I wanted to write this article for several reasons. One is to spread education and awareness of the seemingly high rates of borderline personality disorder or BPD. These two mental health diagnosis’ are commonly mistaken. To people that don’t know the differences, they can be easily confused and mislabeled. I generally find in Salt Lake City and Utah in general, that BPD is more common than bipolar but people with borderline also tend to stick out a bit more, they are more noticeable. People with BPD are often mislabeled as bipolar because of their rapidly changing moods. And while this can also be true for bipolar disorder, here are some of the major differences between BPD and bipolar disorder:
- Nature vs Nurture – Bipolar disorder is genetic and hereditary. It runs in the family, sometimes it can also run in the family with other mental illnesses like schizophrenia. BPD, however, is not genetic, it is learned and is a result of how that person is raised and events in their childhood. BPD has a strong prevalence of trauma that happened in childhood.
- Manic episodes – One of the most notable differences is that people who are bipolar experience mania which is a state of mind that comes and goes for them. They bounce between being depressed and going through mania. Manic people can be spotted by their tendency to talk a lot while bouncing from topic to topic that seem to have little or no connection. They lack awareness when interacting with others, people with them may have checked out twenty minutes ago and people who are manic have no idea that they have lost their audience. Manic people also have a tendency to show levels of grandiosity that can be bizarre in nature. I’ve heard them say that they have a great purpose in life or that they have godlike abilities. You don’t hear people with BPD say these kinds of things. People with BPD do not bounce from being depressed to manic. They do, however, bounce from being calm and stable to angry and aggressive, quite quickly. People with BPD also don’t typically show very much depression.
- Addictive behaviors – For some reason, people with bipolar tend to gravitate towards more addictive type things. They are notorious for drug and alcohol addiction and sometimes gambling. They can’t seem to stay away from their drug of choice. While people with BPD can and do abuse substances, they don’t seem to get addicted nearly as much. While you will see someone with bipolar at 12 step meetings, you won’t see many people with BPD.
- Anger – People with BPD have problems controlling their rage. Even though people with bipolar can be irritable, they quickly move on and the anger level is low. People with BPD can have episodes of intense anger and rage. They can also go on the attack and absolutely lay into people. People with BPD tend to come across as a lot more mean and hurtful. Overall, emotional intensity is much higher in BPD than it is bipolar.
- Relationship styles – People who are bipolar are generally less attached to people and their decisions. Their relationships lack intensity. When they are experiencing mania, they are really flakey and they don’t keep their commitments. They will blow you off and truly not think it’s a big deal. If they are manic, they probably won’t even notice if you are upset about them being flakey. People with BPD have a much more intense relationship style. They are hyper focused on the behaviors of other and get extremely upset if they don’t like what other people do. People with BPD are usually surrounded by people that walk on eggshells; this is not true for people that are bipolar.
- Anxiety – People who have BPD are extremely anxious. They may hide it well but believe me, they have extreme, intense anxiety. It shows up in the form of fear, worry, black and white thinking and making small problems into a major crisis. People who are bipolar are not usually anxious. While they certainly can be, it’s not nearly as extreme.
Getting the right diagnosis is crucial. In order to get the right treatment, you have to get the right diagnosis. While bipolar and borderline have a lot of similarities there are subtle differences that a qualified mental health professional can identify. If you suspect that you may have either bipolar or BPD but aren’t sure, give me a call, I can help. I hope you will give me the opportunity to help you get onto a healthier road.