Bipolar Disorder vs Borderline Personality Disorder (BPD)

Understanding the differences between Bipolar Disorder and Borderline Personality Disorder (BPD) is crucial, especially when seeking the right treatment and support. Both conditions can significantly impact your life, but they are distinct in their symptoms, causes and treatments. 

In this article, we’ll explore the key differences and similarities between these two disorders, helping you make informed decisions about mental health care.

Bipolar Disorder is a mental health condition characterized by extreme mood swings that include emotional highs (mania or hypomania) and lows (depression). These mood swings can affect sleep, energy, activity, judgment, behavior and the ability to think clearly.

Symptoms of Bipolar Disorder

The symptoms of Bipolar Disorder can vary widely. The primary symptoms include:

• Manic Episodes: Increased energy, euphoria, reduced need for sleep, inflated self-esteem, rapid speech and impulsive behavior.
• Depressive Episodes: Persistent sadness, fatigue, feelings of hopelessness, loss of interest in activities, changes in appetite and thoughts of death or suicide.

Types of Bipolar Disorder

There are several types of Bipolar Disorder, including:

• Bipolar I Disorder: Characterized by manic episodes lasting at least seven days or by manic symptoms that are so severe that immediate hospital care is needed. Depressive episodes also occur, typically lasting at least two weeks.
• Bipolar II Disorder: Defined by a pattern of depressive episodes and hypomanic episodes, but not the full-blown manic episodes that are typical of Bipolar I Disorder.
• Cyclothymic Disorder: Periods of hypomanic and depressive symptoms lasting for at least two years (one year in children and adolescents) that are less severe than the full episodes of Bipolar I or II.

Borderline Personality Disorder (BPD) is a mental health disorder characterized by a pervasive pattern of instability in moods, behavior, self-image and functioning. This instability often leads to impulsive actions and unstable relationships.

Symptoms of Borderline Personality Disorder

The symptoms of BPD can be severe and pervasive, affecting many aspects of your life. Key symptoms include:

• Intense Fear of Abandonment: Efforts to avoid real or imagined abandonment.
• Unstable Relationships: Pattern of intense and unstable relationships with family, friends and loved ones.
• Distorted Self-Image: Unstable self-image or sense of self.
• Impulsive Behaviors: Impulsive and often dangerous behaviors, such as spending sprees, unsafe sex, substance abuse, reckless driving and binge eating.
• Self-Harm: Recurrent suicidal behavior, gestures or threats, or self-mutilating behavior.
• Emotional Instability: Intense and highly changeable moods, with episodes lasting from a few hours to a few days.
• Chronic Feelings of Emptiness: Persistent feelings of emptiness.
• Intense Anger: Inappropriate, intense anger or problems controlling anger.
• Paranoia or Dissociation: Periods of paranoia or severe dissociation.

Although Bipolar Disorder and BPD share some symptoms, they are fundamentally different conditions. Here are the key differences:

Nature of mood swings

• Bipolar Disorder: Mood swings between mania/hypomania and depression occur over weeks to months.
• BPD: Mood swings are more rapid and can change within hours or days.

Impulsivity and self-harm

• Bipolar Disorder: Impulsivity is often linked to manic episodes. Self-harm is more associated with depressive episodes.
• BPD: Impulsivity and self-harm are chronic and can occur at any time, often in response to perceived abandonment or stress.

Stability of self-image

• Bipolar Disorder: Self-image is generally stable, though it may be temporarily inflated during manic episodes.
• BPD: Self-image is unstable and can change frequently.

Relationships

• Bipolar Disorder: Relationships may suffer due to mood swings but are not inherently unstable.
• BPD: Relationships are often intense, unstable and marked by a pattern of idealization and devaluation.

It is possible for a person to have both Bipolar Disorder and BPD, a situation known as comorbidity. This can complicate diagnosis and treatment, as symptoms of one disorder can mimic or exacerbate the other. A thorough evaluation by a mental health professional is crucial for an accurate diagnosis and effective treatment plan.

Treatment for Bipolar Disorder typically involves a combination of medication and psychotherapy. Common medications include mood stabilizers, antipsychotics and antidepressants. Psychotherapy, such as cognitive-behavioral therapy (CBT), can help people manage their symptoms and develop coping strategies.

BPD is primarily treated with psychotherapy. Dialectical behavior therapy (DBT) is specifically designed for BPD and has been shown to be effective in reducing symptoms. Other therapeutic approaches, such as cognitive-behavioral therapy (CBT) and psychodynamic therapy, can also be beneficial. Medications may be used to treat co-occurring conditions, such as depression or anxiety.

• Educate Yourself: Learn about the disorder to better understand what your loved one is experiencing.
• Support Treatment: Encourage your loved one to stick with their treatment plan and attend therapy sessions.
• Set Boundaries: Establish healthy boundaries to protect your own well-being while supporting your loved one.
• Seek Support: Consider joining a support group for families of people with mental health disorders.

• Seek Professional Help: Consult a mental health professional for an accurate diagnosis and appropriate treatment.
• Follow Your Treatment Plan: Adhere to your prescribed treatment, including medication and therapy sessions.
• Develop Coping Strategies: Learn and practice coping strategies to manage your symptoms and stress.
• Build a Support Network: Surround yourself with supportive friends and family members who understand your condition.

Understanding the difference between Bipolar and Borderline Personality Disorder is essential for effective treatment and support. Both conditions require comprehensive care and a tailored approach to manage symptoms and improve quality of life. By educating yourself and seeking professional help, you can navigate the complexities of these mental health conditions and work towards a healthier future.

If you or someone you know is struggling with a mental health issue, don’t hesitate to reach out for help. At Granite Hills Hospital, located in West Allis, Wisconsin, we provide a continuum of care that includes inpatient and outpatient programs. If you are interested in treatment, view our services to learn more or call us today at 414-667-4800. 

If you or a loved one is experiencing a mental health crisis, CALL 988 or get to the nearest emergency room.

For physical health emergencies, CALL 911 or get to the nearest emergency room.