COMPARISON: BiPolar Disorder vs BPD

[BPDFamily.com]

Yes Bi-polar individuals will benefit from mood stabilizers and anti-depressants, it is believed to involve chemical imbalance in the brain leading to the symptoms. Personality disorders are believed to be non chemically based. They are dysfunctions and distortions in the persons personality traits. These are learned and developed behaviors. Medication would only be useful to treat co-morbid symptoms such as the depression.

[duncanville1]

Yes Bi-polar individuals will benefit from mood stabilizers and anti-depressants, it is believed to involve chemical imbalance in the brain leading to the symptoms. Personality disorders are believed to be non chemically based. They are dysfunctions and distortions in the persons personality traits. These are learned and developed behaviors. Medication would only be useful to treat co-morbid symptoms such as the depression.

[Runningasfastasican]

Really good overview,Skip. Thanks.

My experience in the difference between BI-Polar and BPD lead me to believe that there is a significant difference between the two... .A BI-Polar individual cycles at a far different rate than a BPD... .a BI Polar individual when they shift... can stay in a certain mode for months and even possibly years,  before things fall apart... .and shift into another mode, that likewise can last for months or years... .and in the case of BI-Polar individuals, medication can be very effective in promoting stability for them... .my experience with BPD... .is that they cycle in days or even hours between various states... .at the risk of sounding rude... .BPD makes BI-Polars look stable... .this is all just my un-educated opinion based on observations of both types of people... .take care all

[heartbroken71]

I have also read that people with BPD are often mis diagnosed as bi polar. My ex said he was bi polar but I really think he is just BPD. I have a friend who is bi polar and her mood swings take sometimes years where as my ex would litterally be minutes. I was loved one day and hated the next and I did nothing.

[innerspirit]

Skip, thanks for the stats about co-morbidity of the two and the explanation for why bi-polar is more typically the first diagnosis.

[Rose1]

My ex is bi polar, adhd and BPD - it's possible to have all 3. The chemical imbalance is hereditary - my D has inherited bi polar but not the others and is not BPD.  There are environmental impacts on both bi polar and schizophrenia and varying degrees of the illness as well.  There are also a number of types of bi polar including rapid cycling and ultra rapid cycling types - common in young people. My D was ultra rapid cycling as a young teenager.

Bi polar does respond to medication although there are variations there like with all things.

The thinking is that BPD may be a coping mechanism by people with bi polar, or a response to an abusive situation, or both. Reality is no one really knows although it appears to be a learned behaviour rather than a genetic chemical imbalance. Bear in mind that a child with this tendency, being raised in a family where untreated bi polar and other conditions exist, rarely has the structure in place to deal with the illness appropriately.

Having said that, I have seen people with various degrees of bi polar cope very well with life, or not at all, have other personality disorders, abuse drugs or alcohol which makes the situation worse - a lot depends on the individual, their willingness to work with the illness and whatever else might be going on - no different to anyone else really. 

BPD has some crossover symptoms. Of course BPD has some crossover symptoms common to all of us if we are honest about it - it's the degree of difficulty and impact on life and others that makes it a disorder.

There is also a group with BPD who have suffered severe abuse as children - again, is it learned, or a coping mechanism? My H's ex was severely abused but in hindsight there is also more going on in the family than BPD. Paranoid schizophrenia for one.

I have for years thought there might be two distinct causes for BPD - severe childhood abuse or learned behaviour coupled with bi polar - symptoms similar.  There has also been some information suggesting that some medications that work for bi polar also have some effect in BPD - perhaps other things going on there. My psych textbook is unclear about causes, but more informative about bi polar. The interesting thing is that this illness can be triggered by external stimuli - ie drug use, stress, or be noticeable from a very young age like in my D's case. A lot depends on how many genes are implicated. The more that is found out the more it is realised there is really no such thing as "classic bi polar". Everyone is an individual.

Hope this helps - many years of research has gone into the above, but there is no clear cause really.  Take care, Rose

[CVA]

This is all great information, And input.

I just have been struggling with this, as her mom is paronoia schizo , and my estranged wife's T gave me the book, stop walking on eggshells. and also that my T believes she has BPD, and with all the whacked out hurtful push and pull i been thru, I do have my doubts.

She thinks she has bi-polar, and is self medicating with ,amino acids, and various alternative approaches while not being supervised.

She has been gone for almost a year now, and wants to reconcile, but our phone conversations, go from 1 step forward to 3 steps backward in days, at times even minutes,

I hurt, and just want to know i am doing all i can do to save my marriage and do the right thing... its so confusing, and i feel she can be very manipulative...

[Chazz]

This is all great information, And input.

I just have been struggling with this, as her mom is paronoia schizo , and my estranged wife's T gave me the book, stop walking on eggshells. and also that my T believes she has BPD, and with all the whacked out hurtful push and pull i been thru, I do have my doubts.

She thinks she has bi-polar, and is self medicating with ,amino acids, and various alternative approaches while not being supervised.

She has been gone for almost a year now, and wants to reconcile, but our phone conversations, go from 1 step forward to 3 steps backward in days, at times even minutes,

I hurt, and just want to know i am doing all i can do to save my marriage and do the right thing... its so confusing, and i feel she can be very manipulative...

Hi CVA

If she's as manipulative and into "push/pull" as you say, it's probably BPD (AXIS 2 Disorder).

Borderlines I, II and III (Axis 1 Disorders) typically display manic or hypomanic features.  

She could possibly have a mood disorder, too. It's been my experience that BPDs can sometimes fit the criteria for Cyclothymia (a long-term condition with fluctuating mood disturbance involving numerous periods of hypomanic symptoms and numerous periods of depressive symptoms - not to be confused with BPD w/narcisistic features).

Given the way they live and "love", how could BPDs not have some kind of mood disorder? It's a chicken and egg thing with the BPD causing the mood disorder.

Personality Disorders may not be the primary diagnosis because of whatcha gotta tell insurance companies. Insurance companies and SSI Disability don't pay for Axis 2 diagnoses, so you tend to see many personality disordered people diagnosed with with Axis 1 disorders.

Substance abuse rehabs are notorious for diagnosing clients with BPD with mood disorders. I've seen a huge increase in the diagnoses of Biploar Disorder in substance abusers since managed care took over. The overwhelming majority of people in drug treatment are on some sort of mood altering medication, anymore. But here's the thing... .Biploar and Depressive Disorders disorders aren't suppose to go away just because you get clean and sober, though the rate of miraculous cures for my clients is nothing short of astounding. And BTW, 12 Step Programs are often BPD maintenance programs (in a good way).

[PotentiallyKevin]

To be honest, every person with borderline personality disorder I have ever met or heard a story about has at one point been diagnosed as having bipolar disorder. In my opinion, it is a wastebasket diagnosis.

Furthermore, I think one of the reasons why bipolar disorder is so negatively stigmatized is really because of  BORDERLINES who are improperly diagnosed as bipolar... .

To a non-professional, and even many so called "professionals", it can be really confusing to distinguish between the two illnesses, which share common symptoms, (lack of self-control, impulsiveness, grandiose thinking, depression, promiscuity, alcoholism etc etc etc) but the core CAUSE of these symptoms (and the love/hate dynamics of borderline personality disorder) are really what separates the two.

For example, many people have digestive problems with similar symptoms. But many things can effect the digestive system. It could be your liver, stomach, diet, kidneys, intestines, colon, glands... .etc etc etc, and without a trained professional's expertise and testing, it would all appear to be the same illness.   

Bipolar disorder is theorized and generally accepted  by the psychological community as being a mood disorder caused by chemical imbalance. The hereditary component of bipolar disorder is very strong. If a close relative has bipolar disorder or another mood disorder, the chances of having bipolar disorder skyrocket. Bipolar disorder does not discriminate. Emotionally Sound, happy, successful, healthy families have just as much a chance as having a child with bipolar disorder as any "dysfunctional" family.

This is not the case with BPD. The evidence suggesting borderline personality disorder is caused by a combination of a highly neurotic personality to begin with, and then being subject to an invalidating or smothering environment. Childhood trauma and abuse is extremely common in BPD. ":)ysfunction" within the family, is also extremely common.

Can people be born with BPD? Possibly, but BPD seems to be more of a problem with interpersonal relationships than a chemical imbalance. There is plenty of evidence that suggests problems with brain structure and inherent mood - which further confuses psychologists, but it is not nearly as cut and dry as it is with bipolar disorder.

In my opinion - and please only take it as is - a person can be born with highly sensitive, erratic, or combative emotions, which then leads to early interpersonal relationship problems, such as not fitting it, not bonding with siblings and parents, and failing at attaining any personal/emotional growth. So in essence, a person CAN be born with a BPD-like nature to begin with. That is why we shouldn't be so fast on crucifying the parents. But, most borderlines that I have come in contact with, have been from extremely invalidating or abusive childhoods.

Bear in mind, that an extremely invalidating/abusive childhood environment DOES NOT guarantee a person developing BPD. That is why there seems to be two factors - environment and predisposition. 

[MrHope]

I have a question and I think I know the answer but I want to here from others here that have a better knowledge of disorders in general.

The question is what the main differences between BPD and Bipolar I, II, III?

A number of the traits are very similar and I have heard that some people can have both.

I have talk to my T and they think she has Bipolar and a case of paranoia and may be some other issues too.

I had my physical today and told my doctor about how she’s acting and how it’s stressing me and think that’s probbaly the root to some of the problem sleeping and weight issues I have. I’m under wait not over. He said that he really want to talk to her and see just what is going on, he also said that it sound like Bipolar as well.

[elvis77]

BPD "episodes" are almost always triggered by perceived rejection or abandonment (or fear thereof). Bipolar cycles have no obvious triggers (though self-care/lifestyle choices do have a significant influence). BPD issues show up due to relationships/interactions; Bipolar symptoms have no significant correlation to this.

Also, while anger may be part of a manic episode, its less commonly so, and is very rarely the dominant emotion. Most people with bipolar disorders genuinely enjoy the manic phases (though their loved ones clearly suffer), while this can't be typically said of BPD's. It's because they feel miserable that they want others to suffer as well.

Hope that helps.

[PotentiallyKevin]

To break bipolar disorder down, Bipolar I = at least 1 manic episode. Bipolar II = no full blown manic episodes, but reoccurring hypo-mania, which is a milder form of mania - no "psychotic breaks."

Bipolar III is widely used differently depending on who is your source. Most accounts refer bp3 as cyclothymia, which has both mild depression and hypo-mania. It also tends to cycle more frequently than Bipolar I and Bipolar II.

More interesting facts: One study showed that people with Bipolar II disorder have a 50+% co-morbidity with seasonal affective disorder. Only about 25% of BP I reported SAD. Most BP II have a fairly predictable mood cycle pattern. They also experience more "normal" times than BP I. BP I tends to have the longest durations of cycles, cycles often lasting years. Most historical accounts of bipolar disorder were BP I. Untreated Bipolar Disorder (especially type I) can be very devastating to the person and anyone associated to them - BUT - the love/hate, black and white thinking, splitting, projective identification issues - are the halmark traits of borderline personality disorder and is generally not associated with bipolar disorder.

A person with bipolar disorder who is manic, is extremely INTERNALIZED, meaning, that they exist and no one else really does. It is a feeling of grandiosity, immortality, exuberance, and endless energy. Ideas flood the mind very rapidly - everything is possible. Most inventors, poets, composers, and artists in history are suspected to have been suffering from bipolar disorder. During their manias they often were inspired to their greatest achievements.

During depression, a person with bipolar disorder withdrawals from society. The will go days without eating, sleep many hours, and feel lethargic and useless. Everything seems to be a huge chore.

Suicide is also remarkably different. Many borderline personality disorder suicides have been ruled "accidental" or meaning their was no absolute intention of committing suicide. Reckless driving, overdosing on pills, self-mutilation taken too far, are the most common forms of borderline suicide. Most borderline suicides are done in the presence of others - whereas bipolar disorder is seldom done in the presence of others. A majority of bipolar suicides are done with little cry for help or warnings. The person appears days before as just fine - a lot of the times, bipolar suicides will make sure they have everything in order. My friend (who had extreme bipolar I) cleaned his entire house, gave away his motorcycle, wrote a note to his family explaining that it wasn't their fault, he was tired of bieng depressed and couldn't take it any longer... .he had planned his suicide while they were on vacation, so they wouldn't interfere nor have to deal with directly with it. He left a note to the police, letting them know exactly where to find his body, and went to a remote place so no one would have to stumble upon it... .when my exBPDgf was suicidal, it was much more reactionary - spur of the moment, and she let the whole world know that they better rescue her... .one of my friend's wife, who I suspect is BPD, called him as she was overdosing on her pills, and said "well honey, I just took a bottle of pills, you better come home... ."

I have mentioned several times that the symptoms of these two illnesses, are very similar, but the core issues are completely different. Read my other posts on this subject.

Kay Redfield Jamison has written three amazing books about bipolar disorder.

An unquiet mind - which outlines her struggle with bipolar disorder as well as does an excellent job explaining everything about bipolar disorder

Touched with Fire - In which she explores the connection with heightened creativity and bipolar disorder

and The Night Falls Fast - In which she explores the causes of suicide and societies outlook on suicide, she even mentions the borderline personality disorder in this book, and in my opinion, makes an excellent comparison.

Read these books if you want to know more about bipolar disorder. There is no one who knows more or has researched more about bipolar disorder than Mrs. Jamison.

[GENERAL ANNOUNCEMENT]

GENERAL ANNOUNCEMENT This board is intended for general questions about BPD and other personality disorders, trait definitions, and related therapies and diagnostics. Topics should be formatted as a question. Please do not host topics related to the specific pwBPD in your life - those discussions should be hosted on an appropraite [L1] - [L4] board. You will find indepth information provided by our senior members in our workshop board discussions (click here).

[Unreal]

Unreal,

   For example, my neighbor's daughter had been diagnosed as bipolar when she was a teenager but the meds for bipolar disorder did not help, there was no mania and when she found out about the criteria for BPD, she, her mother and a doctor agreed that she was borderline.  In addition, the treatment for BPD helped her tremendously.

   My husband's therapist had insisted he was bipolar even though he met 8 out of the 9 criteria for BPD, and never once in the 26 years we have been married, ever had mania.

   My nephew is bipolar and a friend of mine has both bipolar and the borderline personality disorder.

There are many types of bipolar disorder/cyclic disorders. . . bipolar I, bipolar II, cylcothymia.  Check out this:

www.mayoclinic.com/health/cyclothymia/DS00729/DSECTION=symptoms

tell me if it doesn't sound familiar. 

That the treatment didn't work doesn't mean the diagnosis was wrong.  That a treatment does work in some fashion doesn't mean the diagnosis was correct.

There are a lot of problems with overlap/co-morbiditity among some categories of mental illness, and our understanding of how these symptoms develop, what impacts them is continually advancing,  hence the need for another DSM. 

[Salut]

Because of the mood cycling, it seems like in some cases BPD and bipolar could be easily confused.  Are these related, and if they are different problems do they need to be treated differently?

[Ibenhad]

I was looking around this morning and found this. My now exBPDf has been diagnosed at one time or another with both. Hope this helps some of you.

Borderline and Bipolar are closely related. Depression and mood swings are high in bipolar, as a person can be manic (one pole) and depressive (the other polarity) the next.

This switching back and forth is called rapid cycling.

Bipolar has three different forms:

Bipolar I--where the person experiences one or more manic episodes with or without major depressive episodes.

Bipolar II

Bipolar II--where the person has hypomanic episodes as well as at least one major depressive episode. Hypomanic episodes do not go to the extremes of mania (i.e. do not cause social or occupational impairment, and without psychotic features), and a history of at least one major depressive episode. Bipolar II is much more difficult to diagnose, since the hypomanic episodes may simply appear as a period of successful high productivity and is reported less frequently than a distressing depression.

Cyclothymia

Cyclothymia--involves presence or history of hypomanic episodes with periods of depression that do not meet criteria for major depressive episodes.

Borderline Personality Disorder:

It involves this Mnemonic (using the word PRAISE)

A commonly used mnemonic to remember some features of borderline personality disorder is PRAISE:

P - Paranoid ideas

R - Relationship instability

A - Angry outbursts, affective instability, abandonment fears

I - Impulsive behavior, identity disturbance

S - Suicidal behavior

E - Emptiness

Read this information from wikipedia: Differential diagnosis

Borderline personality disorder often co-occurs with mood disorders. Some features of borderline personality disorder may overlap with those of mood disorders, complicating the differential diagnostic assessment.

Both diagnoses involve symptoms commonly known as "mood swings". In bipolar disorder, the term refers to the marked lability and reactivity of mood defined as emotional dysregulation. The behavior is typically in response to external psychosocial and intrapsychic stressors, and may arise or subside, or both, suddenly and dramatically and last for seconds, minutes, hours or days.

Bipolar depression is generally more pervasive with sleep and appetite disturbances, as well as a marked nonreactivity of mood, whereas mood with respect to borderline personality and co-occurring dysthymia remains markedly reactive and sleep disturbance not acute.

The relationship between bipolar disorder and borderline personality disorder has been debated. Some hold that the latter represents a sub threshold form of affective disorder, while others maintain the distinctness between the disorders, noting they often co-occur.

Some findings suggest that BPD may lie on a bipolar spectrum, with a number of points of phenomenological and biological overlap between the affective lability criterion of borderline personality disorder and the extremely rapid cycling bipolar disorders. Some findings suggest that the DSM-IV BPD diagnosis mixes up two sets of unrelated items and an affective instability dimension related to Bipolar-II, and an impulsivity dimension not related to Bipolar-II.

This was a real eye opener for me and really helped me understand my BPD/Bipolar ii now exBPDf . This was someone who had been told they were both types answer.



I had a therapist who knew me quite well, and was 100% sure I have bipolar disorder. A doc I saw in the hospital tried to tell me I had borderline personality disorder. I was SO confused. When I brought this up to the therapist, he said in no way did I have BPD and I was bipolar all the way.

I asked him how he was so certain, and his basic explanation was I do not have trouble holding an interpersonal relationship. It may have turmoil due to my mood swings (rapid cycle bipolar), however, I can maintain the relationship. With BPD, there is a problem interacting with others because your personality, not just your mood, can shift rapidly.

  Much love to you all I have been painted black and left once again.

[twister329]

Bipolar disorder? I asked my teacher about her opinion on it, and she said it's not as extreme as Bipolar disorder. My mother has BPD, and I find it very difficult to believe there's a disorder worse than this! Except maybe sociopaths and the like, but bipolar? I thought BPD and Bipolar had a lot of similarities. Maybe I'm wrong?

[losingconfidence]

I was wondering how frequently people with BPD get misdiagnosed. My roommate/closest friend thinks she might have it (this is after a very long, turbulent period of us having no idea what's going on/why she's having so much interpersonal difficulty) and originally she was tentatively diagnosed with Bipolar II by a fairly desperate doctor who, according to her parents, basically didn't know what else to say. My friend has lived for about 10 years under the assumption that she had a mood disorder, then Bipolar Disorder. I went with her to see a T the other week (she's looking for one now) and the T observed that she doesn't seem to show any of the signs that specifically point to Bipolar Disorder (at least these days). Now, the possibility of BPD is coming up and it seems to be changing her entire approach to things. I was wondering how often people diagnosed with Bipolar Disorder end up actually having BPD.

[GreenMango]

losingconfidence misdiagnosis, or cormorbid diagnoses, or alternative diagnoses are not uncommon.  It's a difficult disorder to diagnose.  Sometimes there are more than one diagnosis going on and sometimes the medical professionals are reluctant to diagnose for BPD for insurance or patient rejecting therapy.

Here is a link and an excerpt to a thread that has a little more info:

It is a significant challenge to determine if someone in your life has Borderline Personality Disorder or any personality disorder. We often do not have a formal diagnosis to rely upon.  

The American Psychiatric Association cautions us against using the DSM criteria for making amateur "cookbook" diagnoses as they are often inaccurate. For our own sake and for the sake of others,  we want to be responsible and constructive in assessing the mental health of others in our life.  First and foremost, these designations were created to help people and families, not label and blame.

When we encounter high conflict and destructive relationship behaviors in others, our first priority could be to triage our situation. Write down the difficult behaviors that we have observed.

• If any are dangerous (e.g., domestic violence, suicidal ideation, or criminal) or fatal to the relationship (e.g., serial adultery, ruinousness spending), it makes sense to immediately start planning for safety.

• For all the others, we should do everything we can to reduce the conflict in the immediate term. This may not be not easy for us.  It usually involves giving in to the other person and providing them space and listening to/validating them. At the same time, we should force ourselves to step back from the conflict and process the hurt or resentment that we are feeling.  This requires a great deal of maturity.  We have tools for neutralizing the situation (stop the bleeding) and we have tools for taking a step backward (rebalancing ourselves). As difficult as it may be, starting here is usually in the best interest of ourselves and our children.

Once the situation is defused as best it can be, we can then start investigating what is going on so that we can make informed decisions.  When we encounter high conflict people with destructive relationship behaviors it is important for us to know that the problems can be caused by a large range of things from immaturity,  short term mental illness (e.g. depression), substance induced illness (e.g. alcoholism), a mood disorder (e.g., bipolar), an anxiety disorder (e.g. PTSD), a personality disorder (e.g., BPD, NPD), or even a learning disability (e.g. Aspergers) and "any combination of the above" (i.e., co-morbidity). It will likely take some digging to sort it out.

The behaviors exhibited during a relationship for all of these afflictions can look somewhat alike but the driving forces and the implications can be very different.  For example, was that lying predatory (as in ASPD), ego driven (as in NPD), defensive (as in BPD), a result of being out of control (as in alcoholism), or ineptitude (as in Aspergers).  Was it situational, episodic (bipolar), or has it been chronic. Yes, all lying is bad, but the prognosis for the future is not that same in all situations. For example, depression and bipolar disorder (mood disorders) are very responsive to drug therapy -- substance abuse often requires intervention and inpatient detoxification -- personality disorders require multi-year re-learning therapies (e.g. DBT, Schema) --  Aspergers is often considered a long term disability.  Chronic bad behavior and situational bad behavior are very different.

It is probably best to resist the temptation to immediately latch onto one of the personality disorder symptoms lists as the magic formula. Doing this may make the situation appear more hopeless and more one-sided than it actually is, and it may send us in a wrong or unhealthy direction.  

Getting back to the subject in the title "What is BPD?" -- personality disorders, per se', are lifelong afflictions -- anyone can act "borderline" in a particular situation. To be a PD, symptoms must have been present for an extended period of time, be inflexible and pervasive, and not a result of alcohol or drugs or another psychiatric disorder -- the history of symptoms should be traceable 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.

"Present for an extended period of time" doesn't mean constantly and obviously present.  Many people with this disorder, especially as they get older, learn to adapt and control or isolate the worst of the disordered actions except when stress pushes them past their ability to control and manage.  This is why the disorder is more visible to the family and close friends. "Present for an extended period of time" means that there have been indications of the disorder at different times dating all the way back to the teen years.

It is also worth noting that personality disorders are spectrum disorders - meaning that there is a broad range of severity.  At the lower end, it is not necessarily a personality disorder at all - people can have personality style like a BPD or NPD.  Surely you know someone that is pretty narcissistic, but not mentally ill.  People with BPD can range all the way from "very sensitive with somewhat nonconstructive ways of coping and avoiding hurt" (BPD personailty style) all the way to social dysfunction (e.g., unable to hold a job) and potentially life threatening behavior (e.g. severe BPD).

Whether it is BPD or BPD personalty style, Bipolar Disorder, or simple depression, etc, you are welcomed and encouraged to work with the members here at bpdfamily.

A high conflict, emotionally abusive parent, child, relationship partner or spouse, regardless of the causation, is a challenge and we need to take appropriate steps for our own wellbeing and that of our family.  And hopefully you want to learn how to rise above and manage your interface with the difficult person in a constructive, mature and healthy way.  It's our very next step to a constructive, mature and healthy future for ourselves.

Tall order, I know.  I had a loved one with this disorder, too.  

Skippy

[Iced]

One of the biggest differences, according to my psyD whom I was seeing, is the greater tendency and even ability for people with bipolar disorder to be self aware and to be able to help themselves through their cycles and one of the reasons attributed is the simple fact that bipolar disorder is a -mood- disorder and not a disorder where a person's way of thinking/mode of operations is where the disorder is coming from.

Where a person with bipolar disorder can sense a 'cycle' about to start - for example, a depressive or a manic phase - and are able to tell themselves - and the people around them, "this is just the bipolar acting up; hang on" and cope with it this way and not let it affect themselves or the people around them to the degree that a BPD's episode might, that sort of self-awareness is something that is not as prevalent amongst people who struggle with BPD and is, in fact, a much greater struggle for people with BPD.

Also, where the triggers for a pwBPD might be almost all emotion-related and situational-related, the trigger for people with bipolar disorder is oftentimes nothing particularly tangible.  It happens - with no probable cause (can't blame a bad conversation with whoever, etc, nothing traumatic happened, it isn't because of a conflict in a relationship) save for bad weather (for those who are affected by seasons) or certain other non-interpersonal-related situations.

A person with bipolar disorder can wake up and feel grumpy for absolutely no reason whatsoever aside from the bipolar... .  and acknowledge and realize it.  This same person at some other point in time can feel suddenly euphoric... .  and also with no particular cause or trigger... .  and acknowledge it and realize it.

Basically, most everyone has had an experience where they suddenly felt the blues for no particular reason, right?  And most people, if they realize they ARE having the blues, could probably communicate this with their loved ones.  "Hey, I'm not feeling too hot today, so I'm going to go out for a walk."

For people with bipolar disorder, these 'blues for no reason' and 'highs for no reason' is what characterizes their disorder the most and they go in cycles for episodic periods of time - lows, highs, and periods of more 'normal' and less extreme moods.

This doesn't mean that people with bipolar disorder can't exhibit characteristics of BPD because they surely can - in the same way even nBPD people can, depending on situation and circumstances.  This also doesn't mean that people with bipolar disorder can't also be pwBPD because they can.  However, for people who are bipolar only, exhibiting behaviors of pwBPD is not their main mode of operations.

They may become destabilized during an episode because of the abrupt change in moods and how they are feeling - going from suddenly feeling fine to suddenly feeling like &%#$ can be a bit jarring.

They may become suicidal because they are desperate about their cyclical situation - a mood disorder where you feel like %$#@ one day and fantastic another for absolutely no particular reason.  Less likely is it because of an emotional reactions such as, "My SO dumped me and now I want to kill myself because nobody loves me!"

They may become withdrawn because their mood disorder affects their ability to function - being too depressed to take care of themselves or being too sky-high and euphoric and feeling invulnerable and being more willing to take risks with their risk-taking behavior generating unwanted results.

Their relationships may suffer owing to the side effects of these episodes of mood imbalances, but it is not characterized by something like, "I hate you, don't leave me".

Another thing, too, is where the treating of unipolar depression can be aided by medications such as SSRI antidepressants, people with bipolar disorder have a tendency to have their mood 'poles' switched over if they are treated with antidepressants alone.

Instead of simply 'feeling better' and 'feeling normal again' which is more characteristic of unipolar depression, they get booted into the realm of feeling the extreme 'high' which can either be mania-mania or mixed mania.

Ever watch those commercials for antidepressants?  That's what some of those warnings - especially about experiencing suicidal ideations while on the meds - are for.

Anyhow, I'm no professional, but I just thought I would share what was shared with me.

Basically, it all seems to boil down to what, exactly, is being affected and how, exactly is the person with whatever disorder acting and reacting, and their understanding and ability to understand and manage according the whys and wherefores.

[Confused1981]

So my ex gf was just now at 21 years old pronounced to not have BPD but bipolar 1. I know there are some similarities between the two but i have questions about them. I do know my xgf has apandament issues as well as reckless behaviors. But do BPD people not have manic episodes. Our break up i beleive was cause by her going into mania, once she went into depression she called me right away. This manic episode last almost 3 weeks. So is it same to say BPD episodes last hours not weeks. Do the actions and lack of thinking about concequences lye in both bipolar and BPD? and insite would help i have done allot of research and really cant find the answers im looking for.

[GreenMango]

I cam only give my experience.  My father is bipolar.  My ex BPD. 

My father has had some years were he has cycled thru both mania and mania many times to years where he has had very few episodes.  His overall well being isn't usually driven by outside interaction, with the exception of his depression on the few occasions where there has been a death of a close loved one.  Usually his cycles as I've seen them are where one day he wakes up and the upward cycles starts to build.  He becomes very active to which accelerates in his "projects".  I've seen him remodeled a kitchen in two weeks, record a music album, create a bunch of culinary sauces and bottle them thinking he will start a business, and reorganize his workshop to rebuild a 1960's Ford Ranch wagon in a matter of a month.  He has grandiose and scattered thinking.  He's going so fast and his "take" on the world is overwhelming in its intensity.  Then he crashes and will spend a month or two in depression which usually culminates in him crying when he hears certain songs or if god forbid he decides to dig thru old pictures.  He's not emotionally manipulative and he doesn't have abandonment issues.  He's brilliantly creative but very unstable.  He's had suicidal ideation with his depression but didn't mention it until he was manic and it wasn't a big deal.  And he readily admits he has a problem.  Yet he refuses medication... .  the highs are worth the lows to him and this is his normal.  It's taken him a long time to learn to how to reign in the most destructive parts of his disorder. 

My ex on the other hand had wildly varying moods.  Most of his mood swings were daily and influenced by his perceptions of external stimuli-someones actions or words.  It caused a cascade effect.  On a whole the overall perception and thinking of the world was threatening or negative.  The threshold for disappointment was almost non existent and the needs were profound.  When they weren't up to the idealized expectation the overall effect on himself and others was destructive and extreme.  This could happen in a single day.

[purpleavocado]

Hi all, I'm wondering what your thoughts are on this.

My ex was dxed with rapid cycling bipolar. However I think she was truly BPD. She has lupiterally every symptom except self injurt. Meds would seem to help for a short time but never really had lasting or noticable effects. I've read that rc bipolar and BPD are often misdiagnosed for one another, and I've also read that some psychiatrics won't reveal the "real" BPD diagnosis to the patient. Does anyone have a sense of how common this is and how it's recognized to be a misdiagnosis? Or how ommon it is to not know the dx?

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[Want2know]

It is possible there is a misdiagnosis involved with your ex.

This is a general statement from the NIH site: Unfortunately, borderline personality disorder is often underdiagnosed or misdiagnosed.*

I also found this one particular study posted on their site, regarding misdiagnosis and bipolar disorder:

Recent reports suggest bipolar disorder is not only under-diagnosed but may at times be over-diagnosed. Little is known about factors that increase the odds of such mistakes. The present work explores whether symptoms of borderline personality disorder increase the odds of a bipolar misdiagnosis. Psychiatric outpatients (n=610) presenting for treatment were administered the Structured Clinical Interview for DSM-IV (SCID) and the Structured Interview for DSM-IV Personality for DSM-IV axis II disorders (SIDP-IV), as well as a questionnaire asking if they had ever been diagnosed with bipolar disorder by a mental health care professional. Eighty-two patients who reported having been previously diagnosed with bipolar disorder but who did not have it according to the SCID were compared to 528 patients who had never been diagnosed with bipolar disorder. Patients with borderline personality disorder had significantly greater odds of a previous bipolar misdiagnosis, but no specific borderline criterion was unique in predicting this outcome. Patients with borderline personality disorder, regardless of how they meet criteria, may be at increased risk of being misdiagnosed with bipolar disorder.**

*www.nimh.nih.gov/health/publications/borderline-personality-disorder/index.shtmlwww.nimh.nih.gov/health/publications/borderline-personality-disorder/index.shtml

**www.ncbi.nlm.nih.gov/pubmed/19889426

[hergestridge]

A few months before my wife was diagnosed with BPD she received a bipolar diagnosis. This was based on the fact that she had a history of depressions and wild mood swings. However, after medicatiton had been tried out and her mood swings had been discussed in detail (the doctor intially didn't know that her "down"/suicidal phases were triggered by criticism or interpersonal conflict) the diagnosis was revised and her medication was changed earlier this summer.

The doctor was not very straight ahead with the new diagnosis, and she was rather discrete about the bipolarity being out of the picture. She told my wife (in my presence) "What you describe to me is not bipolarity, this is personailty-related". And that was it. My wife was sent to see a DBT therapist and has been going since.

But after the above mentioned meeting with doctor my wife has been very reluctant to discuss her illness with me. I have tried to talk about her situation but she doesn't want to talk about it. She continues to read her "bipolar mom" websites and doesn't care much for the DBT (she thinks the therapist is too demanding). I have also told my wife that the doctor meant to tell her that he's borderline (I think it just needs to be said) and that's why she's in DBT. My wife knows enough about psychiatry to know what it means. She says she knows this very well but doesn't want to talk about it because it makes her feel worthless.

Earlier this week - just as her menstruation was about to end - she got into the usual deep anxiety.   Apparently it was worse than usual. She was suicidal and she sought care and was hospitalized for a few days. What she was also very anxious about was a doctor's appointment - an appointment with the doctor that says she's not bipolar - whom she now hates.

When my wife came back from the hospital (yesterday) she told me that she had met a doctor there (at psych ER) how had talked to her and "heard her story", who had told her that she was a "classic case" of Bipolar type II. Said doctor took away all her medication, put her on Lithium + a new antidepressant + Immovane.

I asked my wife if she had told this doctor that her moodswings are usually triggered by criticism, quarrels or her menstrual cycle. The answer was no. She had described this "My mood's all over the place and there's there's no discernible pattern"-persona that she likes to paint up when she wants to be taken care of.

What people don't get it that the doctor can't "find" a diagnosis. All about how you describe yourself. A doctor that observers you over time can see and learn things, but a guy who reads a few journals and meets you once or twice only reflects what you tell him.

My wife can't take the idea of being "an incurable b*tch" (i e BPD) and therefore prefers to lie to herself about her own mental condition. She's even prepared to go on a heavy medication that I'm not sure if she will benefit from. But then again it's that BPD personality. It's not about the truth, it's about the feelings.

There's another thread on the subject "is a BPD diagnos important?" and I really think it is. Not changing doctors is very important. Everyone around a BPD person will become the enemy/the devil, including the doctor. A BPD has a fair chance of being misunderstod because they manipulate and they don't know it.

[an0ught]

This is a fairly recent meta-study specifically focused on BPD-Bipolar co-morbidity. The numbers are not so far off from the previous shared numbers. For people interested in measuring the mind with numbers and the significant challenges to it may want to study the full text.

The relationship between borderline personality disorder and bipolar disorder

Mark Zimmerman, MD, Theresa A. Morgan, PhD

Dialogues Clin Neurosci. 2013 June; 15(2): 155–169.

Abstract:

It is clinically important to recognize both bipolar disorder and borderline personality disorder (BPD) in patients seeking treatment for depression, and it is important to distinguish between the two. Research considering whether BPD should be considered part of a bipolar spectrum reaches differing conclusions. We reviewed the most studied question on the relationship between BPD and bipolar disorder: their diagnostic concordance. Across studies, approximately 10% of patients with BPD had bipolar I disorder and another 10% had bipolar II disorder. Likewise, approximately 20% of bipolar II patients were diagnosed with BPD, though only 10% of bipolar I patients were diagnosed with BPD. While the comorbidity rates are substantial, each disorder is nontheless diagnosed in the absence of the other in the vast majority of cases (80% to 90%). In studies examining personality disorders broadly, other personality disorders were more commonly diagnosed in bipolar patients than was BPD. Likewise, the converse is also true: other axis I disorders such as major depression, substance abuse, and post-traumatic stress disorder are also more commonly diagnosed in patients with BPD than is bipolar disorder. These findings challenge the notion that BPD is part of the bipolar spectrum.

Link to full text: www.ncbi.nlm.nih.gov/pmc/articles/PMC3811087/

[lemon flower]

I used to think my ex was undiagnosed BPD. Now I found out that he had all kind of psychiatric tests e few years ago and that there exists a file of him. He sais that the psychiatrists doesn't want to tell their diagnose to their patients. So maybe they know that he's BPD but keep it to theirselves ?

I don't get this, so they just let him struggle on his own, causin' problems everywhere he goes ? 

recently my ex got himself together again: he's in a hospital right now to detox from his alcoholaddiction. He's in an introspective phase and he is diagnosing himself now as bipolar. From his point of view I get that, still I would say it's BPD: that makes much more sense.

but allready I'm glad that he made a new step in self awareness, maybe it doesn't matter how he is diagnosed, as long as he tries to do something about it... .

It's probably less painful to think you're bipolar than you' re BPD, which is more stigmatising in my eyes.

but suppose he will get some medication fror Bipolar?

he wants to ask his doctor for lithium, and allready he takes seroquel,

can't that be harmful: taking inappropriate medication ?  and I know him: he's always trying to increase the dose, or combining stuff, not to mention drinking on it... .

and what about therapy? IF he might consider that... .

what a mess... .  

[hergestridge]

Triss: Lithium is also used to used for treatment of BPD. I asked this question elsewhere on this forum and got a reply with a link and all. My wife has a combination of seroquel + lithium.

There has been some debate over wether my wife is bipolar or has BPD, but the meds she's one should be doing effect regardless of which.

[lemon flower]

thx hergestridge. currently my ex takes seroquel but to get lithium he needs to see a psychiatrist which he refuses at the moment.

also he was told by someone that taking lithium makes everything you eat taste different and smell strange   

can someone confirm this ?

[hergestridge]

thx hergestridge. currently my ex takes seroquel but to get lithium he needs to see a psychiatrist which he refuses at the moment.

also he was told by someone that taking lithium makes everything you eat taste different and smell strange   

can someone confirm this ?

My wife hasn't had that experience. The only thing she's had (and I've under that's common) is thirst and craving for sweet drinks.

Thing with mood stabilizers is that is makes you kind of dumb I think. Lithium has been effective in some ways but she's been even more prone to ignore her behavioral problems now.

[spemat]

I can speak from my experience.  I am diagnosed with bipolar I disorder and ADHD and sort of PTSD (it's agreed that it is there between my psych nurse).  My manias last several months and are followed by long periods of apathy.  I am consistent in my moods though.  I tend to feel like my body is running on adrenaline and some points and almost dead (yet still hyperactive out of sheer antsy urge, ADHD).  I can't wind down during some episodes.

I deal with delusions and hallucinations.  My whole system literally changes... . I can smell better, taste better, want to take on everything and love everyone, sometimes paranoia, like schizophrenia paranoia but they're consistent with me.

My mom and brother both have BPD, my brother is also addicted to a few things and not sober so his is different than hers.  With them, just based on my gut feeling, it was set off or emotive in nature.  It is like being possessed with me but it is almost like they are overburdened with emotion and want others to feel the way they do.  When I am manic and people try to tell me to calm down, I don't understand their problem and think they are jealous of me or they they are manic or something.  I find that I get argumentative but often with people that are more apt to feed into it not knowing that I won't stop and my mom and brother can seem to defuse and whatnot for some period.  One seems emotional.  If I take meds for bipolar I disorder (Lamictal and sometimes Klonopin) and ADHD (Dexedrine).  I stay stable for years as long as I stop myself at times and eat healthy and take meds but even then, I go off, sometimes due to conflict or a death or something or just because I need meds raised.

[EaglesJuju]

BPD and BiPD seem somewhat similar.  

The difference is there is a baseline of stable normative behavior in BiPD.  There are manic, depressive, mixed, and hypomanic episodes that last up to a week or a few days.  One of the episodes tend to follow another, for example a major depressive episode followed by a manic episode.  

Certain diagnoses of BiPD will be based on their latest episode. The periods of the cycling of the mood can be consistent, for example someone with BiPD can have seasonal manic episodes.  Essentially, it is a temporary spike in their mood and they will eventually go back to their baseline mood.  

On the other hand, with BPD there is no baseline. PwBPD have a persistent pattern of behavior.  A person with BPD can reflect instability with their mood but it tends to last a few hours and rarely less then a few days.  

There is an association between antidepressants and rapid cycling.  To my understanding, there has to be 4 periods of either manic, hypomanic, depression, or mixed episode within 12 months to be have a rapid-cycling specifier.