Mental health conditions can be confusing. Some have similar symptoms, but they are very different in how they affect people. Two often-mixed conditions are Borderline Personality Disorder (BPD) and Bipolar Disorder.
This blog will explain the key differences. It will also help you understand what each condition means, how they are diagnosed and treated, and how to support someone living with either one.
Table of Contents:
What is BPD?
BPD stands for Borderline Personality Disorder. It’s a mental health condition that affects how people think and feel about themselves and others. It can make relationships hard and lead to strong, unpredictable emotions.
People with BPD may:
- Feel emotions very deeply and for a long time
- Struggle with self-image or feel ‘empty’ inside
- Fear being abandoned or rejected
- Act impulsively (e.g. spending, binge eating, or risky behaviour)
- Find it hard to control anger or anxiety
- Switch quickly from idealising someone to feeling hurt or angry with them
- Sometimes self-harm or have suicidal thoughts
These feelings and behaviours can change quickly, even in the same day. This is a key feature of BPD.
What is Bipolar Disorder?
Bipolar Disorder is a mood disorder. It causes extreme mood swings, from emotional highs (called mania or hypomania) to deep lows (depression). These shifts don’t usually happen within hours. They can last days, weeks or even months.
People with Bipolar may:
- Feel very ‘up’, energised, or overconfident during manic episodes
- Sleep less but still feel active
- Make big decisions or take risks without thinking
- Talk quickly and jump from topic to topic
- Feel very sad, hopeless, or tired during depressive episodes
- Lose interest in things they used to enjoy
- Find it hard to focus or remember things
- Struggle with daily tasks during low periods
There are different types of Bipolar, but all involve clear episodes of mania or depression.
BPD vs Bipolar: What makes them different?
BPD and Bipolar both affect mood, but in different ways. Here are the main differences:
Mood changes
- BPD: Moods change quickly, sometimes within minutes or hours. These changes are often triggered by events (like arguments or feeling rejected).
- Bipolar: Moods change more slowly. Episodes last days or weeks. Changes are often not linked to events.
Mood types
- BPD: Emotions can feel extreme but are usually based on fear, anger, sadness or anxiety.
- Bipolar: Emotions shift between mania (high) and depression (low). Mania can feel like excitement or irritability.
Triggers
- BPD: Mood swings are usually a reaction to things happening around the person, especially in relationships.
- Bipolar: Mood episodes often have no clear cause. They can happen without warning.
Self-image and relationships
- BPD: People often have a poor self-image and intense fears of being abandoned. Relationships can feel very ‘all or nothing’.
- Bipolar: These issues may happen during mood episodes but are not ongoing.
Diagnosis
- BPD: Is a personality disorder. It’s diagnosed based on a pattern of behaviours and emotional symptoms.
- Bipolar: Is a mood disorder. It’s diagnosed based on mood episodes that meet clinical criteria.
Can someone have both BPD and Bipolar?
Yes. Some people are diagnosed with both BPD and Bipolar. This can make diagnosis and treatment more complex. A mental health professional will assess all symptoms carefully to make sure the diagnosis is correct.
Why do people confuse the two conditions?
There are a few reasons:
- Both can involve mood swings and impulsive behaviour.
- People with either condition may self-harm or feel suicidal.
- During manic or depressive episodes, people with Bipolar may behave in ways that look like BPD.
- The emotional pain in both conditions can be intense.
Because of this, it’s important that only trained professionals diagnose these disorders. Self-diagnosis or guessing can lead to the wrong treatment.
How are these conditions treated?
Treatment is different for each condition, though there may be some overlap.
BPD treatment
- Talking therapies are key. Dialectical Behaviour Therapy (DBT) is often used.
- DBT helps people manage emotions, cope with stress, and improve relationships.
- Other therapies like Mentalisation-Based Therapy (MBT) or Cognitive Behavioural Therapy (CBT) may also help.
- Medication is not the main treatment but may be used to manage specific symptoms like anxiety or depression.
Bipolar treatment
- Medication is central to treatment. This often includes mood stabilisers (like lithium), antipsychotics, or antidepressants.
- Talking therapies like CBT can help manage symptoms and prevent relapses.
- Regular routines, good sleep, and support networks are also important.
How can you help a loved one?
Whether your loved one has BPD or Bipolar, your support matters. Here are some tips:
- Learn about the condition. Understanding the symptoms can help reduce frustration and fear.
- Stay calm. Intense emotions can feel overwhelming, but staying grounded helps.
- Set boundaries. It’s OK to protect your own wellbeing while being supportive.
- Encourage treatment. Offer to help them find support or go to appointments.
- Don’t take things personally. Some behaviours are part of the condition and not about you.
- Look after yourself. Supporting someone else can be hard. Find your own support network too.
Final thoughts: BPD vs Bipolar
BPD and Bipolar are serious but treatable conditions. While they share some features, they are very different in how they work and how they are treated. Getting the right diagnosis is the first step to recovery.
If you or someone you care about shows signs of either condition, speak to a GP or mental health professional. With the right help, things can and do get better.
