The 7 Differences Between Bipolar Disorder And Borderline Personality Disorder (BPD)

Bipolar disorder.

The emotional element is one of the most important for human beings, since it allows us to assess the implication for us of what happens around us and motivates various types of behavior.

Joy moves us to action and the repetition of behaviors that have generated it, just like pleasure. Sadness leads us to avoid repeating situations. Fear causes us to avoid stimuli. Love and hate lead us to approach or distance ourselves from beings, stimuli or situations. Emotions are not immutable and they change based on events. However, there are different disorders in which those who suffer from it suffer rapid changes in emotionality that they cannot control and that sooner or later make them suffer.

Perhaps the first one that comes to mind is Bipolar Disorder, but there are also others as well-known as Borderline Personality Disorder. These disorders have symptoms that in some aspects make them very similar and sometimes they can even be confused. That is why in this article we are going to analyze the differences between Bipolar Disorder and Borderline Personality Disorder

Bipolar Disorder

Bipolar Disorder is, along with depression, one of the mood disorders, characterized by the presence of one or more manic or hypomanic episodes, which can be preceded or followed by a depressive episode.

In manic episodes it appears an expansive and euphoric mood, it is common for inflated self-esteem and feelings of grandiosity to appear. Other symptoms that can and/or should be present are increased energy levels, decreased sleep, distractibility, failure to assess risks and the emission of high-risk behaviors and the flight of ideas.

In certain severe cases, hallucinations and delusions, verbosity, and irritability/hostility may also occur. Symptoms usually last at least a week. Hypomanic episodes are similar but with a much lower intensity and duration (at least four days), with no alterations such as delirium.

Regarding depressive episodes, a sad mood is experienced for at least two weeks along with anhedonia and avolition, and motivation or the ability to feel pleasure is frequently lost. It is also common for hopelessness and passivity, thoughts of suicide, and sleep and eating problems to appear.

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There are two types of Bipolar Disorder, type 1 and type 2. In the first, it is essential that at least one manic or mixed type episode has appeared, which may or may not be followed or preceded by a depressive episode. The second refers to people who experience one or more depressive episodes along with at least one hypomanic episode.

Borderline Personality Disorder (BPD)

Regarding Borderline Personality Disorder, it is a personality disorder characterized by a pattern of behavior in which affective, emotional and relational instability prevails, along with a high level of impulsivity which begins in the period of adolescence as a result of the interaction between biological aspects and the experiences and learning carried out by the subject.

Among the most characteristic symptoms we find low self-esteem, permanent feelings of emptiness and worthlessness high reactivity to events and interactions, extreme experience of emotions and idealization or devaluation of others in very categorical terms.

Also notable is the presence of an atrocious panic about being abandoned, making frequent efforts to avoid it (although this is not real). Suicidal thoughts (and in many cases attempts to carry them out) or self-harming acts are also common. They may appear alterations linked to dissociation, such as depersonalization or derealization. In certain contexts they may be criticized for being irritable, it is speculated that this is due to a relative difficulty in recognizing and expressing their emotions, although little is still known about this.

Characteristics in which they are similar

From the previous descriptions and diagnostic criteria, we can find that Bipolar and borderline disorder have some similarities evident. People who suffer from both disorders manifest symptoms such as high impulsivity, irritability, and a superficial pattern of relationships (at least at some times). The most important coincidence is the high emotional lability, changing rapidly from one emotional state to another.

In addition to the above, we are faced with two of the disorders that have been most linked to making and/or consummating suicide attempts, with Bipolar Disorder being one of those that has been most frequently linked (along with depression and addictions). ) and being Borderline Personality Disorder the personality disorder that has been most linked to suicide

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Finally, we can find subjects who have both diagnoses, Borderline Personality Disorder and Bipolar Disorder. Although this is clearly indicating to us that they are not considered the same, the truth is that many of the symptoms are very similar.

Differences between Bipolar Disorder and Borderline Personality Disorder

The above common points may suggest that both disorders are very similar and in some cases they could even be confused. But even though Bipolar and borderline Disorder have points in common and part of their symptoms coincide, we are still faced with diagnostic entities with various differences between them. Among the most significant differences we find the following.

1. Presence or absence of euphoria

In both Bipolar Disorder and borderline disorder we find rapid changes in very intense emotions However, while in Bipolar Disorder there are one or more manic or hypomanic episodes that are linked to an expansive and euphoric mood, in borderline disorder a depressive-type affective tone persists, with no euphoria appearing.

2. Stability of changes

Although changes in mood can be very rapid in Borderline or Borderline Personality Disorder, in the case of Bipolar Disorder it can be much more stable and long-lasting. For example, someone with borderline disorder may have constant mood swings throughout a day, or even within an hour or a few. The subject with Bipolar Disorder presents sudden changes, but in the form of episodes that usually last longer.

Despite this, it must be taken into account that those people with Bipolar Disorder called fast cyclers (with at least four changes in emotional polarity in a year) may present greater lability than average, although it will generally not be as marked as in the case of borderline disorder.

On the other hand, the level of impulsivity is stable and constant in patients with borderline disorder, while in Bipolar Disorder it appears only in the manic phase.

3. Reason for the change in mood

Another difference can be found in what exactly triggers the change, while in Bipolar Disorder we find that these changes are considered to be due to alterations and dysregulation of brain neurotransmitters, those of borderline disorder are often located on the outside. , in psychosocial stress, interpersonal relationships and the experiences that those who suffer from it have. That is, someone with Bipolar Disorder may not be aware of what exactly has caused their changes, while the borderline may associate it with a much more specific argument or discomfort.

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4. Presence of asymptomatic periods

Borderline personality disorder, as a personality disorder that it is (its characteristics being therefore integrated into the subject’s way of being), remains consistent over time. That is, there are no asymptomatic periods per se. On the other hand, in Bipolar Disorder we find that between episodes there may be symptom-free periods more or less prolonged, although it is not uncommon for subclinical symptoms to sometimes persist. And although it is not the most common, the episodes may not even be repeated.

5. Level of self-esteem

Although the experience of both disorders usually leads to a decrease in self-esteem and self-concept in the long run, in Bipolar Disorder this will vary greatly depending on the type of episode that the subject is having.

In the manic phase, an expansive mood usually appears in which sensations of grandeur stand out, with self-esteem greatly increased. In depressive phases, mood and self-esteem are usually greatly reduced. In asymptomatic periods this part of the self-concept may be at normative levels, although it may also be altered.

When it comes to Borderline Personality Disorder, as a general rule those who suffer from it tend to have a very low opinion of themselves, often feeling helpless and worthless. In the vast majority of patients, the prevailing sensation is feeling empty and terrified of being abandoned.

6. Relationship with others

We have seen previously that in both disorders there can be the presence of superficial, shallow or unstable relationships. However, we can also observe differences.

The subject with Borderline Personality Disorder usually has feelings of emptiness, of having little value and an extreme panic of being abandoned It is common for them to establish relationships of dependency, needing to be understood, loved and valued. Also that they fight constantly, that they idealize others or devalue them.

However, the subject with bipolar disorder binds to others in a normative way when he is in the asymptomatic phase, appearing superficiality especially in the manic phases, but usually there is no emotional dependence of others (although it can occur in depressive phases).

7. Treatment

Despite being a severe personality disorder, those who suffer from borderline personality disorder tend to benefit greatly from psychotherapy and different psychological techniques (many aimed specifically at this disorder). The treatment of Bipolar Disorder, on the other hand, is usually more complicated and be much more focused on pharmacology, although different therapies have been generated such as interpersonal and social rhythms or different applications of cognitive-behavioral therapy.