Distinguishing Borderline Personality Disorder from Bipolar Disorder

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People often confuse Borderline Personality Disorder (BPD) and Bipolar Disorder as they have some similar symptoms. They both involve mood swings, impulsive behaviour and depression. Bipolar disorder is a mood disorder, defined as your emotional state being inconsistent with your circumstances and interfering with your ability to function whereas Borderline Personality Disorder affects how you relate to others. About 1% of adults in the UK have BPD, while 2% have bipolar disorder.

What is BPD? What are the symptoms?

BPD is a personality disorder. Personality disorders affect how someone thinks, feels, behaves and relates to others. Our personality is the collection of thoughts, feelings, and behaviours that make us the individuals we are. As we are all different, we don’t always feel or think or behave in the same way, especially when we are put in different situations with different people. People with personality disorders like BPD experience significant difficulties in how they relate to themselves and others which causes problems coping day to day. 

Symptoms of BPD can include:

  • A pattern of intense and unstable relationships with others. This is where feelings can change quickly from love and closeness to hatred and anger
  • chronic feeling of emptiness
  • Impulsive or reckless behaviour, such as shopping sprees, gambling, substance abuse or unsafe sex
  • Tendency to perceive things in extremes. This means that situations are either all good or all bad
  • Uncertain about your role in the world
  • Feelings of disassociation. This is described as feeling that you or your surroundings are not real
  • Fear of abandonment. The sufferer may cut off ties with others in anticipation of this to protect oneself
  • Severe episodes of anxiety, depression, or anger
  • Intense interests that change quickly
  • An unstable and distorted sense of self
  • The sufferer may self-harm or have suicidal thoughts
  • Changing opinions about others frequently

Some people feel that a diagnosis helps them to understand their feelings and gives them a sense of relief. It also helps sufferers to explain to others reasons for their behaviour. Whereas others may feel that a diagnosis is not helpful and results in a stigma relating to mental health. Some people prefer not to describe their experiences as medical problems and would rather see them as their response to difficult life events.

What is Bipolar disorder? What are the symptoms?

Bipolar is defined by alternating periods of depression and mania that can last from days to months. Unlike borderline personality disorder, the mood swings of bipolar disorder are not triggered by personal conflicts. They last for days to weeks or months rather than minutes to hours like BPD. Sufferers experience manic episodes and depressive episodes, both of which come with very different symptoms:

Manic episodes can include

  • Extremely elevated mood
  • Grandiose ideas
  • Restlessness and less of a need for sleep
  • Exaggerated confidence in own abilities
  • Poor judgement
  • Racing thoughts or speech
  • Irritability and aggression
  • Reckless or impulsive behaviour
  • In severe cases, hallucinations or delusions

10 Traits of Depressive BPD Episodes

  1. Feelings of worthlessness and low self-esteem
  2. Irritability and guilt
  3. Fatigue or lack of energy
  4. Feelings of emptiness or numbness
  5. Low mood or chronic sadness and tearfulness
  6. Anxiety and worry
  7. Changes in sleep and eating patterns
  8. Social isolation
  9. Difficulty concentrating
  10. Self-harm or suicidal thoughts

The high and low episodes that come with Bipolar can be so severe that it affects the sufferer’s everyday life. To treat Bipolar the effects of an episode need to be controlled to allow the person to live a normal life day to day. Some people with bipolar disorder may enjoy the feelings of euphoria and cycles of being more productive. However, this is then always followed by an emotional crash that can leave the sufferer feeling depressed, worn out and maybe even then in financial, legal or relationship trouble.

What is the treatment?

For people who are diagnosed with BPD, long-term treatment is usually the necessary answer. This treatment mainly involves specific forms of psychotherapy aimed at helping people manage impulses (such as suicidal urges or tendencies to self-harm when they feel upset), feelings of distress or anger, and emotional oversensitivity to interactions with other people. Medications can be used but are not considered the best solution as they do not help address the present issues.

Treatment for Bipolar needs lifelong treatment to keep their condition managed. This will usually include medicine such as mood stabilizers, and sometimes antipsychotics or antidepressants. Therapy can also help people with bipolar disorder understand it and develop the skills they need to handle it. Occasionally hospital stays are necessary to help deal with the manic and depressive episodes.

All clinicians at Oxford CBT practice Cognitive Behavioural Therapy, or are Psychologists, providing evidence-based interventions and support for a range of issues for both young people and adults. If you would like to book an appointment you can do so on our online booking portal. If you have a question please get in touch via our online contact form or call us on 01865 920077.


Therapist Qualified in Borderline Personality Disorder

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