Difference between BPD and bipolar?

[u/Useless-Captain-Mid]

Asking because after being jokingly and seriously told by many people close to me for years that I'm "so bipolar" I looked into the symptoms and criteria for it. And borderline as well. And the main difference to me is that the personality flip flops are a week or longer for bipolar, but can be within a few hours for borderline.

What is the real difference? What do people experience with either? Assuming a person has one or the other, how would they know the difference before a diagnosis? Am I completely wrong on what these two personality disorders mean altogether?

[u/Timber2BohoBabe]

There are actually a lot of differences. For the sake of ease, I will be referring to Borderline Personality Disorder as BPD, and Bipolar as Bipolar.

• The first major one is that BPD is a disorder of personality. It isn't episodic, but instead is an "enduring pattern". Bipolar is episodic. The person will have their normal baseline, but then episodes where their behaviour or mood is abnormal.
  
• BPD usually has a fear of abandonment. This is not the case in Bipolar.
  
• BPD has a pattern of interpersonal struggles, often involving splitting where they go through phases of loving/hating people. Bipolar has relationship issues but only as a result of their behaviours in those episodes. Outside of that, people with Bipolar have normal, healthy relationship (in general).
• People with Bipolar have a sense of who they are. They might not be able to predict their mood or behaviour, but they have a stable sense of self. People with BPD often have problems forming an identity. Sometimes they will be "chameleons" and mimic the personality traits of those they are around.
• Both have impulsivity, but in Bipolar it is episodic and in BPD it is a pattern, especially after interpersonal conflict. People with Bipolar might be more impulsive than the general population even outside of episodes, but it wouldn't usually be as self-damaging as BPD.
• Like you mentioned, BPD has rapidly shifting moods. Bipolar has longer-lasting moods. BPD is like the weather, whereas Bipolar is like the climate. Moods in BPD are often influences by external events like a problem with a coworker. Moods in Bipolar are usually due to more biological factors, like seasonal changes.
• BPD often has feelings of emptiness. This is absent in Bipolar
• People with BPD often have short tempers. People with Bipolar may experience this during mania/hypomania, but not at baseline.
• People with BPD may have psychotic symptoms or severe dissociation, but it is usually induced by stress. Bipolar would have psychotic symptoms potentially, but only during mood episodes.
  
• There are no FDA approved medications for BPD and most medications have shown limited efficacy for BPD. Bipolar is treated with mood stabilizers and antipsychotics, often quite effectively.
  

It is very common for people to have both of these disorders comorbidly. I believe about 20% of BP2 patients have BPD, and about 10% of BP1 patients have BPD.

[u/-Tricky-Vixen- → u/Timber2BohoBabe]

BPD psychotic sx are usually transient and do not involve a sustained hallucinatory or delusional framework. Someone who experiences BPD psychosis/pseudopsychosis does not require hospitalisation and medication is usually ineffective unless it reduces stress levels.

Comparatively, bipolar can experience schizophrenia-like psychosis, though only within a mood episode (if it's outside, then it's either schizoaffective or schizophrenia).

(I have likely bipolar with psychotic features and this is my understanding as per my research and the information I've been given.)

[u/Useless-Captain-Mid → u/-Tricky-Vixen-]

I wondered that, after seeing symptoms for bipolar include hallucinations and psychosis. I see how that would make a big difference. Thank you!

[u/-Tricky-Vixen- → u/Useless-Captain-Mid]

If you want to hear any of my experiences feel free to ask anything! Of course I'm not confirmed diagnosed and my case is complex but all of these symptoms are weird and sometimes hard to understand.

[u/Useless-Captain-Mid → u/Timber2BohoBabe]

Wow, this is super informative! Thanks for such a detailed outline! I like your weather/climate analogy, and how people with BPD are like identity chameleons. This definitely helped explain the differences 🤍

[u/100260]

Bipolar disorder is a mood disorder, not a personality disorder, whereas BPD is a personality disorder.

I have both, and I think the differences are a little more complex than how they’re often described.

It’s not as simple as bipolar being long-term mood changes and BPD being mood changes within hours. Bipolar episodes involve changes in mood, energy, activity, sleep, decision-making, and functioning that persist over time. My episodes last 2–3 months, whereas BPD can involve much more rapid emotional shifts, often in response to interpersonal stress.

I also don’t think it’s accurate to say that everyone with bipolar has a perfectly stable baseline between episodes or that relationship issues only happen during mood episodes. Both disorders are more complex than that, especially when they coexist or when someone has other diagnoses as well.

[u/Useless-Captain-Mid → u/100260]

Thanks for the nuance. Someone else did mention bipolar not being a personality disorder, so I was mistaken on that. I am curious what happens for you when episodes of both occur at the same time?

[u/hestia-listens]

You are partly right about timing, but bipolar disorder is a mood disorder, not a personality disorder. Bipolar episodes usually last days or longer and involve major changes in energy, sleep, activity, thinking, and judgment, not just moodiness. Borderline personality disorder involves ongoing difficulty with emotional control, identity, relationships, impulsivity, and fear of abandonment. Emotional shifts can happen within hours and are often tied to events or relationships. People can also have both. Before an assessment, tracking sleep, energy, mood, triggers, and how long changes last may help a professional see the pattern.

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