This post is part two of four about mental illnesses that are often mistaken for bipolar disorder or one another in general: major depressive disorder, borderline personality disorder, schizophrenia and schizoaffective disorder. In this post: borderline personality disorder. Let’s get to it.
Borderline Personality Disorder
Borderline personality disorder is not a very well-known mental illness, but it’s as common as bipolar disorder. About 1-2% of the population suffers from BPD. The reason it’s called “borderline” is because it was first described as a disorder that existed between neuroticism and psychopathy, but that’s not really an accurate description.
Borderline personality disorder is characterized by a patient’s inability to correctly perceive and interpret situations and relationships. They have intense and extreme moods that can change quickly and are difficult to regulate. They can perceive unintended slights in the actions and words of others which can trigger aggression.
In BPD, self-identity can shift easily. Goals change. Plans change. Opinions change. Anything can change with little to no notice. This includes mood. Patients can go from anger and paranoia to depression with suicidal thoughts or attempts. This plays into the reckless behavior associated with borderline personality disorder. Substance abuse, risky sexual behavior, shopping sprees are among the types of risky behaviors in which patients engage.
Relationships are difficult because patients have low emotional intelligence. They honestly cannot read other people’s emotions or relate to them making it incredibly difficult to respond in the right way. They also express extreme fear of abandonment or rejection that goes way beyond what most people feel. At the same time, they have problems understanding any of their behavior could be wrong because it’s all they’ve ever known and their low emotional intelligence and lack of focus on others hinders them from learning prosocial behavior.
Borderline personality disorder is generally not diagnosed until adulthood and is frequently diagnosed with other disorders like depression and substance abuse. It’s important for anyone that starts seeing these symptoms to get medical help. BPD can and often does lead to suicide or self-harm.
Unfortunately, there are no approved medications for borderline personality disorder. Ones that are often prescribed are anti-psychotics. The main treatment for BPD is therapy, both individual and group. Therapy with relatives is also highly encouraged since relationships are often strained.
Although borderline personality disorder and bipolar disorder may sound similar at first glance, they are not the same disorder. With borderline personality disorder, moods swing incredibly quickly, up to several times a day, and are often in response to what the situation is around them. With bipolar disorder, there are still mood swings but they are more general; they do not relate to the patient’s surroundings or situation. It’s a natural flow over extended periods; even rapid cycling in bipolar disorder is about two weeks per cycle. Basically with bipolar disorder, life is a little more predictable and treatable.