Borderline Personality Disorder and Bipolar Disorder

[carreym27]

Can anyone tell me, what are the differences between those two? Are there any? I'm quite confused, and will appreciate any answers.

[Tegorsk]

Sure you can have both, just as you can have arthritis and a cold. But one doesn't cause the other, nor are they caused by the same thing.

[janny108]

I have a sister with BPD and it has always been hard to relate to her. I've just learned about this and she told me she had this. I'm a Christian and would like to understand this especially when she says stuff and it's all WONDERFUL or it's HORRIBLE. I mean NO ONE'S life is all that good or all that bad and it makes me feel inadequate that my life is not all that great or something.

She met our son and his girlfriend and the way she tells this like they're practically BFF's or something. I don't believe it. I think she exaggerates to what she thinks IDEALISTICALLY.  I'm not sure about this. I'm a matter of fact kind of person. It's like just tell me what happened, not how WONDERUL it was.

[lindahand]

Borderline personality disorder is different from bipolar disorder in one major way. Borderline personality disorder is always there. "Borderline personality disorder is a condition in which people have long-term patterns of unstable or turbulent emotions, such as feelings about themselves and others. These inner experiences often cause them to take impulsive actions and have chaotic relationships." taken from PubMed. These impulsive actions express themselves as repeated spur of the moment suicide attempts, cutting, seeing the world as black and white where people are either good or bad. They are also really helped by a therapy called dialectic therapy which is a talk based or group based therapy.

For bipolar there are three distinct states, and a family member can usually tell which you are in. The first state is depression. Life doesn't feel worth living, you are slowed down physically or perhaps have aches and pains, and your functioning is impaired. For example when depressed I will go days without a shower because it just seems like too much work. It is a spectrum so it can range from mild feelings to the point where you can not get out of bed. The opposite, second state, is hypo mania or mania. Things are speeded up. You may even start to talk faster. You don't recognize the consequences of actions so you may do foolish things like go on spending sprees, or lavish vacations, or buy expensive meals. You may be impatient when people don't see life as you do and become irritable. You may become super sexual. You see yourself as larger than life. This too is a spectrum. For a lot of people hypo mania (the lesser stages of mania) can be an extremely productive and creative time in their lives and is quite enjoyable.

Then the third state is normal functioning. Episodes can last weeks or months or even years. As can the time when one functions normally.

For bipolar disorder talk therapy alone seldom works because it is thought that there are neurochemicals at play causing these extreme changes. Talk therapy definently helps, don't get me wrong, but it alone isn't usually enough to prevent episodes or cure them. Getting on the right medication can produce dramatic changes for people with bipolar disorder.

Hope this helps.

[adel_ezz]

in my view there is some relationship. What intrigued me is the faxct that some who have BPD can get hypomanic which means can be indistinguishable. And i happenned to have asked this question sometime ago here and received answers. One answer came from a lady of the name psyvamp a member of the forum. she answered as follows:

There exists a subgroup within the borderline personality disorder domain where risk genes for bipolar illness may lead to a joint presentation of both illnesses (10). Hypomania (in the case of co-occurring borderline personality disorder and bipolar II disorder) may precede the emergence of borderline personality disorder in some patients, may surface a number of years later than when borderline personality disorder is first recognized, and in still others may become manifest at about the same time one is first diagnosed with borderline personality disorder." ("American Journal of Physchiatry")...

I believe that  this-- along with other information that I have accessed, would demonstrate to me that one could have EITHER condition and develop the other as a co morbidity, or that BOTH conditions can exist in any given host.... BOTH genetics and environmental stimulii have impact on both conditions. A person can have both conditions, yet manifest only the symptoms of one disorder at a time-- or multiple symptoms of both disorders at once.  The BPD, however, seems to be able to go into remission periods, similar to those remissions of cancer patients, whereas no symptoms occur for extended periods of time. BOTH  BPI and BPII & BPD  can be "controlled "  fairly effectively for many patients-- with medications and/or psychotherapy...although that the greatest effects in control of either or both conditions is achieved through the continued monitoring, in depth family history, medication and psychotherapy in a long term setting.

That said... Yes-- to both, you may have either-- or even both. Many of the Symptoms of both disorders co-incide, they cross over so to speak. So that often times-- the two disorders are difficult or nigh impossible to completely distinguish one from the other.

but like I said-- near impossible to separate the two.... I think often times the bipolar is largely genetically  predispostioned, environmentally triggered ( to a large degree) and that the BPD is quite often a side effect or alternative coping mechanism caused by the initial bipolarity and it's affects on the individual psyche. As well as also seems to go hand in hand with the bipolarity -- is depression (major), PTSD (which can be a trigger for the onset of the bipolarity) generalized anxiety disorders, personality disorders ( coping mechanisms)  and drug /alcohol addictions....

[ruckerbenton]

There is something important about the bipolar diagnosis and the borderline personality disorder diagnosis.  These are 2 separate issues.  The diagnostic tool used in psychiatry, the DSM-IV or what ever number of revision it is at, is based on 5 axis system.  Axis I includes acute issues like biploar disorder, major depression, generalized anxiety, substance abuse, ADHD, schizophrenia. (These are just a few diagnosis listed in the DSM)  The DSM gives a listing of symptoms for each of these disorders and the time the symptom must be present and distressing for the person to be labeled with the diagnosis.  A person's symptoms are used to match up a person's diagnosis.  A psychiatrist and other mental health clinicians work together to determine a concrete diagnosis.  With early intervention, therapy and medication these acute disorders can be managed.

Axis II in the DSM includes personality disorders.  These are specifically patterns of behaviors that a person has used for a long time that are technically termed as maladaptive or just not working toward the benefit of the individual.  This category includes borderline personality, passive aggressive personality, dependent personality, narcissistic personality, etc..  Mental retardation is also scored on this axis.  The criteria a person must meet to be labeled with this diagnosis is included in the DSM under the Axis II.  Axis II disorders usually take a very long time to correct.  People able to understand their patterns of behavior can retrain themselves through individual and group therapies.

Axis III is a listing of a person's medical issues such as asthma, diabetes, arthritis, etc.  A psychiatrist must take physical health issues into consideration during diagnosis.

Axis IV is a list of psychosocial stressors and a severity score.  Severity is listed as mild, moderate, and severe.  This portion of the diagnosis is made through a discussion with a clinician.  An example of this might be financial issues, moderate;  lacks support system, severe; chronic health issues (emotional or physical), moderate; relationship issues, moderate.

Axis V is  the Global Assessment of Functioning or GAF.  It's complicated and is used to help determine a person's highest level of functioning in the last year and in the here and now.  These numbers are used in insurance negotiation for level of care treatment.  Each score is 1 -100.  One being the lowest, 100 being the highest.  So the clinician assessing someone must assess how well a person was functioning a year ago and how that person is doing now.  So if the individual is able to maintain hygiene, is able to work part-time, has ability to provide or prepare food and eat it, has a safe level of ability to manage his emotional and physical disease processes, and is safe vs. his current functional level which includes little interest in personal hygiene, is missing work 40 percent of the time, inability to grocery shop and provide food for self, and sleeps all day.  As a clinician, I would say the person was functioning at about a 75 a year ago and is at a 35 now.  35 is the score required for inpatient hospitalization.  The scoring process for this axis is subjective.  Ideally after treatment the person would return to functioning at a 75 or above.  Sometimes, when a person is having success in treatment a year ago the person may have been at a 55 and is now at 90.  Chronic conditions found in Alzheimers and other dementia is usually scored about 20 and is expected to decline.

I treated psychiatric patients for 23 years before my bipolar disorder got the best of me.  I hope this helps.  The DSM is available for purchase and may even be on the internet somewhere.  I would look under DSM-IVR or DSM-V.  Best wishes.  Michelle

[juliekendall73]

I wanted to add that you can get more information on this websit

http://www.psycheducation.org/depression/diagnosis.htm

[juliekendall73]

They both have red for hot emotions, and blue for depressive symptoms, and a sparkly pigment that makes them impulsive.  But the "bipolar" person has a magic ingredient that makes her pigments vary cyclically over time.  There is some consistency to the way this magic pigment works: she tends to be either one way, or another, all symptoms varying together.  Remember, this magic stuff is another "pigment".  She could get a big dose of it, and be bipolar I:  extreme swings separated by years, looking much the same each time they reappear.  If she got a small dose of the "vary" pigment instead, her symptoms might be less clearly "cyclic", more mixed and muddled.  

On the other hand, the "borderline" person has a green ingredient that makes her feel empty, and feel much worse in this way when she is alone.  Plenty of people who wouldn't be called "borderline" have quite a bit of green in them, but if you get a lot of this green pigment, you're more likely to have trouble in relationships.  When two very green people get together, each will feel badly when the other goes away somehow (including emotionally; for example, if one gets mad at the other).  Imagine what happens in a relationship if one person is very green, and the other is not; this can be as troublesome as when both are green.  You've heard these matches described as problems of "co-dependency".  How much "green" a person has seems to depend on both genetics and experience: some kids just turn green no matter how good an upbringing they get; others can develop emptiness from experiences that they had growing up (lots of real or perceived abandonment may do it; certainly sexual abuse seems to do it).  

Just to make it clear that this is not "always somebody's fault": the "match" between a child's temperament and the parenting they receive can be the problem, not the child's temperament or the parenting either.  Some kids can handle a pretty distant parent okay; others can be devastated by this.  Some kids will feel "smothered" by an involved parent; others will thrive with such attention. Children can show these differences right from birth.  You can read more about this "match" in the superb scholarship of Marsha Linehan, Ph.D.  Warning: her book "Cognitive Behavioral Therapy of Borderline Personality Disorder"Linehan prompted a psychiatrist friend to say: "never have I read so important a book that was so boring".  Dr. Linehan repeats the same themes over and over, but for good reason: they're crucial themes to understanding this personality.  You could go to a bookstore that has it and just read the section on "Emotionally Invalidating Environments": it's in the first chapters just after the definition of the disorder.  

So, to summarize: diagnoses are not based on known chemical differences.  They are conveniences for researchers, and are also supposed to help you find the right treatment.  But because symptoms are spread over spectra, from a little to a lot, labels can often be misleading.  Finally, borderline patients have most of the features of bipolar, plus an emptiness streak; and may have less clear "cycling" of their symptoms.  

[carreym27]

Thank you! Your answer really helps, now the difference is a little bit clearer to me.

[paranoid_cataclysm]

Basically borderline personality disorder involves no chemical imbalance but bipolar disorder does however.  BPD involves rapid changes in emotions, much more rapid than BP, and distortions in self image and whatnot.  BP involves switching from depression to hypomania, mania or a mixed state of both every few months or sometimes every day or two or even less and the depression and mania entail many other things.