ADHD vs. Borderline Personality Disorder

male patient talking to his therapist

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Borderline personality disorder, also known as BPD, and attention deficit hyperactivity disorder, also known as ADHD, are two mental health conditions that can lead to difficulties in daily functioning. They share overlapping symptoms, however, they are very different.

BPD presents with instability in moods and relationships, often manifesting in self-destructive and impulsive behavior. ADHD presents as hyperactivity, difficulty focusing, and impulsive behavior.

As you can already see, these conditions have some commonalities. Let’s explore what makes them similar and different plus some avenues for healing and support. 

Similarities and Differences Between BPD and ADHD

The clearest connection between BPD and ADHD is impulsive behavior. To the untrained eye, it isn’t uncommon for one to be unable to differentiate between these two conditions.

This impulsive behavior can make it challenging for folks with either of these conditions to regulate their emotions and sustain interpersonal relationships. 

ADHD
  • Marked by impulsivity caused by motor issues

  • May be caused by trauma

  • Symptoms (e.g., difficulty focusing, restlessness, excessive talking)

  • Treatment helps manage thoughts and behavior

BPD
  • Impulsivity is common and is typically a result of stress

  • May be caused by trauma

  • Symptoms (e.g., dissociation, self-harm, etc.) are protective mechanisms

  • Treatment aims to manage emotional regulation

Impulsivity

BPD’s impulsivity is often triggered by stress. In this condition, it is hard for folks to identify context cues. A context cue is when one pulls on the context that is previously stored in their mind to develop an appropriate response to the scenario they’re currently experiencing.

This leads to difficulty having emotionally regulated responses, thus leading to impulsive behavior that can trigger challenging interpersonal relationships.

In ADHD, impulsivity is related to motor impulsivity, meaning it is a somatic response. This leads to challenges regulating ongoing responses, resulting in emotional regulation issues. When these emotional regulation issues arise, impulsivity occurs, often leading to issues in relationships.

Trauma May Be at the Root of Both Conditions

Experiencing traumatic events during childhood can lead to the development of BPD or ADHD alone. It is also possible to receive a co-occurring diagnosis of both. Despite the shared impulsivity, emotional regulation difficulties, link to traumatic experiences, and interpersonal relationship challenges, each of these conditions has distinctly different symptoms.

Symptoms of Borderline Personality Disorder

BPD is more complex than impulsivity and relational issues. Mood swings and an unstable self-image play a major role in BPD. This can lead to those experiencing BPD having rapidly shifting responses to their internal and external world.

Other key symptoms include:

  • Relational difficulties due to efforts to avoid abandonment 
  • Intense and unstable interpersonal relationships 
  • A pattern of idealizing and devaluing loved ones
  • Self-harming behavior
  • Suicidal ideation 
  • Intense anger that is difficult to control
  • Dissociation

It is important to remember that those who experience BPD won’t always experience every single symptom. It is equally important to remember that each of these symptoms has developed throughout one's lifetime as a protective response to trauma.

Borderline Personality Disorder Risk Factors

A key risk factor that has been established within BPD research is adverse childhood experiences and trauma.

BPD traits can begin to present themselves in adolescence. However, it is important to note that BPD isn’t solely caused by traumatic childhood experiences, and everyone who experiences childhood trauma isn’t going to develop BPD.

An additional factor that can lead to the development of this condition is one’s biological temperament. This means that this condition isn’t based upon simply one’s temperament or one’s childhood experiences. Rather, it is a complex interaction between the two that lead to this diagnosis.  

Symptoms of Attention Deficit Hyperactivity Disorder

The term ADHD can be tossed around casually by those who may feel distracted at times. However, ADHD is a condition that interferes with daily functioning in school, work, home, and relationships. There are two subtypes of ADHD: inattentive and hyperactive. Someone can have either or both subtypes.

Symptoms of inattentive ADHD include:

  • Difficulty remaining focused on the tasks at hand
  • Making mistakes that may seem careless to others
  • Struggles completing tasks at home, school, and work
  • Frequently losing things
  • Excessive forgetfulness

Symptoms of hyperactive ADHD include:

  • Somatic issues of fidgeting and restlessness
  • Pressured and excessive talking
  • Difficulty staying seated when expected to (for example, wandering about the classroom at school or frequently walking around the office for no specific reason at work)

Some may struggle mostly with inattention while others may have a strong mix of hyperactivity and impulsivity. It isn’t uncommon for folks to have a range of all these symptoms, lending to the complexity of this condition.

ADHD Risk Factors

ADHD is regarded as a neurodevelopmental disorder. This means that the development of this condition is due to brain malfunctioning. According to the DSM-5, symptoms must present during childhood, particularly before age 12.

Adverse childhood experiences can also be a risk factor for developing ADHD. 

Can Someone Have BPD and ADHD at the Same Time?

It is possible to have a co-occurring diagnosis of BPD and ADHD. The link between these conditions is becoming an increasingly researched phenomenon. Some experts believe these conditions can occur at the same time because ADHD lends to the biological vulnerabilities that can lead to BPD.

Other experts believe these conditions are linked due to their shared risk factors of trauma and biological vulnerabilities.

Diagnosis of BPD and ADHD

Both BPD and ADHD are diagnosed through a thorough evaluation conducted by a trained mental health professional utilizing the DSM-5 diagnostic information.

In the case of BPD, a referral to a general practitioner for medical tests may be given to rule out any illnesses that could be contributing to the presenting symptoms.

Treatment of BPD and ADHD

Another commonality between BPD and ADHD is that medication and psychotherapy are the suggested treatments for these conditions. However, the specific treatments and medications for each condition are quite different.

ADHD also has some treatments that involve family therapy and school-based support for those who are diagnosed as adolescents.

Medication for BPD is prescribed to manage symptoms of the disorder, like mood swings or depressive states, rather than to treat the disorder as a whole. Dialectical Behavioral Therapy, also known as DBT, was developed to treat folks experiencing BPD. It utilizes mindfulness to develop emotional regulation skills.

ADHD medications are either stimulants or non-stimulants. A stimulant can aid in the production of essential brain chemicals that support thinking and attention. Non-stimulants can take longer to work and are often prescribed when a stimulant wasn’t the best fit due to side effects and/or efficacy.

The suggested therapy for ADHD is cognitive-behavioral therapy (CBT), which focuses on understanding one’s thoughts to begin controlling their actions. Family therapy and parent skills training are two treatment options geared toward the caretakers of ADHD kids. This can help bolster support in the home for a child experiencing ADHD.

Additionally, some children may be offered academic accommodations, such as extra time when taking exams and specialized in-class plans.Support groups for ADHD are another recommended line of support.

Summary

BPD and ADHD are conditions that can be very challenging. Whether a person has an individual diagnosis of one of these conditions or is experiencing both, it is important to remember support is available. If you feel you may be experiencing one or both of these conditions, find a mental health professional and support group for some help and relief. 

A Word From Verywell

Though these conditions can be painful, there are options for relief. Don’t lose hope.

If you or a loved one are struggling with borderline personality disorder or ADHD, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

5 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.
  1. National Institute of Mental Health. Borderline personality disorder.

  2. National Institute of Mental Health. Attention-Deficit Hyperactivity Disorder.

  3. Weiner L, Perroud N, Weibel S. Attention deficit hyperactivity disorder and borderline personality disorder in adults: a review of their links and risks. NDT. 2019;15:3115-3129. doi: 10.2147/NDT.S192871

  4. Ditrich I, Philipsen A, Matthies S. Borderline personality disorder (Bpd) and attention deficit hyperactivity disorder (Adhd) revisited – a review-update on common grounds and subtle distinctions. Borderline Pers. Disord. Emot. Dysregulation. 2021;8(1):22. Doi: 10.1186/s40479-021-00162-w

  5. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. 5th ed. Washington, DC: American Psychiatric Association; 2013.

By Julia Childs Heyl
Julia Childs Heyl, MSW, is a clinical social worker and writer. As a writer, she focuses on mental health disparities and uses critical race theory as her preferred theoretical framework. In her clinical work, she specializes in treating people of color experiencing anxiety, depression, and trauma through depth therapy and EMDR (eye movement desensitization and reprocessing) trauma therapy.