Borderline Personality Disorder vs Bipolar Disorder

Borderline Personality Disorder vs Bipolar Disorder

Table of Contents

Borderline personality disorder (BPD) and bipolar disorder (BP) are two illnesses that are often confused with one another. Though both include mood swings, risk-taking behavior, and impulsiveness, they’re distinctly separate disorders that require different treatments.

What is Borderline Personality Disorder?

Borderline personality disorder, also known as BPD, is categorized by a consistent pattern of mood swings, unstable self-image, and impulsive behavior. The illness is internationally recognized as a disorder in the tenth version of the International Classification of Diseases (ICD) codes (ICD-10).1 ​​​​​​Individuals with borderline personality disorder struggle with intense emotions that can last for either short periods or multiple days. These strong feelings can overwhelm an individual, leading to self-injury or addictive behaviors. Borderline personality disorder is not typically diagnosed in children or adolescents because its symptoms are already similar to the behaviors usually found in young people. Adults are assessed for borderline personality disorder criteria through a:

What Is Bipolar Disorder?

Also known as manic depression, bipolar disorder is defined by significant swings in mood and energy. These changes can affect a person’s daily life, limiting the way they function. These mood swings aren’t driven by interpersonal problems or life events, like borderline personality disorder. Instead, it’s caused by a mood disorder affecting the brain. Bipolar disorder is a recognized disorder in the ICD 10 as Bipolar Disorder ICD 10 F31.3 Bipolar disorder, though typically diagnosed in adults, may also appear in children and adolescents. Unlike borderline symptoms, bipolar symptoms are present even in young people. Furthermore and unlike BPD, bipolar symptoms can last for weeks or months rather than hours or days. To determine if a person meets bipolar disorder, the evaluation may include:4

Physical exams to rule out any medical problems that can cause symptoms.

Psychiatric assessments, like a question and answer bipolar disorder test, that analyze thoughts and behavior patterns.

Tracking and charting moods to identify emotional patterns.

Symptoms should align with the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association (APA). A diagnosis of Bipolar DSM 5 ensures that the correct symptoms for bipolar are present and allows a Bipolar Disorder ICD 10 listing for insurance and medical care.4

Signs and Symptoms of Borderline Personality Disorder

The signs and symptoms of borderline personality disorder are primarily emotional and driven by self-image. For example, people with borderline personality disorder are preoccupied with real or imagined abandonment, and they may make attempts to avoid abandonment from occurring. They often start intimate relationships quickly to avoid loneliness and then leave relationships suddenly in anticipation of being abandoned. Thus, their relationships are often unstable and erratic, which is a hallmark of borderline personality disorder criteria

People with bipolar personality disorder may also experience feelings of chronic emptiness and isolation. They may have difficulty trusting others and have an irrational fear of other people’s intentions. They may participate in risky behaviors such as substance abuse or unsafe sexual activity due to their impulsivity and intense emotions. People with borderline personality disorder may also struggle with self-injury, such as cutting, and thoughts of suicide.

Signs and Symptoms of Bipolar Disorder

Bipolar disorder’s symptoms involve definite changes in energy and mood. People who are bipolar may appear intensely happy and elated (manic episodes) and then become very subdued and lethargic (depressive episodes). Unlike borderline personality disorder, there are three main categories for bipolar disorder, which may be determined through a question and answer bipolar disorder test:

During manic episodes, an individual with bipolar disorder can be extremely energetic to the point where they seem restless and sleep very little. People experiencing a manic episode can also be very elated, irritable, grandiose, and may participate in risk-taking behavior like drug use. During a depressive episode, people with bipolar disorder may sleep for longer periods and feel sad or despondent. Bipolar disorder, in some cases, can lead to suicidal thoughts.

What are the Differences Between Borderline Personality Disorder and Bipolar Disorder?

Although borderline personality disorder and bipolar disorder both include mood changes, there are also many differences. Borderline personality disorder is considered a personality disorder by the APA while bipolar disorder is a mood disorder that affects the brain.5 A child or adolescent may receive a diagnosis of bipolar disorder, while a diagnosis of borderline personality disorder is reserved for adults. Although both disorders can both negatively impact relationships, when it’s borderline personality disorder vs bipolar disorder in regards to self-image, BPD is the most effective.6

How is BPD Linked to Addiction?

The erratic, uncertain relationships and emotions associated with borderline personality disorders can lead an individual to use drugs and develop an addiction. People with BPD may also have problems with impulse control, increasing their likelihood of drug use.7

How is Bipolar Disorder Linked to Addiction?

The symptoms of bipolar disorder, especially during a manic phase, can make a person more likely to participate in risk-taking behaviors like drug use. Impulsivity and grandiose thinking can create a sense of indestructibility, making a person in recovery more likely to relapse. Bipolar symptoms can also lead a person to self-medicate, which can encourage addiction.

Addiction Treatment with a Dual Diagnosis of BPD or Bipolar Disorder

The presence of a mental illness along with a substance use disorder (SUD) is called a co-occurring diagnosis or a dual diagnosis. In a 2019 survey by the National Survey on Drug Use and Health, 9.5 million adults had both a mental illness and a substance use disorder.8 According to the National Alliance on Mental Illness (NAMI), when an individual experience a dual diagnosis, the best treatments address the substance use disorder and mental illness simultaneously.9 The following are interventions used for dual diagnosis clients.


Drug detox can last anywhere from 24 hours to a week. Through detoxification, toxins from drug use are released from the body. A detox may also include a process that weans a client off a drug through tapering, making the detoxification process more comfortable.

Inpatient or Outpatient Rehabilitation

For both borderline personality disorder and bipolar disorder co-occurring with SUD, a rehabilitation clinic offers a client a safe space to revive their medical and mental health care. With inpatient rehabilitation, a client resides at a rehabilitation facility staffed with trained workers. In an outpatient setting, clients may reside at home or outside of the facility, but they make periodic visits to attend medical and mental treatment sessions.


Psychotherapy and psychosocial interventions are effective treatments for dual diagnosis patients. Cognitive-behavioral therapy (CBT) and other behavioral modification programs help clients to change negative thought patterns and learn coping processes, making them less likely to relapse. Psychosocial therapies and support groups also provide clients with healthy avenues to seek help and maintain sobriety.9

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