The Difference Between Bipolar Disorder and Borderline Personality Disorder

Are bipolar and borderline personality disorder the same? These two complex mental health concerns share several characteristics, but there are also a number of key differences between them.

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Types of Bipolar Disorder

There are three versions of bipolar disorder: bipolar I disorder, bipolar II disorder, and cyclothymic disorder. These versions are differentiated by which of the following symptoms a person experiences:

• Manic episodes: These are periods of elevated mood and confidence (to the point of grandiosity, increased energy, and decreased need for sleep. During a manic episode, a person may launch new projects, take on additional responsibilities, and act in an impulsive, reckless manner. To qualify as a manic episode, these symptoms must be present most days, most of the day, for at least a week.
• Hypomanic episodes: A hypomanic episode is similar to a manic episode, with two distinctions. Symptoms may not be as severe, and they won’t last as long. To meet the criteria for a hypomanic episode, a person must experience symptoms for four consecutive days.
• Major depressive episodes: These are the opposite of manic episodes. During a major depressive episode, a person may experience low mood, diminished confidence, lack of motivation, and little to no energy. Major depressive episodes, which last for at least two consecutive weeks. Can also involve abnormal sleep patterns, a pervasive sense of hopelessness, and recurring thoughts of death and dying.

Here’s how the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) defines the three types of bipolar disorder:

• Bipolar I disorder: This version involves manic episodes. People who have bipolar I disorder may also have major depressive episodes, but they are not a requirement for this diagnosis.
• Bipolar II disorder: This type of bipolar disorder is characterized by hypomanic episodes and major depressive episodes.
• Cyclothymic disorder: People who have this type will experience hypomanic and major depressive symptoms. These symptoms will occur on and off over a period of at least two years. They will not endure long enough at any one time to qualify as either a full hypomanic or major depressive episode.

Symptoms of Borderline Personality Disorder

Borderline personality disorder, or BPD, is characterized by instability and impulsivity, particularly in a person’s mood, self-image, and relationships. 

As established in the DSM-5, a person must exhibit at least five of the following nine criteria to be accurately diagnosed with BPD:

1. Frantic efforts to avoid being abandoned, even if there have been no indications that this is likely to occur
2. A pattern of intense but unstable relationships, during which the individual alternately idealizes and devalues the other person
3. Frequent changes in self-image or sense of self
4. Impulsivity in two or more areas that can be sources of substantial harm. Such as spending, gambling, binge eating, sex, reckless driving, and substance use
5. Recurrent threats, gestures, or behaviors related to self-harm or suicide
6. Periods of extreme anxiety or irritability, which can last from a few hours to a few days
7. Persistent feelings of emptiness
8. Inappropriate outbursts of anger, which can include physical violence
9. Occasional periods of paranoia or dissociation (the sense of being detached from their mind, body, or environment)

Similarities and Differences Between Bipolar and Borderline Personality Disorder

Though these are clearly separate conditions. There are understandable reasons why many people wonder, are bipolar and borderline personality disorder the same? As we will discuss below, these reasons include similarities in symptoms, effects, and risk factors.

Similarities

Similarities between bipolar disorder and BPD include:

• Both are complex, oft-misunderstood mental health disorders.
• Bipolar disorder and borderline personality disorder can both involve dramatic mood swings, impulsivity, and recklessness.
• People with both conditions may have difficulty with anger management.
• Both disorders can undermine a person’s ability to form and maintain relationships.
• Bipolar disorder and BPD are both associated with increased risk of substance abuse and addiction.
• Abuse, neglect, and other adverse childhood experiences (ACEs) can be risk factors for both conditions.
• Bipolar disorder and borderline personality disorder are both treatable. When a person with either disorder gets the right type of help, they can learn to manage their symptoms and achieve improved quality of life.

Differences

Of course, the reason that bipolar is not the same as borderline personality disorder is because there are several key differences between the two conditions, such as:

• Bipolar disorder is a mood disorder, which means that its symptoms primarily cause fluctuations in how a person feels. BPD is a personality disorder, which means that its characteristic features are persistent maladaptive behavior patterns. 
• Though trauma can be a risk factor for both conditions. Having a history of trauma is much more common among people with BPD than among those with bipolar disorder. The relationship between BPD and trauma is so significant that some experts have called for it to be reclassified as a trauma spectrum disorder instead of a personality disorder. 
• Bipolar disorder is twice as common as borderline personality disorder. According to the National Institute of Mental Health (NIMH), the past year prevalence of bipolar disorder among American adults is 2.8%. While the past year prevalence of BPD among the same population is 1.4%. 
• BPD is much more likely to require inpatient mental health treatment. For example, though borderline personality disorder affects about 1.4% of the general public. In a typical year, studies have found that people with BPD may represent more than 40% of those who are receiving inpatient care.

Find Treatment for Bipolar Disorder and Borderline Personality Disorder in Atlanta

As we noted when discussing the similarities between bipolar disorder and borderline personality disorder, both are treatable conditions. If you or someone that you care about have been affected by either of these illnesses, Novu Wellness Center is here to help.

At our outpatient treatment center in Atlanta, Georgia, your options include a partial hospitalization program (PHP), and intensive outpatient program (IOP), an evening IOP, and a virtual (online) IOP. In every one of these programs, you or your loved one can expect to receive personalized care. As well as compassionate support from a team of highly skilled professionals.

To learn more about how we can help you or your family member, or to schedule a free assessment, please visit our Admissions page or call us today.