So Really, What is the Difference?

...between bipolar disorder and borderline personality disorder?

First off, I'm seeing a HUGE spike in the number of people being dx'ed as BD. Many of those people, it seems to me, have behavior that seems more like BPD than BD...or, especially if they're young, seem pretty much human...just *normally neurotic* to me.

I'm almost 56. So when I was initially dx'ed with "manic-depression" I was quite surprised. Most people (not all, but most) dx'ed with BD were very obviously mentally ill. As in...I knew a guy with manic-depression who used to go into a local bookstore, jump up on the counter, and start dancing. He'd get kicked out, would disappear for a while, then return a month or 2 later. I believe that my father had BD, but even he had extreme ups and severe downs. As in, at either pole his life would fall apart. Repeatedly. (He was not, however, a substance user.)


Nowadays Facebook has about 150 groups for people with BD. I have suggested to my therapist that I might have BPD more than BD. She looked at me like I had a green face and said, "Oh...no...I've never even thought that, at all..." But I'm not sure I agree. My mood is constantly edgy, irritable, frustrated with people, feeling that people reject me - or will. I'm not crazy-worried about them leaving me, but it doesn't exactly feel good to be dropped, either. My feelings are extremely intense...I feel every little thing VERY strongly. Music is AMAZING! Leaves fluttering are INCREDIBLE! I am fearful of going to bookstores or art museums because so many words and images and colors and feelings make me cry.

And I am extremely self-protective. To the point at which I will fight like a tiger and reject people to avoid being misunderstood and hurt yet AGAIN.


I'd love to hear some direct experience with regard to my question. I know what the DSMIV says. I'd like to hear what people here have to share.

I have a few “ traits “ of BPD abandonment is my major one and also I don’t want to “ bother” anyone to the point I make myself physically sick.

Everyone with BP will have some it’s just the nature of the BP beast.

I feel all my feelings intensely but I just don’t meet the criteria for BPD according to both my T and Pdoc

I internalize most everything so I don’t lash out etc.

My psychiatrist 17 years ago said some of my behaviors mimics traits of BPD but it’s a state when I’m unstable not a true trait. Basically they go away when I’m stable on meds. Also they weren’t there in my childhood. I think they need to also be traits that severely interfere with daily functioning and interactions. Like bipolar moods. It’s normal for everyone to experience a range of emotion but it’s when it’s episode last a length of time that their bipolar -length of time and intensity.

I think and I don’t know this for sure but I think Borderline PD is harder to treat. I remember seeing article online somewhere I’ll copy and past if I find it.

For increased diagnosing I’m not sure it’s an increase rather than better outreach
And visibility via the internet. Better diagnosing too maybe. Increase in population size. Younger adults getting diagnosed as early as their first episode is a good thing I think doctors are more aware of the signs. It took a psychotic break and suicide attempt for me to get diagnosed at 22. If they had caught my mood swings even earlier (they prob started around 18) it could have been prevented-and my intense mood swings were def there and interfering with life. I read an article yesterday that said bipolar patients usually present symptoms 20 years before their diagnosed properly. That’s a decade of lost life and damage to friends and family.

Good questions and lots to think about.
-Louise

I want to also throw this out there. I’m super depressed and am having a really bad episode. I reach out to found like this on my worst days so I can get a need filled. Some bipolar people on here if your seeing behaviors that look like BPD could be because their Sick and can’t think outside of themselves right now. More of s BPD state than trait. —hypotheses.

i've been diagnosed with a bunch of things and i'm honestly not sure which are accurate and which aren't. i end up reading this sub-forum the most because i relate the most here. i'm not sure when it comes to myself personally re bpd vs bp, but i have a couple of friends diagnosed with bipolar, and from my perspective i don't see the slower shifts between manic/depressed, but hourly/daily shifts that often seem triggered by interpersonal things. i think i read somewhere that with BPD, mood swings will always have a trigger, whereas with bipolar, it's not always a case of something sad happening triggering a major depression.

i sometimes (cynically) think that my friends present a different picture to their drs than they do at home. like, watching them is like watching a very clear picture of "i hate you, don't leave me". i think that there is more stigma about bpd than bp - among my friends, borderline seems to have the implications that you are always unstable, manipulative and unpredictable. bipolar has the implications that you are a victim of your brain chemistry.

obviously i'm not a dr, psychologist, or expert on anything, but in my circle of friends i think bipolar is a more "acceptable" diagnosis, because it implies that even when you're doing all you can to control your illness, you can still get really sick. "borderline" around here seems to imply that your illness is more about acting out.

You bring up a good point I don’t know if it’s a distinguishing factor, BPD may also go into a mood without a trigger but I know with that issue I tried describing it to my doctor once as my brain logically knows I should be happy nothing bad happened and idk love my life but at the same time I feel empty-hollowed out, deep deep waves of sadness and even though logic tells me my life is good I’m ambivalent to it because of being depressed. There was no trigger. I have changed from hypomanic to Miley depressed from trigger moving to a new town, an exciting trip that blew me too high. But man did this episode come out of no where withno reason. I guess it’s not black and white because for me at least sometimes there’s s trigger and sometimes not.

I definitely do not experience the BPD classic "I hate you/Don't leave me". In fact, I tend toward "Please just leave me alone".
It's the extreme moods and emotions that I wonder about. I don't seem to have any control over my emotional reactions, to the point at which I am exhausted and even feel flu-like from the roller coaster I'm on.

Anyway, I'd love to hear more on this subject if anyone would like to share.

Doesn't have to do with BP, but I wonder too, how does adult ADHD/ADD differ from BP, particularly mixed or even hypomanic, manic, heck depression too?

New pdoc tacked it onto my diagnosis, but at that point, my reading had suffered quite a lot (most likely from meds I'm thinking, maybe even just stress & the aftermath of a large surgery). Adderall does help me read, but the ADHD diagnosis? Who knows?

I’m not sure about all adhd patients but my brother and also a friend of mine an older mom have it. Neither of them have mood swings but both get really bad anxiety and panic. My brothers super smart but can’t sit in a classroom and can read 4 thick books at s time but switches back and forth till he’s finished them all. —observations though who knows if my friends secretly on a mood stabilizer.

I am diagnosed with both. I experience severe depression that can last years. I also experience mania in that I all but stop sleeping, bounce off the walls and talk at an insane rate. I feel invincible. They are very distinct states that last a while.

Borderline causes me to flip emotions really fast. So I can be having the most amazing day ever and then be in the depths of dispair. I feel everything intensely. Every hurt is like being stabbed in the chest, happiness feels like the best day in the world and rage makes me homicidal. I think in black and white. Things are either good or bad. You're my friend or your not. I like it or I dont. I dont understand grey areas. I can be very manipulative and antagonistic. I fear abandonment and alternate between pushing people away and pulling them close. I get extremely paranoid and I also dissociate to where I feel like I'm watching myself. I'm extremely impulsive and react without thinking. I will decide something is a great idea based on my current emotion and do it.

Some of the overlaps with bipolar include self harm and suicidal ideation. The emotional instability is more rapid fire with BPD. So for me personally I'll get severe depression, but have moments where I feel amazing. I also find that medication helps manage bipolar. It got rid of my depression. But it doesnt do a lot for borderline.

The last time I was hospitalized the psychiatrist said I had borderline not bipolar. She put me on zoloft and I went hypomanic pretty much right away. I cant do antidepressants without a mood stabilizer. When she saw that she agreed with the bipolar diagnosis and added borderline as well.

Sorry for the novel. Hopefully some if it is of value.

yeah thats a really good description of what you go through. Love the novel, I like hearing others stories to distract from my own.

A very interesting and helpful comment, KisstheRain. Thank you.

Don't want to derail the initial post topic, but I will say that I mentioned my attention and memory problems to my pdoc and he asked me if it was continuous or fluctuated with my moods/anxiety. He also asked if I had it since I was a child. Mine fluctuate with my moods, and it wasn't as bad when I was a child so he doesn't think I have ADHD. That being said, I was a really spacey kid, so not sure. I took Adderall in the past although never got an official diagnosis of ADHD. It also helped my concentration and mood to a point, but left me irritable. Anyways, that might possibly be a way to help differentiate.

There is definitely some overlap clinically but I think it's pretty clean-cut diagnostically. There was a time when I questioned my BD diagnosis a lot, and at one point was insisting it was BPD even though that didn't make a lot of sense. My therapist laughed a lot when I told her, and said no, not at all. Doctor said the same. Said everyone is a little bit axis 2 sometimes, but that it was not what was going on. In hindsight my goal of telling them that and insisting was because I didn't want to be on/need medication.

Interesting. Thank you very much for sharing that. They have denied my assertion that perhaps I have BPD, too. Then they ask me about my "manias", my "depressions", my "episodes"....I keep thinking why? Why don't they just tell me that I really do have BPD? I don't know. Maybe I am truly terrified of having bipolar disorder. I read yesterday that the highest risk of sui is among people with BD. Also, that people with BD have a 10 to 20 year shorter life span than people with other MI's. Part of me doesn't care about that, except I am afraid of leaving my cats.

I'm frightened. I've become so reclusive. I'm getting more and more weird. Really tired of "hiding" who I am and feeling like letting my strange just hang out. So it's there; I'm there. Yes: it's me, it's who I am. So what. Go away. Leave me alone. Let me be.

I like KissTheRain’s explanation. It fits in with what I’ve been told.
I have a friend who has borderline PD and some things are very obvious. She has the ‘I hate you, l love you’ thing. She is also frequently suicidal but it’s often manupulative. The police are involved etc and it’s really messy. I’m not saying others are like this but my friend is.
I used to wonder if she also has bipolar and if I also have borderline PD. But I’ve known her for decades and I would say my diagnosis is accurate as is hers.

I have a friend similarly afflicted. At first, she had seemed bipolar; yet, with time, it was clear she was suffering with BPD. She really does suffer with BPD.
(She is learning how to suffer less with 2 times of going through prolonged IOP (mindfulness and other skills).

I think the two conditions are different from each other.
It is possible to deal with BP without having any BPD traits. I have zero BPD traits, for instance. It's also possible to have both concomitantly.

Great topic!


WC

Well, it's true that the people I've known or been close to who had BPD...whew...yes, it was very obvious. The most unfortunate thing I've noticed about those with BPD is that they are in such tormenting pain, but usually refused professional help - or refused, even, to attend a peer support group. The emotional regulation required to sustain any type of relationship is usually painfully elusive for those with BPD.

I worked with someone who had BPD and KisstheRain explained her perfectly. Thank you!

I do not believe that those with Bipolar Disorder automatically have some BPD traits. I think you can have both, but you can also have BP without Axis II features.

I'm glad my novel helped a little. I've been in DBT therapy for a year. I swear every time I bring up an area of concern, my psychologist tells me that's a borderline behavior. I've had to get reassurance that there is a person beyond BPD. A psychiatrist also told me I'm a textbook case of bipolar, as in my picture could be next to bipolar in the dictionary.

I suppose if you are going to do something, you may as well do it well.

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It actually is helpful because it means I have an opportunity to fix it. Shes right too, I look it up after the session and there are many things I do that are characteristic of borderlines. My whole life I had no idea that my thoughts and emotions were different from others. I never understood why I didnt fit in. Now that I'm learning to know myself, I'm learning to love myself.

Thanks for sharing what it's like for you. Your experiences sound really hard and I hope the DBT is helping you

Okay, I understand what you mean. So it sounds like her honesty helps you to be aware of what's happening with you. That you never knew your thoughts and emotions were different from others, but feeling like you didn't fit in...that sounds extremely confusing and painful. You truly deserve so much credit for reaching out for help, and for accepting it. That is HUGE!!

I was diagnosed with ADD, inattentive type ten years after my BP diagnosis. It's made a huge difference -- I take Adderall and it helps me focus and read and according to my doctor, the Adderall is also good for the depression I deal with.