The Distinction Between Bipolar and Borderline Personality Disorder

bipolar disorderOftentimes, bipolar disorder (BD) and borderline personality disorder (BPD) are confused with one another, leading a patient to be misdiagnosed.[1] With that knowledge, a recent study looked to reveal the distinct differences between the two, hoping to lead many to correct diagnosis and treatment.1

With bipolar disorder, individuals have cyclical changes in mood, energy, and activity levels, ranging from depression to mania to hypomania.1 On the other hand, individuals with borderline personality disorder have difficulty with regulating emotions and thoughts, along with reckless and impulsive behavior and unstable relationships.1 As the two seem so different, why are they commonly confused?

Researchers believe that patients with borderline personality disorder are more likely to have co-occurring disorders, as they are more likely to have experienced childhood trauma compared with those with bipolar disorder.1 Therefore, their episodes of depression may last longer and be more severe.1

Researchers conducted a study where they interviewed 268 participants between 1995 and 2012.1 Sixty-two of these participants were diagnosed with bipolar II depression and 206 were diagnosed with major depressive disorder with co-occurring borderline personality disorder (MDD-BPD).1 While depressive episodes are considered part of bipolar disorder, depression is also a separate disorder that often co-occurs with borderline personality disorder.1

Study findings revealed that the average age of patients with MDD-BPD was 33 years old—younger than the average age of 37 in the BD group.1 Also, patients with MDD-BPD were less likely to be married.1 There was no significant difference in race, education level, gender, average number of psychiatric hospitalizations, and time needed off of work between the two groups.1

However, 38 percent of the patients within the MDD-BPD group were diagnosed with three or more non-personality disorders, such as anxiety, mood disorders, and eating disorders.1 Within the bipolar group, this occurred in 26 percent of patients.1 Also, 30 percent of the MDD-BPD group was diagnosed with post-traumatic stress disorder, compared with 10 percent of the bipolar group.1

Also, patients with MDD-BPD were found to have longer and more severe depressive episodes, have a harder time doing day-to-day activities, and had significantly more childhood trauma events, especially physical neglect.1 Patients with MDD-BPD were found to be more suicidal, as twice as many MDD-BPD patients reported three or more suicide attempts than patients with bipolar disorder.1

The only more common factor found in the bipolar group was having an immediate family member with a history of bipolar disorder.1

While it may seem that the two disorders are similar at times, there are several factors that can be investigated during diagnosis that can make the distinction clear.

[1] Pederson, T. (2013, October 15). Study Probes Distinctions Between Bipolar, Borderline Personality Disorder. Psych Central. Retrieved October 17, 2013, from http://psychcentral.com/news/2013/10/15/study-probes-distinctions-between-bipolar-borderline-personality-disorder/60743.html

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