The 7 differences between bipolar disorder and borderline personality disorder (BPD)

The emotional element is one of the most important for human beings because it allows us to value the implication for us of what is happening around us and motivates various types of behavior.

Joy pushes us to action and to repeating the behaviors that engendered it, as well as to pleasure. Sadness leads us to avoid repeating situations. Fear leads us to avoid stimuli. Love and hate lead us to approach or move away from beings, stimuli or situations. Emotions are not immutable and they change based on events. However, there are different disorders in which those who suffer from it experience rapid emotional changes which they cannot control and which sooner or later make them suffer.

Maybe the first thing that comes to my mind is bipolar disorder, but there are others as well known as borderline personality disorder. These disorders have symptoms that in some ways make them very similar and can sometimes even be confusing. That is why in this article we will analyze the differences between bipolar disorder and borderline personality disorder.

    Bipolar disorder

    Bipolar disorder is alongside depression one of the mood disorders, characterized by the presence of one or more manic or hypomanic episodes, which may be preceded or followed by a depressive episode.

    In manic episodes it appears an expansive and euphoric atmosphere, And it is common for self-esteem and feelings of greatness to appear. Other symptoms that may and / or should be present are elevated energy levels, decreased sleep, distractibility, failure to assess risk, and exhibiting high risk behaviors.

    In some severe cases, hallucinations and delusions, verbiage, and irritability / hostility may also occur. Symptoms usually last for at least a week. Hypomanic episodes are similar but with much less intensity and duration (at least four days), without alterations such as delusions.

    As for depressive episodesA sad mood is felt for at least two weeks with anhedonia and abulia, and motivation or the ability to feel pleasure is often lost. It is also common for hopelessness and passivity, suicidal thoughts, and problems sleeping and eating to appear.

    There are two types of bipolar disorder, type 1 and type 2. In the first, it is essential that there has been at least one manic or mixed-type episode which may or may not be followed or preceded by an episode. depressive. The second refers to people who experience one or more depressive episodes alongside at least one hypomanic.

      Borderline Personality Disorder (BPD)

      As for borderline personality disorder, it is a personality disorder characterized by a pattern of behavior in which emotional, emotional and relational instability prevails, as well as a high level of impulsivity, Which begins in adolescence as a result of the interaction between biological aspects and the experiences and learnings made by the subject.

      Among the most characteristic symptoms we find low self-esteem, permanent feeling of emptiness and of little value, Great reactivity to events and interactions, extreme experience of emotions and idealization or devaluation of others in very categorical terms.

      It also emphasizes the presence of excruciating panic to be left behind, making frequent efforts to avoid it (although this one is not real). Thoughts of suicide (and in many cases trying to achieve them) or acts of self-harm are also common. may appear dissociation-related alterations, Such as depersonalization or non-realization. In some contexts they may be criticized for their irritability, it is assumed that due to a relative difficulty in recognizing and expressing their emotions, although little is yet known about this.

        Characteristics in which they are similar

        From the above descriptions and diagnostic criteria, we can see that Bipolar and borderline disorders have some similarities obvious. People with both disorders show symptoms such as high impulsivity, irritability, and a superficial pattern of relationships (at least at times). The most important coincidence is a great emotional lability, which quickly changes from one emotional state to another.

        In addition to the above, we are faced with two of the disorders most related to making and / or consuming suicide attempts, bipolar disorder being one of the most frequently related (along with depression and addictions) and being Borderline Personality Disorder the personality disorder that has been most closely linked to suicide.

        Finally, we can find subjects who have both diagnoses, borderline personality disorder and bipolar disorder. While this clearly tells us that they are not considered the same, the truth is that many symptoms are very similar.

          Differences between bipolar disorder and borderline personality disorder

          The above commonalities may suggest that the two disorders are very similar and in some cases can even be confusing. But although bipolar and borderline disorder have some commonalities and some of their symptoms coincide, we are still dealing with diagnostic entities with several differences from each other. The most significant differences are as follows.

          1. Presence or absence of euphoria

          In bipolar disorder and borderline disorder, we encounter rapid changes of very intense emotions. However, while in bipolar disorder there are one or more manic or hypomanic episodes that are related to an expansive and euphoric mood, in BPD a depressive-like affective tone persists, without the onset of euphoria.

          2. Stability of changes

          While mood changes can be very rapid in BPD or borderline personality disorder, in bipolar disorder it can be much more stable and lasting. For example, a person with BPD may have constant mood swings over the course of a day, or even in about an hour. People with bipolar disorder have sudden changes, but in the form of episodes that usually last longer.

          Despite this, it should be borne in mind that people with bipolar disorder called fast cyclists (With at least four emotional polarity changes in a year) they can show greater lability than average, although they are usually not as marked as with BPD.

          In contrast, the level of impulsivity is stable and constant in patients with BPD, whereas in bipolar disorder it only appears in the manic phase.

            3. Reason for mood change

            Another difference can be found in what exactly triggers the change, while in bipolar disorder we find that these changes are believed to be due to alterations and imbalances in brain neurotransmitters, those in BPD are often located in the brain. outside, in psychosocial stress, interpersonal relationships and the experiences of those who suffer from it. Simply put, a person with bipolar disorder may not be aware of the exact cause of their changes, while the borderline may associate it with a much more specific discussion or embarrassment.

            4. Presence of asymptomatic periods

            Borderline personality disorder, as an alteration of the personality that it is (thus its characteristics are integrated into the subject’s way of being), remains consistent over time. In other words, there are no periods asymptomatic per se. In contrast, in bipolar disorder, we find that between episodes there may be periods without symptoms more or less prolonged, although it is not uncommon for subclinical symptoms to persist sometimes. And while it’s not the most common, they may not even repeat episodes.

            5. Level of self-esteem

            While the long-term experience of both disorders usually results in decreased self-esteem and self-concept, in bipolar disorder this varied widely depending on the type of episode you are having. matter.

            In the manic phase usually appears an expansive mood in which feelings of grandeur stand out, Self-esteem being greatly enlarged. In depressive stages, mood and self-esteem are generally greatly reduced. In asymptomatic periods, this part of self-concept can be at normative levels, although it can also be altered.

            As for borderline personality disorder, as a rule, those who suffer from it often have a very low self-esteem, often feeling helpless and worthless. In the vast majority of patients, the prevailing feeling is to feel empty and panicked about being let down.

            6. Relationship with others

            We saw above that in both disorders the presence of superficial, superficial or unstable relationships can occur. However, we can also observe differences.

            The subject with borderline personality disorder usually has feelings of emptiness, low worth and extreme panic to give up. They often establish relationships of dependence, requiring to be understood, loved and valued. Also that they fight constantly, that they idealize others or devalue them.

            However, the subject with bipolar disorder is normatively related to others when he is in the asymptomatic phase, the superficiality appearing mainly in the manic phases, but there is usually no emotional dependence others (although it can happen in depressive stages).

            7. Treatment

            Although this is a severe personality disorder, those with borderline personality disorder tend to benefit greatly from psychotherapy and various psychological techniques (many of which specifically target this disorder). Treatment for bipolar disorder, on the other hand, is usually more complicated and be much more pharmacologically oriented, although different therapies such as interpersonal and social rhythms or different applications of cognitive behavioral therapy have been generated.

            bibliographical references

            • American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. Fifth edition. DSM-V. Masson, Barcelona.
            • Sants, JL; Garcia, LI; Calderon, MA; Sanz, LJ; of rivers, P .; Left, S .; Román, P .; Hernangómez, L .; Navas, E .; Lladre, A and Álvarez-Cienfuegos, L. (2012). Clinical Psychology. CEDE PIR preparation manual, 02. CEDE. Madrid.
            • Bipolar Disorder Clinical Practice Guideline Working Group (2012). Bipolar Disorder Consultation Tools [Versión resumida]. Madrid. Quality plan for the national health system of the Ministry of Health, Social Services and Equality. University of Alcalá. Spanish Association of Neuropsychiatry. UAH / AEN Num. 2012/1.

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