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Borderline Personality Disorder vs. Bipolar Disorder

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Borderline personality and bipolar: These two disorders are often confused. They both have symptoms of impulsiveness and mood swings. But they are different disorders and have different treatments.

Bipolar Disorder

Also known as manic depression, bipolar disorder causes swings in mood, energy, and the ability to function throughout the day.

Symptoms: Bipolar disorder is known for alternating periods of depression and mania that can last from days to months. During "a mixed state," symptoms of depression and mania happen at the same time.

During times of mania, symptoms might include:

  • A happy mood or an angry, irritated mood
  • More physical and mental energy and activity than normal
  • Racing thoughts and ideas
  • Talking more and faster
  • Making big plans
  • Risk taking
  • Impulsiveness (substance abuse, sex, spending, etc.)
  • Less sleep, but no feeling of being tired

During periods of depression, symptoms might include:

  • Drop in energy
  • Lasting sadness
  • Less activity and energy
  • Restlessness and irritability
  • Problems concentrating and making decisions
  • Worry and anxiety
  • No interest in favorite activities
  • Feelings of guilt and hopelessness; suicidal thoughts
  • Change in appetite or sleep patterns

Treatment: Most people with bipolar disorder need lifelong treatment to keep their condition managed. This usually includes medicine -- usually mood stabilizers, and sometimes also antipsychotics or antidepressants. Therapy can also help people with bipolar disorder understand it and develop skills to handle it.

Borderline Personality Disorder

Borderline personality disorder is a longstanding pattern of swings -- in moods, relationships, self-image, and behavior. People with borderline personality disorder have very strong emotions and often try to hurt themselves, and may have problems with relationships with people.

People with borderline personality disorder are more likely to have other mental health problems, too. They are also more likely to have had some type of trauma as a child than people with bipolar disorder.

Symptoms: A person with borderline personality disorder has trouble controlling his thoughts and feelings, and often has impulsive and reckless behavior. Here are the condition's main symptoms: 

  • Frantic efforts to avoid feeling abandoned
  • History of unstable, intense relationships
  • Poor self-image
  • Impulsiveness (spending, sex, substance abuse, etc.)
  • Self-harm (e.g., cutting) or suicidal behavior
  • Mood swings usually because of stressful events or relationships
  • Feelings of emptiness
  • Problems with anger
  • Paranoia

Treatment: Lifelong treatment is necessary for people with borderline personality disorder.  Treatment usually includes medication to control impulses, aggression, and mood swings. Psychotherapy can help people manage impulses and reactions to stress. Sometimes, short hospital stays are also needed to manage times of crisis.

WebMD Medical Reference

Reviewed by Joseph Goldberg, MD on June 11, 2014

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