Difference Between Borderline Personality Disorder and Bipolar Disorder

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Difference Between Borderline Personality Disorder and Bipolar Disorder

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Treatment and Symptoms of Borderline Personality Disorder and Bipolar Disorder

Bipolar Disorder, (BD) and Borderline Personality Disorder, (BPD) are both mental health issues with dramatic symptoms, which can impact the sufferer and the lives of those close to them heavily.

The two conditions have different causes, symptoms and treatments, but the reason you are here, (and why we have written this article), is that often, the disorders can have similar traits, that cause confusion amongst those who are impacted.

Here we lay out the difference between Borderline Personality Disorder and Bipolar Disorder, key symptoms, how to gain an accurate diagnosis and the available treatment options available to you.

Mood Disorders Vs Personality Disorders

Bipolar Disorder (BD) is a mood disorder.

Borderline Personality Disorder (BPD) is a personality disorder. 

Both of which are mental health conditions.

1. Mood Disorders (Bipolar Disorder)

Severe changes in someone’s emotional state that impede their ability to function properly.

Start at any age and may run in families.

A recent study suggests that nearly 10% of adults living in the United States suffer from some form of Mood Disorder.

Some symptoms include:

2. Personality Disorders (Borderline Personality Disorder)

Persistent emotions, behaviors and thoughts that are not in line with societal norms and ultimately cause suffering.

The majority of sufferers develop symptoms of BPD by their early adulthood.

A recent study suggests over 12% of adults living in the United States suffer from some form of Personality Disorder.

Some symptoms include:

  • Lack of trust in others
  • Paranoia 
  • Suicidal thoughts / actions
  • Depression

Characteristics of Borderline Personality Disorder (BPD)

Borderline Personality Disorder has a range of characteristics that are centered around an individual’s difficulty with regulating their emotions.

People diagnosed with BPD experience persistent, day-to-day emotional symptoms that can impact everyday life.

They will experience lesser control of their impulses and struggle to manage their interpersonal relationships

Various life experiences, such as childhood trauma, can cause borderline personality disorder. Traumatic experiences in someone’s younger life, such as abuse, (whether sexual abuse, physical or emotional abuse), and neglect are two of the key triggers that can lead to BPD. 

Individuals with BPD suffer with Impulse Control Disorder, which according to American Addiction Centers; “…is a condition in which a person has trouble controlling emotions or behaviors. Often, the behaviors violate the rights of others or conflict with societal norms and the law.”

These uncontrollable overreactions and creations of conflict, where someone struggles with their emotional regulation, are one of the common symptoms of BPD.

Their chronic feelings of loneliness and reactive behavior can be so severe that they result in self-harm and/or substance abuse

Key symptoms of Borderline Personality Disorder:

  1. Impulsive behavior
  2. Unstable relationships 
  3. Clingy behavior in attempts to avoid abandonment 
  4. Suicidal thoughts 
  5. Overwhelming feelings of emptiness
  6. Unpredictable and changeable mood swings
  7. Irrational outbursts of intense anger
  8. Chaotic and unstable relationships 

Bpd symptoms of mood instability and a changeable emotional state will present in varying degrees from person to person, but the fact this is a ‘disorder’, means it will seriously impact the individual’s quality of life.

Difference Between Borderline Personality Disorder and Bipolar Disorder. Image - Jonathan Rados, Image
Difference Between Borderline Personality Disorder and Bipolar Disorder. Image - Jonathan Rados, Image

Characteristics of Bipolar Disorder

Bipolar Disorder is a mood disorder that is characterized by extreme shifts in someone’s mood, where they will experience sudden, dramatic changes in their state of mind. 

Genetic factors and changes to the brain structure, and its chemicals, are thought to be the cause of Bipolar Disorder. 

There is a 13% chance you will develop  Bipolar Disorder, if a close family member has the disorder.

These mood disorders can range from extreme highs, (mania), to extreme lows, (depression). 

Manic Episodes

Also known as hypomanic episodes, these episodes of mania present as a ‘high’, manic state where the individual will feel extremely happy, elated and overjoyed.

Here are the symptoms of bipolar disorder during an elevated mood:

  • Extremely happy and elated
  • Talking quickly
  • Easily irritated
  • Not wanting to sleep, as mood is too elevated
  • Making wild decisions that are not in line with their usual character 
  • Experiencing delusions and hallucinations 
  • Wild and outlandish behavior (E.g. reckless driving)
  • Illogical thought processes 
  • Full of important plans and exciting new ideas 
  • Making bold, often disastrous decisions, like wasting money on expensive items
  • Easily distracted 
  • Extremely high activity levels
  • Not eating, potentially resulting in dramatic weight-loss 

Episodes of mania can, at times look similar to, but are not to be confused with Hyperactivity Disorder or ADHD.

Hypomania Episodes

These are similar to mania, but the symptoms are less severe.

Depressive Episodes

Polarized to manic episodes, bipolar depression involves major depressive episodes are intense low periods, where they can be gripped with low self-esteem and feelings of worthlessness.  

People with Bipolar Disorder will often state that their depressive episodes feel more challenging than their manic episodes. After a really high mood, manic depression will feel incredibly tough. 

Here are some more depressive symptoms:

  • Feeling upset and tearful
  • Not able to find enjoyment or interest in things
  • Suicidal thoughts or actions
  • Low confidence and self-esteem
  • Reduced physical activity
  • Self-harming thoughts or actions
  • Over/under eating 
  • Strong feelings of guilt and hopelessness
  • Tired and drained 
  • Drink and/or drug abuse
  • Agitated and uptight
  • Withdrawing and avoiding others

As with manic episodes, the specific symptoms of someone with BD will vary from person to person.

Patterns Of Depression and Mania

Someone with Bipolar Disorder may experience mania more often than a major depressive episode, or vice versa.

Manic episodes can last for anything over a week and severe cases can be dangerous to a person’s health, and may well need to be treated in hospital.

Difference Between Borderline Personality Disorder and Bipolar Disorder. Image, Micheile, Unsplash.
Difference Between Borderline Personality Disorder and Bipolar Disorder. Image, Micheile, Unsplash.

Diagnosis And The Difference Between BPD and BD

Mental health professionals are qualified to form an accurate diagnosis of Borderline Personality Disorder and Bipolar Disorder.

The first step will be to look through the individual’s medical history, ask about symptoms, and look at any family history of mental health conditions, before conducting a clinical interview to complete specific questionnaires. 

Medical professionals will refer to the 5th Edition of the diagnostic and statistical manual of mental disorders, which contains the diagnostic criteria to aid them in an accurate diagnosis. 

Diagnosis of mental illnesses can be difficult, as the symptoms vary in how they present themselves, along with the severity of them, so an accurate diagnosis of either disorder can take time.  

3 Key Differences

1. Family History

Genetic factors can help differentiate between the disorders. BD is more commonly passed down through the family than BPD.

2. Sleep

This can be a key red flag for BP. During a manic episode, a person may be awake for days without experiencing tiredness. Whereas the sleeping patterns of someone with BPD are less commonly disrupted. 

3. Time Frames

Between cycles of mania and depression, someone with BD can have periods of genuinely symptom-free good health that can range in anything from a few days to years, as opposed to BPD, where the symptoms will be persistent, and impact daily life.

Difference Between Borderline Personality Disorder and Bipolar Disorder
Difference Between Borderline Personality Disorder and Bipolar Disorder

Dual Diagnosis

You will have noticed in this article, there is often not much significant difference between the mental health disorders, which makes the diagnosis of BPD and BD something that must be carried out by professionals.

So is dual diagnosis possible?

There are studies that show nearly 10% of people with Borderline Personality Disorder have also received a diagnosis of Bipolar Disorder.

The reliability of these figures is often brought into question, due to the prevalence of BPD symptoms that also appear in people with BD, which can make clinical differentiation of the disorders difficult.

Treatment of Borderline Personality Disorder and Bipolar Disorder

The proper treatment and effective treatment program for any mental health disorder, needs to be based around an accurate diagnosis.

Following which, a personalized treatment program that suits the symptoms and individual needs of the BPD or Bipolar patients is essential.

Borderline Personality Disorder Treatment

Cognitive Behavioral Therapy CBT is a psychotherapy that highlights the importance of how our thoughts affect our behaviors, giving patients healthy ways to break down and cope with their emotional challenges.

Medication – Anti-anxiety and anti-depressant medications can help to control  the symptoms of BPD, acting as mood stabilizers, but will not tackle  the root causes.

Dialectical Behavior Therapy – DBT is another form of CBT, which helps people deal with, and regulate difficult emotions and develop coping skills in 4 main areas: 

  1. Distress Tolerance
  2. Emotion Regulation
  3. Mindfulness 
  4.  Interpersonal effectiveness 

Bipolar Disorder Treatment

Group Therapy – Either alongside peers, or families and loved ones, to better understand the disorder and develop coping strategies. 

Psychotherapy – Sessions with a qualified therapist to understand the condition and learn healthy controls, such as CBT. 

Hospitalization – In more severe or high-risk cases, being admitted for inpatient treatment will be recommended. The length of time will depend on the severity of symptoms and the patient’s response to treatment.

Medication – Antidepressant, antidepressants and various other medications can be prescribed to stabilize the individual’s mood.

Further Reading and Support

We hope this has given you a  good insight to the difference between Borderline Personality Disorder and Bipolar Disorder.

If you think you, or someone close to you, may be suffering with either of these disorders, speak with a medical professional, and do not attempt to self-diagnose. 

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