Borderline Personality Disorder vs. Bipolar Disorder

Borderline Personality Disorder

Borderline personality disorder involves a longstanding pattern of abrupt, moment-to-moment swings — in moods, relationships, self-image, and behavior (in contrast to distinct episodes of mania or depression in people with bipolar disorder) that are usually triggered by conflicts in interactions with other people. People with borderline personality disorder can experience overly strong emotional responses to upsetting life events and often try to hurt themselves. They often have chaotic relationships with people.

People with borderline personality disorder are more likely to have other mental health problems, too. They are also more likely to have had some type of trauma as a child than people with bipolar disorder, although trauma in itself does not cause borderline personality disorder.  They often also can have problems with addictions, eating disorders, body image, and anxiety.

Symptoms: A person with borderline personality disorder has trouble controlling his thoughts and managing his feelings, and often has impulsive and reckless behavior. Here are the condition’s main symptoms:

  • Frantic efforts to avoid feeling abandoned
  • History of unstable, intense relationships
  • Tendency to view people and situations as either “all good” or “all bad”
  • Poor self-image
  • Impulsiveness (spending, sex, substance abuse, etc.)
  • Self-harm (e.g., cutting) or suicidal behavior
  • Mood swings involving anger and depression, usually in response to stressful events or relationships
  • Feelings of emptiness
  • Problems managing anger and unpleasant emotions
  • Paranoia

Treatment: Long-term  treatment is usually necessary for people with borderline personality disorder. Treatment mainly involves specific forms of psychotherapy, such as dialectical behavior therapy (DBT) or transference-focused psychotherapy (TFP) 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 oversensitivities to interactions with other people.  Medications are also sometimes used to help with these symptoms, although they are not always effective and not considered to be the main focus of treatment in borderline personality disorder.  Sometimes, short hospital stays are also needed to manage times of crisis that involve threats to safety and well-being.