Bipolar disorder and borderline personality disorder are often misdiagnosed. They are sometimes also comorbid and since both present with mood challenges and emotional regulation issues, they are sometimes mistaken for one another. I live with both and the symptoms sometimes blur for me. It can be hard to tell which illness is acting up, but I do know I experience distinct symptoms for both.
Bipolar disorder is a mood disorder while BPD is a personality disorder. This essentially means that bipolar disorder affects my mood over longer episodes whereas BPD affects my emotions and interaction with others over short episodes. It can be helpful to better understand the distinction between these two illnesses and I do my best to be aware of this.
Though there is a lot of uncertainty in our understanding of what causes many mental illnesses, we do have some insight into what brings up certain symptoms in certain people. At its most basic explanation, bipolar disorder is a chemical imbalance in the brain. This imbalance is something that I was born with. Borderline personality disorder, on the other hand, is believed, to an extent, to be brought on by environmental factors such as, most commonly, childhood trauma.
One of my current medications is an antidepressant. There are different kinds of antidepressants, the most common affecting serotonin in the brain. I was put on one of these years ago and it sent me into an episode of mania. An antidepressant however, is helpful for me since my depressive episodes are longer, more frequent and more severe than the hypomania I experience. The antidepressant I am on now affects norepinephrine and dopamine. It deals with different brain chemicals. All this to say, the fact that medications that alter my brain chemistry can help manage my symptoms suggests to me that bipolar disorder is more biological.
Borderline personality disorder, however, can be influenced by upbringing and environment. The symptoms of BPD are very interpersonal, and are also related to mood regulation. This can be affected by how we are taught to handle our emotions and how we are taught to interact with others, what we understand to be healthy relationships and how we ask for needs to be met.
These disorders also differ in the way I experience shifts in my mood. My bipolar disorder affects my mood on a greater scale and my BPD affects my mood on a more daily basis. Bipolar mood episodes usually last longer. For me, the longest and most frequent episodes are depressive. These can last weeks or sometimes months and can be debilitating. They are also often accompanied by suicidal thoughts. I’ve learned to notice when a depressive episode is coming and to start doing all the things I can to manage it and to mitigate the symptoms I feel. This means making sure all my basic needs are being properly taken care of; eating well, drinking enough water, sleeping enough (not too much either), keeping active, etc. Bipolar episodes are not like a normal mood shift. Most people joke about having bipolar if they are moody or change their minds, but that’s not how it works.
The shifts in my mood due to BPD are quite different. They can be sudden and usually do not last as long, the same way a healthy person’s mood changes regularly, except more intense. BPD means that regulating my moods is difficult. When an strong emotion is triggered, I feel it more intensely than the average person and it takes longer for me to come back to neutral.
While BPD affects my mood regularly, it also has a number of interpersonal symptoms, meaning symptoms that relate to the way I interact and relate to other people. BPD usually means unstable and volatile relationships. For me, these symptoms show up most in romantic relationships. I can be very reactive and have drastic shifts in mood triggered by events that would not be felt so severely by a healthy person. My ineffective behaviours in romantic relationships are motivated by a desire to have certain needs met and an inability to ask for that in a healthy way. This has changed greatly as I have gone through treatment, therapy and put in the effort to do the work, but it still shows up and can be difficult to manage.
While BPD affects how I interact with others, bipolar disorder turns me inwards and affects more how I relate to myself. My bipolar depression causes feelings of deep emptiness, apathy and lack of motivation.
They may be different in many ways but these disorders share some symptoms; intense emotional responses, disturbances in sense of identity, depression, suicidal thoughts or urges. It can be very difficult to diagnose either disorder and sometimes a long period of observation and assessment is needed.
Struggling with both can be difficult at times. I sometimes can’t tell if my depression is brought on by my brain or triggered by an interpersonal event and managing them requires a different approach. This is why being educated on the differences between them helps me stay healthier and more stable.