and I hope you enjoy my videos and find them helpful and subscribe. I always welcome topic suggestions and comments.


Gunderson J. Borderline personality disorder: a clinical guide. 2nd ed. Washington, DC: American Psychiatric Publishing, 2008.

Gunderson JG, Morey LC, Stout RL, et al. Major depressive disorder and borderline personality disorder revisited: longitudinal interactions. J Clin Psychiatry 2004; 65: 1049-1056.

Galione J, Zimmerman M. A comparison of depressed patients with and without borderline personality disorder: implications for interpreting studies of the validity of the bipolar spectrum. J Pers Disord 2010; 24: 763-772.

Klein DN, Schwartz JE. The relation between depressive symptoms and borderline personality disorder features over time in dysthymic disorder. J Pers Disord 2002; 16: 523-535.

Grilo CM, Stout RL, Markowitz JC, et al. Personality disorders predict relapse after remission from an episode of major depressive disorder: a 6-year prospective study. J Clin Psychiatry 2010; 71: 1629-1635.

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Lindsey Cavanagh says:

Thank you for this. I have major depression and BPD and this really helped me understand myself more

Payne3991 says:

The map behind you confuses the hell out of me. Why has a miniature Alaska & NW seaboard been spiced into half of Mexico?

Jellii Beanz says:

Yeah it's different. It's when they are devoid of narc supply

Angela Walden says:

Thank you for sharing this in a way that the general public can better understand.

Mike Roberts says:

Thank you for that load of disorganized and useless psychobabble.

abby debisschop says:

Thank you for being so generous with your knowledge and insight on this topic. It means the world knowing intelligent people like you are out there exploring ways to help those with this disorder.

jrg305 says:

I work as a licensed dietitian in private practice (often a first line intervention unlicensed psychotherapist, as people come in with disordered eating and eating disorders referred by physician). What is frustrating for me is getting a client to recognize it isn't just their eating and they need to work with a therapist. Then they often wont see a therapist in spite of recommendation or not click with them as good as they click with me, the therapist knows nothing about nutrition and doesn't see the relationship and their role, the therapist only does skills work (CBT/DBT), etc. As such, I can view myself merely as objective information giver on food and nutrition, or I can try to provide care where no one else is providing the needed care. It seems like a specialty that could be covered by both a therapist and a dietitian, depending on either's training and post graduate extra training and experience.
So I read therapy books and watch psych videos and ask my therapist of 8 years (he is a modern psychoanalytic) for tips. But I am highly colored by his practice technique, which doesn't diagnose personality disorders and find it confusing because all the rest of the mental health field seems to work around these diagnosis/medical model.

Leslie Pfeifer says:

My personality disorders have been turned up big time due to my losing my vision in one eye. But I'm working through it. •Heavy sigh•

La Wo says:

Love your videos and approach 😊

Paully Peanuts says:

Ive had cops think I’m on hard drugs because I was too nervous/scared to articulate verbal language when being questioned. Having an episode in front of them didn’t help my case.

B. Neron says:

“Your doctor wants to help you”… your doctor wants to sell pharmaceuticals…

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