Borderline personality disorder vs bipolar: the two mental health conditions are often confused. Both are similar in the sense that they cause symptoms of impulsivity and mood swings. However, the way they affect your day-to-day life and how they should be treated are greatly different.
The purpose of this article is to dissuade the confusion and identify what each of these disorders really are. At the end, we invite you to ask further questions you may have.
What is Bipolar Disorder?
Sometimes referred to as manic depression, a bipolar disorder is categorized by energy, mood, and your ability to function throughout daily responsibilities. People with bipolar will experience both manic and depressive episodes, each of which come with their own set of symptoms: ¹
- Being “jumpy” or “wired”
- Feeling very “up” or “high”
- Lack of sleep (potentially insomnia)
- Loss of appetite
- Participating in reckless activity
- Racing thoughts
- Sense of importance (or power)
- Talking very fast about a lot of different topics
- Unreasonable self-confidence
- Difficulty concentrating
- Feeling very “sad,” “down,” “hopeless,” and “empty”
- Inability to perform simple tasks
- Increase in appetite (potential weight gain)
- Loss of interest in activities you once enjoyed
- Slow talking (forgetting a lot)
- Suicidal ideation
- Trouble falling to sleep
Unlike personality disorders, bipolar symptoms will not appear due to a interpersonal conflict. Rather, they will present themselves in intervals – lasting for days to weeks to months. ²
How is Bipolar Disorder Treated?
Since bipolar disorder is a lifelong condition, treatment needs to be consistent. This usually involves: ³
- Mood stabilizers
- Cognitive behavioral therapy (CBT)
- Family-focused therapy
- Interpersonal and social rhythm therapy (ISRT)
Furthermore, some people find relief from a number of holistic treatments and all-natural medicines, such as black cohosh.
What is Borderline Personality Disorder?
Similar to bipolar disorder, borderline personality disorder (BPD) is characterized by continuous patterns in mood as well as behavior that can lead to impulsive actions. However, it also incorporates self-image issues and cause a lot of problems in relationships. ⁴
People with BPD are likely have their interests and convictions change rapidly due to their view of themselves. In turn, their beliefs may be extreme – whether good or bad. For example, a person who’s seen as a friend one day may become an enemy the next.
BPD symptoms include:
- Abandonment issues (avoiding real or imagined abandonment)
- Anger issues
- Distorted sense of self
- Extreme changes in beliefs and moods
- Feeling of emptiness
- Impulsive behaviors
- Intense and unstable relationships
- Suicidal ideation and self-harming behaviors
- Trust issues
Unlike bipolar disorder, BPD symptoms are triggered by an interpersonal conflict. However, these conflicts may appear to be insignificant to those around them. For example, a brief moment without a loved one may lead someone to have a BPD episode.
How is BPD Treated?
Also different from bipolar disorder, BPD is extremely difficult to treat. There are new and evidence-based treatments that are effective in leaving someone with fewer or less intense symptoms. These treatments are mostly made up of the following psychotherapies: ⁵
- Cognitive behavioral therapy (CBT)
- Dialectical behavior therapy (DBT)
While there are no medications for treating BPD directly, some psychiatrists may prescribe certain substances to help in managing specific symptoms, such as mood swings, depression, or co-occurring mental disorders.
BPD Misdiagnosed as Bipolar
BPD often looks like bipolar disorder and vice versa. While these mental health conditions aren’t necessarily independent of one another (for they do retain similar symptoms), a misdiagnosis may lead a psychiatrist to improperly treat your condition.
In one study, it was revealed that 40% of people who met the diagnosis criteria for BPD but not bipolar disorder were still misdiagnosed with Bipolar Type 2. ⁶ This was due to an overlap in symptoms, such as impulsivity, intense emotions, and suicidal ideation.
BPD may also be misdiagnosed for anxiety, depression, eating disorder, post-traumatic stress disorder (PTSD), and a substance abuse disorder.
Mood Disorder vs Personality Disorder
In order to further differentiate bipolar from BPD, it can help to understand the difference between a mood disorder vs personality disorders.
- Mood disorders are a person’s relationship with their emotions as well as how they handle those emotions. Examples include bipolar disorder, depression, dysthymia, and seasonal affective disorder (SAD). ⁷
- Personality disorders are a pattern of thoughts, beliefs, as well as behaviors that aren’t normal. These patters will vary depending on a person’s personality. Examples include obsessive-compulsive personality disorder, borderline personality disorder, and schizoid disorder. ⁸
While symptoms between the two disorders may be similar, the way a person handles those symptoms will differ. Therefore, treatment for each disorder also varies.
Can You Have Bipolar and BPD?
Yes. While it’s important for you to be aware of the differences between bipolar and BPD, there is a chance you can have a dual diagnosis. In order to clarify whether you do or not, you must show signs of symptoms unique to both bipolar and BPD:
Unique Symptoms of Bipolar Disorder:
- Depressive symptoms within your manic episodes (also referred to as a “mixed episode”)
- Manic episodes which cause euphoric and “high” feelings
- Troubles with the quality and quantity of sleep you receive
Unique Symptoms of BPD:
- Anger issues (intense and sometimes uncontrollable)
- Daily emotional changes triggered by relationships or other stressors
- Feelings of boredom and emptiness
- Intense relationships where you’re unable to regulate emotions
- Self-harming behaviors (i.e. cutting, burning, hitting, injuring yourself)
Which is Worse: Bipolar or BPD?
Each conditions comes with their own set of difficulties and, therefore, there isn’t one which is worse than the other. Whether you have BPD or bipolar disorder or both, it’s important to receive the proper treatment in order to manage emotions.
While BPD and bipolar disorder have a lot of similarities, their key differences require varying treatment methods. If you’ve been diagnosed with one and believe you’re struggling with the other, it’s important to note your concern to your doctor.
Still have questions concerning borderline personality disorder vs bipolar disorder?
We invite you to ask them in the comment section below. If you have any further knowledge to share – whether personal or professional – we’d also love to hear from you.
¹ National Institute of Mental Health (NIMH): Bipolar Disorder
² Current neuropharmacology: Free Interval Duration: Clinical Evidence of the Primary Role of Excitement in Bipolar Disorder
³ Agency for Healthcare Research and Quality: Treatment for Bipolar Disorder in Adults: A Systematic Review
⁴ National Institute of Mental Health (NIMH): Borderline Personality Disorder
⁵ Current Behavioral Neuroscience Reports: What Works in the Treatment of Borderline Personality Disorder
⁶ HHS Public Access: Borderline Personality Disorder and the Misdiagnosis of Bipolar Disorder
⁷ MentalHealth.gov: Mood Disorders
⁸ National Institute of Mental Health (NIMH): Personality Disorders