How to Understand the Difference Between Borderline and Bipolar

When it comes to navigating the mental health system, there is so much terminology and so many overlapping symptoms that it can be hard to understand what is what. This is especially the case with borderline personality disorder and bipolar disorder (formerly known as manic-depression). In this article, I will address the differences and similarities between borderline personality disorder and bipolar disorder, from similar symptoms to different symptoms to the differences in treatment. Hopefully you'll be able to understand them a little bit better!

Instructions

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One of the primary reasons borderline personality is commonly confused with bipolar disorder is because both mental health issues share similar symptoms. One of the symptoms both disorders has is an unstable sense of self. When a person has an unstable sense of self, she lacks a solid, coherent view of what she is like as a person. At any given moment, the person may see herself as either "all good" or "all bad". She may place far more worth on what others think of her than her own view.

Intense anger, irritability, and anxiety are all common symptoms of both disorders. Many borderline and bipolar patients also suffer other mental health problems, particularly anxiety issues, such as social anxiety.

Impulsivity is another common symptom- such impulsiveness may involve sex, substance abuse, or self-harm. It is a common belief that self-harm is only a symptom of borderline personality disorder, but that is not true.

Those with bipolar and borderline are also much more likely than the general population to idealize suicide, and also to attempt it.

One other commonality between the two is that of "affective instability": borderline and bipolar patients may experience erratic and inappropriate responses to daily experiences. They can be extremely sensitive to criticisms.

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A major difference between borderline and bipolar is the speed with which the moods of the patient change. In someone with borderline, mood changes can be very fast. They may have an angry emotional outburst one minute, and a few moments later be extremely joyous. In someone with bipolar, these emotional changes can last days, weeks, or even months.

A second major difference between borderline personality disorder and bipolar disorder is that the borderline personality is more often fraught with feelings of loneliness, emptiness, and fear of abandonment. Bipolar people tend to not have these feelings, or not to the same extent as borderlines.

Bipolar people, on the other hand, are more likely to have psychosis, particularly paranoid psychosis or delusions of grandeur. Thus, while both are commonly admitted to psychiatric hospitals, the reasons either are likely to be admitted for are different. Bipolar patients are more likely to suffer more extreme psychosis, and are thus more likely to be admitted for this. Borderline patients are more likely to be "admitted for outbursts of rage and anger.

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The major difference between borderline and bipolar treatment is that bipolar treatment is first and foremost medication, while borderline personality is treated foremost with psychotherapy. Borderline can sometimes be treated only with psychotherapy. In bipolar, therapy alone is almost never used unless the patient refuses medication.

Bipolar disorder patients tend to respond best with traditional therapies, such as Cognitive Behavioral Therapy or psychoanalysis. Borderline, however, has a specific type of therapy that works well: Dialectical Behavior Therapy (DBT).

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