One of the most common misdiagnoses is that of Borderline Personality Disorder (BPD) versus Bipolar Disorder (BD). It doesn't help that their names are so similar! In fact, studies have found that 40-56% of people with Borderline Personality Disorder had a mistaken diagnosis of Bipolar Disorder. What's the big deal? Well, Bipolar Disorder often requires the use of medications that can have some heavy-duty side effects. These side effects include hair loss, major weight gain, cognitive dysfunction, and movement disorders. The primary treatment for Borderline Personality Disorder is a therapeutic technique called Dialectical Behavioural Therapy (DBT). Sometimes people with BPD will take medication to help with their symptoms, but unlike Bipolar Disorder, they may not have to take them for life. And if they are misdiagnosed, they may be taking these heavy-duty medications for no reason. What is Borderline Personality Disorder?
BPD is a personality disorder, where as Bipolar is a mood disorder. Personality disorders are a pattern of behaviours and thinking that have lasted for a long period of time. They are ingrained into who the person is, and they can cause major problems with functioning in relationships, work, and everyday life.
Can you have Borderline Personality Disorder and Bipolar Disorder?
Yes, you can have BPD and Bipolar. Approximately 20% of people with Bipolar II disorder also have BPD, and about 10% of people with Bipolar I disorder have BPD.
Borderline Personality Disorder or Bipolar Disorder?
It can be pretty difficult to tell the difference between someone with Bipolar and someone with BPD, especially if the person with Bipolar is in a depressed or mixed episode.
Some points:
- Self Harm: Many mental health practitioners will always link self-harm to BPD, as it is in the diagnostic criteria. That said, Bipolar disorder also has a high rate of self-harm, possibly even higher than BPD. - Relationships: Both disorders struggle to maintain healthy relationships. People with BPD will be very paranoid in their relationships, and switch between loving and hating the people in their life for seemingly no reason. People with Bipolar usually have problems in their relationships due to things they have done in an episode, like cheating or emptying the bank account. Their feelings for those they love generally stay consistent throughout episodes. - Feelings of Self - A person with BPD is unsure of who they are as a person. They may change their opinions about things based on who they are around, and they may feel disconnected from themselves. A person with Bipolar Disorder will generally be the same person, just muffled when depressed and exagerrated when manic.
- Periods of Stability: People with Bipolar have periods of stability, even when not medicated, throughout their life. Someone with Borderline Personality Disorder is continually struggling with symptoms.
- Triggers: Bipolar disorder episodes are usually triggered by physical factors such as lack of sleep, too much sun, or substances. Borderline Personality Disorder 'episodes' or mood changes are usually due to interpersonal problems. A fight with a girlfriend, or a reaction to a comment someone made at work would possibly cause someone with BPD to have a mood change, but those same things would be unlikely to cause a Bipolar episode.
- Mood Lengths: Bipolar Disorder episodes are, at a minimum, 4 days long. They often last months. Even a rapid cycling diagnosis is four or more episodes per year. Someone with Borderline Personality Disorder is much more likely to switch moods within hours or minutes.
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