Table of ContentsView AllTable of ContentsSymptomsCausesTriggersDiagnosisTreatment
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View All
Table of Contents
Symptoms
Causes
Triggers
Diagnosis
Treatment
Borderline personality disorder(BPD) andbipolar disorder(BD) are mental illnesses associated with dramatic mood swings. They share common features and are often confused with one another.
The main difference between bipolar disorder and BPD is that bipolar is a mood disorder, and BPD is a personality disorder.
Bipolar, previously known as manic-depressive disorder, features extreme highs and lows that can last for weeks or months. With BPD, however, moods fluctuate more rapidly, cycling through emotional states in a matter of hours or days.
The differences in BPD vs. bipolar symptoms can help steer a diagnosis. The two are also treated differently, so it’s crucial to get an accurate diagnosis.
Theresa Chiechi / Verywell
This article discusses the differences and similarities between BPD and bipolar disorder. It also details the different causes and treatments of the two mental health conditions.
Symptoms of BPD vs. Bipolar
BPD and bipolar share some of the same traits, but they have different symptom patterns, durations, and triggers.
BPDDramatic emotional changes, lasting from a few hours to a few daysEngages in impulsive or unsafe behaviorsOften has inappropriate anger or uncontrolled aggressionFeelings of emptiness and low self-worthSelf-injury or thoughts of self-harm are more commonChronic depressionDistorted self-imageFear of abandonmentCommonly involved in intense and unstable relationships, but may lack close or trusted friendsShorter cycles of mood instabilityEpisodes often linked to stressBipolarDramatic mood changes, extreme highs and lows that last weeks to monthsElevated moods and self-esteem during manic episodesFlat or depressed mood during down episodesFluctuations in weight, energy levels, and sleep needsRacing thoughts, impaired judgement, impulsivity, and excessive talkingSlow speech, impaired cognition, and memory issuesThreatening or combativePossibly suicidal when depressedFrequently has a genetic component
BPDDramatic emotional changes, lasting from a few hours to a few daysEngages in impulsive or unsafe behaviorsOften has inappropriate anger or uncontrolled aggressionFeelings of emptiness and low self-worthSelf-injury or thoughts of self-harm are more commonChronic depressionDistorted self-imageFear of abandonmentCommonly involved in intense and unstable relationships, but may lack close or trusted friendsShorter cycles of mood instabilityEpisodes often linked to stress
Dramatic emotional changes, lasting from a few hours to a few days
Engages in impulsive or unsafe behaviors
Often has inappropriate anger or uncontrolled aggression
Feelings of emptiness and low self-worth
Self-injury or thoughts of self-harm are more common
Chronic depression
Distorted self-image
Fear of abandonment
Commonly involved in intense and unstable relationships, but may lack close or trusted friends
Shorter cycles of mood instability
Episodes often linked to stress
BipolarDramatic mood changes, extreme highs and lows that last weeks to monthsElevated moods and self-esteem during manic episodesFlat or depressed mood during down episodesFluctuations in weight, energy levels, and sleep needsRacing thoughts, impaired judgement, impulsivity, and excessive talkingSlow speech, impaired cognition, and memory issuesThreatening or combativePossibly suicidal when depressedFrequently has a genetic component
Dramatic mood changes, extreme highs and lows that last weeks to months
Elevated moods and self-esteem during manic episodes
Flat or depressed mood during down episodes
Fluctuations in weight, energy levels, and sleep needs
Racing thoughts, impaired judgement, impulsivity, and excessive talking
Slow speech, impaired cognition, and memory issues
Threatening or combative
Possibly suicidal when depressed
Frequently has a genetic component
BPD Symptoms
The main symptoms of BPD include:
People with BPD may also show signs of uncontrolled aggression. The impulsive nature of BPD can make a person more likely to engage in addictive behavior, like drug use and gambling.
Another feature of BPD is called splitting.This term, which refers to two things being split in half, occurs when someone is unable to hold emotionally opposing viewpoints in relation to themselves and others.
As a result, people with BPD tend to view the nature of people and situations as either black-or-white, good-or-bad, or all-or-nothing. With splitting, everything is either the best or the worst—there is no middle ground.
Splitting is usually a coping or defense mechanism to manage the intense fear of abandonment, and it can result in impulsive behaviors and relationship difficulties.
BPD Splitting: Meaning, Triggers, and Treatment
Bipolar Disorder Symptoms
The main symptoms of bipolar include dramatic changes in mood states.
The highs, or elevated, expansive, or irritable periods, are considered manic episodes. The lows, or sad, empty, or hopeless periods, are depressive episodes.
During manic episodes, symptoms of bipolar include:
During depressive episodes, symptoms of bipolar include:
It’s also important to understand manic episodes in bipolar aren’t necessarily beneficial, even though they’re the alternative to depressive episodes. People experiencing mania can be reckless. They often lack self-awareness and are unable to understand how their impulses affect themselves and others.
People with bipolar I disorder often have cycles that switch from a depressive state to a manic state. Manic symptoms sometimes include symptoms of depression within the manic episode, which is called mixed features.
How Is Bipolar Different From BPD?Between cycles, people with bipolar disorder often have periods of true symptom-free wellness lasting weeks, months, or years. On the other hand, peoplediagnosed with BPDtypically have more persistent day-to-day emotional symptoms that can impact everyday life.
How Is Bipolar Different From BPD?
Between cycles, people with bipolar disorder often have periods of true symptom-free wellness lasting weeks, months, or years. On the other hand, peoplediagnosed with BPDtypically have more persistent day-to-day emotional symptoms that can impact everyday life.
Borderline Personality Disorder Test
Do BPD and Bipolar Have Different Causes?
There are a number of complex factors that can cause BPD or bipolar.
Is Bipolar a Disability? How to Qualify for Benefits
Borderline Personality Disorder Causes
A history of emotional, physical, or sexual abuse or parental neglect is prevalent in people with BPD. Parental substance abuse is another potential cause. Research has shown that experiencing stress and trauma as a child and an inability to cope can contribute to BPD later in life.
Genetics, chemical imbalances, andbrain structuremay also play a role in BPD.People with a family history of BPD are at higher risk of having the condition. Many people with BPD have altered brain neurotransmitter function, particularlyserotonin.
Studies have shown that people with BPD can have structural and functional changes in the brain, especially in the areas that control impulses and emotional regulation like the amygdala,hippocampus, and orbitofrontal cortex.
Bipolar Disorder Causes
The causes of bipolar disorder are complex. Most agree that there is no single cause, and a combination of factors often contributes to BD. People who have a direct relative with BD are more likely to develop it.Some research also suggests that people with certain genes are more likely to develop bipolar.
Researchers believe that chemical imbalances play a role in bipolar.There is evidence that an imbalance in one or more neurotransmitters may result in bipolar symptoms.
BPD vs. Bipolar Triggers
Another difference between BPD and bipolar disorder is their triggers. A wide range of factors can trigger bipolar episodes, while BPD episodes are typically related to relationship issues.
BPD Triggers
Triggers for BPD mood swings include:
Bipolar Triggers
Different Diagnostic Criteria for BPD and Bipolar
BPDis diagnosed when a person has a pattern of unstable relationships, impulsivity, and struggles with their sense of self.
Other subtle diagnostic distinctions between BPD and bipolar disorder include:
While both BPD and bipolar can vary in severity, BPD symptoms tend to be more pervasive, last longer, and cause more serious disability. While bipolar disorder can also be debilitating, it is more responsive to treatment and, therefore, more manageable.
How Common Is Misdiagnosis?
Since the two have similar and overlapping diagnostic criteria, misdiagnosis is common. One study estimates up to 40% of those with BPD were first misdiagnosed with bipolar.
People can also be misdiagnosed with BPD instead of bipolar. In some cases, BPD is misdiagnosed in people who actually have autism. This is more common in females and people with a higher IQ whose autism goes undetected in childhood.
Can You Have Both BPD and Bipolar Disorder?Yes, in fact, it isn’t uncommon for BPD and bipolar to occur simultaneously. Current research shows that 10% of people diagnosed with bipolar I disorder are also diagnosed with BPD, and 20% of people diagnosed with bipolar II disorder are also diagnosed with BPD.
Can You Have Both BPD and Bipolar Disorder?
Yes, in fact, it isn’t uncommon for BPD and bipolar to occur simultaneously. Current research shows that 10% of people diagnosed with bipolar I disorder are also diagnosed with BPD, and 20% of people diagnosed with bipolar II disorder are also diagnosed with BPD.
The most effective treatment for these conditions is a personalized treatment plan that suits the symptoms, personal needs, and lifestyle.
BPD
Psychotherapy is the first-line treatment for people with BPD.
There are several types of empirically supported psychotherapies used in BPD, including:
The benefits of medications for BPD are less clear. In some cases, a psychiatrist may recommend medications to treat specific symptoms, such as mood swings, depression, and other co-occurring mental disorders.
Lifestyle adjustments that promote a balanced mood and practicing self-care habits, like getting regular sleep and exercise, and participating in psychoeducation, can help keep the condition under control.
Bipolar Disorder
Having bipolar disorder increases a person’s risk of mortality and shortens their life expectancy.
This is partly due to increased rates of suicide—an estimated 20% of those with bipolar disorder take their own life.However, the majority of people with bipolar disorder die of natural causes. Research links a decreased life expectancy to poor management of underlying health conditions.
Fortunately, treating bipolar disorder can improve a person’s ability to care for their health.
Doctors can treat BD withmedicationsand psychotherapy. Typically, psychiatrists prescribe mood stabilizers and second-generation antipsychotics for the treatment of bipolarThey may also prescribe antidepressant medication to treat depressive episodes in BD.
Psychotherapies that can be used for the treatment of bipolar disorder include cognitive-behavioral therapy and psychoeducation. Other therapies designed specifically for the treatment of BD include interpersonal and social rhythm therapy and family-focused therapy.
Sometimes bipolar is treated with electroconvulsive therapy, a brain stimulation procedure used to treat severe or refractory manic and depressive episodes. Transcranial magnetic stimulation is also used, which stimulates the brain with magnetic waves to help treat subtypes of depression.
Since both BPD and bipolar can be lifelong conditions, ongoing treatment is essential.
A Word From Verywell
Bipolar disorder and BPD are not the same. Having bipolar or BPD can have a significant impact on your life. However, proper maintenance of symptoms can reduce the risk of potential consequences, including substance abuse, suicidal thoughts, and self-harm.
If you or a loved one may be struggling with a mental health challenge like BD or BPD, talk to your doctor about options for evaluation and treatment.
18 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Brüne M.Borderline Personality Disorder: Why ‘fast and furious’?Evol Med Public Health. 2016 Feb 28;2016(1):52-66. doi: 10.1093/emph/eow002Pec O, Bob P, Raboch J.Splitting in schizophrenia and borderline personality disorder.PLoS One. 2014 Mar 6;9(3):e91228. doi: 10.1371/journal.pone.0091228Jain A, Mitra P.Bipolar Affective Disorder.In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.National Alliance on Mental Illness.Borderline Personality Disorder and Bipolar Disorder: What’s the Difference?National Health Service.Bipolar Disorder Causes.Crowell SE, Beauchaine TP, Linehan MM.A biosocial developmental model of borderline personality: Elaborating and extending Linehan’s theory.Psychol Bull. 2009 May;135(3):495-510. doi: 10.1037/a0015616Chapman J, Jamil RT, Fleisher C.Borderline Personality Disorder. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.National Institute on Mental Health.Borderline Personality Disorder.National Health Service.Borderline Personality Disorder.National Institute on Mental Health.Bipolar Disorder.American Psychiatric Association.Bipolar I and Bipolar II disorders.National Institute of Mental Health.Borderline personality disorder.You JS, Lee CW, Park JY, et al.Borderline personality pathology in major depressive disorder, bipolar I and II disorder, and its relationship with childhood trauma.Psychiatry Investig. 2022;19(11):909–18. doi:10.30773/pi.2022.0114May T, Pilkington PD, Younan R, Williams K.Overlap of autism spectrum disorder and borderline personality disorder: A systematic review and meta-analysis.Autism Res. 2021;14(12):2688–710. doi:10.1002/aur.2619Zimmerman M, Morgan TA.The relationship between borderline personality disorder and bipolar disorder.Dialogues Clin Neurosci. 2013;15(2):155–69. doi:10.31887/DCNS.2013.15.2/mzimmermanChan JKN, Wong CSM, Yung NCL, Chen EYH, Chang WC.Excess mortality and life-years lost in people with bipolar disorder: an 11-year population-based cohort study.Epidemiol Psychiatr Sci. 2021;30:e39. doi:10.1017/S2045796021000305Kessing LV, Vradi E, Andersen PK.Life expectancy in bipolar disorder.Bipolar Disord. 2015;17(5):543–8. doi:10.1111/bdi.12296Dome P, Rihmer Z, Gonda X.Suicide risk in bipolar disorder: a brief review.Medicina(Kaunas). 2019;55(8):403. doi:10.3390/medicina55080403
18 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Brüne M.Borderline Personality Disorder: Why ‘fast and furious’?Evol Med Public Health. 2016 Feb 28;2016(1):52-66. doi: 10.1093/emph/eow002Pec O, Bob P, Raboch J.Splitting in schizophrenia and borderline personality disorder.PLoS One. 2014 Mar 6;9(3):e91228. doi: 10.1371/journal.pone.0091228Jain A, Mitra P.Bipolar Affective Disorder.In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.National Alliance on Mental Illness.Borderline Personality Disorder and Bipolar Disorder: What’s the Difference?National Health Service.Bipolar Disorder Causes.Crowell SE, Beauchaine TP, Linehan MM.A biosocial developmental model of borderline personality: Elaborating and extending Linehan’s theory.Psychol Bull. 2009 May;135(3):495-510. doi: 10.1037/a0015616Chapman J, Jamil RT, Fleisher C.Borderline Personality Disorder. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.National Institute on Mental Health.Borderline Personality Disorder.National Health Service.Borderline Personality Disorder.National Institute on Mental Health.Bipolar Disorder.American Psychiatric Association.Bipolar I and Bipolar II disorders.National Institute of Mental Health.Borderline personality disorder.You JS, Lee CW, Park JY, et al.Borderline personality pathology in major depressive disorder, bipolar I and II disorder, and its relationship with childhood trauma.Psychiatry Investig. 2022;19(11):909–18. doi:10.30773/pi.2022.0114May T, Pilkington PD, Younan R, Williams K.Overlap of autism spectrum disorder and borderline personality disorder: A systematic review and meta-analysis.Autism Res. 2021;14(12):2688–710. doi:10.1002/aur.2619Zimmerman M, Morgan TA.The relationship between borderline personality disorder and bipolar disorder.Dialogues Clin Neurosci. 2013;15(2):155–69. doi:10.31887/DCNS.2013.15.2/mzimmermanChan JKN, Wong CSM, Yung NCL, Chen EYH, Chang WC.Excess mortality and life-years lost in people with bipolar disorder: an 11-year population-based cohort study.Epidemiol Psychiatr Sci. 2021;30:e39. doi:10.1017/S2045796021000305Kessing LV, Vradi E, Andersen PK.Life expectancy in bipolar disorder.Bipolar Disord. 2015;17(5):543–8. doi:10.1111/bdi.12296Dome P, Rihmer Z, Gonda X.Suicide risk in bipolar disorder: a brief review.Medicina(Kaunas). 2019;55(8):403. doi:10.3390/medicina55080403
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Brüne M.Borderline Personality Disorder: Why ‘fast and furious’?Evol Med Public Health. 2016 Feb 28;2016(1):52-66. doi: 10.1093/emph/eow002Pec O, Bob P, Raboch J.Splitting in schizophrenia and borderline personality disorder.PLoS One. 2014 Mar 6;9(3):e91228. doi: 10.1371/journal.pone.0091228Jain A, Mitra P.Bipolar Affective Disorder.In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.National Alliance on Mental Illness.Borderline Personality Disorder and Bipolar Disorder: What’s the Difference?National Health Service.Bipolar Disorder Causes.Crowell SE, Beauchaine TP, Linehan MM.A biosocial developmental model of borderline personality: Elaborating and extending Linehan’s theory.Psychol Bull. 2009 May;135(3):495-510. doi: 10.1037/a0015616Chapman J, Jamil RT, Fleisher C.Borderline Personality Disorder. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.National Institute on Mental Health.Borderline Personality Disorder.National Health Service.Borderline Personality Disorder.National Institute on Mental Health.Bipolar Disorder.American Psychiatric Association.Bipolar I and Bipolar II disorders.National Institute of Mental Health.Borderline personality disorder.You JS, Lee CW, Park JY, et al.Borderline personality pathology in major depressive disorder, bipolar I and II disorder, and its relationship with childhood trauma.Psychiatry Investig. 2022;19(11):909–18. doi:10.30773/pi.2022.0114May T, Pilkington PD, Younan R, Williams K.Overlap of autism spectrum disorder and borderline personality disorder: A systematic review and meta-analysis.Autism Res. 2021;14(12):2688–710. doi:10.1002/aur.2619Zimmerman M, Morgan TA.The relationship between borderline personality disorder and bipolar disorder.Dialogues Clin Neurosci. 2013;15(2):155–69. doi:10.31887/DCNS.2013.15.2/mzimmermanChan JKN, Wong CSM, Yung NCL, Chen EYH, Chang WC.Excess mortality and life-years lost in people with bipolar disorder: an 11-year population-based cohort study.Epidemiol Psychiatr Sci. 2021;30:e39. doi:10.1017/S2045796021000305Kessing LV, Vradi E, Andersen PK.Life expectancy in bipolar disorder.Bipolar Disord. 2015;17(5):543–8. doi:10.1111/bdi.12296Dome P, Rihmer Z, Gonda X.Suicide risk in bipolar disorder: a brief review.Medicina(Kaunas). 2019;55(8):403. doi:10.3390/medicina55080403
Brüne M.Borderline Personality Disorder: Why ‘fast and furious’?Evol Med Public Health. 2016 Feb 28;2016(1):52-66. doi: 10.1093/emph/eow002
Pec O, Bob P, Raboch J.Splitting in schizophrenia and borderline personality disorder.PLoS One. 2014 Mar 6;9(3):e91228. doi: 10.1371/journal.pone.0091228
Jain A, Mitra P.Bipolar Affective Disorder.In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.
National Alliance on Mental Illness.Borderline Personality Disorder and Bipolar Disorder: What’s the Difference?
National Health Service.Bipolar Disorder Causes.
Crowell SE, Beauchaine TP, Linehan MM.A biosocial developmental model of borderline personality: Elaborating and extending Linehan’s theory.Psychol Bull. 2009 May;135(3):495-510. doi: 10.1037/a0015616
Chapman J, Jamil RT, Fleisher C.Borderline Personality Disorder. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.
National Institute on Mental Health.Borderline Personality Disorder.
National Health Service.Borderline Personality Disorder.
National Institute on Mental Health.Bipolar Disorder.
American Psychiatric Association.Bipolar I and Bipolar II disorders.
National Institute of Mental Health.Borderline personality disorder.
You JS, Lee CW, Park JY, et al.Borderline personality pathology in major depressive disorder, bipolar I and II disorder, and its relationship with childhood trauma.Psychiatry Investig. 2022;19(11):909–18. doi:10.30773/pi.2022.0114
May T, Pilkington PD, Younan R, Williams K.Overlap of autism spectrum disorder and borderline personality disorder: A systematic review and meta-analysis.Autism Res. 2021;14(12):2688–710. doi:10.1002/aur.2619
Zimmerman M, Morgan TA.The relationship between borderline personality disorder and bipolar disorder.Dialogues Clin Neurosci. 2013;15(2):155–69. doi:10.31887/DCNS.2013.15.2/mzimmerman
Chan JKN, Wong CSM, Yung NCL, Chen EYH, Chang WC.Excess mortality and life-years lost in people with bipolar disorder: an 11-year population-based cohort study.Epidemiol Psychiatr Sci. 2021;30:e39. doi:10.1017/S2045796021000305
Kessing LV, Vradi E, Andersen PK.Life expectancy in bipolar disorder.Bipolar Disord. 2015;17(5):543–8. doi:10.1111/bdi.12296
Dome P, Rihmer Z, Gonda X.Suicide risk in bipolar disorder: a brief review.Medicina(Kaunas). 2019;55(8):403. doi:10.3390/medicina55080403
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