I agree with Ultramar.

I have no training on the issue but I have been in hospital time and time again with BPD patients and have quite a few BPD real life friends. These are just my observations so please dont take offence.

Their mood swings are so different to mine (Im diagnosed BPII) and they seem to go ape **** at the smallest little trigger, then calm down, then its onto the next crisis. They were constantly in crisis, there is constantly drama in their lives. There was always a trigger even though they swore black and blue it was just a mood disruption, but from the outside we could see it clearly. Meds doped them up but had little effect on keeping their moods stable. Their thought patterns were so ingrained that they would swing though the meds.

Many of my BPD friends are now living productive happy, unmedicated, lives after being treated with DBT, CBT and group therapy. Some fought their diagnosis swearing it was bipolar and "they had no control" but in the end they came to realise the doctors were correct and they did infact have a lot of control over their extreme emotions and reactions to things. Now they have accepted that and threw themselves into therapy, some dont even meet the BPD criteria anymore.

Thats not to say bipolar patients dont have control, I think they definitely do have some control over the degree of which the moods escalate. There are sometimes triggers for BP moods but not always. I really do think with the right coping stratagies and therapies I can control the extent of my moods - but I cannot just wake up out of a depression because things are suddenly going my way - as many of my BPD friends did.

Im not in the US and I know of no insurance issue with diagnosis here but the BPD's still fight it. Every time I go to hospital I see it again and again, telling everyone they must have bipolar and the docs are wrong... Im not sure why they would prefer to have BP. I havent met a single person "cured" of BP but I know of a few "cured" BPD people.