Borderline Personality Disorder vs. Bipolar Disorder
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Let's face it: psychology can be confusing. Often, similar names can make it difficult to distinguish disorders from one another – and symptom lists can sometimes seem even more identical than names. Bipolar Disorder (BD) and Borderline Personality Disorder (BPD) are two disorders where both of these issues apply.
This blog clearly shows how these disorders differ, in terms of definitions, symptoms, and how they impact one’s life. Psychology can be confusing – but that doesn't mean it has to be.
What Is Borderline Personality Disorder, or BPD?
Borderline Personality Disorder is a personality disorder that is diagnosed based on rapid mood changes, impulsive behavior, and a fear of abandonment. It is often distinguished based on the difficulties many people with BPD have in managing their emotions and the effects that these struggles have on their relationships.
It is important to remember that you can experience some symptoms of borderline personality disorder (for instance, you might fear being abandoned by the people around you) without actually having a borderline personality disorder. Therefore, it is always better to seek professional help for diagnosis, rather than making assumptions based on symptom lists.
What Characterizes Personality Disorders?
Generally, what indicates a personality disorder is 'long-lasting, all-encompassing, disruptive patterns of thinking, behavior, mood and relating to others.' (Cleveland Clinic). This can mean many things, depending on which of the ten personality disorders is being described and which cluster it's in.
There are three clusters of personality disorders, noted as clusters A, B, and C. BPD is a cluster B disorder, meaning it involves dramatic behaviors people with personality disorders might not have a consistent idea of who they are (including their beliefs, values, and identities), and this can lead them to struggle with relationships. For many people with personality disorders, this can lead to challenges with mental health – which can result in things like substance abuse.
List of BPD Symptoms
Note that this list is not a substitute for diagnosis.
Fear of abandonment, which leads some people with BPD to keep their loved ones close and others to push people away.
Unstable/intense relationships, or difficulty keeping healthy relationships because of changing views and values.
Unstable self-image/sense of self, or a tendency among many people with BPD to see themselves as bad and/or change their beliefs and values often.
Rapid mood changes, or irrational mood swings can last from a couple of hours to a few days.
Impulsive/dangerous behavior, which can include substance abuse, reckless driving, fighting, and binge eating.
Persistent feelings of emptiness, boredom, worthlessness, and other similar emotions can be common.
Anger-management issues, people with BPD can become intensely angry for short periods, often followed by periods of shame or guilt.
Temporary paranoid thoughts, which can include dissociative episodes, feelings of paranoia, and even hallucinations.
The Positives of BPD
People with BPD can have much higher levels of intelligence and empathy than the general population; they were found to score far higher on IQ tests and performed far better than people without BPD when determining others' mental states. Additionally, people with BPD are far more likely to look toward the source of a problem when it first arises, which can allow them to communicate more directly in relationships.
The Science Behind BPD
Several brain differences are hypothesized to result in BPD. This blog will cover one chemical and two biological causes of BPD.
The first biological cause of BPD is a lack of 'top-down' control in people with BPD. In this context, top-down control is what allows people to keep from becoming aggressive – because people with BPD have less of this, they struggle to regulate their anger and frustration. People with BPD also have far more activity in their amygdalas – or the emotional centers of their brains. For many people with BPD, this means that their mood can shift incredibly quickly and often irrationally when they experience negative situations.
One of the major chemical changes in people with BPD is the decreased ability to take in serotonin. The basic function of serotonin is to carry messages around your brain – because people with BPD have less of an ability to do this, they can experience far higher levels of impulsiveness and aggression.
What Is Bipolar Disorder, or BD?
Bipolar Disorder is a mood disorder that can result in dramatic changes in one's mood, mental state, and level of energy. It is diagnosed based on experiences of mania, hypomania, and depression (defined below); people who experience mania and depression (and sometimes hypomania) are diagnosed with Bipolar I and people who experience hypomania and depression without mania are diagnosed with Bipolar II. Some people can alternatively be diagnosed with cyclothymia, in which they experience cycles of hypomania and mild depression that last for two or more years. For people with bipolar disorder, periods where they have 'normal' moods are known as euthymia; in cyclothymia, these periods last less than eight weeks.
What Characterizes Mood Disorders?
Mood disorders all affect your emotional state, whether it'sits anger, sadness, or joy. In people with mood disorders, one or more of these emotions are intensified to the point that affects functioning.
Mood disorders are categorized into two different groups: depression and bipolar disorder. Both depression and BD have several subtypes. In depression, these subtypes are characterized by what causes them and what their effects are – for instance, seasonal effectiveness disorder is caused by the beginning of a specific season (usually fall), and persistent depressive disorder affects people for two or more years.
In bipolar disorder, the subcategories are specified as seen above; the three types are Bipolar I, Bipolar II, and cyclothymia. Mood disorders additionally include premenstrual dysphoric disorder (which causes severe changes in one's emotional state about a week before one's period), and disruptive mood dysregulation disorder (which causes intensified anger in adolescents and children).
Symptoms of Bipolar Disorder
This list is not a substitute for diagnosis.
Mania is characterized mostly by a higher level of energy; people experiencing a period of mania tend to be much more active, talkative, and impulsive. Additionally, manic periods can sometimes lead to symptoms of psychosis, which include hallucinations.
Hypomania is similar to mania, but to a lesser extent; hypomania doesn't severely affect functioning, whereas manic symptoms can have severe effects before they’re diagnosed. For instance, while people having a manic episode might feel that they are invincible, people experiencing hypomania may simply have a higher level of self-confidence.
Depression is a state that's characterized by unusual levels of difficulty with things such as sleep, concentration, and motivation. Additionally, being in a depressive state can result in feelings of overwhelming sadness, irritability, and hopelessness.
The Positives and Negatives of BD
Bipolar disorder can lead to higher risks for many conditions. For instance, having BD can lead to a higher risk for substance abuse, diabetes, and even heart conditions. The difficulties of living with BD can also result in higher levels of anxiety and even suicidal thoughts. Additionally, untreated symptoms of bipolar disorder can result in longer manic and depressive episodes, which can last up to 6 and 12 months respectively when severe.
Despite these issues, there can also be positives to living with BD. For instance, people with bipolar disorder are often far more creative than those around them; many famous artists, writers, and musicians are reported to have lived with BD, including Ernest Hemingway and Tchaikovsky. Additionally, people with BD often tend to be more realistic and resilient than thean average person.
The Science of Bipolar Disorder
Not much is known about the science of bipolar disorder; currently, scientists believe that BD can be caused by a mix of neurochemical factors and genetics. In this section, we will discuss the hypothesized neurochemical factors of bipolar disorder.
There are a few main neurochemicals thought to be involved in BD: norepinephrine, serotonin, and dopamine are among these. Norepinephrine is far lower than average during depressive periods and far higher during manic periods in people with bipolar disorder. People with bipolar disorder – and those related to them – have also been shown to be far more sensitive to a lowered level of serotonin. The most defined connection is likely that with dopamine, however; dopamine is thought to have a huge role in depressive episodes specifically, though increased levels of dopamine can also increase the risk of manic episodes.
Similarities and Differences of Borderline Personality Disorder and Bipolar Disorder
The similarities and differences between borderline personality disorder and bipolar disorder can be grouped into a few different categories: changes in mood, impulsive behavior, and depressive symptoms.
Changes in Mood
One way bipolar disorder is similar to borderline personality disorder is in its effects on mood. Both BPD and BD include drastic changes in mood as part of their symptoms, and in both BD and BPD, these alterations can result in the person with the disorder perceiving themself differently.
However, these changes in mood happen for very different reasons. In people with BPD, their switch in mood is often due to a change in how they see themself, as one of the defining symptoms of BPD is having an unclear sense of who they are. In contrast, people with BD will experience changes in mood because of the switch to a manic, hypomanic, or depressive episode; this change can have effects on the impulsivity and self-esteem of the person with BD as well as their mood, and will often last far longer than the mood changes of people with BPD.
Impulsive Behavior
Borderline personality disorder and bipolar disorder are also similar in that they cause impulsivity in the people who have them. Impulsivity looks very similar between the two; in both people with BPD and people with BD, it may lead to substance abuse, reckless behavior, and a general lack of safety concerning themselves.
However, similar to the changes in mood, what causes impulsive behaviors differs between the two disorders. For instance, impulsivity is related to mania in BD; it is one of the ways mania reduces the ability of people with BD to understand potential consequences. On the other hand, impulsivity in BPD is thought to mostly come from positive urgency – as in, when people with BPD become excited about something, they become much more careless with their actions.
Depressive Symptoms
People with bipolar disorder and borderline personality disorder can all experience severe depressive symptoms. These symptoms can include feelings of worthlessness and suicidal thoughts in both disorders; however, bipolar disorder can additionally include many features of depressive disorders, such as a loss of motivation and feelings of overwhelming sadness. BPD also has a far higher rate of self-harm than BD.
As in the changes in mood and impulsive behavior of these disorders, the root causes are different. In people with BPD, depressive symptoms often come from having an inconsistent sense of self and a fear of abandonment, which can lead to far more negative thoughts in people with BPD. On the other hand, people with BD most commonly experience these symptoms during depressive episodes.
Conclusion
Despite the similarities that are often seen between bipolar disorder and borderline personality disorder, there are far more differences between the two disorders than commonalities. However, both of these disorders are incredibly severe, and living with either one of them can make your life very challenging.
If you are experiencing difficulties in working with your BPD or BD, it may be helpful to seek aid from a therapist. Therapists can help you determine what symptoms of each you may be experiencing, and they can help you correct thinking patterns that may be harming your ability to move forward. A therapist can also help you work through negative coping mechanisms you may have developed to manage these disorders and create helpful habits to replace them.
Additionally, if you believe you may have BPD or BD, a therapist can help you work through your thoughts and seek treatment if it becomes necessary. Therapists have experience in noticing the bipolar disorder warning signs and potential signs of borderline personality disorder, and they can help you determine whether what you're experiencing is a sign of BD or BPD.
If you or a loved one is affected by either of these disorders or requires a diagnosis, Trust Mental Health may be the organization you need. Our BIPOC team of therapists speaks over 18 languages and can connect with you with a therapist within 48 hours of contact. We offer in-person therapy in San Jose, Fremont, Mountain View, and Palo Alto, as well as online therapy all over California. We provide therapy for BD and BPD, as well as depression therapy in California, which can aid you in managing the symptoms.
Key Points
Borderline personality disorder causes fear of abandonment, changes in mood, and lack of sense of self.
Bipolar disorder is diagnosed based on experiences of mania, hypomania, and depression.
These disorders may seem relatively similar based on symptoms, but the causes of the symptoms people with each disorder experience are vastly different.
FAQs
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Getting diagnosed with borderline personality disorder – or any other personality disorder – is very serious, so the process for getting diagnosed is far more in-depth than many other processes. The steps to get diagnosed include an interview with a licensed professional, a discussion about your experiences with and symptoms of BPD, and an evaluation of your medical history. However, though this process may seem complicated, it can be worth it to get a diagnosis.
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The process of getting diagnosed with bipolar disorder is very different from the path to getting diagnosed with BPD; it can involve several types of evaluation, depending on who you consult. These evaluations can include exams to determine your physical and mental health, which are meant to ensure that there isn't any other possible cause of your symptoms. Additionally, you may be asked to keep a record of your moods, or a mood chart, which can further eliminate alternative causes of your symptoms.
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Both of these disorders are severe, and both can cause irrevocable changes in the lives of the people with them. Because of this, it would be impossible to consider either the 'better' or 'worse' of the two, as they each have different, massive effects on the lives of the people who live with them. Additionally, note that comparing two disorders in this way can invalidate the experiences of the people considered to have a 'better' time with their disorder, as it can make them feel that what they're complaining about isn't as significant as it is.