BPD (Borderline Personality Disorder) is a an Axis 2 classifications. BPD is a "Behavioral Disorder". It is a disorder based upon how a person thinks and feels. They cannot process and control their emotions and feelings. It is not "curable" per-se, but can be controlled through a few processes DBT/CBT in which the afflicted learn to accept and understand their thought (so to speak) and learn how to react and respond to them and to others. Medicines may be used with BPD to help them get into a "better place" so they can start to face their thoughts/feelings.

Bi-Polar is a Mood disorder and can be considered a "tangible medical matter". It is often generally affected with chemistry & transmitters. It has hereditary allowances. It may often be treated with some medications (to "control" the moods) and has been noted to be improved with special diets and herbs. Bi-Polar can be very difficult to treat and control. There are my types of Bi-Polar. It too is to be considered not-curable. Medicines are the primary approach to Bi-Polar with therapy coming is as support (after the meds).

Here is a link that may shed some more light:
http://www.psycheducation.org/depression/borderline.htm

bumpy

When asking differential questions about multiple personality disorders, it is important to understand why you are asking the question and how you intend to use the information. Without this perspective and focus, the data may be overwhelming, confusing and misleading.  For example...

~ if your child is not responding to therapy, it makes sense to look more carefully into the possibility that the wrong illness was diagnosed or whether there are comorbid (multiple) personality disorders at play. Bipolar and Major Depressive Disorder, for example, are far more responsive to pharmaceutical therapy than Borderline Personality.

~ If you are trying to get along better with your wife, it's not as important to precisely pinpoint the specific disorder or analyze the comorbidity as it is to recognize and fully understand the problem behaviors and how to constructively deal with them.  

~ If you are recovering from a failed relationship, the important thing is often to understand which behaviors were pathologic (mental illness) and which were just the normal run of the mill problems common to failing/failed relationships - there is often a bias to assign too much to the "pathology" and not enough to common relationship problems, or the issues we created by our own behaviors.

It's important to know that the distinctions are not all that neat and tidy. In a 2008 study, comorbidity with another personality disorder was very high at 74% (77% for men, 72% for women).  This is one reason why there is controversy around the DSM classifications of Personality Disorders - there is so much overlap it is confusing even to professionals - personality disorders are real, but they are not easily or neatly defined.
More info

In the study, comorbidity with mood disorders was also very high at 75% as was anxiety disorders 74%.

Mood/Anxiety Comorbidities ---- Anxiety Disorder -Posttraumatic stress -Panic with agoraphobia -Panic w/o agoraphobia -Social phobia -Specific phobia -General anxiety Mood Disorder -Major depressive -Dysthymia -Bipolar I -Bipolar II More info

Men--------- - 30% 8% 16% 25% 27% 27% - 27% 7% 31% 7%

Women------ - 47% 15% 21% 33% 47% 42% - 37% 12% 33% 9%

Some helpful hints for sorting through this.

• General and Specific There are definitions for "personality disorder" as a category and then there are definitions for the subcategories (i.e., borderline, narcissistic, antisocial, etc.).  Start with the broader definition first.  Keep in mind that to be a personality disorder, symptoms have been present for an extended period of time, are inflexible and pervasive, and are not a result of alcohol or drugs or another psychiatric disorder - - the history of symptoms can be traced back to adolescence or at least early adulthood - - the symptoms have caused and continue to cause significant distress or negative consequences in different aspects of the person's life. Symptoms are seen in at least two of the following areas: thoughts (ways of looking at the world, thinking about self or others, and interacting), emotions (appropriateness, intensity, and range of emotional functioning), interpersonal functioning (relationships and interpersonal skills), or impulse control

• Spectrum Disorders  An extremely important aspect of understanding mental disorders is understanding that there is a spectrum of severity. A spectrum is comprised of relatively "severe" mental disorders as well as relatively "mild and nonclinical deficits".  Some people with BPD traits cannot work, are hospitalized or incarcerated, and even kill themselves.  On the other hand, some fall below the threshold for clinical diagnosis and are simply very immature and self centered and difficult in intimate relationships.

• Comorbidity Borderline patients often present for evaluation or treatment with one or more comorbid axis I disorders (e.g.,depression, anxiety disorders, bipolar disorder, ADHD, autism spectrum disorders, anorexia nervosa, bulimia nervosa). It is not unusual for symptoms of these other disorders to mask the underlying borderline psychopathology, impeding accurate diagnosis and making treatment planning difficult. In some cases, it isn’t until treatment for other disorders fails that BPD is diagnosed.  Complicating this, additional axis I disorders may also develop over time.  Because of the frequency with which these clinically difficult situations occur, a substantial amount of research concerning the axis I comorbidity of borderline personality disorder has been conducted. A lot is based on small sample sizes so the numbers vary.  Be careful to look at the sample in any study -- comorbidity rates can differ significantly depending on whether the study population is treatment seeking individuals or random individuals in the community.  Also be aware that comorbidity rates  are generally lower in less severe cases of borderline personality disorder.

• Multi-axial Diagnosis  In the DSM-IV-TR system, technically, an individual should be diagnosed on all five different domains, or "axes." The clinician looks across a large number of afflictions and tries to find the best fit.  Using a single axis approach, which we often do as laymen, can be misleading -- looking at 1 or 2 metal illness and saying "that's it" -- if you look at 20 of these things, you may find yourself saying "thats it" a lot.     A note in the DSM-IV-TR states that appropriate use of the diagnostic criteria is said to require extensive clinical training, and its contents “cannot simply be applied in a cookbook fashion”.

• Don't become an Amateur Psychologist or Neurosurgeon  While awareness is a very good thing, if one suspects a mental disorder in the family it is best to see a mental health professional for an informed opinion and for some direction - even more so if you are emotionally distressed yourself and not at the top of your game. 

I hope this helps keep it in perspective.  

Skippy

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DIFFERENCES|COMORBIDITY: Overview of Comorbidity

Additional discussions...

Personality Disorders
Borderline and Paranoid Personality Disorder
Borderline and Schzoid/Schizotypal Personality Disorder
Borderline and Antisocial Personality Disorder
Borderline and Histrionic Personality Disorder
Borderline and Narcissistic Personality Disorder
Borderline and Avoidant Personality Disorder
Borderline and Dependent Personality Disorder
Borderline and Obsessive Compulsive Personality Disorder
Borderline and Depressive Personality Disorder
Borderline and Passive Aggressive Personality Disorder
Borderline and Sadistic Personality Disorder
Borderline and Self Defeating Personality Disorder

Other
Borderline PD and Alcohol Dependence
Borderline PD and Aspergers
Borderline PD and Attention Deficit Hyperactivity Disorder
Borderline PD and BiPolar Disorder
Borderline PD and Dissociative Identity Disorder
Borderline PD and P.T.S.D.
Borderline PD and Reactive Attachment Disorder (RAD)

From what I read over the years,
psychiatrist will first treat "possible bipolar" with anti-psychotic meds and see how the patient evolves...
Anti-psychotic meds don't help PD... so if the patient doesn't inprove it's a personality disorder.

When I was writing my new book, the psychiatrist whom I spoke with most often was just spitting mad at this article/study (don't remember which it is). He didn't agree with it.

It's been awhile since anyone posted, but for closure I wanted to add this. This is from my new book, the Essential Family Guide to Borderline Personality Disorder, out in November 2008:

Both people with BPD and those with bipolar disorder experience dramatic mood swings. But there are three crucial differences:

1. People with BPD cycle much more quickly, often several times a day.
2. The mood swings with BPD are more specific: all emotions are affected (fear, anger, sadness) while people with bipolar either have mania (intensely high) or major depression.
3. The moods in people with BPD are more dependent, either positively or negatively, on what’s going on in their life at the moment.



Randi Kreger
BPDCentral.com
Welcome to Oz Community Owner
Stop Walking on Eggshells and the SWOE Workbook
The Essential Family Guide to BPD

i agree with you, they are very different. i was diagnosed bipolar over ten years ago, and have been working on maintaining balance since. it's been an interesting ride, and i haven't always been someone that's easy to be around (i usually recognize it and pull back in attempt not to affect others), but never have entered into some of the behaviors that i'm learning are typical of a BP. i have felt a growing fear-based stigma toward bipolar individuals over the last several years, and i was wondering if perhaps you've noticed anything, pop-culturally or even in the psychiatric arena, that would reflect what i consider to be a gross misunderstanding of what a bipolar individual really deals with? if so, do you think the stigma is exasperated by this trend to diagnose BP's as bipolar?

Thank you so much for posting this. I actually was going to ask the question today about what the difference is.   

Skip, thanks for the statistics on how often this occurs.  I knew it happened a lot but I didn't know any actual numbers on this.  

Almost every borderline that I have known or have heard about by others, has been diagnosed AT LEAST ONCE as being bipolar. It is hugely misdiagnosed. Somewhere in my archives of posts I have ranted about this and the reasons why, I will have to dig it up...

This is actually one of my goals to "blow the lid off" when I finish my psychology degree. Last spring semester I was working on a project comparing the two illnesses and seeing how many of the general population of the school knew about bipolar disorder and how many knew about borderline personality disorder. The results didn't surprise me. Almost everyone has heard of bipolar disorder, and only a select few have heard of borderline - or any PD for that matter. When I asked some of the people to describe bipolar disorder, a lot of them did give me an accurate description... of borderline personality disorder... -sigh.

My wife is currently diagnosed with Bipolar.  She has tried most bipolar medications: Paxil, Prozac, Zoloft, etc.  They help some, irritate other parts of her life, and generally fail to work in the long term.

She clearly exhibits black/white thinking and crazy-making behaviors.  She also cycles incredibly quickly... too quickly for bipolar in my (non-professional opinion).  I can be a god one moment, garbage the next, and back to wonderful later that evening.

I think that having a non-BPD learn how to deal with some of the behaviors is the most helpful with dealing with the BPD behaviors.  This is essentially behavioral therapy for the BPD partner.

However, I think some mood stabilizers can have some helpful effects in making some of the BPD behaviors less accute and perhaps more manageable by the couple.  My wife is currently taking a low dose of Seroquil.  I've notice that during this time we've been much more successful in working with the behaviors.  The behaviors are still there, they just tend to be less intense.  So instead of fearing for my physical safety, many times it's just my feelings that get hurt.  It also seems the frequency of the behaviors is reduced.

I'm still struggling with how to broach the subject with her about the possibility of her being BPD instead of Bipolar... but for now, I'm finding it helpful that at least this mood stabilizer seems to help somewhat for dealing with the behaviors.