The Difference Between Borderline Personality Disorder vs Bipolar Disorder

What is the Difference Between Borderline Personality Disorder vs Bipolar Disorder?

Bipolar disorder and borderline personality disorder (BPD) are two different mental health conditions from different groups of mental health diagnoses, with different diagnostic criteria.

However, despite the difference between bipolar and borderline personality disorder, there is a lot of overlap between the two mental disorders, especially with regards to how they affect mood and behavior.

Some experts say BPD is on a bipolar spectrum. Most agree that the two should be considered entirely separate.

Understanding the similarities, differences, and overlap between the two can help patients with either better understand their potential mental illness, as well as how treatments and medication work to affect the symptoms of both conditions.

What is Bipolar Disorder?

Bipolar Disorder, often discussed in the context of bipolar vs borderline personality disorder or bipolar vs BPD, stands as a significant mood disorder, delineated by its profound and drastic mood swings.

These episodes, inherent to bipolar disorder vs BPD debates, manifest as periods of major depressive disorder, mania, hypomania, or mixed states, each with distinct characteristics and impacts on an individual’s life.

Understanding the differences between bipolar and BPD, particularly in terms of episode duration and symptoms, is crucial for accurate diagnosis and treatment.

A bipolar episode is typically either depressive, manic, hypomanic, or mixed.

Depressive Episodes

Depressive episodes are characterized by low mood, lack of motivation, fatigue, oversleeping, and loss of interest in hobbies and most activities, and are marked by profound sadness, a lack of energy, and an overall disinterest in life.

Symptoms that can mirror those of a borderline personality disorder manic episode but are distinct in their duration and intensity. Individuals may experience significant disruptions to their daily routine, finding little pleasure in activities once enjoyed.

Manic Episodes

Manic episodes are characterized by disordered levels of irritability and high mood, restlessness, delusions of grandeur, outbursts of energy, and feeling fine with very little sleep or poor sleep patterns.

Manic Episodes are a cornerstone in identifying the difference between bipolar and BPD, involving an elevated or irritable mood, hyperactivity, and sometimes unrealistic beliefs about one’s abilities or powers. Unlike BPD’s rapid emotional shifts, manic episodes present a sustained period of high energy and risky behavior that significantly deviates from one’s typical behavior.

Hypomanic Episodes

Hypomanic episodes share most of the symptoms of a manic episode, but without losing functioning. A manic episode can be destructive and typically alienates other people. Hypomanic behavior is still unusual for the person but does not actively disrupt their day-to-day.

Hypomanic Episodes share similarities with manic episodes, though are less severe and do not cause the marked impairment in social or occupational functioning seen in full-blown manic episodes. This distinction is essential in the bipolar vs borderline personality disorder debate, as it highlights the difference in the impact of mood episodes on daily functioning.

Mixed Episodes

Mixed episodes are rare, but involve a combination of manic and depressed symptoms, with day-to-day or hour-to-hour shifts in mood.

Mixed Episodes introduce a complex layer to the bipolar disorder vs BPD conversation. These episodes involve simultaneous symptoms of mania and depression, creating a turbulent experience for the individual. This complexity is a hallmark of BD and helps differentiate it from BPD, where mood shifts are more frequent but less likely to embody this concurrent dichotomy.

What is Mania and Hypomania?

Whereas depression is low mood, physical and mental fatigue, brain fog, loss of motivation, anhedonia, and even suicidal ideation, mania is the mirror opposite – an excessive level of energy, irritability and anger, feelings of grandeur, heightened risk-taking behavior and forwardness.

The general difference between mania and hypomania is severity.

Hypo, as in under, describes a form of mild mania that may be unusual for the person, but cannot be characterized as disordered or debilitating. Manic symptoms, on the other hand, can be very debilitating for someone.

They can lead to dangerous consequences, including unintentional self-harm and property damage.

Types of Bipolar Disorder

In the intricate landscape of mental health, distinguishing between Bipolar Disorder (BD) and Borderline Personality Disorder (BPD) is paramount, especially when discussing the types of bipolar disorder in the context of bipolar vs borderline, or bpd vs bipolar comparisons.

Bipolar disorder, a mood disorder characterized by significant mood swings, diverges into several types, each with unique symptoms and diagnostic criteria, further emphasizing the difference between bpd and bipolar, or bipolar disorder vs bpd considerations.

Bipolar I

Bipolar I requires a diagnosis of at least one or more manic episodes, either lasting more than a week, or severe enough to cause hospitalization.

Bipolar I Disorder stands at the more severe end of the spectrum. This type is highlighted in discussions around bipolar vs borderline personality disorder due to its requirement for at least one manic episode that is either prolonged or intense enough to necessitate hospitalization. The distinction between bipolar and bpd becomes apparent here, as Bipolar I’s manic episodes are more extreme than any mood fluctuations seen in BPD.

Bipolar II Disorder

Bipolar II Disorder is characterized by manic or depressive episodes.

Patients cannot be diagnosed with bipolar II if they have ever experienced a fully manic episode.

Bipolar II Disorder introduces a nuanced perspective to the bipolar vs bpd dialogue. Characterized by cycles of manic or depressive episodes, Bipolar II differentiates itself from Bipolar I by the absence of full-blown manic episodes. This distinction is crucial in the bipolar vs borderline debate, underscoring the differences in symptom intensity and duration between bipolar disorder and borderline personality disorder.

Cyclothymic Disorder

Cyclothymic disorder is a form of mild bipolar disorder, with both mild depressive and mild manic symptoms.

Cyclothymic Disorder, or Cyclothymia, offers a milder but persistent form of mood fluctuation, contributing to the broader discussion of bipolar disorder vs bpd. With a pattern of mild depressive and hypomanic episodes, Cyclothymic Disorder showcases less severe symptoms over a prolonged period, marking a clear delineation in the borderline vs bipolar comparison.

Not Otherwise Specified

Any bipolar condition that doesn’t fall into the above three categories is defined as not otherwise specified.

Not Otherwise Specified (NOS), a category that captures those who do not neatly fit into the other classifications emphasizes the complexity of diagnosing and understanding mood disorders. This category acknowledges the varied experiences of individuals, highlighting the spectrum nature of bipolar disorder, which can sometimes blur lines in the bpd and bipolar discourse.

These include cases where a patient may be rapidly cycling between episodes or has symptoms that don’t fit into the other categories.

What is Borderline Personality Disorder?

Borderline personality disorder is one of four cluster B personality disorders, and one of ten recognized personality disorders.

Cluster B is known as the erratic cluster, due to a common thread of impulsive actions, risk-taking, dramatic behavior, and rapid shifts in mood.

Among these personality disorders, borderline personality disorder is defined by intense, sudden shifts in mood, polarizing attitudes (all or nothing), and a rapidly shifting, unstable sense of self.

Borderline personality disorder is one of the most researched personality disorders, and even had a well-known form of talk therapy created to treat it (dialectical behavior therapy).

At the core of a borderline personality disorder is a fundamentally shaky self-image. People struggling with borderline personality disorder struggle with impulse control and mood shifts, and can experience bpd symptoms of severe anger, physical outbursts, deep depression, and anxiety, lasting days at a time.

Because of these massive shifts – which can even apply to their opinions of people – they have a hard time maintaining relationships with others, including family.

Bipolar Disorder and BPD Similarities

The most significant overlap between bipolar disorder and borderline personality disorder is mood shifts. Both conditions are marked by impulsive actions, irritability, and both depressed and high days. Both conditions struggle with emotional dysregulation. Both conditions are characterized by high-risk behavior. But that is generally where the overlap ends.

The Difference Between Borderline Personality Disorder vs Bipolar Disorder

Where bipolar episodes appear with some sort of structure or consistency, borderline personality disorder shifts can occur much more rapidly. Bipolar disorder episodes are consistently defined as either manic, depressive, or mixed.

The shifts and episodes of borderline personality disorder patients are much more varied, and based on outbursts of a specific feeling, such as sudden overwhelming anger, sudden overwhelming loneliness, or sudden overwhelming emptiness.

Mood and personality changes in BPD are short-lived and frequent, while most cases of bipolar disorder have episodes that last days or weeks.

Hypomania and mania are core parts of the definition of a bipolar disorder, characterized by elation and feeling high. BPD outbursts rarely feel positive or self-aggrandizing.

Bipolar Disorder and BPD Co-Occurrence

While the two conditions exist separately and have their own established definitions, diagnostic guidelines, and potential causes, there is an overlap in diagnostic frequency between bipolar disorder and borderline personality disorder – about 20 percent of people diagnosed with either will also struggle with the other.

This frequency is part of the reason why there is a debate on the topic to begin with. Serious researchers and expert voices in the field of psychiatry have advocated for the idea of the bipolar spectrum, with borderline personality disorder intersecting with bipolar disorder to such a degree that it would be on said spectrum.

While the most recent science makes a clear distinction between BPD and bipolar disorder cases, it’s important for us to understand the relationship between these two conditions, to be able to better identify and treat them.

What we do know is that the overlap between these two conditions is clinically significant. Patients with a comorbidity between Borderline Personality Disorder and bipolar disorder are at an elevated risk for suicide and suffer from greater levels of social impairment. They usually also require greater levels of care.

Treating Borderline Personality Disorder vs Bipolar Disorder

Both Borderline Personality Disorder (BPD) and Bipolar disorder are treatable. But when co-occurring, both mental disorders lead to significantly longer inpatient stays, higher prevalence of substance abuse, and higher inpatient charges. More attention and care must be directed toward patients when treating Borderline Personality Disorder and bipolar disorder, and more research is needed to develop effective clinical strategies to help treat borderline personality disorder and bipolar disorder to optimize outcomes for these patients.