Bipolar Disorder vs. Borderline Personality Disorder

Bipolar disorder and borderline personality disorder (BPD) are two serious mental disorders. Although they are distinct, they share many symptoms, leading to confusion between the two and oftentimes misdiagnosis. Because they are two completely different conditions, each disorder requires a different form of treatment. Diagnosing either of these disorders can be difficult, especially considering these two disorders are often accompanied by shared symptoms like anxiety or depression. Here’s what you need to know about the differences between bipolar disorder and BPD.

Bipolar Disorder

Bipolar disorder is a mood disorder defined by extreme highs and lows, which can also rapidly shift. The highs are referred to as  manic episodes, during which the individual feels euphoria, high energy, increased irritation and aggression. The lows, referred to as depressive episodes, make individuals feel extreme depression and fatigue.

Borderline Personality Disorder

Individuals with borderline personality disorder have difficulty regulating their emotions, which leads to mood swings, impulsiveness, and unstable personal relationships. Individuals with BPD tend to have low self-esteem, which can manifest as self-harm and suicidal behavior.

The Differences

A big difference between BPD and bipolar disorder is that individuals with bipolar experience interruptions in their mood swings in which they can experience regular, mid-range moods. While with BPD, individuals feel a constant state of unstable mood. The causes of each disorder also help differentiate them. Bipolar disorder is a mood disorder, connected in chemical imbalances in the brain. Research has indicated that genetics plays a major role in the development of bipolar disorder. Borderline personality disorder is typically due to invalidating experiences during childhood, such as abandonment, which creates a warped belief system that leads to unstable emotions.

Looking at personal relationships can also help highlight the difference between the two disorders. Bipolar symptoms typically appear out of nowhere, whereas personality disorder symptoms are triggered by conflict within relationships. Essentially, BPD symptoms are triggered by periods of interpersonal stress, whereas bipolar disorder symptoms seem to have no obvious trigger and are random.

Causes and Treatment

The causes and treatments differ depending on which disorder the individual has. It’s important to get the proper diagnosis, as a misdiagnosis could lead to a treatment plan that actually makes things worse.

Bipolar disorder is usually treated with a combination of three types of medication: mood stabilizers, antipsychotics, and antidepressants, although the latter is rather controversial because in some cases it can bipolar symptoms worse. Psychotherapy by a professional psychiatrist or mental health counselor is often recommended to accompany the medication. Doctors aren’t entirely sure what causes bipolar disorder but they believe biological factors may create physical changes in the brain. Genetics are also thought to play a role, as a family history of bipolar means an individual is at greater risk of developing it.

Borderline personality disorder is treated differently. It is mainly treated with psychotherapy, specifically dialectical behavioral therapy (DBT), which was specifically created to treat this condition. Medications may be used for certain symptoms, like depression or anxiety, but the focus is on therapy. Like bipolar disorder, doctors don’t have an exact cause of BPD. Most believe that genetic and environmental influences play a role. Traumatic childhood events, loss, neglect, or bullying may also contribute.


Understanding the differences between these two similar disorders can help reduce the chances of misdiagnosis and improper treatment. To learn more about bipolar disorder and BPD feel free to contact us. If you or someone you know believes they have one of these disorders, or that there has been a misdiagnosis, you can contact us.


Dr. Raul J. Rodriguez

Dr. Raul Rodriguez


Existing patients, please text 561-409-7296 for follow-up appointment requests or if you have medication concerns please text 561-409-7296.