What’s the Difference Between Bipolar and Borderline Personality Disorder?

Bipolar disorder and borderline personality disorder (BPD) have some symptoms in common but are two mental illnesses that require different treatment approaches.
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Bipolar disorder and borderline personality disorder (BPD) have some symptoms in common but are two mental illnesses that require different treatment approaches. It can be challenging to diagnose mental health conditions because there are no biological tests that can distinguish one from another. Both bipolar disorder and borderline personality disorder are mental illnesses that involve mood swings and impulsive behavior but there are some distinguishing characteristics of each. Read on to learn more.

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Characteristics of Bipolar Disorder

Formerly known as manic depression, bipolar I disorder and bipolar II disorder are both characterized by wide swings in mood and energy levels. Periods of extremely high energy, euphoria, and feelings of grandiosity are some of the symptoms of mania, while extreme sadness, low energy, and hopelessness indicate depressive episodes.

During a manic phase, an individual may engage in risky, impulsive, and destructive behavior. Thoughts may become fast-paced and the need for sleep is greatly reduced. During depressive episodes, a person with bipolar disorder feels extremely tired, sad, and hopeless. Many individuals with bipolar disorder are misdiagnosed with clinical depression.

Characteristics of Borderline Personality Disorder

Borderline personality disorder (BPD) resembles bipolar disorder when it comes to impulsive behavior and mood swings. Even though individuals with BPD typically cycle through their emotions more quickly than individuals with bipolar disorder, people with BPD can experience bpd mania symptoms as well as depressive episodes.

However, borderline personality disorder does have marked differences from bipolar disorder because it’s characterized by patterns of unstable relationships. Those with borderline personality disorder are sensitive and struggle with emotional regulation. Often, they turn to destructive coping mechanisms, like self-harm and substance abuse. It’s common for those struggling with borderline personality disorder to also struggle with substance abuse and addiction, which is known as a dual diagnosis.

Additionally, an individual with borderline personality disorder is often tortured by an intense fear of abandonment, leading to unstable relationships or staying in relationships that aren’t healthy. They may experience intense emotional reactions to upsetting or disappointing life events. Additionally, they are typically very self-critical and may engage in self-harming behavior.

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Mood Disorders Versus Personality Disorders

The key difference between bipolar disorder and borderline personality disorder is that bipolar disorder is a mood disorder while borderline personality disorder is a personality disorder. Mood disorders are a category of disorders distinguished by serious changes in mood. Depression falls in this category along with bipolar disorder.

Personality disorders are characterized by ways of thinking, feeling, and behaving that are different from social expectations, causing problems in functioning or distress. Individuals with personality disorders have difficulty perceiving and relating to other people and situations. However, people with borderline personality disorder may experience bpd mania symptoms as well as depressive episodes.

Diagnosing Bipolar and Borderline Personality Disorder

Both conditions can be difficult to diagnose so misdiagnosis isn’t uncommon. Both require medical and psychological exams to rule out other possible issues. To diagnose bipolar disorder, apart from a thorough interview and evaluation, an individual may be asked to keep a daily record of their mood, energy level, and sleep patterns.

Diagnosing borderline personality disorder isn’t based on a particular sign or symptom. There may be a psychological evaluation that includes completing questionnaires. This disorder is diagnosed after a comprehensive clinical interview with the individual as well as previous providers and possibly interviews with family and friends.

Can You Have Bipolar and BPD Together?

If you’ve ever wondered, “can you have bipolar and BPD together?” The answer is yes. According to a National Institutes of Health (NIH) study, borderline personality disorder and bipolar disorder can co-occur as they share many common characteristics. Approximately 20% of individuals with bipolar II disorder and 10% of individuals with bipolar I disorder have co-occurring BPD. Individuals with both disorders have a higher likelihood of hospitalization, longer treatment duration, and a worse response to treatment. Additionally, individuals with co-occurring borderline personality disorder and bipolar disorder are at a higher risk for suicidal behavior.

Treating Bipolar and Borderline Personality Disorder

The approach to treatment is usually different for these two disorders. Bipolar disorder treatment includes medication like mood stabilizers or antipsychotics. Medication is usually combined with psychotherapy.

Borderline personality disorder is primarily treated with psychotherapy along with medications that can be used to treat some of the symptoms, like anxiety and depression, that typically accompany BPD. Medications are also used to reduce impulsivity or cravings for substances.  

Dialectical behavior therapy (DBT) has been shown to be an effective treatment for borderline personality disorder, combining both individual therapy and group therapy. The primary goals of dialectical behavior therapy include helping people regulate their emotions, have more successful interpersonal relationships, increase their distress tolerance, and be more mindful of their thoughts, feelings, and environment.

Another therapy used to treat borderline personality disorder is transference-focused psychotherapy (TFP), which helps people manage the urge to harm themselves. Mentalization-based therapy (MBT) is a form of evidence-based therapy that’s also used to treat borderline personality disorder.

What Are the Possible Treatment Outcomes for Someone With a Dual Diagnosis of Bipolar and Borderline Personality Disorder?

So, can you have bipolar and BPD at the same time? You can. Studies suggest that an estimated 10% of people with bipolar I and 20% of people with bipolar II have comorbid BPD.1 Although there is no cure for either condition, both are manageable with intervention and comprehensive treatment. What are some of the possible mental health treatment outcomes for bipolar and BPD?

Mood Stabilization

Mood instability is the most crucial overlapping symptom between bipolar disorder and BPD. Working toward mood stabilization is one of the most important goals in treatment for these co-occurring conditions.

Improved Emotional Regulation

Emotional dysregulation is another common symptom of both bipolar disorder and BPD. Similar to mood stabilization, improving emotional regulation is another primary focus of treatment. Developing and strengthening the ability to regulate emotions leads to vast improvements.

Strengthened Interpersonal Skills

Managing relationships while living with both BPD and bipolar disorder is difficult. Mental health treatment equips people with the tools and skills to strengthen existing relationships and build new ones.

Medication Management

Medication is a common component of many treatment plans for bipolar disorder and BPD. Mediation management is an important treatment outcome for co-occurring BPD and bipolar.

Crisis Management

Crises are still possible when living with co-occurring bipolar and BPD, even after seeking treatment. Developing crisis management coping skills is another important part of treatment.

Improved Daily Functioning

Co-occurring bipolar disorder and BPD can severely impact quality of life. Both conditions affect a person’s ability to carry out daily responsibilities at work, school, or home. Improved daily functioning is a critical benefit of treatment. 

How Can I Support a Loved One with Bipolar Disorder or Borderline Personality Disorder?

Watching a loved one live with bipolar disorder or borderline personality disorder can leave you feeling lost and helpless. It probably feels like you’ve done everything you can to support your loved one as they navigate life with their condition. Although you can’t manage their life for them or do the work necessary to regulate their symptoms, you can support them in their journey. What are some ways to encourage your loved one with bipolar disorder or BPD?

Educate Yourself

Learn as much as you can about your loved one’s condition including the symptoms, challenges they may deal with, and treatment options. The more you know, the more compassionate you can be.

Avoid Judgment

Understand that mental health disorders are not a person’s “fault.” It might be hard to separate your loved one from their disorder at times but avoiding judgment allows you to provide the best support possible.

Be Patient

Being patient with a loved one who has bipolar disorder or BPD may feel tough at times. You don’t always know where you stand with them and they may lash out at you. If you can be patient, though, they’re more likely to be receptive to your support.

Check In On Them

When someone struggles with their mental health it helps to know that they’re cared for and supported. Make sure your loved one knows you’re there for them. Take the time to check in on them regularly and make yourself available if they need to talk. 

Encourage Mental Health Treatment

Recognize the importance of mental health treatment. Encourage your loved one to seek professional help for their bipolar disorder or BPD. Knowing they have your support could be the final push they need to reach out and seek treatment.

If you may have borderline personality disorder or bipolar disorder, it’s vital to reach out to trained clinicians to receive the proper diagnosis and appropriate mental health treatment. At Clearview, we offer several treatment programs and have experience with and expertise in treating borderline personality disorder and bipolar disorder. Our treatment programs include our Dual Diagnosis Treatment Center, our Women’s Treatment Center, and our outpatient treatment centers.

If you’re struggling and need help, we’re here for you. Call us today at 877.313.8271 or fill out our contact form

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