Bipolar Disorder vs. Borderline Personality Disorder

Do you know that bipolar disorder vs. borderline personality disorder mood swings look interchangeable?...

Bipolar Disorder
March 21, 2025

Do you know that bipolar disorder vs. borderline personality disorder mood swings look interchangeable?Because many mental health disorders share some of the same characteristics, misdiagnosis is common. Unfortunately, some people do not tell their therapist everything that is going on, and what they believe is unimportant information is crucial for a diagnosis.Bipolar disorder (BD) and borderline personality disorder (BPD) are two disorders that are frequently misdiagnosed or co-occur. Perhaps you've been diagnosed with one of these conditions, but your symptoms still bother you?Let's take a closer look at the two conditions and compare and contrast their differences and similarities so you can better understand them.

What Is Borderline Personality Disorder?

A borderline personality disorder is defined by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, as one of the cluster B disorders characterized by thinking and behavioral differences. One of the most noticeable characteristics of BPD is their extreme fear of abandonment. If the fear is severe enough, they may imagine it in their minds.Other signs and symptoms of BPD include:

  • Impulsivity
  • Swing between love and hate for people
  • Chaotic relationships
  • Inconsistent sense of self-image: they can change goals, careers and identity frequently
  • Aggressiveness
  • They may have paranoid or dissociative symptoms
  • Black and white thinking patterns
  • Engage in risky behaviors such as excessive spending, reckless driving, substance abuse, unprotected sex, and gambling
  • Mood swings: rapid mood swings can change within hours
  • Neediness: the fear of abandonment, either real or imagined, is so severe that they may desperately need to hold your attention

The exact cause of BPD is unknown. However, there are some common occurrences within the population of people who suffer from it.A substance use disorder is often present in the parents of someone with BPD. The person has been abused sexually, emotionally, or physically. Actual parental neglect by one or both parents causes the fear of abandonment.Now that we know more about BPD let's dive into BD.

a woman floating under water

What Is Bipolar Disorder?

Bipolar disorder is prevalent in the United States, with an estimated 4.4 percent of adults in the country suffering from it at some point in their lives.A person with bipolar disorder will experience cycles of tremendous depressive and intense manic states.The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, states that BD disorder affects someone's energy and mood levels. Shifts can last longer than someone with BPD and could last months.For example, someone with BD could spend the entire day in bed, only getting out to shower and miss months of school or work. They cannot get out of bed because they lack the necessary energy. After a few months, they may be cleaning the entire house, sleeping very little, and attempting to work two jobs.Some symptoms of a BD manic episode include:

  • Less need for sleep
  • Increased energy
  • Racing thoughts
  • Rapid speech or talkativeness
  • Poor decision-making skills
  • Engage in risky behaviors

Symptoms of a BD depressed episode include:

  • Lack of energy
  • Sleeping too much or insomnia
  • Weight gain
  • Inability to concentrate
  • Loss of interest in activities
  • Feeling sad
  • Feeling hopeless
  • Thoughts of suicide
  • Excessive guilt or shame

Now that bipolar disorder vs. borderline personality disorder is apparent, read on to learn about some of the similarities and differences.

What Are Some Similarities Between the Two?

There are many bipolar disorder vs. borderline personality disorder symptoms that are similar.

Some similar symptoms include:

  • Low self-esteem
  • Paranoia
  • Mood instability
  • Aggressive behavior
  • Impulsive behaviors
  • Risky behaviors
  • Suicidal ideation

What Are the Key Distinctions Between the Two Conditions?

There are some critical differences between bipolar disorder vs. borderline personality disorder. One significant difference is the length of the mood swing cycle.Someone with BP will have months of depression followed by periods of mania, whereas someone with BPS can rapidly change their mood four times in one week.Another distinction is that someone with BD may experience periods of stable mood. In contrast, someone with BPD will experience erratic mood swings. The person with BD may live an everyday life between manic and depressive episodes. Still, the person with BPD does not have the same level of mood stability. A mood swing in individuals with BPD is usually caused by stress or a change in an emotional state. The mood swings of people with bipolar disorder are more unpredictable.

a woman laying on her side on the floor

Treatment Options for Bipolar Disorder vs. Borderline Personality Disorder

Fortunately, there are treatment options for both BD and BPD.

Treatment can include:

  • Cognitive-behavioral therapy (CBT)
  • Dialectical behavioral therapy (DBT)
  • Medications

BD is commonly treated with medications such as mood stabilizers, and people live and usually function as a result. In addition, psychotherapy, such as CBT and DBT, is frequently used to treat BPD.CBT is a method of treatment that focuses on altering one's thoughts, feelings, and behaviors to reduce symptoms. DBT is a cognitive-behavioral therapy that focuses on improving coping skills and learning how to regulate emotions properly. You will, for example, learn how to communicate with your loved ones in a healthy manner.Another option for BPD is mentalization-based therapy (MBT). A therapist will help you learn to focus on how you think.Professionals may prescribe medication for severe symptoms like anxiety, but psychotherapy is the best defense against BPD.It is often wise to avoid thinking too far ahead and instead focus on the present moment. As a result, someone with BPD or BD may benefit from meditation and yoga.If you or a loved one is experiencing symptoms of either condition, you should seek treatment from a therapist.

Conclusion

It is not uncommon for someone to be diagnosed with both BPD and BD.Some other co-occurring disorders that can occur alongside either of these include:

  • Anxiety
  • Depression
  • ADHD
  • PTSD
  • Eating disorders

Both disorders can be life-long and may require ongoing treatment, but you can live a happy life with proper treatment.Effective treatment for bipolar disorder vs. borderline personality disorder is possible with patience and honesty.

Resources

https://www.nimh.nih.gov/health/statistics/bipolar-disorder

https://www.mayoclinic.org/diseases-conditions/borderline-personality-disorder/symptoms-causes/syc-20370237

Author
Jennifer Luttman, LPC, ACS

I am a Licensed Professional Counselor, and owner of Overcomers Counseling. I'm dedicated to helping individuals find strength and healing through life’s challenges. With a deep understanding of mental health and years of professional experience, I specialize in fostering hope and resilience while equipping her clients with tools to thrive. Passionate about empowering others, she creates a safe, supportive space where everyone feels seen, valued, and capable of overcoming obstacles on their path to well-being.

Common Questions about Bipolar Disorder

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