[Movingon69]

I've seen some of you mention you have both. What's the difference in the two? How does a dr. know to diagnose you with both and not just one?

In the specific case where you have both BP and BPD, then *usually* you need to get the bipolar stable before you get a comorbid BPD diagnosis.

Difference is BPD is emotional based while BP is mood based. There is also fear of abandonment, very specific types of relationship issues (idealizing), black-and-white thinking, etc. with BPD.

If you do have both BP and BPD, you *can* diagnose BPD without getting your BP stable. I think drs just have a more difficult time looking at BPD first rather than looking at BP first, especially when there is a family history of BP or if the mood swings last weeks to months.

The other thing is, if you have "mood swings" that last for a minute to a few hours, then it's much more likely that you BPD than ultra rapid cycling BP ("ultradian"). So dr's look at BPD first instead.

I think the mood swing patterns are what help dr's look at BPD or BP first.

[Movingon69]

Originally Posted by bluebicycle

In the specific case where you have both BP and BPD, then *usually* you need to get the bipolar stable before you get a comorbid BPD diagnosis.

Difference is BPD is emotional based while BP is mood based. There is also fear of abandonment, very specific types of relationship issues (idealizing), black-and-white thinking, etc. with BPD.

If you do have both BP and BPD, you *can* diagnose BPD without getting your BP stable. I think drs just have a more difficult time looking at BPD first rather than looking at BP first, especially when there is a family history of BP or if the mood swings last weeks to months.

The other thing is, if you have "mood swings" that last for a minute to a few hours, then it's much more likely that you BPD than ultra rapid cycling BP ("ultradian"). So dr's look at BPD first instead.

I think the mood swing patterns are what help dr's look at BPD or BP first.

That's very helpful. Thanks!

[*Laurie*]

BD and BPD can look similar on the surface. Look a tiny bit more deeply and they are so different. The important thing to remember is the pattern of behavior. I'm not a medical professional, but I have a lot of experience in working with people with mental illness. Something I notice that tends to be outstanding with BPD is the extreme self-hate and self-harming behaviors. Also the "love turns to hate on a dime" behavior. So, the actual sense of Self is very disregulated.


With BD the moods change, but the sense of self remains relatively consistent. Hard to explain...that's why it takes a psychiatrist or therapist to diagnose.

Here's a somewhat helpful article:
https://www.medicaldaily.com/bipolar...w-avoid-335314

I was diagnosed with bipolar first while manic based on my history.

I got the BPD diagnosis added in hospital based on my behaviors mostly I believe. The doctor originally changed the diagnosis from bipolar to BPD, but when she took my bipolar meds away I went manic and she said I had both.

My therapist tells me they overlap a lot and it's not always easy to distinguish.

Originally Posted by *Laurie*

BD and BPD can look similar on the surface. Look a tiny bit more deeply and they are so different.

I couldn't possible agree more.

Relationships, time frames and triggers are very telling. Relationships especially are a gold mine of information. (Idealization/devaluation, love/hate on a dime, sometimes extreme behavior to avoid real or imagined abandonment etc.)

Another thing I would say is emotions vs energy. Widely varying sustained energy levels are defining for BP, which is something missing from BPD.

[HALLIEBETH87]

i dont have ALL bpd symptoms but enough to get the dx as well as bp 1/schizoaffective (whichever my dr decides.)

i get the abadonment, black and white thinking, unstable sense of self, self harming, hx of trauma

[Movingon69]

Thank you all for your responses. That help with some clarity