Bipolar disorder and borderline personality disorder often share many of the same symptoms – mood shifts, emotion dysregulation, impulsivity. In “Is Bipolar Disorder Overdiagnosed in Adults?” I cited a study suggesting that a number of people diagnosed with bipolar disorder actually meet criteria for borderline personality disorder, instead.
So what’s the difference? It’s a complicated discussion. Although some overlap may exist, important distinctions separate the two conditions, yet some researchers believe both conditions are likely a part of a continuum and are, in fact, related to one another.
In this part of a two-part series, I highlight the diagnostic differences between bipolar disorder and borderline personality disorder. In Part II, I focus on differences in treatment for the two conditions.
Development/Nature of the Illness
Borderline personality disorder is a type of “personality disorder” which essentially means that it is a developmental condition – something that has evolved through the entire development of a person’s emotional/behavioral infrastructure.
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I have been diagnosed and treated for DID, Bipolar (ultra rapid cycling), and borderline. While I have never met anyone, I imagine it would be pretty common among folks that suffered childhood trauma.
After recently accepting the Bipolar diagnosis, I have found that getting clear information about the fact (as far as I am concerned) they all exist on a continuum has been hard. It seems that if I had had this info early on in my treatment I at least would not have been so blown away as they each came up.
I dunno. it’s been a long road….not even sure I have said anything here, but your article really got me thinking. Thanks!
~sm
Beautiful, thank you.
I have the dx of bipolar 1 (as did my mother who did not fare well–suicide after many attempts when I was 15 & I had a few attempts myself during the years; last one 4 years ago) & I was helped very much when I was put on Lithium but had kidney malfunction (& now have some kidney damage) & had to get off it after only 2 mos. but it gave me a glimpse of life I have never seen before.
Is this what other people feel like? I had never experienced that lack of internal chaos & hurt & turmoil until I was on Lithium. But then I started the trial & error to find meds & combos that could give me that kind of stability & feeling of peace. Got close, but not close enough as did have a majorly long hypo-manic state that I didn’t report to my meds provider as I didn’t know it was dangerous (about 5 mos. of sleeping only 2-3 hrs.) but I had been relatively “stable” for about 5 years so wasn’t checking in but every 6-9 mos.
And since I spent most of my time depressed this hypo mania felt GREAT. But that was when I suddenly crashed 4 years ago & had an overdose on my psych meds… But I have needed more help than just meds & have been to so many therapists (as therapy w/medication is recommended w/bipolar) but there just wasn’t any relief despite all the “insight” I had.
Heard about DBT in my support group from a guy who had treatment-resistant depression & he said it was the only thing that helped him. I’d never heard of it, but researched it, found a trained therapist, called her & told her my “case” & asked if she thought I would benefit from DBT. She did & boy, did I ever!
2 years w/DBT & individual therapy w/her & I was able to get off Abilify (after 15 yrs. & developing metabolic syndrome as a side effect) & lowering my Lamictal w/the hopes of getting off it; helped w/chronic insomnia & acute anxiety.
I don’t know or care about all the dxes; I know I share the over-sensitivity & over-emotional reactions of the others in the group who all have the dx of borderline & one also has bipolar. My therapist put borderline down as an exploratory dx & I told her to just remove it. I already had a dx sufficient for insurance & for me, I don’t care what the dx is as long as the treatment is helping!
I am probably “both” but I don’t have the relationship dependency thing in that I have isolated myself so much so as not to have friends & just my husband of 36 years & 2 grown children who are doing great despite having me as a mother.
I was diagnosed with Bipolar Affective Disorder. Is it normal for people with this diagnosis to recover to the extent that I may be able to live without medication? I currently take citralopram and seroquol.
What is DBT? I have been diagnosed with BiPolar II. I am on depakoate + and cymbalta for mood stability and mood elevation + zoloft in the afternoon and seroquel and clonozopam to sleep….just started exercising and that feels great plus starting to sleep better…overall seem to be doing okay…infrequent episodes and the rapid cycling seems to have calmed down…plus my brain doesn’t flood but i am no longer a ‘superwoman’ though I still can sign up for too much stuff if life feels too calm….liver and other tests are great….healthy as a horse – so far….
Thank You for the article; There is MUCH ‘unknown’ about how to separate out; I have been diagnosed with both Bipolar { ( I believe 2- I DO NOT NOR ever have had any Manic episodes); My pdoc says i just go hypomanic- I call it high functioning or functioning at my potential ( accused of NOT doing all through childhood)} also Dx with BPD- this Dx and my PTSD got me on Federal disability without a fight- but doctors who treated me later leaned more toward the BiPolar Dx.
Regardless of the diagnosis- I deal with the symptoms that are disrupting my life- I fully agree with a Dx of MDD as well as PTSD ( incest survivor); as to any other diagnosis- I get anxious with stress ( mostly in my home life) I do not have anger issues that are unusually strong; I do not push people away to avoid abandonment- friends with my husband for twenty years, married almost 12; Friends that I have had for 20 years are numerous;
I find it interesting that in all my years of treatment for PTSD and depression up to four years ago- I was never diagnosed with either disorder- these were made only after I was put on SSRIs- only done because my insurance company would not pay for continued care unless I tried them; Now off ALL SSRIs for more than 1 1/2 yrs- life has resumed to normal, still seeing a therapist and on Lamical; but I am also in a custody battle with my sister over my son- once he is home again I fully expect to end active treatment within 6 months- get through the transition, decrease meds and therapy. I do not believe at this time I would meet the criteria for either Dx and I believe that I will return to my life as it was before 4 years ago – no meds and only occasional therapy.
“Bipolar: True delusions and hallucinations are possible in in any type of episode – depressed, manic, or mixed – though not in hypomania.”
Can you clarify something for me please? I thought “manic” was the same as “hypomania”. If it is then this sentence contradicts itself.
Thanks
Sonia
Thank you, thank you, thank you!!! I’ve got bipolar and have always been perplexed how confused some people are over this. To me the differences are quite obvious and it’s frustrating to have people –on account of their confusion– figure one is just “code” for the other. It isn’t, at least for those of us with clear cut bipolar. It’s especially frustrating when defining borderline characteristics are things I can’t even relate to!
When a term like “mood swings” is used loosely, one is left with an idea that is akin to saying that since fever presents in more than one medical condition that those conditions must be pretty much the same thing(!) That would be outrageous.
Thank you for clarifying the erroneous notions that frustrate me so.
Hi Sonia – mania and hypomania are not the same thing although they are closely related. Mania is more severe and can include psychosis. Hypomania is a milder episode that includes high energy, high productivity, and possibly faster than usual thinking and speaking – but it doesn’t include psychosis and in fact does not typically cause a problem in function as mania does – in fact hypomanis is often a time of exceptionally good functioning.
Hi Candida,
Thank you. I needed that clarification because I have referenced your two bipolar/borderline posts for an assignment I am doing for a mental health workers course.
Sonia
I am diagnosed with depression & borderline personality disorder. My coverage has already switch me to the generic of Wellbutrin XL (I now have at least 1 headache a day). I also take Tegretol XR, 3 pills in am & 3 in the pm (1200mg/day): now they want to put me on 2 pills for the whole day. I can’t afford the pills on my own. My concern is functioning day to day at my job & as a single mom. I have read that decreasing my meds can cause seizures, is this true? Any suggestions? HELP.
D, DBT is Dialectical Behavioral Therapy. It is a therapy that was originally developed specifically for Borderline Personality Disorder.
Thanks? I’m enlightened and grateful for this comparison, but even more confused about my own diagnosis.
Am I bipolar, ADHD or bpd? (Don’t we just hate that label — a personality disorder!) Well, this gives me more info to discuss with my psychiatrist — finally one I trust and respect. So in that respect, thanks very much for the concise comparison.
I am at my last straw! I’ve been dealing with this Bipolar disorder for some time! I also was told I have anxiety NOS, mood NOS, and personality disorder with borderline features! Tell me what in the heck that means!
Doesn’t it mean Bipolar? Thats just one question I have. My second is HELP HELP HELP me out. I can not get in on schedule. No matter how hard I try! I sleep so much and go into deep coma’s. House be on fire I’d still be sleeping.
My poor kids learned that unless I am out of bed. Do not talk to me, otherwise I don’t remember speaking to them what so ever. I hate it I can not do a damn thing. My life sucks, I do go to group and see my therpist and Phyc. med doc. I take my meds as I am to.
SOMEONE OUT THERE PLEASE IF YOUR DEALING WITH SAME THING. And fixed it PLEASE tell me how to fix me! I really can not take it anymore. I have Bipolar 1 I am lazy tired bummed out I also have fymalgia (sry spelling sucks)I also have a heart problems restless leg syndrom and wait not done replacement hormones had a complete hystrecotmy at 24 now I’m in my late 30′s.
Mirgrains I am over weight lost my hair from all these damn pills I take. And my memory is the worst. All I want is my life back! Or a normal life on a schedule and so people can rely on me. And I would like to get respected be worthy again.
And I can regain my selfesteam and confidence back. My family and boyfriend have lost their faith in me. I’m not the women I once was, now I can’t stand the person staying back at me in the mirror!
I’m not asking for pitty or being a cry baby! I really want to be a productive strong reliable independent smart go getter pretty healthy women! I once was amazing at everything I did. Always got the job done and then some. I had the up most respect and people needed me!
Now I am a blob of goo that knows nothing can do nothing and forget everything and I upset my family and my boyfriend. WHAT HAVE I BECOME WHO AM I. Because I sure in the heck don’t know. Maybe, after my sucide attempt truly hurt me in more ways than one! I was in a coma for three days in ICU.
Someone please help me am I alone in this or is there other’s that feel as I do? HELP PLEASE!
PAMELA
I am so fusterated w/ shrinks in hospitals who do not know me or my back ground calusly assigning me a bpd I have been thoughly tested and have no signs of any personality disorder. I have only been manic and hypomanic when given any type of anti-depressants. I just lost a lots of friends becouse the shrink did not listen to me or my written PAD which states clearly NO antidepresants, I only went becuse my theapist was so concerned w/ my lack of sleep-I have been sick off and on since getting sepsis a year ago, messed up my schooling because I was in a hospital durring finals week, and beound with three iv’s. I had a normal period the month before and my dr thought something was odd-the continued infections and my sweating at night –did some lab work and found out that a month and a half after the sepsis infection I was in total menapause. I have in the past been dx bipolor, PTSD and disociation-I disagree with the bipolor dx because I am never manic or hypo manic off those meds, but always dx w/ PTSD w/ dissociation. piror to the sepsis I had not been hospitalized for a psych problem in decades, I took no medication, but ate real food-no additives, took omega-3and stayed busy with school and volunteer work. after getting sick and becoming post menapausal, I begain to have systoms of depresstion, well ge yeah, I almost died, went straight to menopause, I’d say thats a resonable, body reaction. I couldnt sleep becouse of all the contstant pain, everytime I moved I woke up. I was afraid to drive in that sleep deprived state and agreed to see a shrink-she told me the medicine was for axiety and to help me sleep. I slept less, behaved eradicly had a panic attak so bad it terified me into going to the hospital to be evaluated, the shink even after talking with my psychlogist, decided to put down bpd because I refused to talk the medications and have to deal with all the dangeous side effects. She never bothered to ask me about my behavior in the past, refused to listen to a dr who knew the normal me, discounted everything I have just been though and against ethical codes told a friend who had come to visit that I was dangerous becouse bpd can cause people to attak others. I’ve never attaked anyone! When I thought about the past hospitalazations I relized that is what I get labeled in hospitals when the Dr does not know me, and yet not one of then did any testing or talk to me about my history-just labeled me and said their was nothing they cold do for me and released me. The last one relesed me with a GAF of 55-my psychchrist was very upset. I have now updated my PAD to I refuse to go to any psych hospital for any reason unless my Drs can be involved and No antidepressants can be given to me for any reason becouse they will cause a manic reaction. I beleive that bpd is the new fad dx and it is a copout for drs who don’t want to bother getting a history or do any teasting. I also beleive that no should give out dx when a person is in a criis. Thats what rule out dx is for and dx should be made when a dr has seen a person long enough to know their baseline.
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