Bipolar disorder and borderline personality disorder (BPD) are both mental illnesses that involve extreme mood swings. Since many BPD and bipolar symptoms overlap, these conditions are often mistaken for each other. But bipolar disorder and BPD are different illnesses, each with their own symptoms and treatments.
How BPD Differs From Bipolar Disorder
Both bipolar disorder and BPD can interfere with relationships, work or school, and the ability to lead a productive life.
In bipolar disorder, which is also called manic depression, a person experiences severe mood swings, resulting in the dramatic emotional highs of mania and the profound lows of severe depression. In BPD, on the other hand, people have both unstable moods and problems with self-image that specifically affect their ability to form healthy relationships. People with personality disorders such as BPD are often not aware that their behavior is abnormal, but their disordered personality makes it difficult for them to deal with other people.
“BPD is based around interpersonal relationships and self-image, versus bipolar disorder, which is manic highs and lows,” says Julie Walther Scheibel, MEd, a therapist based in St. Louis, Mo.
Like bipolar disorder, BPD does lead to mood swings. Unlike bipolar disorder, in which a manic or depressive episode typically lasts for at least a week, a BPD-associated mood swing usually runs its course in a few hours or up to a day.
Although more people are familiar with bipolar disorder, BPD is actually more common. It affects 2 percent of the adult population. Young women are at highest risk of developing BPD.
Symptoms of BPD include:
Episodes of anger, depression, and anxiety
Drug or alcohol abuse
Binge eating or spending
Frequent changes in life goals
Feelings of emptiness
Fear of being alone
Intense, but unstable relationships
Suicide threats or suicide attempts
Bipolar disorder symptoms, on the other hand, include episodic, dramatic shifts from an overly elated mood to severe depression. During manic periods, people with bipolar disorder experience excessive energy, insomnia, irritability, racing thoughts, and difficulty concentrating. While depressed episodes lead to intense sadness, inability to enjoy activities, and suicidal thoughts.
Like those with BPD, people with bipolar disorder often engage in impulsive behavior, but they don’t tend to view their relationships in the same damaging ways as people with BPD. In BPD, people often manipulate others due to distrust and a profound fear of rejection.
Since BPD often occurs along with other psychiatric illnesses, it is not unusual for a person to have both BPD and bipolar disorder.
Treatment for Bipolar Disorder vs. BPD
Treatment for bipolar disorder involves the long-term use of mood stabilizing medications. Bipolar treatment may also involve psychotherapy, which can educate a person with bipolar disorder on how to recognize an impending manic or depressive period so it can be dealt with before it becomes a full-blown episode.
Whereas the mainstay of bipolar disorder treatment is medication, treatment for BPD typically centers around psychotherapy, either group or individual therapy. Anti-depressant medications may also be prescribed, depending on the individual’s specific symptoms.
Both bipolar disorder and BPD are serious mental illnesses that should be managed by a mental health professional.