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Borderline Personality Disorder vs. Bipolar Disorder

Standing in the fluorescent light of the shopping mall, it can be difficult to tell whether a piece of fabric is white or off-white….is it eggshell? Ecru? Ivory? Or white? There is a difference, but sometimes it can be really difficult to determine what it is that you are seeing. In much the same way, some mental health disorders appear very much alike to the untrained eye even though there are distinguishing differences. Borderline personality disorder and bipolar disorder are mental health conditions that share enough similarities that the two can be easily confused.

How They Are The Same?


Moodiness is a significant issue for persons with either of these illnesses. Shifts from positive to negative emotions can make life a series of ups and downs that feels like an out-of-control roller coaster. With bipolar disorder, the positive emotions usually manifest during periods called mania, times when the person experiences high energy, enthusiasm, rapid talking and sleeplessness. Both conditions also experience depressive feelings when the person feels very low, apathetic and tired and has a great deal of trouble concentrating.


Impulsivity describes acting without thinking. With both illnesses, the person may exhibit rash behavior that can take the form of engaging in risky sex (unprotected, unknown or multiple partners), overspending, careless driving or even substance abuse. Heedlessness is the hallmark of these actions.

Substance Abuse

One can imagine that the extreme emotional highs and lows would be tough to manage. Reckless behavior also usually tends to bring serious consequences. Both the person with bipolar disorder and the one living with borderline personality disorder may try to escape these difficulties through use of drugs or alcohol. Unfortunately, self-medicating with alcohol and/or drugs often exacerbates the illness and keeps the person from getting help for the root cause of abuse.

How They Are Different

Biological vs. Behavioral

Most experts believe that bipolar disorder is a genetic, or biological brain disorder. Borderline personality disorder, on the other hand, is believed to be an emotional disorder often stemming from a childhood trauma. Borderline personality disorder may be more akin to post traumatic stress disorder (PTSD) than anything else.

Cause and Duration of Mood Swings

While it is true that both illnesses are characterized by mood shifts, the impetus and longevity of these swings is very different. With borderline personality disorder, the person may experience several intense mood swings within a single day. Something that happens may trigger an angry outburst that quickly evaporates. The person may have several times throughout the day when focusing is problematic. There are rarely any positive emotional swings for the person with borderline personality disorder. With bipolar disorder, the trigger for mood swings is not evident and the episodes of high and low last not for minutes or hours of a single day, but for days or weeks at a time.


Because the illnesses are so different, they require different forms of treatment. Borderline personality disorder benefits most from talk therapies that address the trauma, anxiety and behavior modification. Bipolar disorder usually responds well to a combination of therapy and medication. A mental health professional will be able to identify which condition is actually present when it can be tough for family members or others to discern. Getting the person affected in for a professional evaluation will be key if they are to receive the best and most appropriate treatment for their illness.

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