The three main differences between BPD and bipolar disorder

Borderline personality disorder (BPD) and bipolar disorder are two different mental health conditions that are sometimes confused. Sure, both diagnoses begin with the letter B, and they both involve symptoms of impulsiveness and major mood swings. But it’s important to recognize that they come with different symptoms, risk factors, and treatment methods.

Borderline personality disorder vs. bipolar disorder

Although BPD and bipolar disorder have several of the same symptoms, there are a few important differences between the two conditions.

1. Mood swings

Both conditions involve mood swings, but they differ in duration and nature. For someone living with bipolar disorder, their manic or depressive episodes are a leading symptom and can last for days, weeks, or even months. On the other hand, BPD episodes are typically short lived and may vary by the hour or day. With BPD, mood swings often stem from difficulty managing emotions. 

2. Interpersonal relationships

People with BPD often struggle to maintain healthy relationships. It’s common for them to fear abandonment, have trouble trusting others, and switch between feelings of love and attraction and extreme dislike or distrust in their relationships. Bipolar disorder can also impact people’s relationships, especially during mood episodes, but it’s not a central aspect of the condition.

3. Treatment

Bipolar disorder typically requires medication to effectively manage symptoms. Treatment for BPD is different because it focuses on psychotherapy. The most common type of therapy for BPD is dialectical behavior therapy (DBT), which helps people improve their emotional regulation and communication skills. It also helps people develop a mindfulness practice that can make it easier for them to handle distress.

Understanding borderline personality disorder

Borderline personality disorder is a mental health condition that severely affects a person’s ability to manage their emotions. Some of the hallmark symptoms of BPD include extreme mood swings, impulsive behaviors, emotional challenges, and unstable relationships. BPD looks a little different in each person, but there are several known emotional and behavioral symptoms associated with the condition. 

Emotional patterns in BPD

• Chronic feelings of emptiness
• Paranoia or severe dissociative symptoms 
• Mood swings involving anger, anxiety, and depression 
• Poor self-image

Behavioral aspects of BPD

• Difficulty managing anger, including frequent displays of temper, inappropriate anger, or recurrent physical fights
• Frantic efforts to avoid feeling abandoned
• History of intense, unstable relationships
• Self-harm behaviors 
• Impulsive behaviors, such as harmful substance use, reckless spending, sex, and binge eating

Understanding bipolar disorder

Bipolar disorder is a mental health condition marked by extreme changes in mood, concentration, energy levels, and activity levels. There are three types of bipolar disorder: 

• Bipolar I disorder
• Bipolar II disorder
• Cyclothymic disorder

People with bipolar disorder usually experience mood swings that alternate between manic episodes and depressive episodes. These shifts in mood can last days, weeks, or even months.  During manic episodes, a person feels extremely elated, irritable, or energized most of the day for at least seven days. To be considered a manic episode, a person must experience at least three of the following behavior changes:

• Decreased need for sleep
• Increased or faster speech
• Distractibility
• Racing thoughts
• Increased activity, such as working on several projects at the same time 
• Increased risky behavior, such as spending too much money or reckless driving  

People with bipolar disorder usually experience depressive periods as well, which typically last for at least two weeks and involve at least five of the following symptoms:

• Intense sadness or despair
• Loss of interest in activities the person once enjoyed
• Feelings of worthlessness or guilt
• Fatigue
• Changes in sleep patterns
• Changes in appetite
• Restlessness or slowed speech or movement
• Trouble concentrating
• Frequent thoughts of death or suicide

There’s also something called hypomanic episodes, which are characterized by less severe manic symptoms that last for four days in a row (rather than a week) and don’t usually impact daily functioning. 

Diagnosis and treatment

Working with a therapist or other mental health professional can help you better understand your condition. It can also help you make sure you have the skills and resources to manage your symptoms. Whether you have BPD or bipolar disorder, your therapist may consult the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to ensure an accurate diagnosis.  To help make an accurate diagnosis, your therapist will collect all relevant information during your initial assessment. You’ll discuss your health history, family history, symptoms, and what you’ve already tried to help with those symptoms. From there, your therapist can create a treatment plan to help manage your symptoms and keep you feeling safe.

Treatment strategies for bipolar disorder

For many people with bipolar disorder, their treatment plan will involve a combination of medication management and talk therapy. Therapists may suggest psychotherapy, such as cognitive behavioral therapy (CBT), interpersonal and social rhythm therapy (IPSRT), family therapy, or mindfulness practices. They will also refer you to a psychiatric provider for medication, such as mood stabilizers, antidepressants, or antipsychotic medications.

Treatment strategies for BPD

Once they have diagnosed you with BPD, therapists will usually suggest some form of psychotherapy, such as dialectical behavior therapy (DBT) or mentalization-based therapy (MBT). In therapy sessions, you will learn how to better regulate your emotions. You’ll also learn other skills to help manage and reduce your symptoms. Your mental health provider may also suggest a medication to help with impulsive behaviors or feelings of anxiety or depression. 

Living with BPD or bipolar disorder

If you have BPD, bipolar disorder, or any other mental health condition, it’s important to create healthy lifestyle habits. These habits can help you manage your symptoms. In turn, you can live a more balanced life. In addition to receiving professional mental health treatment, consider learning more about the following coping strategies and lifestyle adjustments. 

• Practice sleep hygiene. Getting enough sleep is essential for keeping your mood stable. It can also help you experience fewer and less severe manic or depressive episodes. Consider going to bed and waking up at the same time each day. Also, limit caffeine near bedtime to create a more consistent sleep schedule.

• Minimize stress. Try to reduce your exposure to stressful people, places, and situations. Also, try focusing on relaxation activities, like yoga, deep breathing, meditation, and guided imagery. 

• Keep a journal. Keeping a journal is a great way to track your moods, monitor your symptoms, and notice any changes in your eating or sleeping. It can also help you learn how to recognize your triggers or spot when you may need to adjust your medication. 

• Build a support system. Being diagnosed with a mental health condition doesn’t mean that you need to navigate the journey on your own. Create a support network of friends, family, and mental health professionals that you trust and feel comfortable with during vulnerable moments. 

Find the right therapist for you with Rula

If you think that you may have bipolar disorder or BPD, consider seeking professional help as soon as possible. Finding a mental health provider may seem intimidating, but it’s the first step toward learning to manage your symptoms and live a more balanced life.  Rula makes it easier to find a therapist who’s in network with your insurance, accepting new clients, and has experience treating your condition and symptoms. And if your treatment requires medication, our platform can even connect you with a psychiatric provider. Find care with Rula