Borderline Personality Disorder vs Bipolar Disorder

Written By: Charlie Health Editorial Team

Clinically Reviewed By: Dr. Don Gasparini

Learn more about the similarities and differences between borderline personality disorder and bipolar disorder, two complex mental health conditions often misdiagnosed or misunderstood.

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Mental health disorders can be difficult to diagnose and manage. Among the many mental health conditions that exist, borderline personality disorder (BPD) and bipolar disorder (BD) are two of the most commonly confused conditions. Although they share some similarities, they are two distinct disorders with their own unique symptoms, causes, and treatments. This blog post will discuss the differences between BPD and BD, their similarities, and how they are diagnosed and treated.

Differences between borderline personality disorder and bipolar disorder

The primary difference between BPD and BD is the duration and nature of their mood swings. BD is a mood disorder characterized by periods of extreme highs and lows, known as manic and depressive episodes. On the other hand, BPD is a personality disorder that affects how individuals perceive and interact with the world around them. People with BPD experience emotional instability, impulsive behavior, and a distorted sense of self-identity.

BD typically presents with episodes of elevated or depressed moods that can last for weeks or months. During a manic episode, a person may feel elated, have racing thoughts, and engage in risky behavior. During a depressive episode, a person may feel sad, lethargic, and have suicidal thoughts. In contrast, BPD causes emotional instability that can fluctuate throughout the day. People with BPD may experience intense feelings of anger, anxiety, and depression, which can trigger impulsive actions such as self-harm, substance abuse, or risky sexual behavior.

What is borderline personality disorder?

Borderline personality disorder is a mental health condition that affects how a person thinks and feels about themselves and others. People with BPD often have an intense fear of abandonment and experience a persistent sense of emptiness. They may struggle to regulate their emotions, resulting in intense and unstable relationships with others. Individuals with BPD often experience intense episodes of anger, impulsivity, and paranoia. They may engage in self-harming behaviors or have suicidal thoughts. BPD symptoms typically begin in adolescence or early adulthood and can persist throughout a person’s lifetime.

What is bipolar disorder?

Bipolar disorder is a mood disorder that causes extreme shifts in mood, energy, and activity levels. People with BD may experience periods of intense mania, followed by periods of severe depression. Manic episodes can cause a person to feel overly confident, have racing thoughts, and engage in impulsive behavior. Depressive episodes can cause a person to feel sad, hopeless, and experience a loss of interest in daily activities. Bipolar symptoms can range from mild to severe and can significantly impact a person's quality of life.

Similarities between bipolar disorder and borderline personality disorder

While BD and BPD are distinct disorders, they share some similarities. Both disorders can cause impulsive behavior, and people with these conditions may engage in risky behavior. Both disorders can also cause significant mood swings and difficulty regulating emotions. People with either condition may experience periods of intense sadness, irritability, or anxiety. Additionally, both disorders may be triggered or worsened by stressful life events or traumatic experiences.

What causes bipolar disorder and borderline personality disorder?

The causes of BD and BPD are complex and not fully understood. However, research suggests that genetics, environmental factors, and brain chemistry may play a role in the development of these disorders. Studies have shown that people with a family history of BD or BPD may be more likely to develop these conditions themselves. Additionally, traumatic experiences such as abuse, neglect, or loss may increase the risk of developing either condition. Brain chemistry may also play a role, as people with BD or BPD may have imbalances in certain neurotransmitters, such as serotonin and dopamine, that regulate mood.

How are bipolar disorder and borderline personality disorder diagnosed?

The diagnosis of BD and BPD typically involves a thorough evaluation by a mental health professional, such as a psychiatrist or psychologist. The process is typically as follows: 

1. A mental health professional will typically conduct a clinical interview
2. They will then review the person's medical history and symptoms, and may use standardized assessments to help make a diagnosis. Official diagnosistic criteria for both bipolar disorder and borderline personality disorder are standardized in the DSM-5 

It is important to note that diagnosis of these conditions can be challenging, as symptoms can be similar to other mental health disorders or may overlap with other conditions.

Can you have borderline personality disorder and bipolar disorder at the same time?

It is possible for a person to have both BPD and BD at the same time. In fact, research suggests that up to 20% of people with BD also meet the criteria for BPD. This can complicate treatment and make it more challenging to manage symptoms. It is important for mental health professionals to accurately diagnose both conditions and develop a comprehensive treatment plan that addresses all aspects of the person's mental health.

How do you treat borderline personality disorder vs. bipolar disorder?

Treatment options for BD and BPD can include medication, therapy, and lifestyle changes. Medications such as mood stabilizers, antidepressants, or antipsychotics may be prescribed to manage symptoms. Therapy, such as cognitive behavioral therapy or dialectical behavior therapy, can help individuals learn skills to manage their emotions, improve relationships, and reduce impulsive behavior. Lifestyle changes such as regular exercise, healthy eating, and stress reduction techniques such as mindfulness or meditation can also be beneficial.

However, the specific treatment approach may differ depending on the mental disorder. For BD, medication is often the primary treatment method, as mood stabilizers or antipsychotics can help manage manic and depressive episodes. Therapy may also be helpful in managing symptoms and improving overall mental health. For BPD, therapy is often the primary treatment approach, as individuals with this condition often struggle with emotional regulation and interpersonal relationships. Dialectical behavior therapy, which focuses on teaching skills to manage intense emotion and improve relationships, has been shown to be particularly effective for BPD.

In conclusion, although BPD and BD share some similarities, they are two distinct mental health disorders with their own unique symptoms, causes, and treatments. It is important to accurately diagnose both conditions and develop a comprehensive treatment plan that addresses all aspects of the person's mental health. With proper diagnosis and treatment, individuals with BPD and BD can manage their symptoms and lead fulfilling lives.

Treating borderline personality disorder and bipolar disorder with Charlie Health

Do you think you might have borderline personality disorder or bipolar disorder? If so, Charlie Health may be able to help.

Our virtual Intensive Outpatient Program provides personalized mental health treatment for teens, young adults, and families dealing with a variety of struggles, including borderline personality disorder and bipolar disorder. 

With the help of experienced therapists and the social support of peers who face similar struggles, you can make strides toward feeling better by regulating your emotions, learning healthy ways to cope with your feelings, and gaining skills for healthy relationships.

Help is here now. We're available 24/7 to get you started on your healing journey.