From an outsider’s perspective, bipolar disorders and borderline personality disorder (BPD) appear to have some overlap. Both may involve extreme emotions and mood swings. However, the likely causes are very different. There are also important differences in symptom presentation and the dynamics of how they may affect different parts of a person’s life. In bipolar disorder, genetics and biological differences play a bigger role in causing symptoms. Borderline personality disorder is more often a product of childhood trauma, although genes and brain differences may be involved.
Bipolar disorders and BPD can both be considered serious mental health conditions. Both are also somewhat misunderstood. Clinicians may not recognize these conditions if they don’t have experience treating them or have an ongoing relationship with the client. As a result, both are often misdiagnosed as other conditions. Learning about the differences between bipolar disorders and BPD can help you have better conversations with providers so you can get the care you need.
In this article, we’ll talk about what bipolar disorders and borderline personality disorder look like, and we’ll share five key differences you should know about.
What are bipolar disorders?
Bipolar disorders are conditions that feature manic or hypomanic episodes. People may also experience depression as a part of bipolar disorders, but some don’t. There’s a lot of variety in symptom presentations and lived experiences with bipolar disorders. Some people may only have one or two bipolar mood episodes in their lifetimes. Others may have them a few times a year or cycle through them quickly, known as rapid cycling. Most people with these conditions have their first mood episode between ages 15 and 25. However, people may develop it as children or into their 40s.
Mania is a type of episode in which a person has an extremely elevated, expansive or irritable mood. People may feel euphoric, energized or invincible and launch into activities or projects. Others may notice them talking a lot or talking faster than usual. Sometimes mania can involve risk-taking or a lack of inhibition. Manic episodes usually interfere with a person’s daily life and require immediate treatment. People who experience manic episodes are diagnosed with bipolar I.
Hypomanic episodes are less intense mood episodes where people feel only slightly more energetic or irritable. Those who have hypomanic episodes may have bipolar II or cyclothymic disorder, also known as cyclothymia. Cyclothymia is characterized by hypomanic and depressive symptoms that don’t meet the full criteria for bipolar disorder or major depressive disorder. There are many other features that people who have bipolar disorders may experience. Rapid cycling is one of them, and some may have mixed features or mixed states. This means they experience mania and depression at the same time or in quick succession.
What is borderline personality disorder?
People who have borderline personality disorder (BPD) have intense mood swings and trouble with emotional regulation. Unlike bipolar disorder, their strong feelings often revolve around their self-image and relationships with others. These mood swings are sometimes known as “splitting.” When a person is splitting, they tend to see themselves and others in black and white. Rather than seeing both the good and bad, people are either one or the other. Splitting and intense emotions can lead to impulsive actions and unstable relationships.
People who have BPD often have a deep fear of being abandoned that stems from periods of stress or trauma early in life. While certain patterns may begin in their childhood or teen years, personalities are still developing at these stages. When people have the support they need, they may never develop diagnosable BPD. For this reason, many clinicians won’t use this diagnosis for people under 18.
5 key differences between bipolar disorders and borderline personality disorder
If you think you may have a bipolar disorder or BPD, learning about these conditions and treatments that help is a great first step. Intense emotions and mood episodes are indications that you should seek out a mental health assessment. It’s OK to form your own opinion about your symptoms and how they’re affecting you. This can help you advocate for yourself. However, a true diagnosis and effective treatment can only be provided by a licensed clinician. In the ideal assessment process, clients and clinicians work together to create an understanding of what’s happening and what treatments may help.
The following are five key differences between bipolar disorders and borderline personality disorder:
Pattern of mood changes
In most bipolar disorders, people have distinct mood episodes with clear beginnings and endings. There are a few basic types of mood episodes that have relatively consistent symptom presentations — these include manic, hypomanic, depressive and mixed states. These states may be triggered by stressful situations, but stress isn’t necessarily a factor that causes bipolar disorders. In contrast, people with BPD may have more consistent difficulty with emotional regulation. When they have extreme positive or negative moods, they’re usually in relation to something that happened in a relationship or their self-image.
Relationship patterns
One of the biggest differences between bipolar disorders and BPD is the role of relationships in symptom presentations. Relationships are central to BPD — people who have this condition usually have deep fears of rejection, which makes certain interactions with loved ones triggering. At the same time, extreme positive and negative reactions make for unstable and chaotic relationships. Bipolar episodes can definitely impact a person’s relationships, too. However, they don’t play a central role, and people typically maintain stability between episodes.
Self-image and identity
People with BPD experience rapid mood shifts and dysregulation tied to their self-image or their relationships with others. In bipolar disorders, mood episodes may affect the person’s self-image temporarily. They may also be more generalized, and people typically return to a more stable state between episodes. For those with BPD, perceived rejection, dismissal or other negative interactions with loved ones are particularly upsetting. When a person “splits,” they may think a person is either purely good or bad. Splitting may happen over a short or long period of time, depending on the person.
Triggers and causes
BPD is most often connected to periods of stress or trauma early in life, and it’s triggered by interpersonal stress. There may be a genetic component as well, but this is a much bigger factor in bipolar disorders. While bipolar mood episodes may be brought on by stress, they often happen independently. Both conditions may involve differences in brain function, but they affect different parts of the brain.
Treatment approaches
People who have either condition will need personalized treatment. In general, the approaches for bipolar disorders and BPD are a bit different. For bipolar disorders, medication is usually necessary. People may receive supportive treatment to learn how to care for themselves proactively and manage mood episodes. For BPD, therapy is the main focus. Those who receive BPD treatment early in life are more likely to have better outcomes. Medication isn’t a primary treatment for BPD, but if a person has a secondary diagnosis like depression, they may need medication.
Get help with your bipolar disorder or borderline personality disorder at Guidelight
With any mental health condition, receiving an accurate diagnosis is the first step toward finding effective treatment. Learning about different conditions can help you find providers who understand what you’re experiencing and have experience treating your condition. Reflecting on what seems to trigger your intense feelings and how your relationships are affected may reveal some helpful insights. If you recognize more than a few symptoms of a bipolar disorder or BPD in your life, you should seek a mental health assessment with a licensed clinician.
Bipolar disorders and BPD are both conditions that have historically carried a lot of stigma. Receiving a diagnosis like one of these isn’t a life sentence — it’s a new way of understanding and talking about what you’re going through. It can also be a source of hope that you’re getting closer to finding treatment that will help. At Guidelight, we treat clients with both conditions. We offer higher levels of mental health care in a supportive community setting to help you find balance and healing.
Are you ready to start the conversation? There’s a seat for you at Guidelight. Contact our team today for more information or to schedule an initial evaluation.