A diagnosis of a mental health disorder can be fluid. Not every symptom presents itself at the initial diagnosis. Sometimes it takes weeks, months, or years before a manifestation of a different mental health disorder presents itself. When a new symptom does appear, the original diagnosis can change.
However, the appearance of new symptoms doesn’t rule out one diagnosis. Often, bipolar disorder and borderline personality disorder are linked. The symptoms of bipolar disorder and borderline personality disorder can make diagnosis difficult at times.
Guidelines exist that outline the signs and symptoms of each mental health disorder. Still, there are instances when the lines between bipolar disorder can blur with borderline personality disorder symptoms. Borderline personality disorder and bipolar disorder share similarities, which can lead to confusion.
Many people mistake the symptoms of borderline personality disorder with bipolar disorder. Due to this difficulty, therapists assess a patient and make a diagnosis based on the guidelines in the Diagnostic and Statistical Manual of Mental Disorders (DSM). The DSM sets a standard protocol for borderline personality disorder and bipolar disorder recognized across the country.
Referring to the DSM is also necessary when behaviors change, and new symptoms occur. People can have more than one diagnosis, and in the case of those with borderline personality disorder, they can be diagnosed with bipolar disorder as well.
Before understanding the difference between bipolar disorder and borderline personality disorder, it is helpful to follow the signs of each mental health disorder.
Bipolar Disorder
There are five different types of bipolar disorder. Most people are familiar with bipolar I and II disorders. The various bipolar disorders are listed below to help explain the difference between the two mental health disorders.
Bipolar I disorder: is marked by severe episodes of depression and mania. When a person is experiencing a manic episode, their behaviors can include overspending, having sex with people they usually wouldn’t have sex with, actively pursue unrealistic plans, become delusional, or be bizarre.
Bipolar II disorder: has severe depression and hypomania episodes, but the mood levels are milder than bipolar I disorder. Those with bipolar II disorder can go for periods between episodes and often live healthy lives. They are usually the fun people to hang out with at events. Hypomanic episodes can progress into manic episodes that lead to instances of over-spending, having sex people that they usually wouldn’t have sex with, an increased frequency of sex, or seek out risky activities.
Cyclothymic disorder: instead of extended periods of depression or hypomanic symptoms, the episodes alternate at a shorter rate.
Mixed features: hypomania, depression, and manic episodes symptoms can occur at the same time.
Rapid-cycling: a person is diagnosed as a rapid-cycler when they have four or more mood swings in one year. The mood symptoms must last a certain amount of time to be considered one episode.
Borderline Personality Disorder
Borderline personality disorder occurs because, according to researchers, the brain is on high alert. The brain flips easily to the fight or flight mode. When the flight or fight switch flips for most people, they can control the urges or impulses. The urge to be self-destructive is demonstrated by active thoughts of suicide, cutting, burning, or comments about committing suicide.
People with borderline personality disorder can slip from one emotion to another. They also have unstable relationships that can influence their feelings. What they like and dislike is often continually changing, as well as a revolving view of oneself.
Emotions tend to run high for those with borderline personality disorder. Some report they feel everything people say, or they can’t control their feelings. They are easily angered, saddened, or happy. Unfortunately, the increased moods also come with an inability to soothe oneself or control responses.
A person explained, “I don’t know why I feel the way I sometimes do. I’m extremely angry or sad and don’t know how to curb those feelings. Those emotions are why sometimes I cut myself. I don’t want to commit suicide, but cutting helps me focus on something else.”
The most common mental health disorders co-occurring with borderline personality disorder are
- Depression or bipolar disorder
- Substance abuse
- Eating disorders
- Anxiety
The chart below distinguishes the difference between bipolar disorder and borderline personality disorder.
| Bipolar I Disorder | Bipolar II Disorder | Borderline Personality Disorder |
| Manic Episode Symptoms | Hypomanic Episode Symptoms | Fear of abandonment |
| Rapid thought cycle | Rapid thought pattern | Unstable relationships |
| Rapid uninterruptable or loud speech | Overly high self-confidence | Unclear or shifting self- image |
| Increased energy – hyperactivity w/ less need for sleep | Rapid and loud speech pattern | Impulsive, self-destructive behaviors |
| Inflated self-image | Increased energy – hyperactivity w/ a decreased need for sleep | Self-harm |
| Overspending | Similar depressive symptoms | Extreme mood swings |
| Hypersexuality | Persistent feeling of emptiness | |
| Substance or alcohol abuse ( Manic and Depressive ) | Extreme anger | |
| Severe depression | Paranoia | |
| Suicidal thoughts | ||
| Need for more sleep | ||
| Low to little energy | ||
| Lack of interest in hobbies, relationships | ||
| Poor self-image |
Causes of Bipolar Disorder or Borderline Personality Disorder
Researchers believe both mental health disorders can be inherited by biological factors or by environmental factors. Environmental factors can include childhood trauma or abuse. Researchers are still uncertain of the exact causes of both bipolar and borderline personality disorders.
Mental health disorders can occur at the same time. The similarities between some, such as borderline personality disorder and bipolar disorder, can make it difficult to diagnose. Because borderline personality disorder and bipolar disorder seem alike, people may diagnose themselves. They can do this by going online and taking quizzes that ask them simple questions regarding their behavior. These quizzes don’t provide the full techniques needed to make an accurate diagnosis. They can be wrong. Instead of seeking answers online, you should talk with a mental health counselor, therapist, or psychologist. Reaching out for help isn’t something to be ashamed of; it is a sign you are ready to heal. Trained mental health professionals can assess and provide the care necessary to improve your mental health. Achieve Concierge is available 24/7 to talk to you about any concerns you have about borderline personality disorder. Call us at (619) 393-5871.