bipolar vs. borderline personality disorder? (and does it matter?)

I know some people on here have formal diagnoses of bipolar and borderline personality disorder and that the two are different but can be comorbid.

It seems like some of the traits of BPD could easily describe bipolar. How does one decide one has BPD or not if the traits mostly seem like bipolar traits? I also think maybe it doesn't matter unless it somehow shifts treatment, which it doesn't sound like it does...

Well, it'd not be a decision, but a diagnosis. But I get what you're saying. It'd be a matter of the number of criteria met and the level of problem it causes in one's life, so it wouldn't matter if "most of" the symptoms were bipolar ones. Does that make sense? Doesn't matter which outnumbers the other -- if enough criteria were met -- for one, the other or both, the respective dx(s) would be appropriate.

I DO think it matters, but don't really want to go into the whys atm.
That aside, it's important the treatment works for one's symptoms.

Wel right now I am a happy BP1... Always waiting for the next episode and diagnosis. I am basically what I am at the moment

The borderline behaviors I am thinking of are the kinds of things people are not likely to be open and vocal about, more internal thought patterns. I don't think it's that likely that all doctors diagnose both properly unless it's the features of BPD that are most obvious. Current psychiatry has an interesting article about how BPD and BP get misdiagnosed. Can't figure out how to link to it...

They do get misdiagnosed all the time from what I have read but because it takes a prudent pdoc to know the difference or want to slap one dx over the other. I think on a closers look the two are very different

Very different and very different treatment and medications.

I wrote a school paper on BPD about 18 years ago. I was sure at that time that I had it. I was already diagnosed with depression and social phobia. I received my bipolar DX years later and still felt BPD was playing a role in addition to bipolar. Last time in the hospital, I asked them about it and the doctor said I don't have BPD. My husband who worked in mental health and had many BPD clients said I don't act BPD, yet I still think I have enough traits to probably qualify. I may talk to my current therapist about it. BPD and BP are similar, yet different. I can see how misgiagnosis could happen, but if someone is trained, there are clear differences. BPD Doesn't get week or months long manias do they? Aren't there emotions more fleeting and chaotic? It's been a long time since I wrote that paper so perhaps I'm forgetting some things though. I think having a correct diagnosis is important only if the person plans to educate themselves on the illness. If you plan to educate yourself, you need the proper direction towards resources. Labels aren't important, but knowing what you should read is.

Oh, I absolutely believe I am bipolar. I wonder about having BPD traits - there are certain people I am attached to and fear abandonment from. Not most, but a few. I also find it hard to handle bad/good news and can overreact to rejection and feel humiliated over nothing. I think I am firmly BPI but was wondering about the intersection.

Also, honestly came up because my new therapist and I were talking about one of my students I struggle with and she said she thought this student sounded like she had BPD. I know the student has something in the anxiety/OCD/mood spectrum (and therefore very difficult for me to advise her), but it made me more curious about BPD vs. BP...I never thought this student had BP, but I wonder about how people with the two interact.

Fear of abandonment is the big thing I have (its really severe) and what leads me to believe I have some BPD stuff I need to work on.

About your student, I don't know what to say. Kids often express illness traits a bit differently than adults I hear. I did some very strange things at 15 during what I believe was my first manic episode. If you are concerned with the students behavior, can you discuss it with their parent? I don't believe you are allowed to talk of possible diagnosis, but maybe just mention the behaviors you notice.

I had a friend once who used to set up my fears of abandonment just by saying she was going to leave her husband all the time. My fears would ping everytime she would have an argument with him. Same thing happens if my parents fight and I'm 41 years old and shouldn't still be having this stuff with my parents.

My understanding is that BPD people tend to react intensely to situations around them, change up and down throughout the day. (This has to be exhausting for people)

Whereas BP moods happen without external causes. Although in a mixed episode it may be hard to tell the two apart. Stress can exacerbates BP symptoms tho.

My pdoc explained to me: BPD is triggered, BP just comes along.

Granted a BPD that is triggered may have such a small trigger that it just seems emotions are coming from no-where.

I see my BP when I wake up and I am so bright and bubbly and the day seems glorious and my smile can't be bigger and I want to race to do everything life has to offer. (Or the flip side, my ability to fight for life is missing and I think I am like a cat crawling into a corner when it is about to die - only I don't die, I just wait for my brain to balance itself out and get back to its job of living).

I see my BPD when I am looking for things to be mad at and finding them, adding coals to it, and reacting. I see it when I have anything happen to me, and my response is sudden, mixed emotions that occur from any direction and have no reasonable basis.

I can see that I am able to unravel my BPD emotions. My BP emotions need to ebb on their own.

Oh, this is good. I will add comment along these lines. My BPD emotions have caused me to become obsessive about some men. Stalking, obsessive communicating, constant thoughts.

My BP emotions cause me to feel the natural world around me is communicating with me on a silent level and I have to stop what I am doing and respond psychically back to it.

I am not a cutter - many BPD people are, but it isn't mandatory like pdocs used to believe. I sabotage myself in other ways.

One of the key things with BPD is a persistant pattern of a given trait. For example, let's take fear of abandonment. Being afraid of losing a small number of people over one's lifetime, especially in certain understandable situations, is normal. However....

With BPD, though this fear might not include everyone, it is more extensive in scope. And it is an active fear, in the constantly scanning the horizon for any clues it might happen. These clues may be real or imagined. Perceived slights can be blown way out of proportion. These fears are usually accompanied by certain reactive behavior, such as provoking trouble over them as a means to "test" the person's loyalty*. Thing is, it is the constant "testing" behavior that would drive a person away. (Being constantly tested to "prove" oneself against unfounded threats and slights is exhausting, for starters.)

(It also might take the form of dumping the object of their FOA out of the blue. So much fearing the abandonment, they employ a pre-emptive strike. Very often followed by desperate attempts to reunite. Then break up. Lather, rinse and repeat till the other person can't take it anymore.)

And voilá, they leave, thus providing "proof". Except that it isn't. Nonetheless, this creates a scenario that happens again and again, establishing the pervasive pattern. But the whole premise is wrong. It's NOT the perceived threat that caused it, it is the behavior it produces that does. Is it any surprise this cycle makes for unstable and tempestuous relationships?

(*I often think of this as "throwing wrenches". Everything can be going along fine, and boom! A crisis out of nowhere.)

My therapist told me that some traits of the not otherwise specified flavor of bipolar disorder can mimic those of borderline personality disorder, i.e. more rapidly-changing mood swings.

Has anyone else heard this?

Definitely, it matters. I had both, but with much therapy, got rid of the bpd. I'll have to live with bipolar. Treatment for them is different. I learned to deal with emotions going along with bpd, but once a manic or depressive episode starts, I'm at its mercy.