Borderline Personality Disorder (BPD) vs. Bipolar Disorder: What’s The Difference?

When it comes to mental health conditions, two that are often confused with one another are Borderline Personality Disorder (BPD) and Bipolar Disorder. Though they both involve emotional intensity, they each have unique characteristics, causes, and treatments. Let’s explore the key similarities and differences between BPD and bipolar disorder.

What’s the Difference Between BPD and Bipolar Disorder?

At their core, BPD and bipolar disorder both affect emotional regulation, but they manifest in very different ways.

Bipolar disorder involves extreme mood swings that occur in distinct episodes. These episodes are typically categorized into manic or hypomanic phases (feeling overly energetic, euphoric, or irritable) and depressive phases (feeling sad, hopeless, or extremely fatigued). These mood shifts can last for days, weeks, or even longer, and are usually more stable and predictable in their duration.

BPD, on the other hand, involves a pervasive pattern of instability in moods, relationships, self-image, and behavior. Emotions seen in BPD can shift rapidly—sometimes within a matter of hours—often in reaction to external events, like interpersonal conflicts or fear of abandonment.

Do BPD and Bipolar Disorder Have Overlapping Symptoms?

Yes, BPD and bipolar disorder share some overlapping symptoms, which is why they are sometimes confused with one another or misdiagnosed. Both conditions can involve:

• Intense mood swings
• Impulsivity
• Difficulty with emotional regulation

However, the mood shifts in BPD are usually much more rapid and connected to specific triggers. In contrast, bipolar mood episodes tend to last longer, often occurring over days or weeks.

Is BPD a Mood Disorder Like Bipolar Disorder?

While both disorders affect mood, BPD is not officially classified as a mood disorder. BPD is technically a personality disorder, and the emotional instability it causes is just one aspect of the condition. Other features of BPD may include unstable relationships, distorted self-image, fear of abandonment, and impulsive behaviors.

On the other hand, bipolar disorder is considered a mood disorder. It’s characterized by extreme mood swings that oscillate between periods of depression and mania or hypomania. This makes bipolar disorder more specifically focused on mood regulation, rather than broader interpersonal and self-image challenges.

Can You Have Both BPD and Bipolar Disorder at the Same Time?

Yes, it is possible to be diagnosed with both BPD and bipolar disorder. This is called comorbidity. In fact, individuals with BPD often experience mood swings that could resemble those seen in bipolar disorder. And some may even be misdiagnosed with bipolar disorder at first.

What Role Does Emotional Dysregulation Play in Each Disorder?

Emotional dysregulation is a core feature in both disorders, but it plays out differently in each.

In BPD, emotional dysregulation is often triggered by external factors, such as interpersonal conflicts or fears of abandonment. People with BPD may experience intense, fluctuating emotions in response to seemingly minor events. These emotional shifts can lead to impulsive behaviors like self-harm or intense outbursts of anger.

In bipolar disorder, emotional dysregulation occurs in the context of distinct mood episodes (mania/hypomania or depression). During the manic phase, individuals may feel euphoric, overconfident, and engage in risky behaviors, while during the depressive phase, they may feel hopeless, lethargic, and unable to find joy in anything.

Are the Causes of BPD and Bipolar Disorder the Same?

The causes of BPD and bipolar disorder are not identical, but both conditions can have genetic, biological, and environmental factors at play.

BPD is thought to stem from a combination of genetic predisposition and early trauma or invalidating environments. Childhood abuse, neglect, or abandonment are common risk factors. Brain studies suggest that individuals with BPD may have differences in how their brains process emotions, which makes them more sensitive to emotional stimuli.

Bipolar disorder, while also influenced by genetics, is more closely linked to biological factors like neurotransmitter imbalances and irregularities in brain structures. Family history of bipolar disorder may increase the likelihood of developing the condition.

How Is BPD Treated Compared to Bipolar Disorder?

Both BPD and bipolar disorder may be effectively treated and managed, though the treatment approaches differ due to the distinct nature of these conditions.

Bipolar disorder treatment focuses on stabilizing one’s mood and preventing episodes of mania and depression. Treatment might involve medications (mood stabilizers, antipsychotics, antidepressants) alongside psychotherapy. 

At Marsh Psychotherapy, we use Cognitive Behavioral Therapy (CBT), Interpersonal Psychotherapy (IPT), and Dialectical Behavior Therapy (DBT) to help clients manage emotional ups and downs, rebuild life goals, and cope with relationship challenges caused by mood fluctuations.

BPD treatment emphasizes developing emotional regulation skills and improving interpersonal relationships. The most effective treatment for BPD is Dialectical Behavior Therapy (DBT), which teaches skills like mindfulness, distress tolerance, and emotion regulation. Interpersonal Psychotherapy (IPT) and Creative Arts Therapy are also used to help clients with BPD better understand their emotions and improve their relationship patterns. Although medications can sometimes be used to manage symptoms, they are not typically the primary treatment for BPD.

Looking for Support with BPD or Bipolar Disorder?

If you’re struggling with mood swings, impulsive behaviors, or unstable relationships, it’s essential to get an accurate diagnosis and work with a therapist who can help you navigate the emotional challenges you face.

At Marsh Psychotherapy, we take a compassionate approach to understanding both BPD and bipolar disorder. If you’re ready to explore how therapy can help you manage your emotions, improve your relationships, and build a stable life, reach out to us today.