While we have more knowledge and understanding of mental health conditions today than ever before in history, some jargon can still confuse you. It is very common to mistake bipolar disorder and borderline personality disorder (BPD) for one another, as they present in somewhat similar ways. But if you look closer, these two are completely different conditions. Knowing the differences between bipolar and BPD can help you or a loved one seek the care you need and deserve early, as early intervention enhances recovery outcomes.
What Is Bipolar Disorder?
Bipolar disorder is a mood disorder. It is characterized by extreme highs (mania/hypomania) and extreme lows (depression). Nearly 4.4% struggle with bipolar disorder at some point in their life in the U.S.
Bipolar disorder is further divided into three subtypes:
Bipolar I Disorder – Bipolar I disorder is characterized by at least one manic episode. This manic episode may be followed by hypomanic and depressive episodes.
Bipolar II Disorder – Bipolar II disorder is characterized by patterns of hypomanic and depressive episodes, without full-blown manic episodes. Hypomanic episodes are of lower intensity than manic episodes.
Cyclothymic Disorder – Cyclothymic disorder, or cyclothymia, is characterized by periodic phases of hypomania and depression that last for a period of time – at least two years.
What Is Borderline Personality Disorder (BPD)?
Borderline personality disorder, or BPD, is a personality disorder. This means that it affects how you relate to yourself and others.
BPD is characterized by a very strong fear of abandonment, which is why it is defined by an intense yet unstable pattern of relationships along with an unhealthy way of perceiving oneself. Nearly 1.4% struggle with BPD at some point in their lives in the U.S.
BPD is also further divided into four subtypes –
Discouraged BPD – Discouraged BPD, or quiet BPD, is called as such as persons with this condition tend to internalize their emotions rather than express them openly.
Impulsive BPD – Impulsive BPD is characterized by intensely uncontrollable impulsive behavior.
Petulant BPD – Petulant BPD is characterized by intense and sudden mood shifts. For instance, they can shift from anger to sadness quickly.
Self-Destructive BPD – Self-destructive BPD is characterized by self-loathing, which is why it leads to emotional instability and self-harm.
In a nutshell, impulsive behavior, emotional reactivity, and self-harm (including suicidal thoughts and ideation) are some common features of BPD.
If anybody is experiencing suicidal thoughts or ideation, please call national suicide helplines like 9-8-8 in the U.S. immediately. This can be a life-saving move.
What Are the Differences Between Bipolar and BPD?
When it comes to bipolar vs. BPD, these mental health conditions share some similarities, such as unstable mood patterns and difficulties in maintaining relationships.
As bipolar disorder is characterized by mood shifts between manic highs and depressive lows, these mood shifts seem extreme and ever-changing. Especially the manic highs can lead to impulsivity and other kinds of reckless behaviors. Moreover, it becomes difficult to maintain healthy interpersonal relationships with this kind of mood disorder.
Meanwhile, borderline personality disorder (BPD) is also characterized by emotional dysregulation, intense mood shifts, and unstable relationships.
Yet, there are differences in bipolar disorder vs BPD in that bipolar disorder is related to chemical imbalances in the brain, while BPD is mainly rooted in insecure attachment patterns and early trauma.
| Features | Bipolar Disorder | Borderline Personality Disorder |
| Categorization | Mood disorder | Personality disorder |
| Core Features | Mania/hypomania and depression. | Fear of abandonment, emotional reactivity, impulsive behavior, and self-harm. |
| Mood Patterns | Episodes of mania/hypomania and depression, where each can last for days/weeks. | Rapid mood shifts |
| Triggers | Mainly related to neurochemical/biological factors. Happen spontaneously. | Typically related tp interpersonal events. |
| Primary Treatment | Medication management involving mood stabilizers and antipsychotics. | Psychotherapy, especially dialectical behavior therapy. |
Bipolar Vs. BPD: Why Are They Often Confused?
- In the conversations regarding bipolar disorder vs. BPD, it is easy to get confused between the two, as both involve mood instability, impulsivity, and suicidal thoughts and ideation.
- Emotional highs and lows show up in both. However, the trigger and speed at which these patterns show up differ in both.
- Co-morbidity levels are high; sometimes, both of these conditions co-occur. Bipolar disorder and BPD can co-exist and worsen each other’s symptoms.
What Are the Differentiators to Look for if Unsure?
If you or someone you know is trying to understand whether they are struggling with bipolar disorder or BPD, then these are some differentiators you need to look out for:
- How long do mood swings last – within a few hours (BPD), or a few days or weeks (bipolar disorder)?
- What is the reason for these mood changes – fear of perceived abandonment (BPD), or without any such external triggers (bipolar disorder)?
- Is there a history of manic/hypomanic and depressive episodes – where there is heightened energy, risky behavior, and low mood and energy (bipolar disorder).
- Do you struggle with persistent issues of identity, self-worth, and fear of rejection (BPD)?
While these questions are not enough to diagnose yourself with one or the other – they can give you an idea. A medical diagnosis can only be made by licensed and trained mental health specialists.
How Is Bipolar vs. BPD Diagnosed?
To diagnose bipolar disorder, mental health specialists will conduct clinical interviews regarding your symptoms of distinct mood episodes and perform physical examinations, like blood tests, to determine whether other medical conditions are the reason for your symptoms. If this is ruled out, then a bipolar disorder can be diagnosed.
To diagnose borderline personality disorder, mental health specialists will use the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) and ask you some questions around:
- Medical history and family history involving mental health conditions.
- Emotions and mood patterns.
- Impulse and behavioral control.
Basically, a BPD diagnosis hinges on five of the nine criteria:
- Fear of abandonment
- Unstable relationships
- Emotional instability
- Inappropriate anger
- Persistent feelings of emptiness
- Paranoia or dissociation
- Self-harm and suicidal behavior.
Treatment for Bipolar Disorder vs. BPD
Bipolar disorder treatment primarily involves medication management with mood stabilizers and antipsychotics. Along with medication, psychotherapy and lifestyle modifications can help in managing the condition.
BPD is mainly treated with psychotherapy, specifically dialectical behavior therapy. Medication management can also help manage symptoms of anxiety and mood-related disturbances. However, no single medication is approved for the treatment of BPD.
Please remember, bipolar disorder or BPD cannot be cured – it needs to be managed. Along with treatment, early, accurate diagnosis, consistent treatment, and a strong support system can enhance the prognosis to where you or a loved one can lead a fulfilling life.
Your Path to a Brighter Future Begins at Skyline Recovery
Understanding the differences between bipolar and BPD is one of the steps you take to be informed in your journey to recovery. However, please remember that you are not alone in this journey – neither do you have to do this on your own.
At Skyline Recovery Center, we offer personalized outpatient recovery options for both bipolar disorder and BPD. Our experts tailor your treatment to your recovery needs as you journey toward a brighter, healthier tomorrow – which is just on the horizon.
Please call us at (424) 353-5206 to schedule a free, confidential consultation today!