Bipolar Depression vs Borderline Personality Disorder

Approximately 2.3 million Americans are currently diagnosed with bipolar depression, which is one of the most common depressive disorders in the world. On top of that, roughly 1.4% of the population experiences borderline personality disorder, another mental illness that impacts mood. These two particular mental illnesses are often compared to each other and sometimes even mistaken for the same disorder by those who are unfamiliar with them. However, when considering bipolar depression vs borderline personality disorder, it is important to note the similarities but also distinguish the specific differences between the two. Looking at symptoms, causes, and treatments for both mental health conditions can help shed light on what separates them from each other.

Bipolar Depression vs Borderline Personality Disorder: Symptoms 

When a person is being diagnosed for a condition, the first thing that a mental health professional looks at are the symptoms they are experiencing. That is because symptoms can easily denote which type of mental illness may be occurring, allowing for the mental health professional to proceed with an accurate diagnosis and treatment plan. While bipolar depression and borderline personality disorder share many of the same symptoms, they do not share them all. 

Bipolar Depression Symptoms

Bipolar depression is characterized by episodes of mania and depression. Some of the most common symptoms related to manic episodes include the following:

  • Extreme elation
  • Excessive talking
  • Increased ego
  • Heightened energy
  • Increased distractibility 
  • Little need for sleep
  • Experiencing delusions
  • Not eating 
  • Impulsive/risky behavior

The symptoms of a manic episode can last for a few days to a few months. It is common for a depressive episode to occur shortly thereafter a manic episode, in which case the following symptoms can develop:

  • Irritability
  • Lethargy
  • Disinterest in activities/hobbies that used to be of interest
  • Self-doubt
  • Feelings of hopelessness or emptiness
  • Experiencing hallucinations
  • Problems sleeping
  • Developing illogical thinking 
  • Waking up early 
  • Suicidal thoughts and tendencies

Those who have bipolar depression can experience rapid cycling or a mixed state when it comes to mania and depression. Rapid cycling refers to mania and depression that continually occur after each other without a period of “normalcy” in between. Mixed state refers to when individuals experience both mania and depression at the same time. 

Borderline Personality Disorder Symptoms

Bipolar depression vs. borderline personality disorder symptoms may seem similar in some ways, but by paying close attention, the differences are abundantly clear. 

Symptoms of borderline personality disorder tend to include the following:

  • Extreme fear of abandonment
  • Suicidal thoughts, behaviors, or threats
  • Detachment from reality 
  • Sudden changes in self-image
  • Impulsive behavior
  • Significant mood swings that can last for a few days
  • Unstable relationships
  • Feelings of emptiness
  • Explosive anger 

Some of the similarities between bipolar depression and borderline personality disorder are most noticeable when discussing mood swings and impulsivity. The other symptoms that are experienced in these two disorders are what clearly distinguishes them from one another.

Causes of Bipolar Depression vs Borderline Personality Disorder

Most mental illnesses have ties to environmental and genetic causes, and bipolar depression and borderline personality disorder are no different. 

Bipolar depression is thought to mostly be caused by chemical imbalances in the brain as opposed to any environmental factors. Studies have shown that specific neurotransmitters (serotonin, noradrenaline, and dopamine) in the brain are imbalanced in those with bipolar depression, creating the extreme emotional ups and downs that are experienced. Because of this, individuals with relatives who have bipolar depression are 4-6 times more likely to develop it, too, as genetic factors can play a role in brain function.

When looking at bipolar depression vs borderline personality disorder, the causes behind them are quite different. There is no official cause of borderline personality disorder, however it is widely thought to be caused by environmental factors more than genetic factors. For example, borderline personality disorder is most common in those who have experienced emotional, physical, or sexual abuse as a child. It is also common in individuals who witnessed parental substance abuse as a child or who experienced trauma but were unable to appropriately cope with it. 

How are Bipolar Depression and Borderline Personality Disorder Treated? 

Neither bipolar depression or borderline personality disorder are curable conditions, rather they can be effectively treated. This means that those who have either one of these disorders will have them for a lifetime. Thankfully, specific therapies and medications can help treat symptoms, making both conditions easier to manage. 

Bipolar depression is often treated with a combination of medication and therapy. Providers will prescribe mood stabilizers or antidepressants to help balance out the chemicals in the brain that are imbalanced. Simultaneously, individuals may also engage in therapy to help support their recovery. The most common therapies utilized for bipolar depression include cognitive behavioral therapy (CBT), psychotherapy, interpersonal and social rhythm therapy, and even electroconvulsive therapy or transcranial magnetic stimulation. 

Borderline personality disorder is most effectively treated with therapy and lifestyle changes. Medications may be prescribed to help treat specific symptoms, but usually most individuals engage in dialectical behavioral therapy (DBT) or mentalization-based therapy to help treat symptoms. Additionally, they may also engage in good self-care, getting enough rest, exercising, eating well, and living an overall healthy life.

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