Initially, you may not see the difference between bipolar disorder and borderline personality disorder. Both disorders involve issues with impulse control and mood shifts, and even clinical doctors have trouble sorting out the proper diagnosis within the first few sessions. With bipolar disorder, you experience a series of depressive or manic mood episodes, and having borderline personality involves a persistent behavioral pattern. The intense ups and downs of both mental disorders look very similar at first glance.
Whether you have questions about your or a loved one’s severe mood shifts, you may suspect either disorder but have difficulty telling which disorder applies the most. Mental health is complex, and finding the right diagnosis and treatment may prove just as complicated since every person differs.
While they may battle the same symptoms, each person faces unique struggles inside. Plus, giving antidepressants to someone suffering from bipolar disorder can sometimes make them feel worse. Both disorders call for different therapeutic techniques and medications, which also means respecting and acknowledging the sufferer’s unique situation, too.
Depression Doesn’t Feel the Same for Each
You may assume depression looks like blaming the self for problems the person didn’t create in the first place, or someone who feels emotionally and physically exhausted. That may summarize the surface, but mental health disorders make sufferers feel depression differently. Those with borderline personality disorder (BPD) suffer from shame, emptiness, painful incoherence due to a fractured self-sense compared to typical depressive features of self-criticism and low self-esteem.
So, people suffering from each disorder may have changes in appetite or sleeping patterns, but how they feel inside differs. Someone with bipolar disorder (BD) may feel guilty and focus on previous mistakes, but someone with BPD experiences depression more abstractly with feelings of frustration, anger and anxiety. While each disorder looks intense from the outside, you can tell the difference based on the persistence of symptoms.
Bipolar Disorder Is Less Constant Than BPD
People commonly confuse BD and BPD because of how moods shift for sufferers. Those experiencing hypomanic or manic and depressive episodes from BD also have occasions where they don’t undergo episodes at all.
BD sufferers sense a baseline emotionally and have “breaks,” but BPD sufferers don’t get any breaks — the impact is constant, and the person feels the symptoms most of the time. BPD may also prove comorbid with other cluster B personality disorders, such as narcissistic, histrionic and antisocial.
Relationship Impacts on Borderline Personality Disorder
The roles that others play in each disorder varies and can help you spot the difference. Bipolar symptoms may make an appearance in complete absence of interaction, but some episodes may be triggered by a loaded and emotional interaction with someone.
Mood disorders look like they come from out of the blue, but BPD is a personality disorder — not a mood disorder. However, the DSM-5 classifies personality disorders equal to thought and mood disorders regarding disability and impact.
Someone with BPD experiences symptoms concerning their interaction with others, whether they are more dependent, independent or competitive, for example. Mood and anxiety disorders can also prove comorbid with personality disorders. With BD, there are no causal links to interactions with others.
BPD depends on how the sufferer sees themselves and interacts within relationships. Their symptoms are more reactive and can be triggered by an interpersonal event, such as a sense of abandonment, rejection or frustration. BPD symptom activity depends to a large degree on what’s going on in the sufferer’s life from moment to moment. That’s why a relationship with a BPD sufferer may feel stormier —the symptoms are persistent.
Finding the Right Diagnosis
It’s normal to feel like something is off in your mood shifts. If diagnosed with BD, you may question it if you feel your shifts are always linked with an interaction with someone else. Speak up and ask for more testing.
Keep a diary of your experience — you’re the one living in your skin. Your clinician doesn’t see your day-to-day life. Both BD and BPD come with management challenges, but finding the right diagnosis and treatment plan is a significant part of finding a healthy balance in living your life. Both disorders respond well to personalized treatment, so speak up with your unique experiences to find the right diagnosis and what works for you.