Understanding Borderline Personality Disorder (BPD)
Borderline personality disorder (BPD) is a mental health challenge that affects an individual’s personality. It often manifests with intense and fluctuating emotions, impulsive behaviour, negative self-image, and difficulties in interpersonal relationships.
People with Borderline personality disorder often have a history of childhood trauma, abuse, or neglect. They may struggle with negative anticipation of the future and feel like their life doesn’t matter. In challenging times, people with borderline personality disorder may be susceptible to alcohol or substance misuse.
Symptoms of BDP
Borderline personality disorder can sometimes look like bipolar disorder as some characteristics appear in both mental health challenges. However, these symptoms mainly differ in duration and behavioural triggers. For example, individuals with borderline personality disorder often struggle with feelings of emptiness, fear of abandonment, loneliness and isolation.
The most common BPD symptoms include:
Intense and fluctuating emotions: People with BPD may experience intense and sudden mood swings, from feeling happy and confident to sad or anxious, within a short period. They may also struggle to regulate their emotions, leading to impulsive behaviour such as self-harm or substance misuse.
Fear of abandonment: People with BPD often fear being abandoned or rejected by those close to them. This fear can lead to desperate attempts to avoid abandonment, such as clinging to relationships or acting out in anger.
Unstable relationships: People with BPD may have difficulty maintaining stable and healthy relationships, often experiencing intense and dramatic conflicts with others.
Impulsive behaviour: People with BPD may engage in impulsive and risky behaviour such as binge eating, substance abuse, reckless driving, and unprotected sex.
Negative self-image: People with BPD may have a distorted sense of self-image, which can lead to feelings of emptiness, low self-worth, and difficulty understanding their own emotions and needs.
The lack of emotional control, or emotional dysregulation, is often related to childhood abuse, sexual abuse, or severe, life-changing trauma.
Understanding Bipolar Disorder
Bipolar disorder is a mood disorder, a mental health challenge characterized by extreme mood shifts and changes in energy and activity levels.
These episodes can range from periods of high or manic episodes, where an individual feels euphoric, energetic, and impulsive, to periods of low or depressive episodes, where they experience feelings of sadness, hopelessness, and loss of interest in activities.
There are seven different types of bipolar disorder, including:
- Bipolar I disorder
- Bipolar II disorder
- Cyclothymic disorder
- Bipolar with mixed features
- Bipolar with seasonal pattern
- Rapid cycling bipolar
- Unspecified bipolar disorder
The causes of bipolar disorder are still not precisely determined. Experts suggest it may be a combination of genetic, environmental, and chemical factors.
Symptoms of BDP
Symptoms of bipolar disorder tend to vary and mainly depend on the current episode that the person is experiencing. Common characteristics of bipolar disorder include:
- Sudden mood swings from being cheerful to impulsive, easily agitated, unfriendly
- Lack of concentration and pressured speech
- Unexplained sadness and lack of energy
- Increased activity, energy and motivation
- Feeling hopeless and having low self-esteem
- Uncontrollable episodes of crying or irritability
- Inability to feel joy, pleasure or activity that you once liked
- Increased need for sleep or the opposite, insomnia
- Negative thoughts and negative anticipation for the future
- Frequent appetite changes
Manic and depressive episodes can last from a few weeks to a few months. The symptoms a person experiences depend on if they are experiencing a manic or depressive episode.
Differences Between BPD and Bipolar Disorder
The main difference between borderline personality disorder and bipolar disorder is that BPD is a personality disorder, whilst BD is a mood disorder. Mood disorders describe a state of extreme mood changes. Personality disorders affect a person’s feelings, behaviour and way of thinking.
People with personality disorders often struggle with establishing emotional relationships with other people, social interactions and perception of the outer world. Still, people with borderline personality disorder might experience BD symptoms of manic and depressive episodes, but these episodes do not last as long.
Navigating mental health challenges can be difficult, and at Leaf Complex Care, we provide unparalleled support for individuals with BPD and BD.
Mood Swings and Frequency
One of the main differences between borderline personality disorder and bipolar disorder is the frequency of mood swings. For example, people with bipolar disorder experience mood shifts in episodes that can last from several weeks to months. The episodes can repeat in a cycle throughout the year, or some people can have just one episode within twelve months.
In contrast, people with borderline personality disorder face an ongoing cycle of fluctuating feelings and emotions regarding their self-perception, mood, and behaviour. A person with BPD can have repeating mood swings within a day, but most people experience one or two extreme emotional swings during a week.
The Diagnosis Process
Many people experience mood and energy changes during a week or day due to different emotional and social factors. Therefore, diagnosing bipolar disorder or borderline personality disorder can be a challenge. The first step towards assessment is checking the family history.
The diagnostic process of both includes medical and mental health evaluation to exclude other possible causes. Diagnosing bipolar disorder often includes a detailed interview and evaluation with mental health professionals. Also, people may be asked to run a diary and record their mood, energy and sleep patterns.
Borderline personality disorder diagnosis is not determined by specific symptoms or characteristics. Instead, the evaluation consists of answering questionnaires from the Diagnostic and Statistical Manual (DSM) and a comprehensive clinical interview with the person and his family or friends.
Triggers
The most common triggers for symptoms in people with borderline personality disorder include:
- Separations, personal or in the family
- Conflicts
- Job loss
- Divorce or death of a loved one
- Refusal- actual or a subjective perception
People with borderline personality disorders have a deep fear of abandonment or being alone which triggers intense emotional reactions and feelings of discontent, anger, negative thoughts about themselves, and impulsive reactions.
The following factors typically trigger symptoms of manic or depressive episodes in people with bipolar disorder:
People with borderline personality disorders have a deep fear of abandonment or being alone which triggers intense emotional reactions and feelings of discontent, anger, negative thoughts about themselves, and impulsive reactions.
The following factors typically trigger symptoms of manic or depressive episodes in people with bipolar disorder:
- Stressful events
- Interrupted sleep pattern or lack of sleep
- Misuse of alcohol or other substances
- Season changes
- Pregnancy and hormone imbalance
- Disagreements with close people and family
- Divorce or death of a loved one
All these specific factors can cause intense emotions in people with bipolar disorder and borderline personality disorder, leading to mood and emotional instability episodes.
Episodes
Episodes of borderline personality disorder occur due to a sudden and unexpected trigger. The intense emotions as a response to the trigger are regarded as a defence mechanism, provoking highly negative or positive emotions about themselves, another person or an event. The episodes occur cyclically, with frequent changes from good to bad feelings. The cycling wave may last hours, days, months, or years before the other extreme.
In bipolar disorder, mood swings can change from manic episodes to depressive episodes. Some individuals may experience emotional swinging between the episodes, whilst others not. Bipolar episodes typically last for several weeks or months.
Treatment
Treating borderline personality disorder and bipolar disorder requires an accurate diagnosis and appropriate approach.
Whilst these mental health challenges are treated differently, some common treatment options show positive results in both bipolar and personality disorders.
The effective treatment approach for people with BPD and BD may involve the following:
- Medication
- Psychotherapy, including individual and group therapy
- Dialectical behaviour therapy particularly effective in people with borderline personality disorder
- Cognitive behaviour therapy
- Transference focused psychotherapy
Proper diagnosis and treatment options are made by a mental health professional who is thoroughly informed about your symptoms and mental health challenge.
Similarities of Bipolar Disorder and Borderline Personality Disorder
Borderline personality disorder may sometimes look like bipolar disorder as there may be an overlap of specific symptoms. For example, people with borderline personality disorder may experience symptoms of a manic episode, with hyper-excitement and high energy levels. Also, they can have signs of depressive episodes like a highly negative mood, feeling a lack of perspective and hopelessness.
Similar Symptoms
BPD and BD do share some similarities, including:
Mood instability: Both disorders involve significant and unpredictable changes in mood, which can be distressing and disruptive for the individual.
Impulsivity: People with BPD and BD may both engage in impulsive behaviours, such as reckless driving, substance abuse, or risky sexual behaviour.
Unstable relationships: Both disorders can impact an individual’s ability to maintain stable and healthy relationships due to mood swings, distrust, and difficulty regulating emotions.
Self-destructive behaviour: Individuals with BPD and BD may both engage in self-destructive behaviour, such as self-harm or suicidal thoughts.
However, while there are some similarities between BPD and BD, the underlying causes and treatment approaches for each mental health challenges are different. Receiving the proper diagnosis from a qualified mental health professional is essential for appropriate treatment and a better quality of life.
Are BPD and Bipolar Disorder Related?
Many people with BPD can also be diagnosed with bipolar i or bipolar ii disorder. Studies show that almost 20% of people with bipolar i disorder have BPD and 10% of people with bipolar ii disorder also have BPD.
Can BPD Be Mistaken for Bipolar?
At first glance, borderline personality disorder may be mistaken for bipolar disorder. However, more in-depth observation clearly shows the difference between bipolar and BPD.
Do People with BPD Have Empathy?
Emotional detachment as a defence mechanism in people with borderline personality disorder makes them less sensitive to other people’s feelings and perceptions.
Why Timely and Personalised Care is Needed for BPD and Bipolar Disorder
Leaf Complex Care provides person-centred and humanized care to people with mental health needs. Our highly trained team are experts in emotional support by implementing individual and solid Positive Behaviour Support plans for people with additional complex needs.
We provide support in stages, and our priority is to build a strong and meaningful relationship with the person we serve and their family.
If you are looking for consistent support where your privacy, dignity and needs will be met and respected, Leaf Complex Care is the right choice for you. We deliver personised care for children and adults with complex care needs in Bristol, Slough, Somerset, and the Midlands. Contact our offices or get in touch here on our website.
