Key Differences of Borderline Personality Disorder vs Bipolar Disorder

While Borderline Personality Disorder (BPD) and bipolar disorder share similar symptoms, they are separate disorders. BPD involves intense, short-term emotional reactions that are typically triggered by feelings of tension in relationships. On the other hand, bipolar disorder is characterized by longer episodes of mood dysregulation that cycle between mania, hypomania, and depression. 

Read on to learn more about the differences between bipolar disorder vs. borderline personality disorder, including their causes, symptoms, treatment, and more. 

If you or a loved one are struggling with a mental health disorder—like bipolar disorder and borderline personality disorder—and need treatment, call our compassionate team of mental health experts today.

Comparing Borderline Personality Disorder vs. Bipolar Disorder

Borderline Personality Disorder (BPD) vs. bipolar disorder are often confused because they share similar mood-dysregulation symptoms and have similar names. However, they are very different mental health conditions with separate symptoms, causes, and treatment protocols. 

Key difference 

The main differences between bipolar and borderline include:

• How they’re triggered: BPD is triggered by external events like conflict or stressful situations. Bipolar mood changes are caused by an internal event stemming from changes in brain chemistry. 
• How they’re treated: BPD is mainly treated through talk therapy, particularly Dialectical Behavioral Therapy (DBT). Bipolar treatment typically uses a combination of several types of talk therapy along with medication to help balance brain chemistry. 

Key similarities

While bipolar and BPD are separate conditions, there are several similarities between the two. This can make it difficult to distinguish without proper clinical evaluation, so it’s important to know how they are alike and how they differ.

Key similarities include:

• Mood Instability: Both disorders involve intense and unpredictable mood changes.
• Impulsivity: Individuals may engage in risky behaviors like reckless spending or substance abuse.
• Difficulty Maintaining Relationships: Both disorders can cause strained or unstable personal relationships.
• High Risk of Self-Harm or Suicidal Thoughts: Both conditions are linked to an increased risk of self-harm or suicidal behavior.
• Periods of Depression: Both disorders may feature episodes of deep sadness or depression.
• Emotional Intensity: Individuals experience strong, overwhelming emotions.
• Misdiagnosis Risk: Due to symptom overlap, they are often misdiagnosed as one another.
• Need for Long-Term Treatment: Both typically require ongoing therapy and management for effective treatment.
• Potential for Co-occurring Disorders: High rates of anxiety, PTSD, or substance abuse in both conditions.
• Impact on Daily Life: Both can significantly disrupt work, social, and daily functioning.

Understanding Borderline Personality Disorder (BPD)

Borderline Personality Disorder (BPD) is a mental health condition that causes people to experience strong, intense episodes of extreme emotional distress. These emotions can change rapidly, cycling between happiness, depression, anger, etc. Individuals who suffer from BPD often struggle to maintain close relationships due to a strong fear of abandonment and intense sensitivity to interpersonal tension such as arguments, etc. 

BPD can be very difficult for people to live with as it affects nearly all aspects of their lives. However, treatments such as DBT (dialectical behavioral therapy) are quite effective in helping to combat the symptoms of BPD and significantly increase a person’s threshold for being able to manage emotions effectively. 

Causes of borderline personality disorder

While researchers don’t know exactly what causes BPD, some studies show evidence of causes to be genetic, environmental, and social in nature [1].

These studies show evidence of BPD being caused by:

• Genetics
• Brain abnormalities
• Childhood trauma (familial, social, environmental, etc.)
• Highly unstable family environments
• Certain personality traits
• Chemical imbalances

Regardless of where BPD originates, treatment is the same for all cases. This is good news as it’s not currently possible to know exactly what causes BPD to occur in an individual, only that they present symptoms. 

Signs of Borderline Personality Disorder

If you or a loved one suspect an occurrence of BPD, it’s important to understand the signs to look out for. Once you see evidence of BPD, you’ll be able to get treatment for the disorder. 

Signs of Borderline Personality Disorder include:

• Intense Mood Swings: Rapid changes in mood, such as feeling very happy, then suddenly very sad, angry, or anxious.
• Fear of Abandonment: Extreme fear of being left alone or abandoned, leading to frantic efforts to avoid separation.
• Unstable Relationships: Difficulty maintaining healthy, stable relationships, often alternating between idealizing and devaluing others.
• Impulsive Behaviors: Risky actions, such as binge eating, reckless driving, spending sprees, or substance abuse.
• Chronic Feelings of Emptiness: A persistent sense of feeling empty or void inside.
• Unstable Self-Image: Difficulty maintaining a consistent sense of self; frequent changes in goals, values, or career plans.
• Intense Anger: Difficulty controlling anger, often resulting in explosive outbursts or physical fights.
• Self-Harm: Engaging in self-injurious behaviors, such as cutting or burning, as a way to cope with emotional pain.
• Paranoia or Dissociation: Experiencing paranoia or feelings of detachment from reality, especially during times of stress.
• Emotional Sensitivity: Extreme sensitivity to stress or criticism, leading to strong emotional reactions.

Symptoms of Borderline Personality Disorder

Once you understand the signs and what to look out for, a mental health physician will assess your symptoms and diagnose you properly. 

Symptoms of BPD include:

• Intense Mood Swings: People with BPD often experience rapid mood changes, shifting from happiness to sadness, anger, or anxiety within hours or even minutes.
• Fear of Abandonment: An overwhelming fear of being left alone or abandoned, which can lead to frantic efforts to keep people close, even if the fear is not based on reality.
• Unstable and Intense Relationships: Relationships can be very chaotic and marked by intense emotions. Individuals with BPD may quickly shift from idealizing someone to devaluing them.
• Impulsive Behaviors: Engaging in risky activities such as reckless driving, substance abuse, or binge eating, often as a way to cope with intense emotions or feelings of emptiness.
• Chronic Feelings of Emptiness: A persistent feeling of emptiness or void that is difficult to fill, leading to dissatisfaction or hopelessness.
• Unstable Self-Image or Identity: Difficulty maintaining a consistent sense of self. A person with BPD may frequently change their goals, values, or career plans.
• Difficulty Controlling Anger: Experiencing intense, inappropriate anger or difficulty managing feelings of rage, which can lead to explosive outbursts or physical altercations.
• Self-Harm or Suicidal Thoughts: Engaging in self-injurious behaviors, such as cutting or pulling out hair as a way to cope with emotional pain or thoughts of suicide.
• Paranoia or Dissociation: Feeling disconnected from reality or experiencing paranoia, especially during stressful situations. This may feel like being “in a fog” or observing oneself from the outside.
• Extreme Emotional Sensitivity: Being highly reactive to stress, criticism, or rejection, which can trigger intense emotional responses and exacerbate symptoms.

Borderline Personality Disorder Treatment

Treatment for Borderline Personality Disorder is treated via individual and group psychotherapy sessions carried out by mental health professionals known as a community mental health team (CMHT).

This CMHT team helps provide a structured support system for daily treatment, while still granting patients the freedom to go about their daily lives when not in sessions [3]. For those who struggle with more moderate to severe BPD, a care program approach (CPA) is assigned as well. A CPA program includes:

1. Comprehensive assessment 
2. Customized care plan
3. Assignment of a social worker or nurse to coordinate your treatments
4. Regular treatment reviews to adjust as necessary

DBT (Dialectical Behavior Therapy) is also regularly used as a therapeutic intervention for BPD in tandem with other psychotherapies. This treatment has been shown to be particularly effective for treating BPD women with a history of self-harm and/or suicidal behaviors. 

Understanding Bipolar Disorder

Bipolar disorder (known previously as manic depression) is a mental health condition that causes extreme cycles in mood, energy levels, and brain function. This can lead to levels of mental distress or mania that can have significant effects on an individual’s life and day-to-day functioning [4]. 

Bipolar comes in three separate types, which include:

• Bipolar I: Characterized by episodes of mania that last a week or more, Bipolar I mania and depression symptoms are typically so extreme that immediate medical intervention is required. In some cases, episodes will occur where both depression and mania are present at the same time. This can be incredibly difficult to navigate and is known as rapid-cycling when 4+ instances of mania or depression occur within a year. 
• Bipolar II: Less severe than Bipolar I, Bipolar II symptoms include depressive episodes and hypomanic episodes that are milder than a typical manic episode. While still difficult to live with, this form of Bipolar is less challenging to live with than Bipolar I. 
• Cyclothymic Disorder: Also known as cyclothymia, this form of bipolar causes frequent hypomania and depression symptoms. These experiences are not intense or long enough to be classified as full-on bipolar episodes but are still categorized as bipolar and benefit from treatments.  

Causes of bipolar disorder

Bipolar disorder is caused by a number of environmental factors, genetic factors, and more. Causes of bipolar disorder include:

• Genetic Factors: Family history of bipolar disorder or other mood disorders increases the risk.
• Brain Structure and Function: Abnormalities in brain structure, neurotransmitter imbalances, and changes in brain function may contribute.
• Neurochemical Imbalance: Irregular levels of neurotransmitters like serotonin, dopamine, and norepinephrine can affect mood regulation.
• Hormonal Changes: Hormonal fluctuations, particularly thyroid hormone imbalances, can trigger mood episodes.
• Environmental Triggers: Stressful life events, trauma, or major changes (e.g., divorce, job loss) may trigger the onset of symptoms.
• Substance Abuse: Alcohol or drug abuse can worsen symptoms or contribute to the development of mood episodes.
• Sleep Disruptions: Irregular sleep patterns or lack of sleep can exacerbate mood instability.
• Childhood Trauma: Early-life abuse, neglect, or other traumatic experiences may increase the risk.
• Chronic Stress: Long-term stress or high-pressure situations can trigger mood episodes in vulnerable individuals.
• Medical Conditions: Certain medical conditions, like thyroid issues or neurological disorders, can contribute to mood changes.

Signs of bipolar disorder

Signs of bipolar disorder can be separated by manic and depressive behaviors. If you or a loved one are showing signs of bipolar, it’s important to reach out to a mental health professional for help. Signs of bipolar disorder include:

• Elevated or irritable mood
• Notably increased or decreased energy levels
• Insomnia or lack of need for sleep
• Suicidal or self-harming behaviors
• Inflated self-esteem
• Impulsive or risky behaviors
• Loss of interest in activities
• Rapidly switching between depression and mania

Symptoms of bipolar disorder

Once you’ve begun getting treatment for bipolar, a clinical physician will help you define and understand the exact symptoms you may be experiencing. Symptoms of bipolar can be split into manic and depressive as follows:

Manic Symptoms of Bipolar Disorder:

• Elevated or euphoric mood
• Increased energy and activity levels
• Decreased need for sleep
• Racing thoughts and rapid speech
• Inflated self-esteem or grandiosity
• Impulsivity and risky behavior (e.g., reckless spending, substance abuse)
• Easily distracted
• Agitation or irritability
• Hyperfocus on projects or ideas
• Delusions of grandeur
• Hallucinations (in severe cases)

Depressive Symptoms of Bipolar Disorder:

• Persistent sadness or hopelessness
• Loss of interest in activities once enjoyed
• Fatigue and low energy
• Changes in appetite (eating too much or too little)
• Sleep disturbances (insomnia or excessive sleeping)
• Feelings of worthlessness or excessive guilt
• Difficulty concentrating or making decisions
• Thoughts of death or suicide
• Social withdrawal or isolation
• Physical aches or pains without a clear cause
• Slowed thinking, speech, or movement

Bipolar disorder treatment

Bipolar disorder treatment typically includes a combined protocol of medications and therapy [5]. 

Medications may include:

• Mood stabilizers
• Neuroleptics
• Antidepressants

Psychotherapy treatments may include:

• Cognitive Behavioral Therapy (CBT)
• Dialectical Behavior Therapy (DBT)
• Family-Focused Therapy (FFT)
• Interpersonal and Social Rhythm Therapy (IPSRT)
• Mindfulness-Based Cognitive Therapy (MBCT)
• Group Therapy

Get Treatment for BPD and Bipolar Disorder at Connections

If you or a loved one are struggling with BPD or bipolar, it’s important to get the help you need as soon as you can. At Connections, we offer same-day admission and a comfortable, home-like environment for stabilization and mental health recovery. 

With a max of 6 beds and 24/7 expert clinical supervision, we pride ourselves on providing a treatment environment where our clients feel seen, safe, and treated like a person–not just a patient. 

Our evidence-based inpatient mental health treatment program includes:

• Cognitive-behavioral therapy (CBT)
• Dialectical behavior therapy (DBT)
• Medication management
• Family-like environment
• 24/7 clinical support & supervision
• Personalized treatment plans 
• & More

Call our friendly team today to get insurance-covered inpatient treatment for mental health disorders at 844-759-0999.  

Sources

[1] https://www.nimh.nih.gov/health/publications/borderline-personality-disorder#:~:text=Researchers%20aren’t%20sure%20what,the%20disorder%20in%20their%20lifetime.

[2] https://www.nhs.uk/mental-health/conditions/borderline-personality-disorder/treatment/

[3] https://www.nimh.nih.gov/health/topics/bipolar-disorder#:~:text=What%20is%20bipolar%20disorder%3F,day%2Dto%2Dday%20tasks.

[4] https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/symptoms-causes/syc-20355955

[5] https://www.nimh.nih.gov/health/topics/bipolar-disorder