Addiction Recovery - Dual Diagnosis

Borderline vs Bipolar: The Key Differences Between Borderline Personality and Bipolar Disorder

Is there a difference between borderline and bipolar? Our blog examines why borderline personality disorder and bipolar disorder are different.

Borderline vs Bipolar: Do You Know the Differences Between Them?

Table of contents

Written by

Brian MooreBrian Moore

Content Writer

Reviewed by

Jeremy ArztJeremy Arzt

Chief Clinical Officer

October 24, 2023

The Forge Recovery Center

In mental health, borderline personality disorder (BPD) and bipolar disorder may appear to be similar but very distinct. It can be challenging to fully understand these conditions, affecting different people differently.

There’s huge differences between these two treatable conditions.

People with BPD frequently experience powerful and unpredictable emotions. Relationships may be difficult for them, and they may worry excessively about others abandoning them. These strong emotions can force individuals to act impulsively or even harm themselves.

On the other hand, bipolar disorder is different. Everything revolves around mood changes. Bipolar disorder patients have moments of intense sadness (depression) and other times when they feel extremely triggered or irritated (mania). It's like an emotional rollercoaster that never stops going up and down.

Borderline vs Bipolar: Key Differences 

Although bipolar disorder and borderline personality disorder are separate mental health conditions, they can have similar mood instability. The main variations are as follows:

Borderline vs Bipolar: Mood Swings

Mood swings are fast and intense in people with borderline personality disorder, usually occurring within hours or minutes. These mood swings are frequently brought on by external factors or interpersonal issues.

Bipolar disorder involves more prolonged mood phases. People with bipolar disorder go through distinct periods of mania (strong mood, excessive activity) and depression (severe sadness) that can last for days, weeks, or even months.

Borderline vs Bipolar: The Pattern of Mood Swings

The mood shifts in BPD tend to be reactive and strongly related to certain occasions or social pressures. For instance, a person with BPD could experience severe anger following a perceived rejection.

Bipolar mood swings often follow a cyclical pattern without a direct external trigger. Manic or hypomanic (a lesser kind of mania) phases are unique and are followed by depressed episodes.

Borderline vs Bipolar: Sense of Self and Relationships

People with BPD frequently struggle with self-worth and have insecure self-identities. Additionally, their relationships are unstable and unpredictable, marked by idealization (viewing someone as ideal) and devaluation (seeing someone as useless).

While people with bipolar disorder may experience changes in self-esteem during manic and depressive episodes, it is not typically characterized by intense identity disturbances and rapidly shifting views of others seen in BPD.

Borderline vs Bipolar: Impulsivity and Self-Harm

BPD is more frequently linked to impulsivity, self-harming activities (such as cutting or burning), and suicidal thoughts, particularly in emotional distress.

Self-harming actions are not a distinguishing characteristic of bipolar disorder, even though impulsivity can happen during manic episodes. Depressive episodes are more strongly associated with suicidal thoughts or behaviors.

Borderline vs Bipolar: What is Borderline Personality Disorder?

Borderline Personality Disorder, or BPD, is a mental health disorder characterized by constant emotional instability, impulsivity, unstable self-image, and difficulty connecting with others. People with BPD often experience powerful, rapidly changing emotions, behave impulsively, and intensely fear abandonment. These symptoms have the potential to severely interfere with everyday life and make it challenging to maintain healthy relationships and a sense of self.

Mental health experts commonly diagnose and treat BPD, and several therapy approaches, including Dialectical Behavior Therapy (DBT) and medication, may be used to control its symptoms while improving general well-being.

Borderline Personality Disorder Symptoms

Various signs of borderline personality disorder generally appear in early adulthood. They can have a big influence on a person's life. The following list of signs and symptoms of borderline personality disorder includes:

Strong and Unstable Feelings

Extreme shifts in mood from elation to depression, anger, or anxiety are typical of someone with borderline personality disorder (BPD).

Fear of Being Neglected

BPD is characterized by a chronic fear of abandonment or rejection. Desperate actions to prevent actual or imagined abandonment may result from this fear.


People with BPD may act impulsively and engage in unsafe sexual activities, excessive spending, or reckless driving. These behaviors frequently take place without consideration for their effects.

Unstable Relationships

Relationships with those with BPD tend to be unstable and unpredictable, marked by idealization and devaluation of others. They could struggle to sustain strong and wholesome ties.

Negative Self-Image

BPD patients may struggle with having a clear sense of who they are. They could battle with emptiness and tend to believe that they are naturally terrible or imperfect.

Self-Harming Behaviors

As a coping mechanism for emotional distress, some individuals with BPD turn to self-harming activities like cutting or burning themselves.

Chronic Feelings of Emptiness

A deep emotion of inner emptiness or nothingness is typical among BPD sufferers. They can have a sense of loss in their life.


Dissociation, or the sensation of being cut off from oneself or reality, is a symptom experienced by certain BPD patients. This may seem like a disassociation from one's ideas, feelings, or environment.

Angry Outbursts

In BPD, intense anger and trouble regulating it are common, sometimes brought on by feelings of abandonment or rejection.

Suicidal Ideation or Attempts

Particularly during emotional upheaval, people with BPD may struggle with suicidal thoughts or engage in self-destructive activities.

Paranoia or Brief Psychotic Episodes

When under great stress, people with BPD may occasionally go through periods of paranoia or temporary psychotic symptoms.

What Causes Borderline Personality Disorder?

Although the precise cause of borderline personality disorder is unknown, it is most likely due to a combination of genetic, environmental, and neurological variables. In the process of figuring out the causes of BPD, researchers have made progress. The following are some variables considered to contribute to the development of BPD:

Genetic Factors

Evidence supports the idea that BPD could have a genetic component. People with a history of the condition may be at a higher risk because it tends to run in families. However, specific genes firmly linked to BPD have yet to be discovered.

Brain Abnormalities

Studies on the brain's structure and function, particularly in regions associated with emotion regulation and impulse control, using neurological and brain imaging techniques have suggested that patients with BPD may have variations in these aspects. These variations might factor in the emotional instability and impulsivity associated with BPD.

Environmental Components

Environmental variables and events from early life are believed to have a key role in the emergence of BPD. These elements might consist of:

Childhood Trauma

Childhood trauma, such as physical, sexual, or emotional abuse, neglect, or other traumatic events, might raise one's chance of developing BPD.

Invalidating Environment

BPD might emerge due to a person's upbringing in a setting where their emotional experiences and emotions are routinely discounted or rejected.

Unstable Family Life

Risk factors can also include instability or unpredictability in the home environment throughout a child's formative years.

Genetic Susceptibility

Some people may be more vulnerable to environmental stresses due to a genetic tendency, which raises their likelihood of developing BPD in reaction to negative events.

Neurobiological Factors

BPD is believed to be influenced by abnormalities in the brain's chemical messengers and how its emotional control circuitry functions.

Temperamental Factors

Certain personality traits, such as impulsivity and emotional sensitivity, may make individuals more susceptible to BPD when combined with other risk factors.

CTA background

We’re here to help you find your way

Would you like more information about borderline vs bipolar? Reach out today.

Borderline Personality Disorder Test

Typically, mental health professionals use a clinical examination to formally diagnose Borderline Personality Disorder. Although there isn't a single, conclusive test for BPD like a blood test, there are tools and questionnaires that may be used by both patients and therapists to determine the possibility of BPD.

These resources can be a jumping-off point for conversations with mental health experts. Still, they shouldn't be utilized for self-diagnosis. Go for a thorough evaluation from an experienced therapist or a psychiatrist for a proper diagnosis and appropriate treatment.

Medication for Borderline Personality Disorder

Medications can be utilized for managing specific symptoms of Borderline Personality Disorder, such as depression, anxiety, or mood swings, which frequently co-occur with BPD but are not typically the first line of treatment for BPD. A psychiatrist may recommend antidepressants, mood stabilizers, and antipsychotic medications to help stabilize mood and ease certain BPD-related symptoms.

However, medication is frequently paired with psychotherapy, particularly Dialectical Behavior Therapy, the gold standard treatment for BPD. The person's particular symptoms and requirements should be considered while making medication decisions.

How is Borderline Personality Disorder Treated?

Borderline Personality Disorder (BPD) is a mental health condition that affects approximately 1.6% of adults in the United States. It can be challenging to treat because it often coexists with other mental health disorders, such as depression and anxiety.

There are currently no specific medications approved by the FDA for the treatment of BPD. However, there are various types of treatment that have shown to be beneficial in managing the symptoms and improving overall quality of life for individuals with BPD.


Therapy is a crucial component of BPD treatment, as it can help individuals learn how to cope with their emotions and manage impulsive behaviors. Two types of therapy that have shown to be effective for BPD are:

Dialectical Behavior Therapy (DBT)

DBT is a type of therapy that combines elements of cognitive-behavioral therapy and mindfulness techniques. It focuses on teaching individuals how to regulate their emotions, improve relationships, and develop coping skills for dealing with intense emotions.

Mentalization-Based Therapy (MBT)

MBT helps individuals with BPD develop the ability to understand their own and others' thoughts and feelings. This therapy focuses on improving social relationships and communication skills.


While there are no medications specifically for BPD, certain types of medication can be helpful in managing specific symptoms that often coexist with BPD, such as depression, anxiety, and impulsivity. Some commonly prescribed medications for individuals with BPD include:


Antidepressants can help improve mood, reduce impulsivity, and regulate emotions in individuals with BPD. Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) are commonly prescribed for BPD.


Antipsychotic medications can be used to manage symptoms such as hallucinations, paranoia, and disordered thinking in individuals with BPD.


Self-care is an essential aspect of managing BPD. It involves taking care of one's physical, emotional, and mental well-being. Some self-care practices that may be beneficial for individuals with BPD include:


Regular physical activity can help reduce stress, improve mood, and regulate emotions in individuals with BPD.

Mindfulness and relaxation techniques

Practicing mindfulness and relaxation techniques such as meditation, deep breathing, or yoga can help individuals with BPD manage intense emotions.

In conclusion, while there is no specific cure for Borderline Personality Disorder, a combination of therapy, medication, and self-care practices can help individuals manage symptoms and improve their overall quality of life. It is essential to work with a mental health professional to develop an individualized treatment plan that addresses the unique needs and challenges of each person with BPD.

CTA background

We’re here to help you find your way

Do you have more questions about borderline vs bipolar? Reach out.

How is Bipolar Disorder Treated?

Bipolar Disorder is a mental health condition that affects approximately 2.8% of adults in the United States. It is characterized by extreme mood swings, ranging from manic episodes of high energy and euphoria to depressive episodes of low mood and energy.

Like BPD, there is no specific medication approved by the FDA for the treatment of Bipolar Disorder. However, several types of treatment have shown to be effective in managing symptoms and improving overall functioning. These include:


Medication is a crucial component of Bipolar Disorder treatment, as it can help stabilize mood and reduce the frequency and severity of mood episodes. Some commonly prescribed medications for Bipolar Disorder include:

Mood stabilizers

Mood stabilizers such as lithium, valproate, and carbamazepine are commonly used to prevent mood swings and stabilize the individual's overall mood.


Antipsychotic medications can also be used to manage symptoms such as hallucinations and delusions in individuals with Bipolar Disorder.


Therapy is an essential part of treating Bipolar Disorder, as it can help individuals understand their condition and learn how to manage their symptoms effectively. Some types of therapy that have shown to be beneficial for Bipolar Disorder include:

Cognitive Behavioral Therapy (CBT)

CBT focuses on identifying and changing negative thought patterns and behaviors that contribute to mood swings in individuals with Bipolar Disorder.

Interpersonal and Social Rhythm Therapy (IPSRT)

IPSRT helps individuals with Bipolar Disorder establish and maintain a regular daily routine, which can help stabilize moods and prevent relapse.


Self-care practices are also crucial in managing Bipolar Disorder. They involve taking care of one's physical, emotional, and mental well-being. Some self-care practices that may be beneficial for individuals with Bipolar Disorder include:

Sleep hygiene

Maintaining a regular sleep schedule and practicing good sleep habits can help regulate moods in individuals with Bipolar Disorder.

Stress management

Learning how to manage stress effectively can help reduce the risk of mood episodes in individuals with Bipolar Disorder.

In conclusion, while there is no cure for Bipolar Disorder, a combination of medication, therapy, and self-care practices can help individuals manage symptoms and maintain stability. It is essential to work with a mental health professional to develop an individualized treatment plan that addresses the unique needs and challenges of each person with Bipolar Disorder.

With proper management, individuals with Bipolar Disorder can lead fulfilling and productive lives.

Bipolar vs Borderline: Both Conditions are Treatable at The Forge Recovery Center

While Bipolar Disorder and Borderline Personality Disorder have some similar symptoms, they are two distinct mental health conditions that require different treatment approaches.

Both conditions can seriously hinder a person from enjoying a full, happy life.

At The Forge Recovery Center, we understand the importance of personalized treatment for these disorders. Our experienced team uses evidence-based therapies and a holistic approach to address the unique needs of each individual. Guided by a trauma-informed philosophy, we’ve carefully curated

If you or a loved one is struggling with Bipolar Disorder or Borderline Personality Disorder, know that recovery is possible. Contact The Forge Recovery Center today to learn more about our treatment programs and begin your journey towards a healthier and happier life.

Newsletter banner

Sign up for our newsletter

Stay updated with the latest news, resources, and updates from The Forge Recovery Center.