BPD vs. Bipolar: How Do They Compare?

borderline personality disorder vs. bipolar disorder

Borderline personality disorder is a serious mental health disorder affecting how someone sees themselves, others and the world around them. Bipolar disorder is a psychiatric disorder defined by both depressive and manic episodes in most people, although it may only include manic symptoms. People often wonder how to compare BPD vs. bipolar, and what the similarities and differences are.

What to Know About BPD vs. Bipolar

Before going into how borderline personality disorder and bipolar disorder compare, it’s useful to have an overview of what each of these conditions is on its own.

What Is Borderline Personality Disorder (BPD)?

Borderline personality disorder or BPD is a mental health disorder where a person will feel an extreme fear of abandonment. Other signs and symptoms of BPD include:

  • Extreme emotional reactions
  • Impulsivity
  • Patterns of unstable relationships
  • Intense mood swings
  • A distorted sense of self or self-image
  • Feeling empty, bored and isolated
  • Relationships that quickly change from idealization and intense love to hatred
  • Ongoing fear of rejection or being abandoned
  • Extreme reactions to real or perceived abandonment
  • Anxiety
  • Depression
  • Risky or self-destructive behaviors
  • Hostility or aggression
  • Instability in career or goals
  • The inability to self-soothe
  • Recklessness

While everyone might occasionally experience one or more of the symptoms above, someone with borderline personality disorder will have them consistently in their lives.

Unfortunately, around 80% of people who have borderline personality disorder show suicidal behaviors and anywhere from 4 to 9% of people with BPD die by suicide.

What Is a Personality Disorder?

Since BPD is defined as a personality disorder, it’s useful to know what’s meant by this term as well.

Personality disorders are defined by a person’s way of thinking, behaving and feeling. Everyone’s personality is different, but when someone has a personality disorder their thoughts, feelings and behaviors veer from cultural expectations, cause problems in functionality and lead to distress, especially for the people around them.

There are ten personality disorders, and these typically begin to appear by early adulthood.

Personality disorders can be treated, and some people see good outcomes. Psychotherapy, also known as talk therapy, is the primary form of treatment for personality disorders including borderline personality disorder.

While doctors and researchers aren’t entirely sure what causes personality disorders like BPD, it’s likely a combination of genetics and differences in certain areas of the brain. In particular, someone with BPD might have differences in the parts of the brain that manage emotions, aggression, and impulsivity.

How Is BPD Treated?

There are no currently approved medications for the treatment of personality disorders, although sometimes doctors may prescribe medications to treat certain symptoms. For example, someone with borderline personality disorder may be prescribed mood stabilizers or antidepressants.

The most commonly used form of psychotherapy for BPD is called dialectical behavior therapy or DBT. DBT is meant to help people shift their unhealthy behavioral patterns and become more aware and mindful of what they’re feeling and experiencing and how they’re reacting at any given moment.

Along with medicine and psychotherapy, the environment is important for someone with BPD. For example, people with this personality disorder benefit from an environment that’s relaxed and calm rather than chaotic.

What is Bipolar Disorder?

Before comparing BPD vs. bipolar, what is bipolar disorder on its own?

Bipolar disorder is characterized by extreme changes in mood, energy and activity levels that can cause severe impairment in a person’s functionality and daily life.

Bipolar disorder was previously known as manic depression, and it’s considered a very serious mental health disorder requiring careful treatment and management. Around 2.9% of Americans are diagnosed with bipolar disorder. Of those, 83% of diagnosed cases are severe. Most people are diagnosed with bipolar somewhere between the ages of 15 and 25.

Symptoms of Bipolar Disorder

Bipolar disorder will lead to extreme shifts in mood and behavior. How frequently these shifts occur can depend on the person.

For example, some people will have periods of mania and depression each lasting months or even years. Other people may have much briefer periods of mania and depression.

Some of the symptoms of mania include:

  • Impaired judgment
  • Feeling bored or distracted
  • Feelings of invincibility
  • Aggressiveness
  • Engaging in risky behavior
  • Feeling euphoric or high
  • Increased self-esteem and self-confidence
  • High energy levels
  • Talking quickly and jumping from one topic to another
  • Racing thoughts

When someone is in a period of mania, they may spend excessive amounts of money, engage in risky sexual activities, or abuse drugs and alcohol.

Symptoms of a depressive episode can include:

  • Feelings of hopelessness and despair
  • Extreme sadness
  • Insomnia and other sleep disturbances
  • Anxiety
  • Pain
  • Guilt
  • Changes in eating patterns
  • Changes in weight
  • Fatigue and extreme feelings of tiredness
  • Inability to experience pleasure
  • Problems with memory, concentration and attention span
  • Irritation
  • Inability to attend school, work or other commitments
  • In severe cases, suicidal thoughts or behaviors

When someone experiences either manic or depressive periods, symptoms of psychosis can occur as well. With psychosis, someone may not be able to make a distinction between reality and fantasy.

How Is Bipolar Disorder Diagnosed??

Based on criteria from the Diagnostic and Statistical Manual, fifth edition (DSM-5), for someone to receive a diagnosis of bipolar disorder they should have symptoms for at least seven days including symptoms of mania and depression.

Conditions that commonly co-occur with bipolar disorder include:

  • Post-traumatic stress disorder (PTSD)
  • Substance abuse
  • Anxiety disorder
  • Attention-deficit hyperactivity disorder (ADHD)

What Are the Different Types of Bipolar Disorder?

There are three types of bipolar disorder. These include the following.

Bipolar I Disorder

Bipolar I disorder is characterized by at least one manic episode and at least one previous depressive episode. When someone has bipolar I disorder, other possible causes including schizophrenia have to be ruled out before a diagnosis can be made.

Bipolar II Disorder

Bipolar disorder includes one or more episodes of depression and at least one hypomanic episode. Hypomania is less severe than mania.

Someone with bipolar II disorder will usually be more functional during periods of hypomania than someone during a period of mania.

Cyclothymia

Cyclothymia is the least severe bipolar diagnosis and includes periods of mild depression alternating with hypomania.

How Is Bipolar Disorder Treated?

The goal of any bipolar disorder treatment program is to reduce episodes of both mania and depression and allow the person with bipolar to live a normal life. Treatment usually includes a combination of medication and psychological interventions such as talk therapy.

Lithium carbonate is the most common prescription drug for the treatment of bipolar disorder, and antipsychotics and anticonvulsants may be used as well.

In terms of talk therapy, cognitive behavioral therapy is frequently the form that’s used with bipolar disorder although others may be used as well.

Comparing BPD vs. Bipolar

There are some similarities which you can see as you look at the symptoms of BPD vs. bipolar, so how do the two compare? Are there significant distinctions that can be made?

First, bipolar is considered a mood disorder, while borderline personality disorder is a personality disorder. This is a key difference. With a mood disorder like bipolar, someone likely recognizes that problems exist because of the condition and it causes them significant stress and impairment.

With a personality disorder like BPD, it’s difficult for the person who has the condition to see the problem. Their personality is who they are, so they may feel that other people around them are a problem, but they fail to see the reality of the situation.

Some of the other areas of difference when comparing BPD vs. bipolar include the following:

  • Sleep: Symptoms related to sleep cycles are a big part of bipolar disorder, but not part of BPD. Someone with bipolar may have insomnia and other disturbances in their sleep cycles during periods of mania and depression, while someone with BPD tends to have normal sleep cycles.
  • Cycle Lengths: With both bipolar and BPD, a person will have extreme shifts in mood and behavior. However, with bipolar, these changes tend to occur in cycles lasting for weeks to months. With borderline personality disorder, the mood swings are much shorter and can last just a few hours in many cases.
  • Self-Harm: Self-harm is less common in bipolar than BPD; however, with bipolar disorder, the suicide attempt rate is higher.
  • Relationships: People with bipolar disorder are less likely to have close relationships with people because of the challenges they face with their symptoms. People with BPD focus much of their life on relationships, although they are very intense and full of a lot of conflicts.
  • Impulsivity: Someone with bipolar disorder may act impulsively when they’re in a period of mania, but otherwise they might not have this symptom while people with borderline personality disorder tend always to act impulsively.

Certain factors can put someone at a higher risk of developing BPD as well. This includes a family history of borderline personality disorder, as well as a history of childhood trauma.

Can You Have both BPD and Bipolar?

When comparing BPD vs. bipolar, you may wonder along with the overlap in symptoms if it’s possible to have both. The answer is yes, it is possible to have both BPD and bipolar. In fact, around 20% of people diagnosed with type II bipolar disorder have a diagnosis of borderline personality disorder as well. For people with type I, around 10% are also diagnosed with BPD.

People who have both BPD and bipolar disorder tend to be diagnosed with bipolar first because the changes in symptoms can be easier to detect.

While BPD vs. bipolar have similarities, they also have differences. Both can be challenging for the person struggling with them, as well as their loved ones but treatment and management techniques can help someone with one or both of these disorders live a fulfilling life.

 

 

Sources:

WebMD. “Borderline Personality Disorder vs. Bipolar Disorder.” Accessed May 1, 2019.

Huizen, Jennifer. “What’s the difference between borderline personality disorder and bipolar?” Medical News Today. February 6, 2019. Accessed May 1, 2019.

Mayo Clinic. “Borderline Personality Disorder.” Accessed May 1, 2019.

Smith, Melinda and Segal, Jeanne Ph.D. “Borderline Personality Disorder (BPD).” Helpguide. November 2018. Accessed May 1, 2019.

Nordqvist, Christian. “What should you know about bipolar disorder.” Medical News Today. December 7, 2017. Accessed May 1, 2019.

Cirino, Erica. “Dual Diagnosis: Bipolar and Borderline Personality Disorder.” Healthline. October 3, 2017. Accessed May 1, 2019.

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