In Part I of this two-part series, I discuss the differences between bipolar and borderline personality disorder in terms of diagnosis. In this part, I focus on differences in treatments for the two conditions.
Bipolar disorder has been considered a biological illness for many years, and the research has focused largely on medications. A standard repertoire of medications is used to treat bipolar:
In terms of non-medication treatment, the focus is on the following:
A program called Interpersonal and Social Rhythm Therapy (IPSRT), which we discuss in Bipolar Disorder For Dummies is well studied and targets sleep/wake and general daily rhythms along with interpersonal stress and demands. IPSRT seems to reduce the frequency and severity of symptoms when used in tandem with medication.
What’s most important to note about bipolar as contrasted to borderline personality disorder is that bipolar is generally considered more biological than psychological and tends to respond more fully and consistently to medication treatment. Many (though certainly not all) people with bipolar disorder can achieve remission of symptoms – elimination or reduction of mood cycle episodes – with medication treatment.
The treatment of borderline personality disorder has a history of conflicting approaches and less clear data. Traditionally, borderline personality disorder has been seen as more psychological than biological, but more recently awareness of the neurobiological components of this very difficult-to-treat condition has increased.
The treatment research has focused more on therapy models than on medication, and the core symptoms of the disorder have not shown consistent or robust responses to any family of medications.
Currently a few competing models of therapy intervention for borderline personality disorder are available:
In the medication corner, some studies have been done on the use of mood stabilizers in the treatment of borderline personality disorder – focusing on the core symptoms of mood reactivity. However, medications don’t have a strong track record in this disorder.
Medication is most commonly used in borderline personality disorder to treat associated conditions, including depression, anxiety, rage attacks, and eating disorders. Antidepressants/anti-anxiety medicines are commonly used in these scenarios, and the results can be quite positive, but the core personality symptoms are not typically resolved with these medications.
Some treatment approaches for bipolar disorder and borderline personality disorder overlap:
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From Psych Central's Dr. Candida Fink & Joe Kraynak:
Bipolar Borderline Personality Disorder Differences Diagnosis | Bipolar Beat | Candida Fink, MD | Bipolar Beat (September 7, 2010)
Last reviewed: 2 Sep 2010