The Difference between Bipolar Disorder and Borderline Personality Disorder

Bipolar disorder and borderline personality disorder are serious medical illnesses that can disrupt a person’s ability to live a normal life. Both disorders are characterized by unstable moods, relationships and behavior, leaving many to wonder if bipolar and borderline personality disorder are related. Here’s more information about the difference between bipolar disorder and borderline personality disorder.

Bipolar vs. Borderline Personality Disorder: The Similarities

Bipolar disorder and borderline personality disorder (BPD) share many similarities, including:

Mood Changes

— Bipolar disorder causes extreme shifts in mood from depression to mania (a mood characterized by abnormal elation and energy, racing thoughts and speech, a decreased need for sleep, etc.). BPD is also associated with mood changes, causing people to frequently switch between feeling fine to feeling extremely distressed in a matter of minutes.

Impulsive Behavior

— Both bipolar disorder and BPD cause people to act impulsively. These impulsive behaviors can include rash spending sprees, reckless driving, foolish financial investments, risky sexual behaviors, binge eating, substance abuse and self injury.

Drug and Alcohol Abuse

— It’s not uncommon for people with untreated bipolar disorder or BPD to abuse alcohol or drugs as a way to cope with their symptoms. Unfortunately, substance abuse only aggravates symptoms and can hinder or hide a true bipolar or BPD diagnosis.

Bipolar vs. Borderline Personality Disorder: The Differences

Although bipolar disorder and BPD share some similarities, there are some fundamental differences that separate the two. For example, bipolar disorder is a mental (or brain) disorder, while BPD is an emotional disorder. Both disorders are characterized by mood swings, but the length and intensity of these mood swings are different. While a person with bipolar disorder typically endures the same mood for days or weeks at a time, a person with BPD may experience intense bouts of anger, depression, and anxiety that may last only hours, or at most a day. Bipolar mood shifts are distinguished by manic episodes of elation, but BPD mood shifts rarely involve feelings of elation. The cause for these mood shifts also vary. BPD mood shifts are usually a reaction to an environmental stressor (such as an argument), while bipolar mood shifts seem to occur out of nowhere.

Another difference between bipolar and borderline personality disorder is the types of emotions people with these disorders experience. People with BPD may view themselves as fundamentally bad or unworthy and are more prone to feelings of loneliness, emptiness and a severe fear of abandonment.

Bipolar vs. Borderline Personality Disorder: Treatment

One of the most significant differences between bipolar and borderline personality disorder is treatment. The most important part of bipolar treatment is medication, followed by psychotherapy. BPD treatment, on the other hand, focuses on psychotherapy, not medication. Sometimes antidepressant drugs and mood stabilizers are prescribed based on specific target symptoms, but medication for BPD is often used as a last resort. The type of psychotherapy used to treat both disorders also varies. Bipolar disorder patients respond best to traditional therapies, such as Cognitive Behavioral Therapy, while BPD patents tend to respond better to Dialectal Behavior Therapy.

In addition to psychotherapy and pharmaceutical medications, some people have successfully eased their bipolar and borderline personality disorder symptoms with holistic treatments, such as yoga, acupuncture, meditation and herbal/natural supplements.