Borderline Personality Disorder (BPD) vs Bipolar Disorder
April 13, 2021 | Farah Jassawalla

Borderline Personality Disorder (BPD) vs Bipolar Disorder

Borderline personality disorder and bipolar disorder are two mental health conditions that are often misdiagnosed. And the reason why they’re often misdiagnosed is that both involve symptoms of sudden and intense emotional responses, depression and impulsive behavior.

However, there lies a significant difference between them in terms of the type of mental disorder, symptoms, and treatment options.

Borderline personality disorder (BPD)

Borderline personality disorder (BPD) is a personality disorder marked by a sense of alienation from people; not being able to relate to them or perceive social situations appropriately. People suffering from BPD are unable to meet behavioral social expectations, resulting in severe personal and interpersonal conflicts.

Bipolar Disorder

Bipolar disorder is a mood disorder. As the name suggests, it is about functioning across two opposite poles. Sometimes you’re high on energy, and everything appears rosy, even when things are bad. Other times, you get stuck with depression even when everything appears to be fine. People with bipolar disorder have serious changes in mood (mood swings).

Prevalence in the United States

Borderline personality disorder grips around 1.4 percent of adults in the United States, as reported by the National Institute of Mental Health. While bipolar disorder is relatively common and affects about 2.6 percent of the U.S population.

Diagnosing Borderline Personality Disorder (BPD) and Bipolar Disorder

Both mental health conditions are challenging to diagnose. Multiple medical and psychological questionnaires related to the severity and duration of symptoms are required to rule out other closely related mental disorders. 

For diagnosing BPD, a mental health professional conducts a comprehensive clinical interview with the patient, consults with previous healthcare professionals, and interviews the patient’s family, friends, and relatives too.

To diagnose bipolar disorder, you are asked to keep a track of your daily mood swings, differing energy levels, and changing sleep patterns. Its diagnosis is further categorized as bipolar I and bipolar II disorder.

Bipolar I disorder is when you have one classic episode of mania, lasting for about 7 days. Bipolar II disorder is characterized by one major depressive episode, in addition to an episode of hypomania.

Symptoms of Borderline Personality Disorder (BPD) and Bipolar Disorder

Here, we review the difference between the symptoms of Borderline Personality Disorder (BPD) and Bipolar Disorder.

Symptoms of Borderline Personality Disorder include:

Frantic attempts to avoid feelings of abandonment

Unstable relationships

Being sarcastic and bitter

Tendency to view the world as white or black

Poor self-image

Impulsiveness (spending, sex, substance abuse, etc.)

Self-harm (e.g., cutting) or suicidal behavior

Wide mood swings involving anger and depression, lasting from a few hours to days

Feeling empty inside

Being unable to cope with unpleasant emotions


For bipolar disorder, symptoms during the mania phase of the cycle include:

An excessively happy or angry mood (nothing in-between)

Reduced need for sleep

High physical and mental energy 

Fast-paced thoughts and ideas

Growing more talkative than usual

Making unrealistic plans

Impulsive behavior (substance abuse, sex, spending, etc.)

Poor judgment

Taking risks like never before

Symptoms during the depressive phase of the cycle include:

A sudden drop in energy

Insomnia or hypersomnia

Prolonged sadness

Less activity and energy

Restlessness and irritability


Being unable to concentrate

Poor decision-making

Loss of interest in life

Feelings of guilt and hopelessness

Suicidal thoughts

Loss of appetite

Treatment for Borderline Personality Disorder (BPD)

Psychotherapy (primary treatment option)

Dialectical behavior therapy (DBT) in combination with individual therapy and group therapy to develop mindfulness

Cognitive-behavioral therapy (CBT) to break false perceptions of reality

Transference-focused psychotherapy (TFP) for controlling self-harm urges

Mentalization-Based Therapy (MBT)

There are no FDA-approved medications for BPD. However, some drugs are used to manage symptoms of anxiety, depression, impulsive urges, and substance cravings. You can find suitable medication from Shifa4U online. 

Treatment for Bipolar disorder

Medications like mood stabilizers or antipsychotics


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Farah Jassawalla

Farah Jassawalla is a graduate of the Lahore School of Economics. She is also a writer, and healthcare enthusiast, having closely observed case studies while working with Lahore's thriving general physicians at their clinics.