While bipolar disorder and borderline personality disorder share some symptoms, understanding their key differences is critical for getting the right help and support.
Rogers’ Dr. Tyler Rickers, DO, medical director, Focus Depression Recovery residential care for adults, explains.
What is bipolar disorder?
People living with bipolar disorder experience two main mood states. In the depressive state, symptoms can include:
- Persistent sadness or low mood
- Lack of pleasure
- Low energy
- Trouble focusing
- Changes in sleep (too much or too little)
- Feelings of hopelessness or helplessness
- Guilt or worthlessness
- Suicidal thoughts
Mania is the other mood state, and symptoms can include:
- Elevated mood and energy
- Talking rapidly
- Impulsivity
- Decreased sleep
- Hypersexuality
- Grandiose thoughts, such as special abilities or powers
- Paranoia or delusions
These symptoms typically last for days or weeks, not just a day or a few hours.
What is borderline personality disorder (BPD)?
People with borderline personality disorder often struggle with interpersonal relationships and may experience:
- Fear of abandonment
- Self-harm
- Anger
- Impulsivity
- Frequent mood swings (more so than bipolar disorder)
- Chronic feelings of emptiness
- Sensitivity to criticism and rejection
- Black-and-white thinking
- Unstable sense of self
- Paranoia, anxiety, delusions, or dissociation (losing track of time, feeling disconnected from the world or their body) during times of high stress
What are some of the main differences between bipolar and BPD?
There are two major differences between bipolar disorder and BPD. First, while both can involve mood swings and impulsivity, they tend to occur more frequently in people with BPD.
Second, although both can include psychosis, which is hallucinations, delusions, or paranoia, the duration of those symptoms is different. In bipolar disorder, psychotic symptoms usually last for several days during a manic episode. In BPD, these symptoms tend to be short-lived and typically improve once a highly stressful situation ends.
Due to the crossover of symptoms with bipolar disorder, BPD can be difficult to diagnose. It can be challenging to see the subtle differences between the two. Unfortunately, there’s a lot of stigma with BPD because people don’t understand it, which causes fear, and sometimes clinicians are reluctant or ill-equipped to treat it. Although BPD tends to get diagnosed less, it is more prevalent than bipolar disorder.
How are bipolar disorder and BPD treated?
One of the reasons why it’s important to understand the differences between the two is because they’re treated differently.
Treatment for bipolar disorder includes:
- Cognitive behavioral therapy to help people manage their thoughts, emotions, and behaviors
- Medications, such as mood stabilizers
- Social rhythm therapy, which is having regular routines for things like going to bed and waking up in the morning
BPD treatment is mostly therapy based, such as dialectical behavior therapy, in which we help people manage their emotions, improve their relationships, and reduce self-harming behavior.
What myths do you want to debunk?
Some may think people with bipolar disorder can’t lead a fulfilling life. The truth is that they’re very capable and creative. Similarly, people with borderline personality disorder are often characterized as manipulative and difficult.
We know that they are brain diseases and not something people choose to have. Unfortunately, stigma keeps people from seeking treatment.
What hope would you give to people who struggle with bipolar disorder or BPD?
It’s not hopeless. Get educated, communicate your symptoms as clearly as you can with your doctors, and don’t let stigma stop you from getting the care you need and deserve. We know that treatment helps people get better.
Rogers provides mental health treatment
If you or a loved one is struggling with their mental health, we provide compassionate and proven care for children, teens, and adults across the country.
When you’re ready, we’ll be here. Call 833-308-5887 for a free, confidential screening.
