Borderline personality disorder and bipolar disorder are often confused, as they share some overlap in symptoms. To clarify between the two, here's a breakdown, plus treatment options for both.

Symptoms of borderline personality disorder

Borderline personality disorder (sometimes called BPD) is a particular pattern of extreme personality traits. Unlike many other mental health conditions, personality disorders are usually present in some form throughout a person’s life. Some of the most prominent symptoms of borderline personality disorder usually include the following, though there are also many others:

Intense, often irrational emotions: You might tend to feel things very deeply in a way that is often out of proportion to a situation.
Tumultuous personal relationships: Your relationships with other people might be unstable, and you might experience quick changes from very positive feelings to very negative ones.
Impulsive behavior: You might take actions that are risky, dangerous, or erratic.

Symptoms of bipolar disorder

Bipolar disorder is a mood disorder characterized by extreme moods. These moods include both deep depression and feelings of euphoria that are often known as mania. Bipolar disorder can also involve extreme changes in a person’s energy level or thought processes. Among others, some of the most common symptoms of bipolar disorder include:

Episodes of depression: All people diagnosed with Bipolar Disorder have experienced episodes of clinical major depression.
Episodes of mania: Mania can include variety of symptoms including feeling incredibly happy and excited; feeling so full of energy that you might not need to sleep or eat; impulsive and/or dangerous behavior; and being unable to rest.
Frequent or extreme mood changes: You might find that your mood changes very quickly or from one extreme to the other.

Borderline personality disorder vs. bipolar disorder

Although borderline personality disorder and bipolar disorder share some features, they are very different conditions. Most importantly, bipolar disorder is a mood disorder, which means that it mainly concerns extreme emotional states. In contrast, borderline personality disorder involves patterns of instability in several areas of a personal life, especially relating to one’s behavior and interpersonal relationships.

Borderline personality disorder often involves some symptoms related to mood. However, a diagnosis of bipolar disorder specifically requires that a person has experienced clinical major depression. A person who has never experienced a period of depression might be diagnosed with borderline personality disorder, but that same person would not be diagnosed with bipolar disorder.

Diagnosis for borderline personality disorder and bipolar disorder

Despite their differences, the symptoms overlap enough that in some cases it can be difficult to know whether a person is experiencing borderline personality disorder or bipolar disorder.

A few key features that help mental health practitioners decide on diagnoses for these two disorders include:

Are the symptoms mostly mood-related? If so, then the diagnosis will more likely be bipolar disorder.
Has this person experienced major depression? If the answer to this question is no, then the diagnosis cannot be bipolar disorder.
Does this person tend to have difficult interpersonal relationships? Unstable relationships are very often a sign of borderline personality disorder.
Does this person demonstrate a fear of abandonment? Manipulative, controlling, or clingy behavior toward other people is common in borderline personality disorder, often due to an underlying fear of abandonment.
Have symptoms existed throughout this person’s life? Personality disorders are defined in part by their presence throughout an individual’s life, whereas bipolar disorder may have a clear onset.

Treatment for borderline personality disorder and bipolar disorder

Therapy can be a very helpful treatment for both borderline personality disorder and bipolar disorder. (See more information below on selecting a therapist for one of these disorders.)

Additionally, the following tools may help you manage borderline personality disorder or bipolar disorder:

Medication: Medication, particularly mood stabilizers, is a common choice for managing bipolar disorder. Medication may also be part of treatment for borderline personality disorder. Though most medications come with side effects, a psychiatric professional can help you manage these side effects and find the most effective treatment.
Check-ups: Symptoms that seem like borderline personality disorder or bipolar disorder can sometimes be related to underlying medical conditions. It’s important to stay up-to-date with visits to your primary care physician to rule out related medical conditions.
Mindfulness Practices: Some studies have found that meditation and other mindfulness practices can be a tool for easing symptoms of borderline personality disorder, and they can also help reduce the anxiety that sometimes comes with bipolar disorder.
Hotlines: If you’re having thoughts of suicide or need immediate support, you can always call the National Suicide Prevention Hotline at at 1-800-273-8255. The Substance Abuse and Mental Health Services Administration hotline at 1-800-622-4357 can also help you locate resources and treatment options.

Treatment for borderline personality disorder

Dialectical Behavioral Therapy (DBT) is often considered the best treatment for individuals with borderline personality disorder. For these individuals, several studies have found that DBT can be very effective in improving coping skills, stabilizing mood, improving interpersonal skills, and reducing risk of suicide.

Some other kinds of therapy that you might consider for borderline personality disorder include:

Additionally, you’ll want to make sure that your therapist is qualified to treat borderline personality disorder. This will usually involve:

Advanced education in a field related to mental health, such as psychiatry, psychology, or social work;
Licensure to practice in the state where you live;
Additional training and/or experience in treating borderline personality disorder specifically. Often, this means a certification in practicing DBT.

Treatment for bipolar disorder disorder

Several different kinds of therapy have been shown to be effective for treating bipolar disorder. Most often, psychotherapy is used in combination with medication managed by a psychiatrist.

A few of the most common psychotherapy options for Bipolar Disorder are:

In addition to these therapy approaches, you’ll want to make sure that your therapist is qualified to treat bipolar disorder. This will usually involve:

Advanced education in a field related to mental health, such as psychiatry, psychology, or social work;
Licensure to practice in the state where you live;
Additional training and/or experience in treating bipolar disorder specifically.

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