BPD Related Conditions Bipolar Disorder vs. BPD: What Are the Differences? By Kristalyn Salters-Pedneault, PhD Kristalyn Salters-Pedneault, PhD Kristalyn Salters-Pedneault, PhD, is a clinical psychologist and associate professor of psychology at Eastern Connecticut State University. Learn about our editorial process Updated on December 13, 2022 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by David Susman, PhD Medically reviewed by David Susman, PhD David Susman, PhD is a licensed clinical psychologist with experience providing treatment to individuals with mental illness and substance use concerns. Learn about our Medical Review Board Print Arief Juwono/Moment/Getty Images Table of Contents View All Table of Contents Symptoms Causes Diagnosis Treatment Prevention Borderline personality disorder (BPD) has been controversial since it was first recognized in the "Diagnostic and Statistical Manual of Mental Disorders" in 1980. One controversy that still has not been resolved is whether or not BPD is related to bipolar disorder since they have many similar symptoms. Both conditions are characterized by mood instability and impulsivity, but there are also important distinctions. Bipolar disorder involves dramatic shifts in mood and activity levels, whereas BPD is marked by emotional dysregulation. Learn more about the differences between bipolar disorder and BPD. If you are experiencing symptoms of a mental health condition, talk to a healthcare provider to receive a diagnosis and treatment. Symptoms Mood instability and impulsive behavior are frequently experienced both by people with bipolar disorder and by people with BPD. Bipolar disorder is associated with mood shifts from depression to mania or hypomania. Mania is characterized by elation, a decreased need for sleep, and increased activity. Hypomania is similar to mania but less severe. BPD is also associated with mood changes, sometimes called emotional dysregulation or affective instability. People with BPD frequently change from feeling fine to extremely distressed in minutes. Bipolar Disorder Extreme shifts in mood Mood episodes lasting a week or more Restlessness Racing thoughts Increased energy and activity levels Reduced need for sleep Grandiosity Reckless, risky behaviors Impulsivity Psychosis during severe manic episodes BPD Rapid changes in mood Mood episodes lasting hours or days Emotional dysregulation Fear of abandonment Unstable self-image Intense, unstable relationships Anger issues Feelings of worthlessness Paranoid thinking Impulsivity Self-harm or suicidal behaviors The Truth About BPD Causes Research suggests that while bipolar disorder and BPD may co-occur, they appear to be separate conditions with different causes. While researchers do not fully understand the exact causes of each condition, it is believed that several factors play a part in increasing a person's susceptibility to developing each condition. Bipolar Disorder Genetics: Bipolar disorder is believed to have a strong genetic link. It is one of the most heritable mental health conditions. Trauma and stress: Childhood trauma and stressful events may also be linked to bipolar disorder.Brain differences: Some studies suggest that brain structure and chemistry differences may also contribute to bipolar disorder, although more research is needed to understand this link better. Borderline Personality Disorder Abuse and trauma: BPD is strongly associated with childhood abuse and trauma. Factors such as poor maternal attachment, parental substance use, and physical, emotional, and sexual abuse are associated with BPD. Brain differences: People with BPD may have differences in areas of the brain associated with emotional control. Genetics: Research also suggests that the condition may have a genetic link. BPD tends to run in families, meaning having a close relative with the condition may increase the risk that a person will also have it. Are Bipolar Disorder and BPD Related? Although it is not yet clear-cut, research has not found a strong relationship between BPD and bipolar disorder. There is some evidence that people with BPD are diagnosed with bipolar disorder at higher rates than individuals with other personality disorders. Diagnosis When making a diagnosis, healthcare providers will look at several different factors to help distinguish between bipolar disorder and BPD. Some significant components separate the two. Quality: While the disorders are both characterized by mood changes, the quality of the mood changes can be very different. People with bipolar disorder tend to experience mania and depression, while people with BPD experience intense emotional pain and feelings of emptiness, desperation, anger, hopelessness, and loneliness.Time: In BPD, mood changes are often more short-lived. They may last for only a few hours at a time. In contrast, mood changes in bipolar disorder tend to last for days or even weeks.Cause: Mood shifts in BPD usually react to an environmental stressor, such as an argument with a loved one, whereas mood shifts in bipolar disorder may occur out of the blue.Degree: The mood shifts typical of BPD rarely involve elation. Usually, the shift is from feeling upset to feeling OK, not from feeling bad to feeling a high or elevated mood, which is more typical of bipolar disorder. Treatment Because bipolar disorder and borderline personality disorder are distinct conditions, it is essential to treat each disorder individually for the best chance of symptom relief. Bipolar Disorder Medication is the primary treatment for bipolar disorder, although psychotherapy can also be helpful. Mood stabilizers can help balance moods and minimize the risk of experiencing extreme highs and extreme lows. Lithium was the first medication that was developed for the treatment of bipolar disorder. It is still commonly used today as a first-line treatment. Types of medications that are often prescribed to treat bipolar disorder are antipsychotics and anti-convulsants, which may include: Abilify (apripiprazole)Depakote (divalproex sodium)Haldol (haloperidol)Lamictal (lamotrigine)Topamax (topiramate) Borderline Personality Disorder BPD was previously regarded as challenging to treat, but more recent evidence indicates that treatments can be very effective. It is most often treated with psychotherapy, but medications may also be prescribed to help manage specific symptoms. Dialectical behavior therapy (DBT) is a form of psychotherapy that was specifically created to treat borderline personality disorder. This approach is a form of cognitive behavioral therapy (CBT) that teaches people stress management, emotional regulation, and relationship skills. Other therapies that can also be helpful include CBT, mentalization-based treatment (MBT), and group therapy. Medications sometimes prescribed to treat BPD symptoms include antidepressants, anti-anxiety medications, antipsychotics, and mood stabilizers. Prevention Unfortunately, it is not possible to prevent bipolar disorder or borderline personality disorder. The exact causes of each condition are not known, and both are believed to be affected by genetics to some degree. However, there are things you can do that will help you prevent serious outcomes associated with your condition. Bipolar Disorder There is no way to prevent bipolar disorder. However, early detection and treatment can help improve outcomes. Watch for warning signs and learn more about the condition so you can be on the lookout for early symptoms. If you have been diagnosed with bipolar disorder, some things can help reduce the risk and severity of having mood episodes: Adhere to your treatment planAvoid drugs and alcoholAvoid triggersEat a balanced dietFind ways to manage stressGet enough sleepStick to a consistent schedule Borderline Personality Disorder There is no surefire way to prevent borderline personality disorder. Some steps can lead to better outcomes, such as: Avoiding drugs and alcoholMinimizing stressUtilizing relaxation strategiesSeeking treatment at the first sign of symptoms Summary Bipolar disorder and borderline personality disorder share some common symptoms, but they are distinct conditions. They do sometimes co-occur, so future research on the genetic and biological causes of BPD and bipolar disorder may reveal some undiscovered relationships between the two conditions. The exact causes of the two conditions are not clear, but genetics is strongly linked to bipolar disorder, while trauma is strongly connected to borderline personality disorder. Both conditions have different treatments, so getting an accurate diagnosis is essential. A Word From Verywell Bipolar disorder and borderline personality disorder can lead to mood instability and impulsivity symptoms. Talk to your doctor if you suspect you have one of these conditions. They can evaluate your condition and refer you to a mental health professional for further assessment, evaluation, and treatment. Early treatment can minimize the effect that symptoms have on different areas of your life and ensure that you can live life to the fullest. How the DSM-5 Classifies Personality Disorders 12 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Gunderson JG, Stout RL, Shea MT, et al. Interactions of borderline personality disorder and mood disorders over 10 years. J Clin Psychiatry. 2014;75(8):829-834. doi:10.4088/JCP.13m08972 Gordovez FJA, McMahon FJ. The genetics of bipolar disorder. Mol Psychiatry. 2020;25(3):544-559. doi: 10.1038/s41380-019-0634-7 Lee JG, Woo YS, Park SW, Seog DH, Seo MK, Bahk WM. Neuromolecular etiology of bipolar disorder: possible therapeutic targets of mood stabilizers. Clin Psychopharmacol Neurosci. 2022;20(2):228-239. doi:10.9758/cpn.2022.20.2.228 Cattane N, Rossi R, Lanfredi M, Cattaneo A. Borderline personality disorder and childhood trauma: Exploring the affected biological systems and mechanisms. BMC Psychiatry. 2017;17(1):221. doi:10.1186/s12888-017-1383-2 Krause-Utz A, Frost R, Winter D, Elzinga BM. Dissociation and alterations in brain function and structure: Implications for borderline personality disorder. Curr Psychiatry Rep. 2017;19(1):6. doi:10.1007/s11920-017-0757-y Amad A, Ramoz N, Thomas P, Jardri R, Gorwood P. Genetics of borderline personality disorder: systematic review and proposal of an integrative model. Neurosci Biobehav Rev. 2014;40:6-19. doi:10.1016/j.neubiorev.2014.01.003 Patel RS, Manikkara G, Chopra A. Bipolar disorder and comorbid borderline personality disorder: patient characteristics and outcomes in US hospitals. Medicina (Kaunas). 2019;55(1):13. doi:10.3390/medicina55010013 Choi-Kain LW, Finch EF, Masland SR, Jenkins JA, Unruh BT. What works in the treatment of borderline personality disorder. Curr Behav Neurosci Rep. 2017;4(1):21–30. doi:10.1007/s40473-017-0103-z Stoffers JM, Völlm BA, Rücker G, Timmer A, Huband N, Lieb K. Psychological therapies for people with borderline personality disorder. Cochrane Database Syst Rev. 2012;2012(8):CD005652. doi:10.1002/14651858.CD005652.pub2 Ripoll LH. Psychopharmacologic treatment of borderline personality disorder. Dialogues Clin Neurosci. 2013;15(2):213–224. National Institute of Mental Health. Bipolar disorder. National Institute of Mental Health. Borderline personality disorder. By Kristalyn Salters-Pedneault, PhD Kristalyn Salters-Pedneault, PhD, is a clinical psychologist and associate professor of psychology at Eastern Connecticut State University. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Speak to a Therapist for BPD Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.