Understanding the differences between Borderline Personality Disorder (BPD) and Bipolar Disorder can be challenging, as they share some similar symptoms. However, they are distinct mental health conditions with unique features, diagnostic criteria and treatment approaches. 

What is Borderline Personality Disorder (BPD)?

Borderline Personality Disorder, commonly referred to as BPD, is a mental health condition characterized by pervasive instability in moods, behavior, self-image and functioning. According to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition), BPD symptoms include:

  • Intense fear of abandonment
  • Unstable and intense relationships
  • Distorted self-image
  • Impulsive behaviors (e.g., spending sprees, substance abuse)
  • Self-harming behaviors or suicidal ideation
  • Emotional instability
  • Chronic feelings of emptiness
  • Inappropriate, intense anger
  • Stress-related paranoia or dissociation

Causes of BPD

The exact cause of BPD is unknown, but it is believed to result from a combination of genetic, environmental and social factors. Traumatic experiences, such as childhood abuse or neglect, significantly contribute to the development of BPD.

Borderline Personality Disorder (DSM 5)

A mental health professional diagnoses BPD based on the criteria listed in the DSM-5. There isn’t a specific borderline personality disorder test, but a thorough clinical evaluation, including a detailed interview and discussion of the patient’s history and symptoms, is essential for diagnosis.

What is Bipolar Disorder?

Bipolar Disorder, previously known as manic-depressive illness, is a mood disorder characterized by extreme mood swings that include emotional highs (mania or hypomania) and lows (depression). The primary types of Bipolar Disorder are Bipolar I, Bipolar II and Cyclothymic Disorder.

Symptoms of Bipolar Disorder

The symptoms of Bipolar Disorder vary depending on the phase:

Manic/Hypomanic episode

  • Increased energy or activity
  • Elevated or irritable mood
  • Decreased need for sleep
  • Racing thoughts
  • Distractibility
  • Inflated self-esteem or grandiosity
  • Engaging in risky behaviors (e.g., excessive spending, unprotected sex)

Depressive episode

  • Persistent sadness or emptiness
  • Loss of interest in activities
  • Fatigue or low energy
  • Difficulty concentrating
  • Changes in appetite or weight
  • Feelings of worthlessness or guilt
  • Suicidal thoughts or behaviors

Is Bipolar Disorder genetic?

Bipolar Disorder is believed to have a significant genetic component. According to the National Library of Medicine, research suggests that it is heritable, meaning it can run in families. Environmental factors, such as stress or traumatic events, can also trigger bipolar episodes in susceptible people.

Diagnosis of Bipolar Disorder

A mental health professional diagnoses Bipolar Disorder through a comprehensive evaluation, which may include a bipolar test, clinical interviews and a review of the patient’s medical and family history.

Key Differences Between BPD and Bipolar Disorder

While BPD and Bipolar Disorder share similar attributes, there are some distinctive differences. This includes:

Mood patterns and cycles

One of the primary differences between BPD and Bipolar Disorder is the pattern and duration of mood changes. In Bipolar Disorder, mood swings typically last for weeks to months, with distinct periods of mania/hypomania and depression. Conversely, individuals with BPD experience rapid mood shifts that can occur within hours or days, often triggered by interpersonal conflicts or perceived abandonment.

Impulsivity and behavior

Both disorders involve impulsivity, but it manifests differently. In BPD, impulsive behaviors are often a response to emotional distress and can include self-harm or substance abuse. In Bipolar Disorder, impulsivity is more likely to occur during manic or hypomanic episodes and may involve risky behaviors such as reckless spending or promiscuity.

Interpersonal relationships

People with BPD often have intense and unstable relationships, characterized by a pattern of idealizing and then devaluing others. This instability stems from their fear of abandonment and difficulty regulating emotions. In contrast, people with Bipolar Disorder may experience relationship issues primarily during mood episodes, but their interpersonal functioning can be relatively stable during periods of euthymic (normal mood).

Self-Image

A distorted and unstable self-image is a hallmark of BPD, leading to frequent changes in goals, values and career aspirations. People with Bipolar Disorder may also experience changes in self-esteem, but these fluctuations are typically linked to their mood episodes rather than a chronic instability of self-image.

Treatment Approaches

Finding the right treatment for you can be overwhelming. There are multiple options in which you can choose from, some being:

Therapy for Borderline Personality Disorder

Therapy is the cornerstone of treatment for BPD. Dialectical Behavior Therapy (DBT) is particularly effective, helping people develop skills to manage emotions, reduce self-destructive behaviors and improve relationships. Cognitive Behavioral Therapy (CBT) and schema-focused therapy are also beneficial.

Borderline Personality Disorder medication

While there is no specific medication for BPD, medications such as antidepressants, antipsychotics and mood stabilizers can help manage specific symptoms like depression, anxiety or mood swings.

Treatment for Bipolar Disorder

Treatment for Bipolar Disorder typically involves a combination of medication and psychotherapy. Mood stabilizers, such as lithium and antipsychotic medications are commonly prescribed to control manic and depressive episodes. Psychotherapy, including CBT and psychoeducation, helps people understand their condition, recognize mood triggers and develop coping strategies.

Importance of ongoing support

Both BPD and Bipolar Disorder require ongoing support and treatment. Regular therapy sessions, medication management and support from family and friends are crucial for managing symptoms and maintaining stability.

Empowering Treatments: BPD vs Bipolar

While Borderline Personality Disorder and Bipolar Disorder share some overlapping symptoms, they are distinct conditions with different causes, diagnostic criteria and treatment approaches. Understanding these differences is essential for accurate diagnosis and effective treatment. If you or a loved one is experiencing symptoms of either disorder, seeking help from a mental health professional is the first step towards recovery.

River Point Behavioral Health, located in Jacksonville, Florida, offers multiple inpatient and outpatient services for both adults and adolescents. We have a dedicated team of mental health professionals in the fields of psychiatry, medicine, nursing, social work, education and activity therapy to provide our services. To learn more about the different programs we offer, visit our Treatments & Services page.