Bipolar disorder and borderline personality disorder (BPD) have some symptoms in common, but are two mental illnesses that require different treatment approaches. It can be challenging to diagnose mental health conditions because there are no biological tests that can distinguish one from another.
Both bipolar disorder and borderline personality disorder are mental health challenges that involve mood swings and impulsive behavior. However, there are some distinguishing characteristics of each. Read on to learn more.
What is Bipolar Disorder?
Bipolar disorder is a mental health condition that affects how a person experiences shifts in mood, energy, and motivation. These shifts go beyond ordinary ups and downs, disrupting daily life, relationships, and decision-making.
What makes bipolar disorder different from most mood-related conditions is that these changes happen in cycles or episodes, which can last for days, weeks, or even longer.
Two Types of Bipolar Disorder
There are two main types: bipolar I and bipolar II. Both involve significant mood episodes, but the intensity and pattern of those episodes can vary. Because symptoms often overlap with other conditions like depression or anxiety, getting an accurate diagnosis isn’t always straightforward.
Characteristics of Bipolar Disorder
Formerly known as manic depression, bipolar I disorder and bipolar II disorder are both characterized by wide swings in mood and energy levels. Core characteristics that define the condition include:
Mania
Mania is marked by periods of extremely high energy, euphoria, and feelings of grandiosity. During a manic phase, a person may engage in risky, impulsive, and destructive behavior.
Thoughts may become fast-paced, and the need for sleep is greatly reduced. Sleep often decreases, but energy increases. People in a manic episode may act impulsively or take risks they normally wouldn’t consider.
Depression
Signs of depression are defined by extreme sadness, low energy, and hopelessness. During depressive episodes, a person with bipolar disorder feels extremely tired, sad, and hopeless. Everyday tasks can feel overwhelming.
These episodes can last for weeks and are often the reason people seek help. In fact, the most common misdiagnosis for bipolar disorder is depression, possibly because many people with bipolar disorder first seek help during a depressive episode before any manic symptoms appear.
What is Borderline Personality Disorder?
Borderline personality disorder is a mental health condition that affects how a person regulates emotions and relates to others. It involves patterns of emotional reactivity, impulsive behavior, and unstable relationships that can significantly impact daily life.
What makes borderline personality disorder different is that the emotional changes are more reactive and short-lived, and they often center around relationships and self-worth.
Characteristics of Borderline Personality Disorder
Borderline personality disorder is defined by emotional sensitivity, unstable relationships, and difficulty managing intense feelings. Core characteristics that define the condition include:
Emotional Instability
People with borderline personality disorder often feel emotions more strongly and for longer periods than others. These emotions can shift quickly and are usually triggered by events that feel upsetting, disappointing, or threatening.
Fear of Abandonment
A deep fear of being left or rejected is common. Even minor changes in a relationship can cause panic or emotional distress. This fear may lead to efforts to avoid real or imagined abandonment, sometimes at the cost of personal well-being.
Unstable Relationships
Relationships may swing between closeness and conflict. A person may see someone as loving one moment and uncaring the next. These shifts often reflect the person’s inner experience of insecurity or fear.
Impulsive Behavior
Impulsive actions often happen in response to emotional pain. This may include substance use, self-harm, disordered eating, or other behaviors that provide short-term relief but lead to longer-term consequences.
Shifting Self-Image
A person with borderline personality disorder may struggle to maintain a stable sense of self. How they see themselves can often change, especially in response to how others treat them or how they feel in the moment.
Defining the Differences Between BPD and Bipolar Disorder
Understanding the differences between borderline personality disorder and bipolar disorder can make it easier to find the correct diagnosis, treatment, and support. Here, we’ll outline how the two conditions differ in how they affect mood, behavior, relationships, and long-term care.
If you or someone you love has been struggling and wondering which diagnosis fits best, these details can offer more clarity.
Quick Comparison: BPD vs. Bipolar Disorder
|
FEATURE |
BORDERLINE PERSONALITY DISORDER |
BIPOLAR DISORDER |
|
Mood Changes |
Intense and short-lived, often in response to stress or relationships |
Last for days or weeks and are less tied to outside events |
|
Mood Episode Types |
Emotional swings like sadness, anger, or anxiety |
Manic, hypomanic, and depressive episodes |
|
Impulsivity |
Ongoing and emotionally driven |
Often linked to manic or hypomanic states |
|
Self-Image |
Frequently shifts based on mood or relationships |
More stable over time |
|
Relationships |
Unstable with an intense fear of abandonment |
May be affected by mood episodes, but are generally steadier |
|
Root Causes |
Often related to trauma and early emotional experiences |
Strong genetic and biological factors |
Mood Patterns and What Drives Them
Mood changes in BPD are usually fast and tied to what’s happening in the moment. Someone may feel okay in the morning and angry, overwhelmed, or rejected by the afternoon. These shifts are intense but tend to pass within a day or two.
Bipolar disorder involves mood episodes that last longer and aren’t always connected to outside events. A person may feel energized and confident for days during a manic episode or deeply withdrawn for weeks during a depressive one, even if everything in life seems stable.
Impulsivity and Decision-Making
In BPD, impulsive behavior is often a response to emotional pain or fear of being left behind. These actions can include spending sprees, substance use, or self-harm, and they may happen often, even during calm periods.
With bipolar disorder, impulsivity usually shows up during mania or hypomania. A person might suddenly take big risks, make fast decisions, or feel unstoppable. Once the episode ends, they may return to a more stable pace.
Self-Identity and Relationships
BPD often involves a shifting sense of who you are. Self-worth, goals, and values can change quickly, especially in response to relationships. This can lead to a constant search for connection or a fear of being alone.
When those needs feel threatened, someone with BPD may feel intense anger, anxiety, or emotional overwhelm. These emotions can quickly affect how they see themselves or how they respond in the moment.
In bipolar disorder, self-identity is usually more consistent, though mood episodes can still strain relationships. Someone may act differently during a manic or depressive phase, but their overall sense of self stays more intact.
Where it Starts
BPD is often linked to early emotional trauma, such as abuse, neglect, or unstable relationships in childhood. These experiences can affect how someone handles emotions and connects with others later in life.
Bipolar disorder tends to run in families and is influenced more by brain chemistry and genetics. While stress can trigger episodes, it’s not typically the root cause.
Diagnosing Bipolar and Borderline Personality Disorder
Both conditions can be challenging to diagnose, so misdiagnosis isn’t uncommon. Both require medical and psychological exams to rule out other possible issues.
Bipolar Disorder Diagnosis Process
To diagnose bipolar disorder, apart from a thorough interview and evaluation, a person may be asked to keep a daily record of their mood, energy level, and sleep patterns.
Borderline Personality Disorder Diagnosis Process
Diagnosing borderline personality disorder isn’t based on a particular sign or symptom. There may be a psychological evaluation that includes completing questionnaires.
This disorder is diagnosed after a comprehensive clinical interview with the individual, previous providers, and possibly interviews with family and friends.
Can You Have Bipolar and BPD Together?
Yes, it is possible to have both bipolar disorder and borderline personality disorder at the same time. This is called a co-occurring or dual diagnosis, and is pretty common — about 20% of bipolar II patients and 10% of bipolar I patients have co-occurring BPD.
Overlapping Symptoms
Although the two conditions are separate, they can overlap in certain symptoms like mood changes, impulsivity, and relationship struggles. When someone has both conditions, it can be hard to understand what’s causing which symptoms.
One day may feel unpredictable or emotionally intense, while another day may be overwhelmed by exhaustion or hopelessness. This can, understandably, leave people feeling frustrated, misunderstood, or unsure where to start with treatment.
Treatment Can Address Both Conditions
Recovery is still possible, even if both disorders are present. Many people benefit from a mix of medication to help stabilize mood and therapy to build emotional awareness, coping skills, and healthier relationships.
With the right support, things can get more manageable over time. Many find that they feel more in control and less alone once they understand what they’re facing.
What Treatment for a Dual Diagnosis of Bipolar and BPD Looks Like
It’s understandable to feel overwhelmed when you’re living with both bipolar disorder and borderline personality disorder. The symptoms can overlap, making it hard to know where to start.
Treatment can provide clarity, structure, and tools that make everyday life feel more manageable. Here’s an overview of what it focuses on and how those changes can help day to day.
Mood Stabilization
Mood instability is the most crucial overlapping symptom between bipolar disorder and BPD. Working toward mood stabilization is one of the most critical goals in treatment for these co-occurring conditions.
- Helps reduce the intensity and unpredictability of mood swings
- Makes it easier to maintain routines and responsibilities
- Lowers the risk of crisis-level emotional episodes
Improved Emotional Regulation
Emotional dysregulation is another common symptom of both bipolar disorder and BPD. Similar to mood stabilization, improving emotional regulation is another primary focus of treatment. Developing and strengthening the ability to regulate emotions leads to vast improvements.
- Makes it easier to respond calmly to stress or conflict
- Reduces emotional burnout and reactivity
- Supports better decision-making and follow-through
Strengthened Interpersonal Skills
Managing relationships while living with both BPD and bipolar disorder is difficult. Mental health treatment equips people with the tools and skills to strengthen existing relationships and build new ones.
- Encourages healthier communication and boundaries
- Helps rebuild trust and reduce conflict
- Supports stronger social connections and a more stable support system
Medication Management
Medication is a common component of many treatment plans for bipolar disorder and BPD. Mediation management is an important treatment outcome for co-occurring BPD and bipolar.
- Helps stabilize mood and ease specific symptoms
- Makes other parts of the treatment more effective
- Offers structure and predictability through medical support
Crisis Management
Crises are still possible when living with co-occurring bipolar and BPD, even after seeking treatment. Developing crisis management coping skills is another important part of treatment.
- Helps reduce harm during emotionally intense moments
- Provides tools to stay grounded in high-stress situations
- Lowers the chances of hospitalization or emergency care
Improved Daily Functioning
Co-occurring bipolar disorder and BPD can severely impact quality of life. Both conditions affect a person’s ability to carry out daily responsibilities at work, school, or home. Improved daily functioning is a critical benefit of treatment.
- Makes it easier to stick with routines and goals
- Improves focus, energy, and task completion
- Increases stability in everyday responsibilities
How to Support a Loved One with Bipolar Disorder or BPD
Watching a loved one live with bipolar disorder or borderline personality disorder can leave you feeling lost and helpless. It probably feels like you’ve done everything you can to support your loved one as they navigate life with their condition.
Although you can’t manage their life for them or do the work necessary to regulate their symptoms, you can support them in their journey. Below are some ways to encourage your loved one with bipolar disorder or BPD.
Educate Yourself
Learn as much as you can about your loved one’s condition, including the symptoms, challenges they may deal with, and treatment options. The more you know, the more compassionate you can be.
Avoid Judgment
Understand that mental health disorders are not a person’s “fault.” It might be hard to separate your loved one from their disorder at times, but avoiding judgment allows you to provide the best support possible.
Be Patient
Being patient with a loved one who has bipolar disorder or BPD may feel tough at times. You don’t always know where you stand with them, and they may lash out at you. If you can be patient, though, they’re more likely to be receptive to your support.
Check In On Them
When someone struggles with their mental health, it helps to know that they’re cared for and supported. Make sure your loved one knows you’re there for them. Take the time to check in on them regularly and make yourself available if they need to talk.
Encourage Mental Health Treatment
Recognize the importance of mental health treatment. Encourage your loved one to seek professional help for their bipolar disorder or BPD. Knowing they have your support could be the final push they need to reach out and seek treatment.
Get the Right Diagnosis — and the Right Support
When you’re struggling with intense mood swings, relationship challenges, or emotional pain that feels hard to explain, getting an accurate diagnosis can be life-changing. Whether you’re living with borderline personality disorder, bipolar disorder, or both, the right treatment can help you feel more stable, more understood, and more in control of your life.
At Clearview, we offer specialized programs for people navigating borderline personality disorder, bipolar disorder, or a dual diagnosis of both. Our approach combines evidence-based therapies with compassionate, individualized care to help you build lasting progress.
You don’t have to figure this out alone. We’re here for you. Call us today at 877.313.8271 or fill out our contact form.
