33 thoughts on “Difference Between Bipolar Disorder and Borderline Personality Disorder

  • February 18, 2014 at 11:09 am

    I have bipolar disorder with ultradian cycling, mixed states, and my primary “baseline” as you call it is actually dysphoric mania (or agitated depression.) I’m pretty much depressed and manic all the time with few to no “normal” times (although less intense periods do occure.)

    Often people (generally with bipolar 1) tell me I probably just have BPD instead, which is annoying. What they don’t understand is I have a very clear cycle. 3-7 days. I can feel it shifting inside of me like the waves in an ocean. In fact, before I was diagnosed I used to call my shift in energy and moods “the tides.” The lenght of time of 3-7 days seems to be sometimes random and sometimes can shift due to a trigger (like not enough sleep or too much stress at work.)

    Having mixed states puts me at risk for these “explosive” episodes, too. I can feel them coming. I know how I feel when I’m on the edge of an episode and often it is triggered by soemthing external when it happens (like too much stress or frustration.) I actually warn the people around me that I am not feeling well and I need to be relaxing as much as possible. After an episode I feel like something in my brain snaps back into place. But, my body feels weak and sick often for 24 hours. Usually I only have one episode and then it’s calm for a while, but if I’m not doing well I can have mini episodes building up to a big one over a period of time. (such as a few weeks.) It’s exhausting.

    I also struggle with executive cognitive functioning issues such as organization, memory, focus, and processing. I have a lot of thought blocking and problems with racing thoughts. I also have intermittent low grade psychosis (paranoia), but at one time I had a major delusion that lasted 5 years, (that a secret organization was out to get me, and I was the chosen one with magical powers.)

    I’m currently not in treatment or on meds or anything like that thanks to our lovely healthcare system.

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    • February 19, 2014 at 6:23 am

      I have a similar situation but am on meds. I also respond well to them, thank God! Another thing that doesn’t get mentioned often is that people with Bipolar often have a great deal of coexisting anxiety peoblems that exacebate the moodswings and produce an instability between episodes. This can also lead to wrong diagnosis.

      It doesn’t make things easier if, like me, you started cycling in childhood, and you have a subtype that allows some, even if not much, sleep.It’s taken a bit, but finaaly, a neuropsychiatrist tested me half to death and agreed I was, most definitly, a BiPo I, mixed. some atrocious subtype known only to people like him.So I have the right to my meds with no further tinkering.Phew!

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    • September 18, 2015 at 2:48 am

      Very good article, I especially can relate to the duration aspect of BPD symptoms.I was diagnosed “correctly” with BDP within my first year of entering public school. It’s been over half a century since then and my condition in continually misdiagnosed by doctors and health professionals. One aspect, I didn’t see mentioned was environment. From my own experience, my BPD characteristics, anger, impulse behavior are reduced depending on my environment. I’ve read a research paper which has a similar opinion that a person with Bipolar disorder isnt impacted by their environment vs someone with BPD.

      I believe BPD is genetic. A look at one side of my family clearly shows, at least to me, BPD is genetic and far more prevent in society than studies suggest. A recent BPD study done in Europe using over 1000 twins showed a genic marker at Chromosome 9. The research had a couple note worthy conclusions, BPD can be identified throught DNA and BPD was severly misdiagnosed. This European three country BPD genic study can be found online for anyone interested.

      If BPD is genetic it answers why some children were abused and others were not,
      e.g. the raising or controlling parent doesnt have the BPD gene hence no child abuse but the child is diagnosed with BDP later in life. In the opposite scenario, the raising parent has the BPD gene and abuse occures in various forms.

      There are, in my opinion, many high functioning BDP individuals in society. Some who live remarkable lives. Let me give a example of a famous historic figure. Who was diagnosed with depression but was not abused as a child. Yet seems to clearly show BPD behavior, General George Patton. I believe Patton to be a American hero and a person with BPD. Patton spoke several languages, war historian, and was arguably the best tank commander of world war II. Still he is remembered for his slapping of a service man ,his inappropriate public comments (valgure language or insults) and impulses behavior (attempting a rescure a woman from two men forcing her into a car, gun drawn. Except the woman was married and the men were merely helping his wife into the car). Along with his excessive controlling behavior. As A expert on BPD from the V.A. once called people with the condition a “border lion”. In General Pattons case the description has a ring of truth.

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  • February 20, 2014 at 8:58 pm

    A few comments: Diagnosis is such an imperfect science, and no one is ever in agreement about what the criteria for a particular diagnosis should be; in other words, it’s all subjective. I absolutely see a lot of the distinctions that are referenced in this post, but I think that the subjectivity factor complicates things, plus the fact that there is such a HUGE spectrum of presentations and experiences of various diagnoses. This is common with unipolar depression, for instance. True, the criteria for “major depression” indicates a change from baseline functioning, but there are many people who chronically meet the criteria for major depression (not just dysthymic disorder, or whatever the new term from DSM 5 is; I forget and don’t have it in front of me – recurrent depressive disorder, or did I make that up?). Maybe it’s different with Bipolar Disorder, though; maybe it’s more common for the episodes to be more distinct. I have such trouble with the Bipolar diagnosis; I often can’t differentiate from Borderline PD (as this article does so well), plus for kids it’s hard to distinguish from ADHD (or others such as ODD – which I don’t really view as a disorder of in itself). I also believe there to be various subtypes of Borderline PD (see the work of Theodore Millon), with different derivations, presentations, internal experiences, etc. Plus, some versions of Borderline tend to come with the other Cluster B PD’s, whereas other versions tend to go along with the Cluster C PD’s — and there is such a distinction here. And of course, BPD so often is conflated with PTSD.

    I know I’m just rambling. My point is, it’s so hard to really make a definitive diagnosis of anyone…

    Don’t want to sound like I’m critiquing the article by any means.

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    • February 21, 2014 at 9:49 am

      True enough. And with the disorders like Bipolar, Schizophrenia, personality does seem to have some affect on presentation, but not the course.Ofte I feel that in the case of the so-called personality disorders, you seldom have pure cases, there is so much going on, that most people have a little of a fewthings making life difficult. It makes them even harder to treat, and at times, so distructive.

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  • February 21, 2014 at 9:01 am

    Helpful differentiation, thank you.

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  • February 21, 2014 at 9:43 am

    Stephanie: You bring up a lot of great points. I think a lot comes down to having an adequate/complete history, and that isn’t always easy to obtain. I could see how things could get real blurry [like, you mention, when determining between ADHD/ODD, etc.]. One must also not get so clouded that it becomes impossible to reconsider a diagnosis as more information comes to light.

    But: It sounds like you have developed an incredible amount of self-awareness/insight. It could be frustrating when you have that amount of self-awareness/insight, yet someone [who is supposed to be treating you] won’t pay enough attention to the info you are trying to relay because they automatically put you into some sort of category and subsequently undermine the validity of your own observations.

    Of course, even worse [as is with so many, like yourself] is not even having the opportunity to have a CHANCE to OBTAIN a diagnosis [equating to TREATMENT which may or may not include med’s] due to inadequate insurance coverage/lack of funds.

    Many find on-line support [which could also be a great place for further resources one would never have been aware of]. But, there is also a lot of misinformation out there [and unhealthier groups to be found].

    It certainly makes it more challenging if you are forced to rely on medication [and with the most particularly helpful one being especially un-affordable] to help maintain some sense of stability and quality of life.
    But, your insight and determination can go a long way towards helping yourself….Best wishes

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  • February 22, 2014 at 1:03 am

    Very good and very interesting. I have BP 2 and my symptoms are classic, though it took over 30 years to get a correct diagnosis. I have a coexisting disorder known as alcoholism, which is common, too. Drink to kill the painful moods.

    On the other hand, there is my only sibling who has borderline personality disorder. Her symptoms are also classic. She will never get help (like many with bipolar illness), as she thinks there is nothing wrong. She abuses prescription drugs…mostly opiates. I strongly feel her one son has bipolar, but like her, he’ll never accept help. He abuses both alcohol and meth (among other drugs).

    Suffice it to say, I and my sibling, my nephew, and others come from a long line of mental illnesses.

    I am grateful that mine is successfully treated and that I admitted I had a problem, both with a mental illness AND alcohol.

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    • February 22, 2014 at 1:04 am

      P.S. To maintain my mental health, I have to distance myself from both sibling and nephew. They can literally make me sick.

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    • May 8, 2014 at 9:26 am

      my daughter is involved with someone that has been diagnosed with bipolar. He is so controlling and she has two young daughters, she is trying to break away but he won’t allow it says he will kill himself and can’t live without her. All his actions are about how he feels. I am so worried. He is supposed to be on meds and I know he drinks. I have made friends with him because the opposite was not an option. Please, please give me some advise.

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      • May 12, 2014 at 12:23 pm

        Hi, Markie. Giving advice over the Internet is difficult and ill-advised. Even when I’m dealing with a manic episode in my own family and I see first-hand what’s going on, I have difficulty deciding which course of action is best. You have a host of options that range from doing nothing to seeking a court-ordered mental health assessment or even calling the police if you feel that someone is in physical danger, including your daughter, grand daughters, or this man. You might start by expressing your concerns to this man about his own well-being in the hope that it generates a discussion in which this man voluntarily seeks help. If nothing else, a dialog like that is likely to provide you with additional details and a better sense of how serious the situation is. You then have more to work with in planning your next steps.

        Assuming this man is symptomatic, know that confrontation usually causes more harm than good. Speaking in “I” statements helps a great deal (see my post “Defusing Confrontation with ‘I’ Statements.” Also, approaching issues as problems that need to be solved rather than as disagreements over who’s right and wrong is very helpful. (See “Dealing with the Problem Pileup.”)

        The National Alliance on Mental Illness has a free 12-week Family-to-Family course for loved ones of those with bipolar disorder and other serious brain illnesses. Visit nami.org and look for a local affiliate near you and see if they’re offering the course. The course helps you learn about various illnesses that affect the brain and helps you build empathy and develop practical skills, including communication and problem-solving.

        Reply
  • February 24, 2014 at 5:00 pm

    This is specious information. The diagnosis depends on who is making it, during which part of the lifespan of the patient, and when in history it is made. The symptoms are often the same and the Meds often tried are the same. Someday maybe there will be biological markers for diagnosis, until then we should be skeptical of sound diagnoses made by guess.

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  • February 28, 2014 at 2:35 am

    Yes, we have no bananas!

    There is no,such thing as Borderline Personality Disorder, Bipolar Disorder, Etc., etc.

    What does exist is the fake science of psychiatry which is trying to diagnose everyone who does not buy into The New World Order.

    Call me crazy, but also call me an American!

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    • July 9, 2015 at 4:26 pm

      I have come from a mentally ill mother and have always been disturbed with depression and mania, rejection, abandonment, neglect. I think I have been psychotic all my lif. I see things differently… Drugs, tv, sex, religion…. Everything I understand is different to what is supposedly real. I think I am not sick, that it is the rest of the world…. I married a drug addict, had 4 kids. Moved away to qld . Got sued by my father, went bankrupt, had nervous breakdowns, got breast cancer, lost the plot ,ended up in mental ward, have my rights taken away, and am starving with my kids in a filthy home I can’t afford. I believe I have schizophrenia,mand I’m always in fear.

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    • June 21, 2018 at 12:42 pm

      I. Absolutely agree after so called assessment
      with a psychiatrist today. I realize how well I have managed a lifetime of madness. No matter what it’s called it’s mine and I resent The labels. I do find neuroscience helpful to understand me and medication to keep me out of trouble!! I took a Long walk by the lake in a beautiful park and the wildlife much more healing than any healthcare professional !

      Reply
  • March 13, 2014 at 4:54 pm

    As similar as these two disorders are, would the medication for the two disorders be similar as well? would they have similar affects?

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  • March 14, 2014 at 2:55 pm

    It is very hard to differentiate between those two illnesses, very few things can help you tell them apart.

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  • June 15, 2014 at 10:43 am

    Actually, dysphoric mania is 40% of mania by some studies, hardly “uncommon”- less common, but not uncommon. Hypomania/mania also is marked by racing thoughts, agitation, high energy level, pressured speech, and insomnia….all things which differ it from a BPD mood lability issue. Even with ultraradian cycling, there is a cyclical pattern to it that isn’t there with BPD.
    Also, although self-injury can be there with bipolar, and it can be missing in borderline, it usually is present in borderline.
    And, of course, it is possible to have both.

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    • October 26, 2014 at 3:59 am

      You are very mislead about BPD, everything you mentioned so called “lacking in BPD” are very present in BPD, full blown mania is not unless….. And that’s the key word “unless”. You seem to base your information on a what the previous social perception of BPD is rather than actual facts. You should look up the DSM & base your facts on that rather than personal opinion

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      • October 26, 2014 at 4:02 am

        Also self-harms is a KEY feature of BPD along with having one of the highest suicide rates much more so than bipolar or many other psychiatric conditions

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      • October 8, 2016 at 6:15 pm

        Actually suicide rates for BORDERLINE PERSONALITY DISORDER among women are only 10 percent – for men it is higher but you don’t see many men with borderline personality disorder.
        I have worked as a health professional in mental health for over 20 years and there is a VERY CLEAR and distinct difference between personality disorders and TRUE mental illness (bipolar) – the difference is that ONE Of them actually responds to medication — personality disorders do NOT respond to medications and borderline personality behaviour is LEARNED behaviour. Thus, if it is learned – it can be UNLEARNED as well. It takes alot of work, CBT and DBT – but borderline personality disorder leaves people stuck in the victim role, and thus they never get out of the drama, as they are always looking for a “hook” – someone to rescue them, and then when the rescuer doesn’t live up to the expectations (the I love you, I hate you) – the victim then persecutes the attempted rescue. It is a constant state of chaos – living in the drama triangle. The borderline personality disordered person has to want to make change – there are NO medications that will work for any Axis II personality disorder – again, most is learned or from deep trauma at an early age — so you don’t need trauma, if you learn BAD coping and behavioural patterns from your earliest influeners. Borderline personality disorder is NOT a mental illness. I have had many psychiatrists refuse to work with clients because they INSIST they are mentally ill, when in fact – it is a personality disorder plain and simple – whereas TRUE mental illness will be helped by drugs because it is an imbalance of brain chemistry.

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      • January 5, 2017 at 9:39 am

        I agree with you. But the borderline patient doesnt make himself a victim, its us who work with them that do. We often treat them as Children who don’t know their best.

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  • June 30, 2014 at 1:27 am

    Hello, I’m diagnosed with PTSD, MDD, BPD, and GID. I’ve known those with BPD, probably including my mother, who have had difficulty with interpersonal relationships. People had to walk on “eggshells” around my mother, unclear whether that moment would be the one that would initiate an angry meltdown. I have children, adult children, and family that I have worked hard for 45 years to ensure controllable distance from them, i.e. I have not wanted to risk exposing them to my daily presence and I have wanted to temper the effect of a possible suicide should I ever execute it. Yet, given that I have friendships that do not require others to walk on eggshells I seem to be missing the hallmark symptom of BPD. I wonder about it. There are symptoms that I do have, e.g. periods of impulsivity, chronic suicidal thoughts, self injurious behavior, emotional instability, and frequent dissociation, but I wonder at the absence of difficult interpersonal relationships which feels like an absence of fear of abandonment. I think I’ll stop here now.

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  • September 30, 2014 at 3:46 pm

    Very interesting. I have been diagnosed at one time with histrionic personality disorder as well as bipolar I. I take meds for bipolar disorder and therapy for co-existing anxiety, etc. My reading on BPD made me doubt the diagnosis; I seem to be a high-functioning version of this disorder. I likely have the diagnosis because my doctor knows I do have trouble maintaining surface relationships. I rub people the wrong way. I do have some very close friends but not very many; however, I have been married to the same person for 21 years. I just seem to be tightly wound a lot of the time, but I rarely have outbursts or acting out. I just recently started blogging at http://www.julielwhitehead.wordpress.com about my experience with bipolar disorder. Feel free to stop by and check it out.

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  • January 16, 2015 at 9:13 pm

    I have been to so many doctors and have had so many diagnosis, several say bi-polar and several say bpd, I have had this for so long that I don’t even know what my “base” is, so how am I supposed to know which I am, and does it even matter?

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  • February 11, 2015 at 8:49 pm

    Very interesting read. I think that the reason for the uncertainty in diagnosing Bipolar versus borderline lies also in the lack of constant exposure to the baseline personality of an individual. As you mention in this article, “The depression is the longer lasting and usually much more difficulty part of [bipolar], and this can look like borderline personality disorder with its chronic sadness.” I have only had a few interactions with therapists to look into my ADD, but he has mentioned that the hardest part is only seeing someone a handful of times and then being expected to make a decision about a disorder. The therapist doesn’t get to see the baseline as often and can only go on information he/she is provided and the mood of the individual while they are there. This problem combines on itself when a person sees multiple different doctors with different opinions and/or interpretations of the individual seeking treatment.

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  • February 24, 2015 at 3:53 pm

    Isn’t everyone a little bit of everything? Why is it so important to ‘diagnose’ everyone?

    One can be cranky due to lack of sleep, or PMS, or menopause, or diet, or a miserable job. That doesn’t make them bipolar.

    It upsets me when the first diagnosis I get is ‘depression’, when I’m NEVER asked ‘how’s my sleep’? Answer: rotating shifts–not good; snoring husband–again, not good; 10 years of the above– tired and cranky.

    But, remove those obstacles and I’m living the dream. Does that make me bipolar because occasionally I get great sleep and occasionally I don’t?

    Oh, but if I take this little pill, everything will be even-keel. That’s a cop out. Just fix the problem. Don’t put a bandaid on it.

    Or, am I wrong and everyone falls into one category or another?

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  • March 2, 2015 at 10:41 pm

    Thanks for this; it’s very helpful information. I wish I’d found it a bit earlier on when I kept researching bipolar disorder but it seems I have BPD instead.

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  • March 10, 2015 at 5:26 pm

    so confused now

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  • June 10, 2015 at 11:27 am

    Very good article and excellent comments.
    I have been diagnosed with BPII that seems relatively stable after YEARS of wondering. I had a friend (note the past tense) who was diagnosed as bipolar but was really, truly, off-the-wall BPD. “Drama queen” indeed.
    I do appreciate just me’s comments. Every person on earth has different wiring in their brains. That means different personalities, talents, and reactions. It takes all kinds to make things work.
    Perhaps treatment should be based on all symptoms that affect our lives and those of others. Or actually accept differences and try to mitigate the situations that trigger the problems. (I’m not hopeful there.)

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  • July 19, 2015 at 12:33 pm

    my wife has BPD and i am trying to learn all i can about the disease so i can learn to accept putting up with her.

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  • March 1, 2016 at 3:41 am

    BPD and BP can both be symptoms , just of a little varying kind, of an attachment disorder. These diagnoses are just trying to describe the symptoms/effects of early abuse or neglegt and what it does to the brain: emotional dysregulation, hypomania, impulsivity, dissociation, detachment, attention deficit etc. So in that way, depending on your early environment (specially the first 3 years of life), you can have all or just some of these symptoms. And therefor several ‘diagnoses’

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  • July 3, 2016 at 6:40 am

    Superb posts on this blog…..really , really good stuff

    I have cPTSD, Bipolar II, GAD….

    My feeling is that childhood abuse and invalidation does absolutely cause Borderline for most…..but a genetic switch may be at play for many…..for me MTHFR is my switch….

    I am stable with limited meds, DBT and other alternative things along with a year now of psychodynamic therapy….some say 5 years is necessary for Borderline or Bipolar in hardcore therapy….

    How I know I have cPTSD/Borderline is that when my house is empty I get depression a lot of the time……I have a limited sense of self….not totally empty thankfully……but my chameleon like self is the absolute key and I will conqueror this after 4 decades of tormented living……

    I can do this and you can too!

    And yes….childhood abuse, neglect and abandonment set the stage for this too even our Bipolar…

    Finally…an absolute key to healing is to have Forgiveness, Gratitude and Grace! Do it not for those who harmed you
    ….do it for your inner child!

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