Understanding the Difference Between Bipolar and Borderline Personality Disorder (BPD)

There has been a lot of mention about the similarities between Bipolar and Borderline Personality Disorder (BPD). There is a possibility that you could have both disorders, but it takes an experienced psychiatrist to determine if you do or pinpoint the real culprit. Before we continue, it’s important to define each – BPD is a personality disorder while Bipolar Disorder affects the brain’s chemicals.

Bipolar disorder and borderline personality disorder are comorbid somewhere between 15 and 20 percent of the time, according to Current Psychiatry. Comorbid means the simultaneous presence of two chronic diseases or conditions in a patient.

It’s important to get the right type of treatment which means you need to be diagnosed correctly. If not, you could be deprived from effective medications which help you control your symptoms. In the end, if you’re not diagnosed correctly then you’re going to have a hard time managing your disorder. This will limit your ability to have a normal fulfilling life.

Bipolar Disorder

Someone living with bipolar disorder will experience extreme highs (mania) followed by extreme lows (depression). The moods swings from high to low are known as a cycle. The cycle frequency depends on the severity of the bipolar condition and can last days, and weeks. I like to characterize bipolar mood swings as extreme mania with a crash right after into depressive phase.

People living with bipolar have a chemical imbalance which can trigger a cycle at any time. A cycle can be triggered by lack of sleep or stress dealing with work or a negative thought pattern. Here are common triggers –

  • Stressful life events
  • Disruptive sleep patterns
  • Disruption in routine
  • Too much external simulations
  • Drug and alcohol abuse
  • An Illness that is not treated or managed.
  • Conflict and stressful interactions with people

Borderline Personality Disorder (BPD)

Someone who has BPD will also suffer from mood swings which cause the common confusion in diagnosis between bipolar and BPD. But, the mood swings are not as solid or balanced. The highs and lows of BPD may swing between desperation, anxiety, and anger. The cycles in BPD are more frequent than those people living with bipolar disorder because it’s the situations around them which can trigger a cycle.

BPD is very much dependent on what’s going on around them. Here are common triggers –

  • Perceived or real abandonment
  • Rejection of any kind
  • Loss of a job
  • Locations that invoke negative memories
  • Reminders of traumatic events
  • Ending a relationship

Understanding the difference –

“Experts note that one of the main differentiating factors between bipolar and borderline personality disorder is that symptoms of personality disorder are pretty consistent and ongoing, while people with bipolar disorder appear to have “breaks” between their extreme mood swings, in which they experience a mid-range mood where most of the symptoms that are confusing between the two disorders (impulsivity, anger, irritability, extreme emotion) aren’t present.”

The graph shows why it’s hard to diagnosed correctly if it’s bipolar or BPD. In the illustration, you can see the purple areas showing the similarities between both in the beginning stages. This is an overlapping of symptoms which does lead to a misdiagnosis.

Difference in Treatment

There is also a difference in how bipolar and BPD is treated. For example, the first line of defense for bipolar is medication while for BPD it’s Dialectical Behavior Therapy.

The treatment for bipolar disorder involves three types of medication – mood stabilizers, antipsychotic, and antidepressants. It’s important to note the medications prescribed will depend on the severity of your bipolar. For example, if you don’t suffer from hallucinations, then an antipsychotic drug will not be prescribed for treatment. In other words, the severity will determine the prescribed medication and dosage. A mood stabilizer like Lithium will be prescribed to lower Serotonin levels in your brain. This helps level out your mood swings. An antidepressant will be prescribed to manage the depressive extremes in your cycle. This will affect the neurotransmitters – Serotonin and Norepinephrine in the brain.

The treatment for BPD is Dialectical Behavior Therapy, a cognitive-behavior approach. It’s about teaching the person to handle situations better in their environment. The approach emphasizes how some people react more intensely or uncommonly to emotional situations i.e. family, friends, and romantic. Some people get more aroused quickly and have a hard time coming down to normal baseline levels.

People with borderline personality disorder will experience extreme swings in their mood because of situations around them. Dialectical Behavior Therapy is about building the person’s strength so they can deal with the environment better. It’s about reducing the negative energy around them and learning to accept things as they are. This will reduce how frustrated they get in situations allowing them to handle their mood swings better.

Importance of Asking Questions

Researching and asking questions are the most valuable things you can do for yourselves. Write down your symptoms and let your doctor know because this will help them give you a clearer diagnosis. Remember, your doctor’s diagnosis depends on the information you provide so it’s important to control your treatment by providing whatever you can about your symptoms. This will lower the chances of a misdiagnosis.

Helping others beat bipolar disorder. After living with Bipolar for over 16 years, I have self-educated myself to come up with creative ways to live a normal productive life. It`s time to give back by helping others transform!