Yes, You Can Have ADHD and BPD at the Same Time

Having both ADHD and BPD can intensify daily challenges, but with proper treatment, healing is possible.

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Living with either attention-deficit/hyperactivity disorder (ADHD) or borderline personality disorder (BPD) can present day-to-day challenges, particularly when it comes to emotional regulation, interpersonal relationships, and overall mental well-being. These difficulties can become even more pronounced when the two conditions coexist, which occurs more frequently than many might assume. Below, we’ll explore the relationship between ADHD and BPD, including how their symptoms can interact, why they’re sometimes misdiagnosed, and how treatment can support people navigating both conditions.

The link between ADHD and BPD 

ADHD is a neurodevelopmental disorder characterized by persistent patterns of inattention, impulsivity, and hyperactivity that significantly impact functioning in various areas of life. BPD, on the other hand, is a personality disorder marked by instability in mood, self-image, and interpersonal relationships, often accompanied by intense fear of abandonment and impulsive behaviors.

While these two conditions are distinct, research suggests that they can frequently co-occur—a situation known as comorbid ADHD and BPD. Studies indicate that individuals with childhood ADHD are more likely to meet the criteria for BPD compared to the general population. Shared symptoms, such as impulsivity and emotional dysregulation, may partially explain this overlap. Moreover, the presence of both conditions often leads to greater functional impairment, underscoring the importance of early and accurate diagnosis.

Common symptoms and traits of ADHD and BPD 

ADHD and BPD share several overlapping symptoms, which can make distinguishing between them challenging. Below is a breakdown of their key features:

Difficulty concentrating

People with ADHD often struggle to sustain attention due to difficulties filtering distractions. For those with BPD, concentration challenges may arise from intense emotions or stress related to interpersonal conflicts. In both cases, this symptom can disrupt work, education, and daily responsibilities.

Emotional dysregulation

Intense emotions are hallmarks of both conditions. For those with BPD, mood swings are often tied to perceived or real fears of rejection or abandonment. ADHD, on the other hand, can lead to impulsive emotional responses, such as sudden anger or frustration, making it difficult to navigate relationships.

Relationship challenges

BPD is characterized by unstable and intense relationships, with frequent shifts between idealization and devaluation of others. ADHD may also strain relationships due to forgetfulness, impulsivity, or difficulty focusing during conversations. Combined, these traits can heighten interpersonal challenges.

Impulsive behaviors

Impulsivity is a shared feature of ADHD and BPD, although its manifestations may differ. In ADHD, impulsivity might appear as interrupting others, making hasty decisions, or engaging in risky activities. For people with BPD, impulsive behaviors are often driven by emotional distress and may include spending sprees, substance use, or self-harming behaviors.

Differences between ADHD and BPD

While ADHD and BPD share some similarities, their underlying causes and core symptoms differ. As mentioned, ADHD is a neurodevelopmental disorder that often manifests early in childhood. In contrast, BPD is a personality disorder that usually develops later in life, typically after childhood developmental patterns have stabilized. 

Also, while the conditions share some overlapping symptoms, they often have subtle distinctions. Take emotional dysregulation for example. In ADHD, especially childhood ADHD, emotional outbursts are short-lived and often tied to frustration or impulsivity. In BPD, though, emotional reactions are intense, prolonged, and often triggered by interpersonal conflict or perceived rejection. These subtle distinctions help clinicians tailor treatment approaches for both conditions.

Diagnosing ADHD and BPD 

Diagnosing ADHD and BPD can be complex due to overlapping symptoms and the influence of co-occurring conditions. For ADHD, clinicians look for a history of persistent inattention, hyperactivity, or impulsivity that significantly impairs daily functioning. ADHD diagnosis typically involves behavioral assessments, medical history reviews, and input from family members or teachers.

BPD diagnosis, on the other hand, focuses on identifying patterns of emotional instability, impulsivity, and interpersonal dysfunction. Clinicians may use structured interviews and diagnostic tools to evaluate the presence of BPD criteria, including chronic feelings of emptiness and intense fear of abandonment, before making a BPD diagnosis.

Importantly, accurate diagnosis requires careful evaluation to avoid misdiagnosis. For example, the emotional dysregulation associated with ADHD may be mistaken for BPD, or vice versa, without thorough assessment by a qualified mental health professional.

 

Therapeutic approaches and strategies for ADHD and BPD

Effective treatment for ADHD and BPD often involves a combination of therapies, medications, and lifestyle adjustments tailored to each individual’s needs.

Cognitive and behavioral therapies

Cognitive-behavioral therapy (CBT) is widely used to address both conditions. For ADHD, CBT helps individuals develop organizational skills, manage time, and reduce impulsive behaviors. Dialectical behavior therapy (DBT) — a form of CBT — is a particularly effective BPD treatment. This therapy teaches skills for emotional regulation, distress tolerance, and improving interpersonal effectiveness.

Medication

Medication can play a key role in managing BPD and ADHD symptoms. Stimulants or non-stimulant medications are commonly prescribed for ADHD to improve attention and reduce impulsivity—common ADHD symptoms. For BPD, medications such as mood stabilizers or antidepressants may be used to address specific BPD symptoms like mood swings or anxiety. In cases of co-occurrence, medication plans must be carefully tailored to avoid adverse effects or exacerbating either ADHD or BPD symptoms.

Mindfulness-based interventions

Mindfulness techniques can benefit both ADHD and BPD by promoting self-awareness and emotional regulation. For ADHD, mindfulness practices may help improve focus and reduce impulsivity in addition to professional mental health support. For individuals with BPD, these practices can provide grounding strategies to manage intense emotions and reduce reactivity alongside other kinds of BPD treatment (like therapy and mood stabilizers or other medication).

Routine and structure

Consistent routines are essential for managing ADHD and BPD. For ADHD, structured schedules can help with time management and task completion. In BPD, predictable routines can provide stability and reduce emotional volatility. Incorporating regular therapy sessions, self-care activities, and relaxation techniques into daily life can enhance overall well-being.

How Charlie Health can help

If you are struggling with attention-deficit/hyperactivity disorder (ADHD), borderline personality disorder (BPD), or both, Charlie Health is here to help. Charlie Health’s virtual Intensive Outpatient Program (IOP) provides more than once-weekly mental health treatment for young people and families dealing with serious mental health conditions, including ADHD, mood disorders, comorbid ADHD and BPD, and more. Our expert clinicians incorporate evidence-based therapies into individual counseling, family therapy, and group sessions. With this kind of holistic treatment, managing your mental health is possible. Fill out the form below or give us a call to start healing today.