Bipolar vs Borderline Personality Disorder


Bipolar and Borderline personality disorder (BPD) are two different disorders that can affect someone’s mood. Statistically speaking, the likelihood of having BPD or bipolar disorder is 2 in 100, so both have the same commonality of occurrence. Many young people may begin to develop signs of BPD or bipolar, so it is important to look for any symptoms and seek help if they begin to get worse. Both have very similar symptoms, and it can often be difficult to differentiate between them as both can cause mood instability. However, the treatments for these two personality disorders are different, so it is essential to receive an accurate diagnosis from a medical professional. 

Bipolar Disorder 

Bipolar disorder is a mental illness that can affect your mood. Typically, someone suffering from bipolar disorder will experience severe mood swings. Formerly known as manic depression, bipolar disorder can cause manic episodes such as extreme emotional highs (mania or hypomania) and extreme lows (depression). These intense emotional reactions can also lead to impulsive behaviour that can be difficult to control. Switching between manic or depressive episodes may happen occasionally or several times a year. Someone who is experiencing a manic episode may feel impulsive or full of energy, whereas someone who is experiencing a depressive episode may feel lethargic, sad, or hopeless and is likely to lose a lot of motivation towards hobbies and interests. 

Symptoms of Bipolar Disorder 

Like other personality disorders, people with bipolar disorder have a distinct set of symptoms that can typically be found in most people with a diagnosis. However, there are different types of bipolar disorder, including: 

  • Bipolar I disorder – This is usually identified as having one or more manic episodes followed by a depressive episode. This type of bipolar can occasionally trigger psychosis in some people. 
  • Bipolar II disorder – People who have bipolar II disorder will typically experience a minimum of one depressive episode or one hypomanic episode that lasts no more than a few days. However, they will not have experienced a manic episode lasting for at least a week or more.
  • Cyclothymic disorder – This is distinguished by the length of time someone has experienced episodes. Typically to be diagnosed with cyclothymic disorder, a person needs to have experienced symptoms of depression and hypomania for at least two years. 

In general, most people who suffer from bipolar disorder tend to experience the following symptoms:

When experiencing depressive episodes the following symptoms can apply: 

  • Lack of energy 
  • Difficulty concentrating 
  • Lack of interest in activities
  • Feelings of guilt and despair
  • Feeling pessimistic about almost everything
  • Self-doubt
  • Being delusional, having hallucinations, and disturbed or illogical thinking
  • Loss of appetite
  • Trouble sleeping or irregular sleeping patterns 
  • Suicidal thoughts
  • Feeling sad, hopeless or irritable
  • Feelings empty or worthlessness

Equally, when someone is experiencing manic episodes they may also experience the following symptoms: 

  • Excessive talking 
  • Excessive energy
  • Having lots of new ideas or important plans
  • Being easily distracted
  • Feeling irritated or agitated over the slightest thing 
  • Irregular sleep patterns 
  • Not eating properly 
  • Carrying out tasks that have disastrous outcomes – for example, spending large amounts of money on expensive and sometimes unaffordable items
  • Feeling extremely happy or overjoyed
  • Feeling self-important

Specific symptoms in everyone will vary depending on the severity of the mood disorder, but if you are experiencing any intense emotions or symptoms listed above then you should speak to a mental health professional for medical advice. 

Causes of Bipolar Disorder

It is hard to know for sure what the exact cause of bipolar disorder is; however, specialists believe that there are a few factors combined that increase the chances for a person to develop this mood disorder. Some of the factors include:

  • Chemical imbalances – one explanation for bipolar disorder is that it can be caused by a chemical imbalance in the brain. Evidence suggests that an imbalance in neurotransmitters in the brain could lead to the development of bipolar disorder. 
  • Hereditary – bipolar disorder is also thought to be carried in genetics, if it exists in the gene pool the chances of developing the condition are increased. 
  • Triggers – If someone has a predisposition to bipolar disorder, encountering trauma or undergoing substance abuse could trigger symptoms. 

Treating Bipolar Disorder

The treatment for bipolar disorder and borderline personality disorder will be approached differently and will differ depending on the severity of the symptoms. 

  • Medication – medication such as mood stabilizers can be prescribed long-term to help prevent manic and depressive episodes. 
  • Psychological therapies – talking therapies such as CBT and counselling can be given to help to manage the symptoms of bipolar disorder and help gain a better understanding. 
  • Lifestyle changes – after speaking with a healthcare professional, they may advise lifestyle changes to include more exercise, a better diet, and a stricter sleeping structure to help establish a better routine. 
bipolar vs bpd

Borderline Personality Disorder (BPD)

Borderline personality disorder is a mental health condition that impacts the ability to regulate emotions. It is one of the more severe mood disorders as it can have a huge effect on self-perception and can negatively impact relationships with other people. Similar to bipolar disorder, someone with BPD may experience severe mood swings and can flip between feeling happy and excitable to feeling down and disheartened very quickly. Typically, someone with borderline personality disorder may view things in set or extreme ways and may be unable to see the complexities of situations. For example, they may see things as wholly good or bad. 

On average, people who have borderline personality disorder are also more likely to self-harm due to their strong beliefs and negative feelings about themselves. 

Symptoms of BPD

Borderline personality disorder has very similar symptoms to bipolar disorder in that it can cause emotional instability and erratic mood shifts. These interchangeable moods can also create unstable relationships with others. However, there are a few different symptoms that can commonly be found including: 

  • Emotional instability – this symptom is similar to bipolar disorder as it can cause someone to feel depressed, rage-filled and sorrowful for a while then can quickly change to being happy and positive within a short period of time. Sometimes moods can be so severe that suicidal thoughts can develop. 
  • Disturbed thought patterns – someone with BPD may experience unsettling or uncomfortable thoughts in their day-to-day life. These could range from thoughts of self-hatred to fixed beliefs about imaginary scenarios or delusional thinking. Some severe cases may cause people to hear voices or experience hallucinations. 
  • Impulsive behaviour – similar to bipolar disorder, impulsive behaviour can be a symptom of BPD; however, the types of impulses may differ. Whereas someone with bipolar disorder may act impulsively towards things such as new purchases and challenges, someone with borderline personality disorder may act impulsively towards self-harming or display reckless behaviour doing things such as excessive drinking or gambling. 

other symptoms of borderline personality disorder may also include: 

  • Chronic feelings of sadness or emptiness
  • Unintentional or uncontrollable anger
  • Feelings of dissociation
  • Feeling cut off from oneself and experiencing feelings of unreality
  • Diving headfirst into intense relationships—or ending them on a whim

Causes of Borderline Personality Disorder

BPD can arise due to similar factors that can also cause bipolar disorder. Typically, BPD is not caused by a single factor but rather a combination of different factors. Some of these include:

  • Genetics – often a predisposition for BPD can be carried in family history, making it more likely to develop this mental health condition. 
  • Problems with brain development – research has shown that people who suffer from BPD usually have an underdeveloped part of the brain. Scans show that the amygdala, hippocampus, and orbitofrontal cortex were smaller than usual. This can cause unusual brain activity and may account for unregulated mood patterns. 
  • Experiencing trauma – if someone has a predisposition to mental health conditions and experiences trauma, such as an attack, neglect, or abuse, they may become triggered and develop BPD in response. 
  • Imbalance of chemicals in the brain – similar to bipolar disorder, borderline personality disorder can be caused by an imbalance in the neurotransmitters in the brain. 

Treating Borderline Personality Disorder

Treatment methods for BPD share some similarities with treatment for bipolar. However, typically psychological therapies will be more appropriate and effective than medication in most scenarios. Typical forms of treatment include:

  • Care program – this will assess social and care needs and may assign a key worker such as a social worker or nurse to ensure that the care of the individual is met. 
  • Psychotherapy – this includes talking therapies to help the individual understand their symptoms and behaviour to try and work out coping methods. 
  • Dialectical behaviour therapy (DBT) – this type of therapy is specifically designed for people with BPD. The aim of DBT is to help prevent someone from falling into the vicious cycle of negative emotions. This is done by suggesting positive changes that could be applied to behaviour and everyday life. 
  • Therapeutic communities – these are secure places where people with BPD can take part in group therapy and speak with others who have similar issues. 
  • Art therapy – art therapy can be used to help people with BPD feel calm and express their emotions when they don’t respond effectively to language. 

Medication for BPD

Typically medication is not advised for people with BPD; however, research shows that some medications may be effective in treating symptoms such as anxiety and depression that may arise as a symptom of BPD. This approach is different from bipolar disorder, as medication is usually advised for most people with this condition. 

In general, symptoms of bipolar disorder and BPD will manifest in similar ways. However, the difference lies in the methods of treatment. At The Wave Clinic, we specialise in helping young adults through challenging periods, and we have a range of treatment programs available to help with various mental health conditions. Contact us today to find out more. 

Fiona - The Wave Clinic

Fiona Yassin is the founder and clinical director at The Wave Clinic. She is a U.K. and International registered Psychotherapist and Accredited Clinical Supervisor (U.K. and UNCG).

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