The Difference between Bipolar Disorder and Borderline Personality Disorder

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

It’s normal and healthy to experience changes in your mood. No one goes through life feeling the same every day, all the time. However, drastic mood swings and rapid changes in mood can a symptom of a medical problem—more than one, in fact. In the case of bipolar disorder and BPD, thvere is a great deal of confusion generally about mood changes and how they might differ in patients with the two disorders.

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.

As an example of this, you might see a person with BPD who is desperately attached to a friend, family member, or partner one moment, and storming off in a rage without that person the next time you see them. Or the person you know might seem to be incredibly upbeat and energetic at times, even engaging in some risk-taking behavior that surprises you—only to be depressed and inactive at another time.

Impulsive Behavior

No one wants to be seen as thoughtless or fickle, but impulsive behaviors can create this situation. Sooner or later everyone makes a foolish or reckless decision. However, people exhibiting impulsive behavior regularly take chances that seem dangerous, or do even serious things without first thinking their consequences through. They may even seem surprised when their impulsive behaviors cause trouble—because they just didn’t consider the possible results before they took action.

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.

Impulsive behaviors can be frightening to friends and loved ones. Seeing someone you love self-harm, by cutting themselves, for example, is difficult and upsetting. Many times people close to the patient with impulsive behaviors aren’t sure what might be causing the problem, and they’re not even certain whether they should seek help for their friend or loved one. This is one reason why bipolar disorder and BPD are so difficult to treat.

Drug and Alcohol Abuse

For many people, light, social use of alcohol or prescribed medications don’t pose a problem. That’s because the concept of moderation, while requiring discipline, is an attainable goal most of the time. However, for people with untreated bipolar disorder or BPD, moderation is difficult or impossible.

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.

As an example, for someone with bipolar disorder, stimulants may be a temporary fix for feelings of depression. Alcohol or opiates might be the same kind of band-aid for feeling too manic. For those with BPD, substance abuse might “take the edge off” the way it feels to rapidly go from rage to despair to terror, or between other extreme moods.

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 bipolar disorder experience a fairly full range of emotions, but at inappropriate times, or to unhealthy degrees. 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. And while both patients might feel like their mood changes come “from nowhere” at times, the BPD patient can typically identify the triggering incident that set them off.

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.

The bottom line with either bipolar disorder or BPS is finding a treatment center that has the expertise and training to successfully distinguish between various mental and emotional disorders—and the capacity to treat them all. A holistic approach that accounts for the entire person’s situation is the kind most likely to work.