Borderline personality disorder (BPD) and bipolar disorder are often confused, even within the mental health field. Maybe you’ve heard conflicting definitions, or seen heated debates online and wondered: what’s the difference between these two conditions?
In this article, we’ll explain the differences between BPD and bipolar disorder, where their symptoms overlap, and why focusing on a label may not be the most helpful approach for your healing.
If you believe you may have BPD or bipolar disorder but aren’t sure where to turn, Acceptance Path Counseling is here to help. Our licensed counselors will help you work through intense emotions, manage impulsive urges, and build healthier interpersonal relationships.
What Is Borderline Personality Disorder?
Borderline personality disorder, or BPD, is classified as a personality disorder in the DSM-5, the diagnostic manual used by mental health professionals. Rather than describing a specific illness with a clear cause, BPD outlines a pattern of intense feelings, thoughts, and behaviors that consistently recur over time.
People with BPD often experience:
- Intense fears of abandonment, sometimes leading to frantic efforts to prevent people from leaving.
- Unstable relationships, where someone may be seen as perfect one moment and deeply flawed the next.
- A shifting sense of self, with unclear or inconsistent values, goals, or identity.
- Impulsive behaviors that can cause harm, such as risky spending, substance use, unsafe sex, reckless driving, or disordered eating.
- Self-harm behaviors, including cutting or suicidal gestures.
- Rapid and intense mood swings, often triggered by interactions or perceived slights.
- Chronic feelings of emptiness or emotional numbness.
- Difficulty managing anger or experiencing it as overwhelming.
- Moments of dissociation, paranoia, or feeling detached from reality, especially during stressful times.
What Is Bipolar Disorder?
Bipolar disorder is classified as a mood disorder, which means it primarily involves changes in a person’s emotional state over time. Unlike personality disorders, mood disorders are about fluctuations in emotional “climate” rather than deeply rooted personality patterns.
There are two primary types:
Bipolar I Disorder
Characterized by at least one manic episode, which includes:
- Significantly elevated mood, energy, and activity levels.
- Feelings of power or invincibility.
- Racing thoughts, little need for sleep, and risky or impulsive behaviors.
- In severe cases, hospitalization may be required.
Depressive episodes may also occur, but aren’t required for diagnosis. The defining feature of bipolar I is full-blown mania.
Bipolar II Disorder
Defined by at least one hypomanic episode (a milder form of mania) and one major depressive episode.
- Hypomania is noticeable but less extreme, and typically doesn’t lead to hospitalization or a break from reality.
- Individuals with bipolar II do not experience full manic episodes.
Overlapping Symptoms Between BPD and Bipolar Disorder
Here’s where the confusion often begins: BPD and bipolar share many symptoms, but they manifest in different ways.
Mood Instability
Both disorders cause strong emotional shifts:
- With BPD, moods can shift quickly, sometimes within minutes or hours, and are often triggered by interpersonal stress.
- With bipolar disorder, mood episodes (mania, hypomania, depression) tend to last for days, weeks, or even months.
Impulsivity
Acting without thinking is common in both BDP and bipolar:
- With BPD, impulsivity is ongoing and can show up in daily life in the form of spending, eating, or risky behavior.
- In individuals with bipolar disorder, impulsive behavior tends to emerge specifically during manic or hypomanic episodes.
Relationship Struggles
- BPD causes individuals to become involved in intense, unstable relationships marked by fear of abandonment and emotional ups and downs.
- While not a core diagnostic trait of bipolar disorder, mood episodes can cause serious strain on relationships due to changes in behavior or emotional shifts.
Why BPD and Bipolar Disorder are Often Misdiagnosed
Due to their overlap in symptoms, misdiagnosis is common for individuals with BPD and bipolar disorder, even when evaluated by mental health professionals. In fact, nearly 40% of individuals diagnosed with BPD were previously misdiagnosed with bipolar disorder.
This isn’t just a paperwork issue; it can affect treatment plans, medication choices, and how individuals perceive themselves.
The Role of Diagnosis for Those with BDP or Bipolar Disorder
A diagnosis can be extremely helpful for individuals with BPD or bipolar disorder. It gives clinicians a shared language and can help them decide on the right treatment, whether through therapy, medication, or a combination.
But mental health labels aren’t the whole story. They don’t define who you are or determine what your healing process has to look like.
Think of it like this: getting a diagnosis is like taking painkillers for a headache. It may ease symptoms, but if the root cause is dehydration, you still need water. In the same way, emotional distress often comes from deeper patterns, not just the label.
Instead of focusing on finding the “perfect” diagnosis, it may be more helpful to focus on:
- Understanding your emotions, thoughts, and urges.
- Learning skills to manage impulsivity and mood swings.
- Building healthier relationships with yourself and others.
- Exploring what matters most to you and living in alignment with your values, even when emotions feel overwhelming.
The Benefits of Working with A Mental Health Professional
Working with a mental health professional who understands both BPD and bipolar patterns can help you gain practical tools for managing your emotions. This might include:
- Coping strategies for intense emotional waves.
- Techniques to pause before acting on an urge.
- Communication skills to express needs without damaging relationships.
- Clarifying your values, so you can take action toward a life that feels meaningful, even on your hardest days.
Start Your Healing Journey with Acceptance Path Counseling
You don’t need a perfect diagnosis to start healing from BPD or bipolar disorder. With a licensed mental health counselor, you can talk through your emotions, understand yourself better, and work toward the life you want.
If you’re in Texas and ready to begin your healing journey, Acceptance Path Counseling is here to help. We offer confidential in-person counseling in Houston as well as secure virtual therapy across the state.
Schedule your appointment with us today.
